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: 1229176
Sex: M
Age: 34
State: OH

Vax Date: 03/25/2021
Onset Date: 04/15/2021
Rec V Date: 04/19/2021
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: Sulfa drugs

Symptom List: Dysphagia, Epiglottitis

Symptoms: Bell Palsy started a couple weeks after my first Phizer vaccination

Other Meds:

Current Illness:

ID: 1229177
Sex: F
Age: 15
State: MA

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/19/2021
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: erythromycin

Symptom List: Anxiety, Dyspnoea

Symptoms: Date of Birth obtained was incorrect and patient was 15 at time of vaccination.

Other Meds: none

Current Illness: none

ID: 1229178
Sex: F
Age: 67
State: PA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: SULFA PCN BEE STING-ANAPHYLAXIS

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

Symptoms: POST VACCINE, BECAME DIZZY, HEART RACING. BROUGHT TO OBS VIA W.C. AT 1145. WATER GIVEN, LAYING DOWN, VSS, S/S RESOLVED SOON AFTER. ESCORTED TO EXIT VIA WHEELCHAIR WITHOUT ISSUES AT 1215 WITH FAMILY MEMBER. 1145 INITIAL BP 152/91 HR 84 SATS 97% RA 1200 BP 153/96 HR 81 SATS 99% RA 1210 BP 150/102 HR 88 SATS 97% (INSTRUCTED TO MONITOR BP AT HOME WITH AUTO CUFF AND CALL PCP IF DOESNT IMPROVE PER ONSITE MD INSTRUCTIONS, ASSYMPTOMATIC; STATES ANXIETY INDUCED.

Other Meds: METFORMIN MONTELUKAST SYNTHROID LOVASTATIN VIT B VIT D CLARITIN

Current Illness: NA

ID: 1229179
Sex: F
Age: 16
State: IN

Vax Date: 03/25/2021
Onset Date: 04/15/2021
Rec V Date: 04/19/2021
Hospital: Y

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

Lab Data:

Allergies: No known allergies

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: lethary and altered mental status 2.5 weeks after COVID vaccine. Found to be septic (hypotension, hypothermia, suspected infection). Admitted to ICU. Required 15L vapotherm for respiratory support and several fluid boluses for blood pressure. Urine culture resulted positive for a bacterial infection. Started on antibiotics and improved. Concern for vaccine adverse event is low.

Other Meds: Diazepam (sch), famotidine (sch), gabapentin (sch), MVI (sch),

Current Illness: none

ID: 1229180
Sex: F
Age: 67
State: TN

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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

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

Symptoms: Body aches, flu-like symptoms, headache, mild fever

Other Meds: Armour Thyroid

Current Illness: none

ID: 1229181
Sex: F
Age: 92
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/19/2021
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: Polyethylene Glycol, Polysorbate

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

Symptoms: Swelling of eyes and face with significant capillary leakage.

Other Meds: Diltiazem, Losartan, Metformin, Actonel, Calcium, Vitamin D3, Multivitamins, Baby Aspirin 81 mg

Current Illness: N/A

ID: 1229183
Sex: F
Age: 41
State: NY

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: Pt presented after 30 min wait post vaccine with bilateral hives to arms, stomach, chest, and neck. pt states has has a h/o hives of unknown origin. Pt DID take a Zyrtec today as per her normal for allergies. Pt given 50 mg of PO liquid benadryl with some relief post additional 30 min wait pt had increased itching to head and thighs. Earlier Hives did resolve, pt refused ambulette transport will go to Urgent care with her friend that came with her. Pt denies SOB, or chest pain, LSCTA, VSS at time of leaving vax site.

Other Meds:

Current Illness:

ID: 1229184
Sex: F
Age: 57
State:

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/19/2021
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: Pharyngeal swelling

Symptoms: Patient became diaphoretic stating "I don't feel good". Pt had syncopal episode. Patient placed on stretcher, +pulse and +resp., Pt immediately regained consciousness and talking. Pt taken to ER. Determined to have vasovagal response and discharged.

Other Meds:

Current Illness:

ID: 1229185
Sex: M
Age: 30
State:

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Body discomfort and pain in the injection area

Other Meds: No

Current Illness: No

ID: 1229186
Sex: F
Age: 54
State: NV

Vax Date: 04/05/2021
Onset Date: 04/12/2021
Rec V Date: 04/19/2021
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: Zarontin, Demerol, Erythromycin, Levaquin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I had an electrical jolt run from the back of my neck into the scalp and down the left side of my neck into my left arm with pain pressure and soreness in these area and in the base of my head with some confusion and stiffness in the left side of my face followed by the right side. This lasted for six days afterward

Other Meds: Synthroid, Dyazide, Depakote

Current Illness: NONE

ID: 1229187
Sex: F
Age: 35
State: LA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: none known

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

Symptoms: Rash and irritation started to back and neck approximately 3 hours after vaccine. Soreness to vaccine site started at the same time. No other complaints.

Other Meds: Adderall 20 mg BId Lexapro 20 mg po daily Vitamin D 50,000 units weekly MVI daily Levothyroid 137 mcg daily

Current Illness: none

ID: 1229188
Sex: F
Age: 52
State: MI

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/19/2021
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: contrast, lamictal, penicillin, sucralose

Symptom List: Rash, Urticaria

Symptoms: local panniculitis with skin desquamation and possible cellulitis

Other Meds: Lasix, folic acid, metoprolol, singulair, mvite, gabapentin, motrin, drisdol

Current Illness:

ID: 1229189
Sex: F
Age: 21
State: MO

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/19/2021
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: Client began to feel dizzy and lightheaded. She also complained of nausea. Nurse observed client appeared pale. Nurse took pt's vitals over the next 18minutes and they remained stable. After about 18min client stated she was feeling better and was released to personal vehicle shortly after that.

Other Meds:

Current Illness:

ID: 1229190
Sex: F
Age: 54
State: FL

Vax Date: 03/31/2021
Onset Date: 04/06/2021
Rec V Date: 04/19/2021
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: None

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

Symptoms: I have an incessant scent of cigarette smoke, everywhere I go, when there is no one smoking near me, and no one else can smell it.

Other Meds: Acyclovir Spironalactone 5-htp GABA Melatonin

Current Illness: None

ID: 1229191
Sex: F
Age: 60
State: IL

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: Immediately after injection large knot formed at injection site and bruised.

Other Meds:

Current Illness:

ID: 1229192
Sex: F
Age: 60
State: IL

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/19/2021
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: Aspirin, Sulfa

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

Symptoms: Within 5 minutes, it appeared tongue was swelling a bit. A metallic taste was also present. Next 3 days, mild fatigue, low grade fever, headache and sore arm were experience. Day 4 light headedness and fatigue increased and grew progressively worse each day. Heartbeat & blood pressure elevated over normal, but not in dangerous zone. It felt like when I had anemia years earlier. Day 8 I went to urgent care, suspecting anemia. Blood test was normal, except for slightly lower sodium. Day 9 I followed up with regular doctor, and Thyroid test was ordered. It was normal. Day 10 tongue swelling and metallic taste improved, and other symptoms started to subside. As of day 18, all symptoms gone, I felt "normal" again and was able to resume regular activity and exercise routine.

Other Meds: No prescriptions, vitamins D3 (2000 IU) and Preservision Areds 2

Current Illness: None

ID: 1229193
Sex: F
Age: 28
State: WA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/19/2021
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: NIL

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

Symptoms: Extreme arm pain for about 3 days

Other Meds: NIL

Current Illness: NIL

ID: 1229194
Sex: F
Age: 46
State: VA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/19/2021
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: chocking sensation/coughing and wheezing Pt self administered her own epi pen EMS squad called and pt transported to local ER

Other Meds:

Current Illness:

ID: 1229195
Sex: F
Age: 63
State: NC

Vax Date: 04/16/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: Nosebleed THis morning I got a nosebleed with no cause or provocation. I have not had one in years and when I do get a nosebleed, it is drips. THis was flowing blood that lasted 12-15 minutes

Other Meds: Vita D Elderberry CBD

Current Illness: Shingles after vaccine dose 1

ID: 1229196
Sex: F
Age: 57
State: IN

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: 12:15 Patient advised feeling short of breath and dizzy after receiving vaccine. Asked patient to lower her mask and take deep breaths. Patient denies chest pain, N/V or other symptoms. Patient given drink and windows opened. Patient declines to go to ER at this time. Contacted nursing supervisor for assistance. Will continue to monitor. 12:20 Patient still c/o SOB. 12:25 Patient transported to ER for further evaluation. Report called to ER by RN.

Other Meds: unknown

Current Illness: none

ID: 1229197
Sex: F
Age: 43
State: FL

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
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:

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

Symptoms: fever, chills, muscle aches, joint pain, nausea, fatigue

Other Meds:

Current Illness:

ID: 1229198
Sex: F
Age: 40
State: NM

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Latex, Sulfa, Ativan, Clonazepam & depakote

Symptom List: Unevaluable event

Symptoms: Patient complained about a sore throat about 5 minutes after her vaccine. She carries an Epi-pen with her regularly due to allergies. She said she did not "feel" like she needed to use the epi-pen, she did accept some water to drink, During her 30 minute wait time we checked in with her several times and there were no changes other than her arm being sore. After her wait time, she said she felt well enough to leave but still had a sore throat and sore arm. We discussed making sure her epi-pen was available if she started to feel worse. She left the pharmacy. About 10-15 minutes later we found out she was slumped over the steering wheel in her vehicle and EMS had been called. We saw the ambulance outside and took her vaccine consent form to the EMS. She was taken to the ER. I followed up with her on 4/18/2021 and she said she was given benadryl and steroids to treat the reaction and was still recovering from the reaction.

Other Meds: unsure

Current Illness: unsure

ID: 1229199
Sex: F
Age: 26
State: CA

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Latex - rash

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

Symptoms: Patient reports onset of intermittent paresthesia feeling like numbness affecting tips of fingers and toes. She also reports 3/d watery green diarrhea. Otherwise feeling well. Lab evaluation for paresthesia/neuropathy and diarrhea alternative cause ordered but pending at this time.

Other Meds: None

Current Illness: None

ID: 1229200
Sex: F
Age: 17
State: VA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: Denies

Symptom List: Injection site pain, Pain

Symptoms: Pt received vaccine. Patient moved to waiting area. After a few minutes, pt reported dizziness, vision changes, and feeling faint. VS were taken: BP46/31. EMS called at 12:25. Patient moved to cot and laid supine with legs raised on chair. VS taken two more times: 96/60 and 110/90. EMS Arrived at 12:35. Patient reported improvement in symptoms. Patient refused EMS Transport and chose not to go to ED.

Other Meds: Denies

Current Illness: Denies

ID: 1229201
Sex: F
Age: 59
State: MO

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 04/19/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Gillion bar syndrome, spinal tap confirmed on April 17, 2021 Pain started in her back in April 10th 36 hours after shot went down her back to but and legs. Friday April 16,2021 she could not walk. Hospital on the 16th by the 17th her arms and hands were affected. Still in the hospital to current date receiving IVIG to see if that will work for her.

Other Meds: None

Current Illness: None

ID: 1229203
Sex: F
Age: 66
State: NC

Vax Date: 03/23/2021
Onset Date: 04/06/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Ibuprofen Demerol (some may not be true allergy, rather adverse reaction)

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

Symptoms: Unprovoked Calf DVT in low risk patient

Other Meds: Multivitamin Vitamin C Vitamin D Zyrtec/Cetirizine 10 mg Potassium 10 mq

Current Illness: None

ID: 1229204
Sex: F
Age: 60
State: IN

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/19/2021
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 diagnosed

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Shingles-left shoulder blade and left breast (vaccine in left arm); began two days after vaccine with tingling on shoulder blade, then red rash, then painful blisters; stinging/stabbing pain; inability to sleep due to discomfort Lymphadenopathy-swelling in my left breast and chest; much discomfort

Other Meds: Levothyroxine 25 mg Women's daily multivitamin Calcium/Vitamin D3 600 mg

Current Illness: None

ID: 1229205
Sex: F
Age: 20
State: IL

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 3/24/21 Incoming Triage Nurse call: Hospital called and said patient is there now and had got her 1st Covid Vaccine- Moderna and she did get a small rash on her left forearm that does itch and is red. Nurse said patient got the shot in her left arm and got the rash on her forearm a few minutes later. 3/26/21 ER HPI: dx: urticaria 20 year old female who presents with ITCHING IN LEFT FOREARM. GOT COVID SHOT ON 3/24/21 AND HAS HAD INTERMITTENT ITCHING ON LEFT FOREARM SINCE. PT DENIES SHORTNESS OF BREATH AND CHEST PAIN. PT STATES WHEN TAKES BENADRYL GETS BETTER AND THEN RETURNS. PT STATES SAW Doctor AND WAS TOLD TO GO TO ER IF IT DID NOT IMPROVE IN 24 HOURS. Triage nurse: Presents to the ER from home with complaints of itching and redness to left lower forearm. States she had the Covid injection (first one) on 03-24. States had taken Benadryl after the injection to help with itching. States "redness comes and goes." Complaining of headache, 8/10 pain, constant throbbing with onset yesterday. States Tylenol did help alleviate pain some, not completely. States she was instructed per PCP to come to ER if redness, itching continues

Other Meds: Current Outpatient Medications: ? B-D 3CC LUER-LOK SYR 23GX1-1/2 23G X 1-1/2" 3 ML MISC, Use one each to inject medroxyprogesterone into a large muscle every 12 weeks., Disp: 1 each, Rfl: 5 ? Cyanocobalamin 1000 MCG SUBL, Place 1 tablet

Current Illness:

ID: 1229206
Sex: F
Age: 48
State: CA

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Starting on 4/18/2021... started to feel soreness/discomfort in my left armpit. By 4/19/2021 MORNING... it was swollen, too (it currently feels like an apricot/peach is in my armpit)

Other Meds: Tylenol (taken on 4/17/2021 at 10pm and 4/18 at 6:30am), Nasacort, Vitamin C, Triphala (ayurvedic herbs), ProBiotic, Collagen, DHEA

Current Illness: none

ID: 1229207
Sex: F
Age: 42
State: CT

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Ceftriaxone, morphine, zofran, cipro

Symptom List: Nausea

Symptoms: 9 hours after vaccine, severe headache, severe body aches, motrin taken, reduced a bit. At midnight woke up soaked, then at 3 am in pain and with fever. By 24 hours, fever gone, headache for another 12 hours. In the 8 days since, feeling tired, sleepy. History of chronic headaches, that are the same since. Had covid in December, feeling more unwell after vaccine than disease

Other Meds: Xanax, ibuprofen, vitamin d, vitamin c, iron, diphenhydramine, lomotil

Current Illness: None

ID: 1229208
Sex: M
Age: 76
State: CO

Vax Date: 03/11/2021
Onset Date: 03/21/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Patient urinated and passed a small blood clot. Happened once ten days after vaccination and then resolved. Patient had another episode 4/9/2021, passed small blood clot with urination, and again, resolved

Other Meds: None

Current Illness: None

ID: 1229209
Sex: F
Age: 87
State: PA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 04/19/2021
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: Became very dizzy with loss of balance. Sight in left eye became very blurry. Significant difficulty walking. Significant cognitive impairment including loss of memory and not understanding what was being said to her. Fell over and broke her left arm that required surgery.

Other Meds: None, only vitamins

Current Illness: None

ID: 1229210
Sex: M
Age: 34
State: TX

Vax Date: 04/18/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: penicillin

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

Symptoms: Patient returned to pharmacy next morning with swollen lips

Other Meds:

Current Illness:

Date Died: 04/08/2021

ID: 1229211
Sex: F
Age: 80
State: FL

Vax Date: 03/20/2021
Onset Date: 04/06/2021
Rec V Date: 04/19/2021
Hospital: Y

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: hemorrhage in the brain

Other Meds:

Current Illness:

ID: 1229212
Sex: F
Age: 35
State: IL

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
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 allergies

Symptom List: Erythema, Pruritus

Symptoms: Received the first dose of Moderna on April 17,2021 at a educational facility, on her right arm and has developed a round yellow dot on the shot she got it is full of liquid she would like to know what she needs to do. No fever or chills just a pain in the arm which is normal .

Other Meds: No over the counter medications

Current Illness: No illness just the pain on the right arm

ID: 1229213
Sex: M
Age: 16
State: IL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/19/2021
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: Within 2 minutes of receiving the vaccine, he started sweating, he then vomited, lost vision and hearing. Had trouble breathing. Ambulance called

Other Meds: None

Current Illness: None

Date Died: 04/13/2021

ID: 1229214
Sex: F
Age: 62
State: NY

Vax Date: 04/09/2021
Onset Date: 04/13/2021
Rec V Date: 04/19/2021
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: NKA

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

Symptoms: WE RECEIVED A CALL ON TUESDAY AFTERNOON THE 13TH OF APRIL FROM THE MEDICAL EXAMINER REQUIRING INFORMATION ON HOW TO CONTACTB THE PATIENT'S DOCTOR. WHEN ASKED AS TO WHAT HAPPENED WE WERE TOLD THAT THE PATIENT WAS FOUND DEAD IN HER APARTMENT ON TUESDA.Y. WE DID INFORM THEM THAT THE PATIENT HAD RECEIVED THE JANSSEN VACCINE AT THE PHARMACY ON FRIDAY THE 9TH. WE DONT KNOW THE CAUSE OF ADVERSE EVENT.

Other Meds: LABETALOL 300MG LEVETIRACETAM 750MG ATORVASTATIN 20MG TELMISARTAN 80MG ASPIRIN 81MG

Current Illness: NONE KNOWN

ID: 1229215
Sex: F
Age: 52
State: TX

Vax Date: 04/01/2021
Onset Date: 04/03/2021
Rec V Date: 04/19/2021
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: Neomycin sulfate

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe and sustained Tinnitus

Other Meds:

Current Illness:

ID: 1229216
Sex: M
Age: 19
State: KY

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/19/2021
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: no, unknown

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

Symptoms: Within hours of getting the shot, patients left eye started turning red. He visited a medical facility and they diagnosed him pink eye and gave him antibiotic drops. The drops did not seem to be working and by that Monday he went to see the eye doctor. Eye doctor said it was viral pink eye and thought it was strange that this came about right after the vaccine and in the eye on the same side he was vaccinated. Over the next days and weeks, the viral infection moved to the other eye. Both eyes stayed swollen, red and tearing constantly. He has lost some of his vision and says that things far away are very fuzzy looking. The doctor said it was the worst case of viral pink eye he has ever seen and that he would have it for the long haul of 4 to 6 weeks. He had to do a medical withdrawal from college due to missing too much of the nursing program he is enrolled in. The pinkeye is still ongoing and we don't know when it will be over.

Other Meds: none

Current Illness: none

ID: 1229217
Sex: F
Age: 52
State: FL

Vax Date: 04/07/2021
Onset Date: 04/14/2021
Rec V Date: 04/19/2021
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: IV Iodine allergic reaction (hives)

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

Symptoms: Significant menstrual bleeding, 24 hrs a day, still lasting as of the date of this report (so far, a total of 6 straight days). I, the patient, have been through menopause and have not had a period in over 17 months.

Other Meds: None

Current Illness: None

Date Died: 04/03/2021

ID: 1229218
Sex: F
Age: 81
State: TX

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/19/2021
Hospital: Y

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: My mom had a brain aneurysm 45 minutes after receiving her second Covid vaccine on Wednesday, March 31st, 2021. She was rushed to Medical Center. After her CT Scan she was put on Life support that morning. After consulting with Doctors we took her off Life Support at 4:00 pm on Friday April 2nd and she passed away 29 hours later at 9;00 pm on Saturday, April 3rd.

Other Meds: Meloxicam

Current Illness: none

ID: 1229219
Sex: M
Age: 26
State:

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Severe dizziness/ presyncope

Other Meds:

Current Illness:

ID: 1229220
Sex: F
Age: 56
State: NC

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 04/19/2021
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: Patient received her second dose 4/19/21 but wanted it noted that she developed a localized rash around the injection site with her first dose (on 3/22/21). rash resolved on its own without medical intervention

Other Meds: unknown

Current Illness: unknown

ID: 1229221
Sex: F
Age: 49
State: IL

Vax Date: 03/24/2021
Onset Date: 03/26/2021
Rec V Date: 04/19/2021
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: Venlafaxine

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

Symptoms: Rash over half body, better now after antihistamines Now still very bad burning in mouth, tongue, lips throat Skin feels sunburned

Other Meds: Levothyroxine 0.88mg Alprazolam 0.25mg Mirtazapine oral disintegrating tab 3.75mg Ceririzine Hydrochorido (Zyrtec) 10mg Eszopiclone 2-3mg Flaxseed oil 1200mg Vitamin /c with natural rose hips 500mg Multivitamin D3 50mcg L-Lysine 5

Current Illness: None

ID: 1229222
Sex: F
Age: 43
State: CT

Vax Date: 04/05/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: n/a

Symptom List: Vomiting

Symptoms: Moderna COVID-19 Vaccine: I received the first dose on Moderna on Monday, April 5, 2021 at 4:16pm. That evening, my arm was sore. The next day, I was very tired and my arm was quite sore. Monday morning, April 19, 2021, I awoke and saw a red blotch or rash at the injection site. The redness is hot to the touch. My arm is sore again. And I'm exhausted and feel "run down." I was surprised by this on day 14.

Other Meds: daily multi-vitamin & allergy, birth control pill, probiotic

Current Illness: n/a

ID: 1229223
Sex: M
Age: 58
State: TX

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/19/2021
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: Patient was vaccinated with Moderna#1 on 3/15/2021 . He received a second dose of Pfizer 4/19/2021. Troubleshooting: This was missed in screening two times; the scribe and vaccinator did not ask birth date and did not ask to see the vaccine card prior to injection. MD counseled the patient.

Other Meds:

Current Illness:

ID: 1229224
Sex: F
Age: 64
State: NV

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/19/2021
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: Sulfa

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

Symptoms: Angioedema. Started approximately midnight 4/8/2021 and finished spreading approximately 10:00 am 4/9/2021. Fully resolved 04/12/2021.

Other Meds: Lisinopril 20/HCTZ 12.5 daily Metformin 1000 mg bid Atorvastatin 20 mg daily Vitamin B 12

Current Illness: None

ID: 1229225
Sex: F
Age: 54
State: UT

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 04/19/2021
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: Avalox, tetrocycline, Cipro

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Shot was administered on 2/27/21 and 3/20/21 at the same location, by the same nurse. She was administering most of the shots while I was there (both times). She pinched my skin and barely injected the needle (subcutaneously). I felt nothing either time, no side effects. I am 5'4", 185 lbs. I called today and the nurse told me, "I sometimes give a shot that way to skinny people in order to not hit bone". I explained to her that I am not skinny. I saw her give the shot to the individual before me the same way. We were all in the high risk groups those days. The nurse told me to contact the health department. I did, and I first got a text telling me to contact rep, they could not do anything. I have since contacted the State Dept. of Health. My concern

Other Meds: Zolpidem, Tizanidine, Telmisartan

Current Illness: None

ID: 1229226
Sex: F
Age: 55
State: CA

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Nausea, headache, sore arm, aches, chills, low-grade fever, sore throat

Other Meds: Losartan

Current Illness: None

ID: 1229227
Sex: M
Age: 34
State: CA

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
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:

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

Symptoms: Fever highest at 102. Chills. Body aches. Muscle aches. Severe migraine. Weakness.

Other Meds: Advil migraine

Current Illness: Anorectal abscess. Had surgery

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm