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: 1233785
Sex: M
Age: 42
State:

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/20/2021
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: Tinnitus began 12 hours later

Other Meds: sertraline hcl 100 mg

Current Illness:

ID: 1233786
Sex: F
Age: 36
State: SC

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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: Roughly 5 to 10 minutes after receiving the vaccine, pt said she had tingling down her lower arm and in her fingers. Pt also had slight swelling/redness on the inside of lower part of arm. Gave pt some benadryl and water and monitored for 15 minutes. She said she didnt feel any worse. Her husband took her home and said he would keep an eye on her.

Other Meds: Unknown

Current Illness: None

ID: 1233787
Sex: F
Age: 36
State: WI

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 04/20/2021
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: hydrocortisone

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

Symptoms: Ringing in the ears. Did two burst and tapers of oral prednisone, but once down to 20 mg daily the ringing would return. Went to ENT 2 weeks ago and they injected a steroid to the ear drum, this helped for 1 week and 2 days, now the ringing is back.

Other Meds: none

Current Illness: none, gall bladder removal on 12/22/2020

ID: 1233788
Sex: M
Age: 55
State: PA

Vax Date: 03/24/2021
Onset Date: 04/15/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: o I recently needed to travel to perform a walkdown of the nuclear power facility. o I opted to drive, and had "layovers" i over 01-APR-2021 through 09-APR-2021 (yes, happy easter). o I kept public interaction to a minimum, but, having to eat, make a containment entry, and answer nature's call, some interactions were close quartered, and prolonged. o Upon my return I started a (10) day quarantine, as directed by CDC guidance . o I had muscle aches, and general fatigue, but attributed that to long daily drives in holiday traffic throughout the trip

Other Meds: BIMATOPROST

Current Illness: NONE

ID: 1233789
Sex: M
Age: 39
State: NC

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Seal Salt Penicillin

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

Symptoms: I got the vaccine and chills, fever, nausea, diarrhea and dizziness. I was kind of our of breath and fatigue, I wasn't able to life anything and constantly out of breathe. It was hard for me to do anything, I had to rest all the time and take off of work. I was driving to work and had to keep pulling over because I felt dizzy. I ended up going to the Dr. and had test ran and they said I was extremely dehydrated and I didn't understand because I drink a lot of water. they hooked me up an IV and gave me fluids. They said I was Healthy just extremely dehydrated it. My injection site was kind of tender but nothing more. I'm still having issues. I'm just always thirsty no matter how much water I drink.

Other Meds:

Current Illness:

ID: 1233790
Sex: F
Age: 17
State: CO

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/20/2021
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: Pt attended outreach clinic and received Moderna COVID-19 Vaccine dose #1 at age 17. Current EUA states Moderna vaccine is ineligible for pts < 18yo; pt was not an original participant on provided list. Pt left in stable condition and per CDC recs is ok to receive dose #2.

Other Meds:

Current Illness:

ID: 1233791
Sex: F
Age: 65
State: MN

Vax Date: 03/07/2021
Onset Date: 03/01/2021
Rec V Date: 04/20/2021
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: Allergic to long hair cats

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: CONTINUOUS ROVING HEADACHE SINCE 3/12. ALL SIDES OF THE BRAIN. 24/7 INTERMITTENT BUT EVERYDAY. LEVEL 1-2-3. PRIOR TO VACCINE, ZERO VACCINES IN MY LIFE. HEADACHE STILL CONTINUING

Other Meds: New Chapter Vitamin B Comples/1 tablet per day

Current Illness: Hashimotos/hypothyroidism (no medication is taken)

ID: 1233792
Sex: F
Age: 15
State: KY

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/20/2021
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: Error: Patient Too Young for Vaccine Administered

Other Meds:

Current Illness:

ID: 1233793
Sex: M
Age: 17
State: IL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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: About 10 minutes after getting vaccinated, patient felt dizzy. We let him lay down on the floor and monitored his blood pressure. His blood Pressure (average of 2 readings) was 119/85, pulse 86. Patient felt ok after 5 minutes. We observed him for extra 5 minutes before he left the clinic feeling well, without any symptoms of dizziness.

Other Meds: None

Current Illness: None

ID: 1233794
Sex: F
Age: 55
State: PA

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 04/20/2021
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: Crustaceans, vancomycin, penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Numbness in heel of right hand lasting 1 week Headache within 1 hour lasting 36 hours post shot. Within 40 minutes, lasting 3 hours bi-lateral biceps and triceps aching. Fatigue for 5 days. Irritable for 6 days

Other Meds: Xarelto, plaquenil, Prozac

Current Illness: None

Date Died: 04/19/2021

ID: 1233795
Sex: F
Age: 62
State: MI

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/20/2021
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: unknown

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

Symptoms: Information obtained from the Hospital. Began to not feel well the next day, SOB, diarrhea and fatigue. Was admitted to hospital on 4/9/21, diagnosed with COVID, placed on a vent and died on 4/19/21.

Other Meds: Vitamin D3, Celexa. Lisinopril, Trental, Coumadin, Multivitamin

Current Illness: unknown

ID: 1233796
Sex: F
Age: 22
State:

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/20/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Vaccine administered 13:50, adverse event started 14:05. Patient had flushing/sweating, tachycardia. BP 114/68 -- > 119/68, HR 70 -- > 70, RR = 16 -- > 16, Temp 98F -- > 98F, O2 sat = 100%. At 14:52, patient denied lightheadedness, patient stable, released from vaccination site.

Other Meds:

Current Illness:

ID: 1233797
Sex: M
Age: 65
State: NC

Vax Date: 03/23/2021
Onset Date: 03/26/2021
Rec V Date: 04/20/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Left lower extremity DVT- symptoms within days of vaccination, did not present for diagnosis for about 3 weeks.

Other Meds: losartan monteleukast pravastatin

Current Illness: none known

ID: 1233798
Sex: F
Age: 57
State: GA

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 04/20/2021
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: Mustard, peanuts, pollens

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

Symptoms: Rash (hot to touch, like a sunburn) on front of torso & R neck, burning sensation; escalation of her chronic pain (diffuse myalgias, arthralgias, neuropathy worse). Remaining symptomatic 3 weeks after initial eval.

Other Meds: Amitriptyline, Clonazepam, Duloxetine, Gabapentin, Humalog, Ibuprofen, Levemir, Levocetirizine, Lisinopril, Percocet, Rosuvastatin, Trazodone

Current Illness: None

ID: 1233799
Sex: F
Age: 42
State: IL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
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: Burning chest sensation that flows to face , arms and hands. Pain in chest

Other Meds: Metformin

Current Illness:

ID: 1233800
Sex: F
Age: 43
State:

Vax Date: 04/07/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Itchy red bumps on ankles, knees, fingers (mosty ankles). Look like measles or mosquito bites. They itch like mosquito bites. One or 2 showed up on day 8, by Day 10 many were on my ankles.

Other Meds:

Current Illness:

ID: 1233801
Sex: F
Age: 24
State: IN

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/20/2021
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: NKA

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

Symptoms: PATIENT WAS COMPLAINING ABOUT NAUSEA AND VOMITING, PAINFUL ARM , SHAKINESS, DIZZINESS. NAUSEA STATED AROUND 230 PM ON 4/19/21 AND SHAKINESS, DIZZINESS PAINFUL ARM STARTED ON MORNING OF 4/20/21. VOMINTING ON 4/20/21 EARLY IN THE MORNING.

Other Meds: PATIENT NOT ON ANY PRESCRIPTIONS OR OTC PRODUCTS

Current Illness: NO ILLNESSES SINCE THE PAST MONTH

ID: 1233802
Sex: F
Age: 17
State: SC

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

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient attended a Spanish speaking vaccine clinic. There was a language barrier despite a translator and patient was given a moderna vaccine although she is only 17 years old. She has had no side effects.

Other Meds: None

Current Illness: None

ID: 1233803
Sex: F
Age: 74
State: TX

Vax Date: 02/24/2021
Onset Date: 03/18/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Levaquin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I have been on Humira for more than 14 years with a year off in approximately 2018. I have had either the TST or Quantiferon test every year per my physicians' orders. All tests have been negative. My last negative test was in February 2020 and was the Quantiferon test. I had the Quantiferon test performed on 3/18/21 which came back positive. I was retested on 4/6/21 and it was again positive. The first test was administered 3 weeks after the second Pfizer vaccine. CDC guidelines recommend waiting at least 4 weeks after the vaccine was administered so I had the second test.

Other Meds: Humira, Low dose aspirin. Vitamin D3, Zinc, Vitamin C, carvedilol, piroxicam, Benicar, Amlodipine, probiotic, Triamt/HCTZ, Synthroid,Bupropion.

Current Illness: None

ID: 1233804
Sex: F
Age: 45
State: OH

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
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: Walking from bathroom to bed (three paces total), tunnel vision resulting in complete blackout visually. No loss of consciousness. No precipitating symptoms, other than existing body aches, chills, and sweating. Severe nausea, body aches, and cold sweat drenching the bedsheets. Tingling in both hands, similar to that accompanying oncoming numbness. Vision returned once supine. Conscious breathing and raising legs above heart reduced syncopal symptoms after 20 minutes. Unable to rise from bed to alert family members due to risk of loss of consciousness and vomiting. Fever of 99.5 F, chills, body aches, moderate nausea, sleeplessness continued for several hours. Oral dose of promethazine 12.5mg at about 10am 17 Apr 2021 reduced nausea and ended sleeplessness.

Other Meds: Ecsitalopram, Bupropion XL, Etodolac SR, Multivitamin, Vit C, Magnesium, Calcium, Vit D, Loratadine

Current Illness: none

ID: 1233805
Sex: M
Age: 47
State: TN

Vax Date: 01/13/2021
Onset Date: 01/23/2021
Rec V Date: 04/20/2021
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: None

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

Symptoms: Acute onset of tinnitus of left ear

Other Meds: Lamotrigine, methylphenidate, omeprazole

Current Illness: None

ID: 1233806
Sex: M
Age: 71
State: MI

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 04/20/2021
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 reported

Symptom List: Unevaluable event

Symptoms: Minutes after receiving vaccine, patient slumped over and was unresponsive. He appeared to stop breathing, was diaphoretic, and very pale. Four people eased patient to the floor. Once on the floor, the patient snorted and appeared to be breathing, His pulse was tachycardic and thready. Unable to obtain a blood pressure. 911 was called. Patient opened his eyes but was still unresponsive to verbal commands. Patient given a tube of icing (glucose) as his wife could not report when he had last eaten. Slowly, he began to come around. When EMS arrived, patient was assisted to sitting position and then onto gurney. Vitals signs were obtained and reported to be WNL. EMS spoke with patient and wife and convinced patient to be evaluated at ER.

Other Meds: Blood thinner

Current Illness: Denied

ID: 1233807
Sex: F
Age: 47
State: NY

Vax Date: 03/31/2021
Onset Date: 04/07/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: I am a menopausal woman with last date of period August 2019. On 4/7/21 I developed abdominal bloating and cramping related to menstruation. On 4/8/21 I developed mild mucous vaginal discharge with blood streaks. Thereafter, I developed tan discharge for a few days. I've continued to have upper GI pain for the next 2 weeks. I went to the ER on 4/18/21 for lab work up and they performed a right upper quadrant Ultrasound. I have a GI appointment today for further work up.

Other Meds: Singulair 10 mg daily, Xyzal 5 mg daily, Pepcid 20 mg daily, multivitamin, Calcium, Vitamin C, Probiotic.

Current Illness: None

ID: 1233809
Sex: F
Age: 62
State: DC

Vax Date: 03/03/2021
Onset Date: 03/06/2021
Rec V Date: 04/20/2021
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: PCN

Symptom List: Injection site pain, Pain

Symptoms: Patient felt fine after first dose on 2/3/2021 other than a sore arm and tiredness. Approx, 2-3 days after the second dose, she started experience pain and swelling in both feet and legs. Since then, she has been seen by her rheumatologist, vascular surgeon and primary care physician. Her symptoms have included both legs being bright red and warm to the touch with significant difficulty walking over the past month. Her right leg has completely resolved but her left leg remains swollen and painful. Patient states it looks like she suffered a burn - her leg is still very red and skin is peeling. Her PCP recently diagnosed her with cellulitis likely related to vaccination.

Other Meds: Synthroid, plaquenil

Current Illness: none

ID: 1233810
Sex: F
Age: 63
State: FL

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Percocet, Amitriptyline, Gabapentin, Penicillin, Sulfa, Steroids, Nexium, Vicodin, Erythromycin, Bee stings, Nuts, Cats

Symptom List: Injection site pain, Menorrhagia

Symptoms: Full body rash on April 11. Started with ears, face and went down entire body to my toes. (Did not have rash on my stomach, butt or breasts. Used Benadryl and tylenol and it went away. Felt like my body was on fire and very hot to the touch, but no fever. Full body rash again on April 19. Started with ears, face again. Immediately took Benadryl and tylenol. This time we could watch the rash spread throughout my body. This time included stomach, not breast or butt. Once again very hot to the touch, put ice packs on my chest and arms and legs. 8 hours later it was gone. Very sensitive skin to the touch could not put on any clothing at all.

Other Meds: Synthroid, Losartan, Rosuvastatin, Famotidine, Flecainide, Acyclovir, Montelukast, Loratodine, Pregabalin, Vitamin D, Ipratropium Bromide, Selenium, Zinc, Biotin, B12, Fish Oil, Tumeric, Niacin, Magnesium, Docusate Sodium, Probiotic, and A

Current Illness: Covid long hauler

ID: 1233811
Sex: F
Age: 67
State: TX

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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: No known allergies.

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

Symptoms: At this time there is no adverse reaction, the purpose of this report is to document a medication/vaccination error. Patient was administered her 1st dose of Pfizer on 3/27/21, she was scheduled to follow up for 2nd dose on 4/16/21 but missed her appt, patient attempted to reschedule for 2nd dose and was rescheduled incorrectly for 4/20/21. Patient was administered a dose of Moderna on 4/20/21. Patient was observed for 30 minutes and did not develop any adverse reaction, she was instructed to continue t monitor and seek emergency medical attention if need be. Patient verbalized understanding and states she was feeling well upon release.

Other Meds: None reported by patient.

Current Illness: None reported by patient.

ID: 1233812
Sex: M
Age: 66
State: AZ

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 04/20/2021
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: Allergic to Cipro and Meloxicam

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Developed sensitivity/pain of the tongue as well as a change in the ability to taste some foods. As of today these symptoms have been present for 3 weeks and continue to persist.

Other Meds: Psyllium powder.

Current Illness:

ID: 1233813
Sex: F
Age: 41
State: CA

Vax Date: 04/07/2021
Onset Date: 04/18/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Site: Swelling at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild

Other Meds:

Current Illness:

ID: 1233814
Sex: F
Age: 28
State: WV

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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

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

Symptoms: Vasovagal response, patient assisted to floor by significant other. Patient diaphoretic and loss consciousness briefly but quickly regained consciousness. Patients vital signs BP 124/74, HR 67, O2 97%. Patient given orange juice and water. Patient kept for observation for 35 minutes and patient verbalized that she was feeling better. Patient left site via private car driven by her significant other.

Other Meds: NO

Current Illness: NO

ID: 1233815
Sex: F
Age: 3
State: TN

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List: Nausea

Symptoms: Mother of patient called into clinic stating she took patient to ER for leg swelling. patient was treated for cellulitis around injection site.

Other Meds:

Current Illness:

ID: 1233816
Sex: F
Age: 56
State: KS

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

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

Lab Data:

Allergies: n/a

Symptom List: Injection site pain

Symptoms: Tinnitus developed one hour after receiving the first dose of the vaccine. It turned on like a light switch (not there and then very loud and intrusive). It appears to be louder in my left ear (the side I had the vaccine) but it is hard to tell. It felt like my head or ears were stuffy (not like a stuffy nose) so I took a decongestant but it didn't have much or any effect. I have had some mild and transient tinnitus in the past (nothing like what happened after the vaccine), but have had very few problems over the last couple years. It usually happened when I slept wrong (neck issue) and then went away not long after getting out of bed. It is now exactly two weeks after the first dose and the tinnitus has decreased but is still present. I have not gone to my doctor as they report not knowing much about the connection between the vaccine and tinnitus. I have tried a few things suggested on-line with indeterminant results. It does appear to be lessening with time and hopefully that progress will continue. I am concerned about getting the second dose since the side-effects are reported to be worse with the second dose of all the Covid-19 vaccines. I don't want to be left with a permanent problem especially one that is really intrusive and hard to manage.

Other Meds: n/a unless you mean a multivitamin & probiotics

Current Illness: n/a

ID: 1233817
Sex: F
Age: 51
State: CT

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Antihistamines given for chicken pox when I was younger.

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

Symptoms: Sever hearing loss and tinnitus. Day after shot clogged ear and fullness, noise. Went to ent hearing test showed severe hearing loss was put on round of steroids.

Other Meds: none

Current Illness: none

ID: 1233818
Sex: F
Age: 55
State: NY

Vax Date: 04/07/2021
Onset Date: 04/17/2021
Rec V Date: 04/20/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Purple , looking like blood clots on the back of her leg

Other Meds: None

Current Illness: None

ID: 1233819
Sex: F
Age: 61
State: NY

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/20/2021
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: Within minutes of vaccine, slight taste in mouth, otherwise only a slightly sore arm and no appetite. Within 12 hours, sharp pain in both knees, right ankle, right wrist; throbbing right arm, dizzy/vertigo, very rapid heartbeat. Within 24 hours, bedridden with low grade fever, continued dizziness, very rapid heartbeat, headache, but no joint pain. Within 36 hours, still rapid heartbeat with erratic pulse at times, and no appetite. Within 48 hours, heart rate beginning to slow somewhat, increasing with exertion. By 72 hours, heart rate finally back to pre-vaccine rate. Six days after injection, dizziness returns. On seventh day, dizziness is gone but still no appetite. Funny taste persists. Anticipate post-vaccine issues to continue until day 10, same as first dose.

Other Meds: SYNTHROID, 88mcg

Current Illness: none

ID: 1233820
Sex: M
Age: 71
State: CA

Vax Date: 03/25/2021
Onset Date: 04/04/2021
Rec V Date: 04/20/2021
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: Penicillins

Symptom List: Erythema, Pruritus

Symptoms: Developed shingles 10 days after 2nd dose of Pfizer Covid vaccine

Other Meds: Bone Aid (calcium), fish oil, turmeric, ginger

Current Illness: no

ID: 1233821
Sex: M
Age: 35
State: IL

Vax Date: 04/10/2021
Onset Date: 04/17/2021
Rec V Date: 04/20/2021
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:

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

Symptoms: low grade fever, body aches, chills, fatigue; all symptoms resolved within 18 hours

Other Meds:

Current Illness:

ID: 1233822
Sex: M
Age: 45
State: MO

Vax Date: 03/31/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
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: Swollen lymph node 14-16 days after first injection

Other Meds: Mega Men Vitamins, T180 Burn

Current Illness: None

ID: 1233824
Sex: F
Age: 29
State: LA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/20/2021
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: NKDA, NONE

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: At approximately 0845, patient began to complain about a tightness in her throat and chest. This was 13 minutes after receiving her COVID vaccination while sitting in post vaccination waiting area. Was escorted to the Clinic where she was assessed by medical provider, and EMS was called. Pulse oximeter showed 100% oxygenation. EMS arrived approximately 0920 and transported patient via ambulance to Emergency Room.

Other Meds: NONE

Current Illness: NONE Known or mentioned upon screening

ID: 1233825
Sex: M
Age: 55
State: MI

Vax Date: 04/06/2021
Onset Date: 04/19/2021
Rec V Date: 04/20/2021
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: NKDA

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

Symptoms: 55 y/o male with PMHx of obesity, LLE cellulitis (hospitalized in 2018), and varicose veins seen in unit 4/19/21 due to LLE cellulitis not responding to bactrim DS. Patient reports remote history of bilateral cellulitis and hospitalized once for IV abx for 4 days in 2018. He denies DVT history. He was prescribed compression stockings, unsure of compression grade but he isn?t wearing them due to the ongoing pain. He was seen by nursing on 4/2/21 reported leg erythema and swelling starting that day. He was given Rocephin and had Bactrim ordered. The leg swelling/erythema/pain improved minimally with Bactrim DS but still had symptoms so he was seen today. He reports posterior calf tenderness. he denies fevers, chills, sweats, dyspnea, chest pain, SOB, palpitation, abdominal pain, N/V/D/C at this time. exam shows LLE with anterior erythema, tenderness, warmth, and (+) homan sign. 1-2+ BLE edema. He was COVID 19 positive on 11/10/20 and again on 3/15/21. Received moderna on 3/9/21 and 4/6/21. Labs sent to local hospital show D-Dimer >1000 and CBC with thrombocytopenia to 111K per lab with 3+clumping.

Other Meds: Multi-vitamin, Bactrim

Current Illness: Left leg cellulitis, Bilateral LE varicose veins

ID: 1233826
Sex: M
Age: 44
State: TN

Vax Date: 04/02/2021
Onset Date: 04/05/2021
Rec V Date: 04/20/2021
Hospital: Y

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: Chest discomfort intermittently over next 48 hours worse with exetion

Other Meds: Vit D

Current Illness: GERD

ID: 1233827
Sex: M
Age: 64
State: IA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/20/2021
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: Pain in extremity

Symptoms: Patient's COVID symptoms started 4/8/21, 1 day post vaccination. Patient did have positive COVID19 test on 4/15/21.

Other Meds:

Current Illness:

ID: 1233829
Sex: F
Age: 69
State: FL

Vax Date: 03/09/2021
Onset Date: 03/16/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Latex, Sulfates, Citrus, Bannanas, undercooked eggs,

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

Symptoms: Left arm became extremely inflamed, itchy & swollen. Started as a small area on 03/16/21 then expanding to cover my entire left forarm from my elbow to my wrist by 03/18/21. I sent a phot to a friend that works for a doctor & was told to have it seen ASAP. My doctor was out of the office that day (Friday March 19th) my insurance company told me to go to the ER. I went , They diagnosed it as cellullitis on my left arm and also an allergic uticaria on my right arm. I was prescribed Cephalexin 500 mg & Prednisone 20 mg & Claitin D. The area cleared up, however it is coming back. I currently have an area of red, itchy and a little swollen of approxiamately 3" x 3 1/2" on my right arm.

Other Meds: Simvastatin, Amitriptyline, Vitamin D, Probiotics

Current Illness:

ID: 1233830
Sex: M
Age: 53
State: NJ

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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: n/a

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

Symptoms: While sitting after receiving his vaccine he patient started to feel dizzy. Then his eyes rolled back and he went limp. He was unconscious for under a minute. A police officer came since we called 911 but the patient was already awake and felt better. He declined an ambulance.

Other Meds: losartan/hydrochlorothiazide

Current Illness: n/a

ID: 1233831
Sex: M
Age: 30
State: MA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/20/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Systemic: Chills-Mild, Systemic: Confusion-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Systemic: Shakiness-Mild, Additional Details: patient was rushed to the hospital by the ambulance, i followed up with the patient and he left the hospital hours after on the same day. patient is now recovered and feeling well.

Other Meds:

Current Illness:

ID: 1233832
Sex: F
Age: 52
State: CT

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/20/2021
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: Dilaudid Fentanyl Morphine Tapazole Demerol Vicodin

Symptom List: Vomiting

Symptoms: 1st in the series Nausea and sleepiness 2nd Headache on the day of the injection Large red and warm wheal at injection site lasting at least one week after shot

Other Meds: Privigen brand Intravenous Immunoglobulin g.

Current Illness:

ID: 1233833
Sex: M
Age: 45
State: CA

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/20/2021
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: NA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I suffer from Meniere's disease and have had 2 episodes over the past 6 months. Since the vaccine I've had several small episodes and two big episodes in the span of 2 weeks and ongoing. A big episode will knock me out for hours even up to a day. See symptoms below. Small episodes: Dizziness-feel tipsy Nausea Headaches Vomiting Big episodes: (includes small) Full vertigo, feels like I'm drunk and have trouble walking. Feels like room is spinning Migraines Pressure in my head makes me feel like a bobble head and wobbly This has affected my work. My doctor told me to report this to you. I got the 1st vaccine shot on 04/05/21. I suffer from Meniere's disease and have had 2 episodes over the past 6 months. Since the vaccine I've had several small episodes and two big episodes n the span of 2 weeks and ongoing. . A big episode will knock me out for hours even up to a day. See symptoms below. Small episodes: Dizziness Nausea Headaches Vomiting Big episodes: (includes small) Full vertigo, feels like I'm drunk and have trouble walking. Feels like room is spinning Migraines Pressure in my head makes me feel like a bobble head and wobbly My second does is scheduled for 04/26/21, should I take it?

Other Meds: Atorvastatin Calcium 40MG 1xday HCTZ 25/Triamterene 37.5MB 1xday Amlodipine Besylate 10MG 1xday Pantoprazole NA 40MG 1xday Metoprolol Tartrate 50MB 2xday

Current Illness:

ID: 1233834
Sex: M
Age: 16
State: CO

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/20/2021
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: patient was given vaccine that had been refrigerated for 7 days (outside window of storage per the EUA)

Other Meds:

Current Illness:

ID: 1233835
Sex: F
Age: 41
State: PA

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 04/20/2021
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: prednisone hives dairy sensitivity

Symptom List: Injection site swelling, Limb discomfort

Symptoms: hives over entire body started on elbows , knees , neck, face scalp , elevated heart rate.

Other Meds: claritin 10 mg probiotic advil as needed

Current Illness: none

ID: 1233836
Sex: M
Age: 80
State: IA

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
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: moderate (101-102deg. F) for 24 hrs. For first three hours strong chills. Considerable chills for 3-4 days.

Other Meds:

Current Illness: none

ID: 1233837
Sex: M
Age: 57
State:

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/20/2021
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: Chills beginning 30 hours after vaccination and continuing for 3-4 hours. Sore arm below injection site beginning shortly after injection and lasting for 3 days.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm