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: 1229435
Sex: F
Age: 61
State: OH

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: muscle aches in neck on left side, and general muscle aches all over. These were whose on the second day after the shot. On day 3, all muscle aches were gone.

Other Meds: L-Thyroxine Amiodipine Besylate Valsartan Vitamin D Krill

Current Illness:

ID: 1229436
Sex: M
Age: 81
State: MN

Vax Date: 02/17/2021
Onset Date: 04/19/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient had a breakthrough case of COVID-19

Other Meds:

Current Illness:

ID: 1229437
Sex: F
Age: 16
State: CO

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: n/a

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

Symptoms: Patient was given off label administration of Moderna vaccine at age 16. Vaccine is indicated only for age 18 years and older.

Other Meds: n/a

Current Illness: n/a

ID: 1229438
Sex: M
Age: 70
State: PA

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

Lab Data:

Allergies: Sulfa based drugs.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Next day had mild chills and headaches that lasted two days. Five days later developed a severe migraine headache. This is the first migraine I have had in over six months. Migraine lasted April 10th thru 11th, with extreme vertigo. Mild after effects lasted for one full week.

Other Meds: Repatha, Metoprolol, Levothyroxine.

Current Illness: Fibromyalgia

ID: 1229439
Sex: F
Age: 50
State: TX

Vax Date: 01/28/2021
Onset Date: 01/29/1921
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: N/A

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

Symptoms: Manuel factor report number 2021094198 Manufacturing report number 2021093966 Stomach hurt nauseated throwing up dehydrated low platelet count admitted to the hospital.

Other Meds: N/A Note reaction occurred day of injection at 630 pm

Current Illness: N/A

ID: 1229440
Sex: M
Age: 49
State: SD

Vax Date: 03/17/2021
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:

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

Symptoms: Delayed onset large local ecchymosis.

Other Meds:

Current Illness:

ID: 1229442
Sex: M
Age: 16
State:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient passed out in observation area, another patient called out for assistance. Patient appeared diaphoretic, bp 85/50. I have patient water and observed him for an additional 15 mins afterward. Retook blood pressure, 110/78. patient awake, talking to father. States he "feels much better".

Other Meds:

Current Illness:

ID: 1229443
Sex: M
Age: 63
State: TN

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: Pharyngeal swelling

Symptoms: later that night patient began to have extreme back pain, legs hurt even to touch (lasted for days), knees rubbery ...patient had pain for 11 days...patient had dizziness and his balance was off...patient had difficulty breathing ...patient stayed in the er all day underwent a battery of tests "all day" ...in the end didnt have answers ....still having problems breathing and coughing ...patient was zapped of all energy and had difficulty even dressing self

Other Meds: none

Current Illness: follicular lymphoma diagnosed 2018

ID: 1229444
Sex: F
Age: 28
State: PA

Vax Date: 04/08/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pain and soreness in left arm, upper back, and neck as well as nausea day of administration (12:30am). Ongoing on and off nausea since administration. Deep burning sensation on side left side between neck and shoulder. Mild joint pain. Ongoing fatigue (11 days).

Other Meds: None

Current Illness: None

ID: 1229445
Sex: M
Age: 45
State: OH

Vax Date: 03/22/2021
Onset Date: 04/05/2021
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: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient stated he experienced a fever (102 degrees F) two weeks after first dose. COVID test was negative. He also experienced soreness in armpit that started at an unknown time and lasted until fever stopped two days after starting. Patient treated with Tylenol.

Other Meds:

Current Illness:

ID: 1229446
Sex: M
Age: 76
State: PA

Vax Date: 03/11/2021
Onset Date: 03/25/2021
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

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

Symptoms: RASH ALL OVER BODY JOINT PAIN SHORTNESS OF BREATH

Other Meds: LISINOPRIL HCTZ 12.5M ATORVASTATIN 10M AMLODIOPINE 10M ALEVE ANTIHESTIMINE CALCIUM ASPIRIN 81 MG

Current Illness: NONE

ID: 1229447
Sex: M
Age: 49
State: WI

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: fluoroquinolone antibiotics, anti inflammatories and steroids

Symptom List: Rash, Urticaria

Symptoms: Day after vaccination started getting bruises appearing. Day 1 and 3 got red circular shaped rashes with pale centers. Got another bruise on day 4. Wen tto ER where bloodwork was done. Normal 1 week after vaccination hives started. Day 9 skin feels like it is burning in the sun.

Other Meds: Vitamin d

Current Illness: Small fiber sensory neuropathy

ID: 1229448
Sex: F
Age: 24
State: NY

Vax Date: 04/18/2021
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:

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

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: pt fainted but woke up immediately after and was responsive and aware -Mild, Additional Details: pt fainted and hit her head, woke up 30 seconds after and was responsive and aware of what happened and surroundings. she hit her head on the wall corner when she fainted but claimed to be okay. we called 911 and she refused treatment when they arrived. her mom picked her up and she went home.

Other Meds:

Current Illness:

ID: 1229449
Sex: F
Age: 53
State: MO

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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: Amoxicillin, mold, and any bug bites

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

Symptoms: Fever of 100.3 (normal temp is 97.5) Significant lethargy and tiredness. Lack of appetite

Other Meds: No prescriptions. Multivitamin, potassium, magnesium, and omega 3 krill oil

Current Illness: None

ID: 1229450
Sex: F
Age: 26
State: OH

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

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

Symptoms: Patient experienced blood in her urine the day after each dose of the vaccine. The first time she went to her health care provider who treated her for a UTI prophylactically and completed a urinalysis where it was identified she did not have an infection. The patient confirmed she was not have menstrual bleeding and her mense came between both vaccines. She has as hormonal (lilyetta) IUD and does occasionally have a menstrual cycle. She recieved a 7 day course of keflex and no treatment after the second vaccine

Other Meds: clonidine wellburtin benxoyl peroxide

Current Illness: none

ID: 1229451
Sex: F
Age: 33
State: AZ

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

Lab Data:

Allergies: unknown

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

Symptoms: This patient apparently had a vaccine on 4/13 and then showed up at the same clinic on 4/15/21 and got a second dose of Moderna

Other Meds: unknown

Current Illness: unknown

ID: 1229452
Sex: M
Age: 24
State: NY

Vax Date: 04/19/2021
Onset Date: 04/19/2021
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: NKDA

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

Symptoms: Walking to observation and felt dizzy and lightheadead. Sat down in chair and WC obtained and taken to med evaluation area for further evaluation. Fluids offered and lying supine. Denies any further dizziness. Did not eat or drink this morning prior to vaccination and worked out the day before. History obtained and discussed next vaccine to be given in med eval area lying down. Ambulated without any furhter dizziness, 32 oz water and has designated driver in car, instructed not to drive home. pt verbalized understanding discharge ambulatory at 1333.

Other Meds: N/A

Current Illness: None

ID: 1229453
Sex: M
Age: 21
State:

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: Patient felt faint around 5 min after vaccination. He was sweaty, pale, and dizzy. He was given water, peanuts, and a fan. . Patient laid flat on the ground for 15-20min and began felling better. He left on his own shortly after that.

Other Meds:

Current Illness:

ID: 1229454
Sex: M
Age: 34
State: PA

Vax Date: 04/19/2021
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: Patient, who has a h/o vasovagal reactions with injections was fine for 15 minutes, then started to feel warm and slightly woozy. He did not have any loss of consciousness. VSS and he felt better quickly after placing him in a reclined position.

Other Meds:

Current Illness:

ID: 1229456
Sex: F
Age: 62
State:

Vax Date: 03/11/2021
Onset Date: 03/19/2021
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:

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

Symptoms: Left eye infection on 3/19/21,3 internal styes (lower lid); swelling, infection, pain, itching. 3/22/21 trip to urgent care-prescribed Ofloxacin sterile eye drops, both eyes 3x day.3/26/21-2 additional styes developed internal upper lid left eye. 3/27/21 trip to urgent care-prescribed 300 mg Clindamycin 3 x day for 10 days. 3/29/21 follow up with Optometrist. No further prescriptions. Infections mostly clear 4/2/21. 4/15/21-6th stye developed inside lower lid a week after 2nd dose. Treating at home with warm compresses and eye drops.

Other Meds:

Current Illness:

ID: 1229457
Sex: F
Age: 63
State: MD

Vax Date: 04/08/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin; tomatoes, eggplant

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

Symptoms: Headache within about 50 minutes of receiving shot; intense fatigue by six hours later. Day after shot, awoke with every joint in my body swollen. (literally - all). Entire week following, experienced excessive fatigue. Never experienced any muscle soreness, not even at injection site.

Other Meds: Liothyronine Sodium Tab 5 MCG (4 daily) Metoprolol Succinate Er 24 hr 50 Mg Tab (1 day)

Current Illness: none

ID: 1229458
Sex: F
Age: 62
State:

Vax Date: 03/08/2021
Onset Date: 03/25/2021
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: Unevaluable event

Symptoms: Reports that she starting having leg pain in right leg. States that it starting out intermittent but has gotten worse. Especially at night. Did have some redness to that leg a couple days ago but has resolved.

Other Meds:

Current Illness:

ID: 1229459
Sex: F
Age: 46
State: PA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
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: N/A

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

Symptoms: 23 hours after receiving the shot, I had the chills, fever, body aches, headache for about 2 1/2 days. Two weeks later I had a virus that I was to just rest and stay hydrated. A month later, I have been told I have shingles.

Other Meds: Plaquenil Klonopin Lexapro Aromasin Vitamin B12, D, and C

Current Illness: I had an outpatient surgery the day before.

ID: 1229460
Sex: F
Age: 20
State: FL

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: NKA

Symptom List: Injection site pain, Pain

Symptoms: FAINTED, THROAT TIGHNESS, DIZZINESS, HARD OF HEARING

Other Meds: NOT KNOWN

Current Illness: NONE

ID: 1229461
Sex: F
Age: 30
State: MO

Vax Date: 04/05/2021
Onset Date: 04/07/2021
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: I had my first dose of Covid 19 Pfizer vaccine on the 5th of April, 2021 at 1pm. I had sore arm and was fatigued which was expected. However, the day I had my vaccine was also the day my menstrual cycle started and just to assure myself I informed the pharmacist and asked if that was okay and they said it shouldn?t be a concern. I was doing fine until toward the end of day 3. I was expecting my period to stop as it always does on 3rd day but I started bleeding heavier that day there after. It didn?t worry me much until I started discharging huge blood clots as big as an apple 2 times every after 30 mins from that moment. I rushed to the ER later that night(still bleeding heavily with blood clots every now and then) but I was not admitted since my vitals and the blood counts were normal at that moment. I went back home and hoped the bleeding would stop but again with on pain or fever what so ever I kept bleeding all day. This is my 5th day of bleeding. Then on Sunday morning, I still kept bleeding heavy and I was too weak that I went back to the ER again. This time , (day 6) I got admitted because I have had lost a lot of blood and I needed blood transfusion. My HB dropped from 11.3 to 6.7 and it went further down to 5 something. I got 3 units of blood transfusion in the ER. They did ultrasound, CT scans(with and without contrast) and still couldn?t figure out the cause of the bleeding. My uterus showed no problems but my body was not even responding to Tranexamic acid to stop the bleeding. So the doctor proceeded with an angiogram and did an emergency uterine artery Embolization to stop the blood supply to the uterus. The bleeding stopped there after and I started regaining my vitals. However, the cause of the bleeding still remains unknown.

Other Meds: none

Current Illness: none

ID: 1229462
Sex: M
Age: 21
State: MA

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

Lab Data:

Allergies: None

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

Symptoms: Patient has significant history for syncopal and near syncopal episodes when getting injections and blood drawn. Patient experienced syncopal episode today and was asissted the ground. Patient denied any complaints and signed a refusal of care.

Other Meds: None

Current Illness: None

ID: 1229463
Sex: F
Age: 46
State: UT

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: Avocado

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vaccine mixed with incorrect diluent (sterile water instead of normal saline). Pt informed of error and offered revaccination. Pt reports sore arm at injection site for a couple of days after vaccination; no further s/s noted.

Other Meds: Metformin

Current Illness: Diabetes Type 2

ID: 1229464
Sex: M
Age: 57
State: NJ

Vax Date: 03/15/2021
Onset Date: 03/27/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Started with a bad headache that wouldn't go away. Then heavy pressure over my eyes, and feeling very tired. Symptoms went away for a few days, then returned. Got tested for COVID-19, with a PCR lab test, and the results were positive.

Other Meds: Presciptions: Atorvastatin, Symbicort, Telmisartan Supplements: Vitamin C, Vitamin D3, zinc, calcium, magnesium, Co-Q10, probiotic / acidophilus

Current Illness: None

ID: 1229465
Sex: M
Age: 48
State: IN

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 known

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

Symptoms: Began to feel fatigued on afternoon of 041821. Also began to feel aches in middle to lower back and hips. Increased in severity into the evening and night. Restless night with chills and sweats. Heart rate averaged between 85 bpm and 99 bpm while resting in bed throughout the night. Aches decreased in severity throughout morning and day of 041921. Feeling fatigued and sweaty throughout morning and day of 041921.

Other Meds: Vyvanse 50mg, Losartin 50mg, Wixela 250-50

Current Illness: None

ID: 1229466
Sex: F
Age: 22
State: IA

Vax Date: 04/18/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: rec'v vaccine at 2:20pm, reaction of less than 2 seconds of faintness at 2:25pm, EMS was called and arrived @2:29pm, vitals were good, condition was confirmed ok and pt declined transport with EMS. Left on her own accord after a full 30 minutes post vaccine wait.

Other Meds:

Current Illness:

ID: 1229467
Sex: M
Age: 33
State: CA

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: arm pain, chills, body ache

Other Meds:

Current Illness:

ID: 1229468
Sex: F
Age: 67
State: MI

Vax Date: 03/12/2021
Onset Date: 03/16/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Cipro, Bee stings, another antibiotic that was prescribed recently for a UTI

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

Symptoms: Patient describes "fluid accumulation" around neck and shoulders, which she herself did not notice, but was noticed by her chiropractor at her appointment approximately 4-5 days after receiving first dose, and again after her second dose of moderna vaccine, which was administered on 4/15/2021. After each dose, the swelling lasted approximately one week.

Other Meds: levothyroxine, metoprolol, multi vitamin, vitamin c, vitamin D3, vitamin B12, Calcium, Magnesium, Potassium, Evening Primrose Oil

Current Illness: none

ID: 1229469
Sex: F
Age: 41
State: MA

Vax Date: 04/13/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: About 5 minutes after Pfizer dose #2, patient complained of inability to move left UE, then had trouble responding to questions, follow commands, seemed almost aphasic. BP was high, up to 240/140, but HR, O2 sat were normal. After a few minutes, she was able to talk and move left UE, stated that everything had gone black or dark for a bit. She was monitored, sent via ambulance to ED.

Other Meds:

Current Illness:

ID: 1229470
Sex: F
Age: 54
State: CO

Vax Date: 04/15/2021
Onset Date: 04/16/2021
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: sulfa, celery

Symptom List: Tremor

Symptoms: about 20 hours after shot, woke up feeling achy, sore. 24 hours after shot, started running fever (101.5). felt sick to stomach, headache, achy and had chills. slept for 6 hours. about 36 hours after shot, finally felt ok, but woke up the next day with a rash all over upper torso. I am now four days past my vaccination and my entire upper torso itches. will continue with benedryl hoping this ends soon.

Other Meds: levothyrozine; metformin

Current Illness:

ID: 1229471
Sex: F
Age: 86
State: IL

Vax Date: 03/13/2021
Onset Date: 03/19/2021
Rec V Date: 04/19/2021
Hospital: Y

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 had 1st Pfizer vaccine on 3/13/21. She states she went to ER on 3/19/21 and was found to have a blood clot behind her left knee (found by ultrasound). She was put on Eliquis. Patient had 2nd Pfizer vaccine on 4/3/21. Patient did not mention blood clot at time of 2nd vaccine. Patient was admitted to hospital on 4/13/21 for stroke. It was attributed to bleeding in brain and patient was taken off Eliquis and put on a new blood thinner. She will be discharged on 4/20/21 to rehab.

Other Meds:

Current Illness:

ID: 1229472
Sex: F
Age: 70
State: WA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: cabbage makes me sick

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

Symptoms: daily headaches since my 2nd dose

Other Meds: Eliquis, 5 mg 2 times per day, Sotolol 80 mg daily , Folic Acid 1 mg daily , Atorvastatin, 40 mg daily, Fossamax 70 mg 1 x per week, Methotrexate, 10 mg 1 x per week Ferrous Gluconate - 324 mg 3 x per week Calcium magnesium citrate - 4-5 pi

Current Illness: Adult On-Set Stills Disease

ID: 1229473
Sex: F
Age: 95
State:

Vax Date: 02/20/2021
Onset Date: 04/01/2021
Rec V Date: 04/19/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1229474
Sex: M
Age: 70
State: OH

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)

Other Meds:

Current Illness:

ID: 1229475
Sex: M
Age: 21
State: MT

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

Lab Data:

Allergies:

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

Symptoms: Patient received a 3rd injection. Patient unreported that he had the completed Moderna course at a previous stay at the hospital. Patient was monitored and had no significant changes.

Other Meds:

Current Illness:

ID: 1229477
Sex: M
Age: 52
State: NY

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: No adverse event at this time

Other Meds: No

Current Illness: No

ID: 1229478
Sex: F
Age: 55
State: NC

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: IM
Vax Site: LA

Lab Data:

Allergies: Codeine, Buspar

Symptom List: Pain in extremity

Symptoms: Patient received vaccine in am and by 6pm same evening developed vaginal spotting.

Other Meds: Vivelle-dot Progesterone Lisinopril

Current Illness: NOne

ID: 1229479
Sex: F
Age: 32
State:

Vax Date: 04/15/2021
Onset Date: 02/05/2021
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: Fully vaccinated with Pfizer vaccine second dose on 2/5/21. Her Boy friend became positive for Covid 4/15 so she got tested and was positive but reports only slight congestion

Other Meds:

Current Illness:

ID: 1229480
Sex: F
Age: 27
State: LA

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

Lab Data:

Allergies: Levofloxacin

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

Symptoms: Immediately had an inflamed red patch about 2"x1" in size. Was hot to the touch and eventually broke out into several milia approx. 48 hours after injection. General fatigue and muscle aches for 12 hours after injection. Injection site swelling and inflammation subsided after 4 days from initial injection.

Other Meds: Citalopram 20 mg, Trazadone 150 mg, Vyvanse 20 mg

Current Illness:

ID: 1229481
Sex: F
Age: 50
State: CA

Vax Date: 03/25/2021
Onset Date: 03/28/2021
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: None

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

Symptoms: Hive like rash on all parts of my body. Starting the Sunday afternoon after vaccination on scalp. Showing up where my body parts rest against my torso.

Other Meds: Hyzaar, simvistatin, paxil, omeprozol, bentyl, B-Complex, iron.

Current Illness: None

ID: 1229482
Sex: F
Age: 47
State: MD

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

Lab Data:

Allergies: sulfa antibiotics

Symptom List: Vomiting

Symptoms: patient felt hot and tongue felt like she had eaten a hot pepper, within 10 minutes she said symptoms subsided. She was being kept for observation for 30 minutes due to drug allergy.

Other Meds:

Current Illness:

ID: 1229483
Sex: F
Age: 29
State: MN

Vax Date: 01/13/2021
Onset Date: 02/01/2021
Rec V Date: 04/19/2021
Hospital: Y

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: Hospitalization within 6 weeks of COVID vaccination.

Other Meds:

Current Illness:

ID: 1229484
Sex: M
Age: 28
State: CO

Vax Date: 04/18/2021
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:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1229485
Sex: F
Age: 37
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient reported experiencing sensation of rapid heart rate and dizziness. Patient monitored and elevated heart rate noted. Consistent elevated heart rate noted patient transported to local emergency room for further evaluation and care.

Other Meds:

Current Illness:

ID: 1229486
Sex: F
Age: 59
State: VA

Vax Date: 01/06/2021
Onset Date: 01/27/2021
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: Vicodin - GI; Lisinopril - cough; Avocado - throat swelling

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

Symptoms: Nausea (intermittently) since the vaccine; just wait for the nausea to subside

Other Meds: HCTZ 12.5 mg; Prilosec 10 mg; Zyrtec 10 mg; Aygestin 0.5 mg; Atorvastatin 10 mg; Vitamin D 2000 mg

Current Illness: None

ID: 1229487
Sex: F
Age: 79
State: NC

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: n/a

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

Symptoms: patient complained of leg pain and extreme headache

Other Meds: did not give

Current Illness: blood pressure

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm