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: 1238816
Sex: M
Age: 59
State: SC

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: I woke up at 0300 AM with ringing in both ears, aka, Tinnitus. It still persists.

Other Meds: Telmisartan 80mg Diltiazem 240mg, Omerazole 20mg, Red Yeast Rice

Current Illness: Upset stomach

ID: 1238817
Sex: F
Age: 79
State: NM

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/21/2021
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: Temperature excurssion of vaccine while trying to vaccinate homebound individuals VAccine deemed not properly stored but given to patients CDC notified, recommend repeat vaccination

Other Meds:

Current Illness:

ID: 1238818
Sex: M
Age: 41
State: IL

Vax Date: 04/16/2021
Onset Date: 04/18/2021
Rec V Date: 04/21/2021
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: NKDA

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

Symptoms: Patient with persistent numbness to the contralateral thumb from the injection site 2 days after the injection and persisting for at least 3 days from the onset

Other Meds: Trulicity 0.75, jardiance 25, lantus 60, metformin 1000 BID, crestor 20, viagra 20

Current Illness: DM, HLP

ID: 1238819
Sex: M
Age: 22
State: IN

Vax Date: 04/11/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies: Allergic to alcohol.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Swelling, redness, bumps, itchiness, and skin hardening in a 3 inch diameter around injection site about a week after injection.

Other Meds: Prescriptions Estradiol 6MG, Spironolactone 100MG, Metformin HCL XR 1000MG daily. Vitamin D2 1.25MG weekly. Over-the-counter Zyrtec one a day.

Current Illness: none

ID: 1238820
Sex: F
Age: 38
State: CA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Fainting, ~5 minutes after getting out of bed in the morning. Collapsed to floor. Recovered after a few minutes in prone position. Minor injuries caused by fall.

Other Meds: None

Current Illness: None

ID: 1238821
Sex: F
Age: 74
State: WA

Vax Date: 02/17/2021
Onset Date: 02/25/2021
Rec V Date: 04/21/2021
Hospital: Y

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: Corn (very mild allergy)

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

Symptoms: Breathing problems starting Feb 25th, approx 2PM, escalating until Mar 1st when patient went to Walk-In Clinic for immediate care. Her oxygen saturation level was found to be in the upper 80's percentage. Was then taken by ambulance to Hospital and given oxygen. At hospital she was given a blood thinner drip. Also performed CT scan and found blood clots in her lungs. She was released to return home approx 24 hrs later with blood thinner pills (Eliquis) and at-home oxygen generation. These were necessary for approx two weeks until her O2 levels returned to normal without supplemental O2.

Other Meds: Levothyroxine

Current Illness:

ID: 1238822
Sex: F
Age: 20
State: FL

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 04/21/2021
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: Pyrexia, White blood cell count decreased

Symptoms: 48 hours after Moderna vaccine [ given at outside facility] patient started with puffy eyes, rash around the eyes with redness of both eyes. Slowly the rash spread to entire face including the neck region. At 72 hours post vaccination she noted swelling and redness around the lips with tightness in chest prompting here to seek help. Noted to have generalized swelling and erythema to face along with the periorbital area and eye lids on exam [ after Benadryl]- no respiratory distress. Reaction thought to possibly be an acute worsening of her underlying eczema but could not rule out vaccine reaction. Treated with Benadryl, Zyrtec and Prednisone

Other Meds: none

Current Illness: none

ID: 1238823
Sex: F
Age: 29
State: TX

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/21/2021
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: Patient is a 29 y old female with no history of previous reaction to vaccines or medications. She was given Pfizer COVID vaccine at 12:08 pm and within approximately 2-3 minutes while sitting in discharge area she began to feel dizzy. She was tachycardic with a HR of 140. Denied anxiety history , denied cardiac history. No itching, No SOB. Only c/o dizziness. BP was initially elevated 133/94. She was provided water, and a snack. No difficulty swallowing or breathing. She was observed for an extended period of time, and HR came down to 90's briefly, but went back up to 120-130's with complaint of dizziness when HR would accelerate. This continued for nearly an hour, with sustained HR 110-120's and BP elevations as high as 179/105 with no HX of HTN, so EMS was called. She was transported to ER via EMS for evaluation . Accucheck per EMS was 99 and 12 lead EKG was done by EMS showing sinus tachycardia. She remained alert and oriented entire episode.

Other Meds: None

Current Illness: None

ID: 1238824
Sex: F
Age: 64
State: OH

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: AT 12:00am on 04/10/2021 I started throwing up and it went on until 1:00am. I was finally able to sleep and was find the next day. No more issues since.

Other Meds: Calcium Citrate daily Mega 3 Fish Oil daily Prenatal vitamins daily Potassium daily 25 mg Hydrocholoride daily Biotin daily Vitamin D 5000 mg weekly 81mg aspirin daily

Current Illness: N/A

ID: 1238825
Sex: M
Age: 73
State: MO

Vax Date: 03/22/2021
Onset Date: 04/19/2021
Rec V Date: 04/21/2021
Hospital: Y

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

Lab Data:

Allergies: Lovastatin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient had a stroke within 4 weeks of second dose of moderna Stroke is embolic in nature This report was made at the request of the family Patient also has untreated Afib and was not on anticoagulation x 2 years which is the most likely cause of the stroke

Other Meds: Methotrexate ASA Lipitor Singulair Kenalog Multivitamin Flonase Zyrtec

Current Illness: none

ID: 1238826
Sex: M
Age: 55
State: CO

Vax Date: 04/09/2021
Onset Date: 04/18/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Sore throat for 2 days followed by runny nose, congestion, mild aches, possible low fever, basically cold symptoms

Other Meds:

Current Illness:

ID: 1238827
Sex: F
Age: 33
State: MN

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/21/2021
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: NKA

Symptom List: Rash, Urticaria

Symptoms: Approx 24 hours latter the patient developed an itchy macular/papular rash on her face including her eyebrows. Her scalp and neck were spared. Nothing like this has ever happened to her before. She is improving when I saw her on 4/20/21

Other Meds: None

Current Illness: None

ID: 1238828
Sex: F
Age: 53
State: FL

Vax Date: 04/14/2021
Onset Date: 04/16/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Starting the Friday following the immunization (2 days after), patient started running a fever of 100-102 consistently even while taking Tylenol. This continued for 4 days and even still on Monday when she called to report it. She also developed a sore throat and lost her voice temporarily on Sunday.

Other Meds: Synthroid, Cytomel

Current Illness: None

ID: 1238829
Sex: M
Age: 34
State: MI

Vax Date: 04/08/2021
Onset Date: 04/18/2021
Rec V Date: 04/21/2021
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: Eurythromycin sensitivity (mild)

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

Symptoms: Mildly swollen red splotches/bumps on several fingers (and underside of left big toe). Only mildly itchy unless scratched - then they become extremely itchy with burning sensation. Skin issues still present, but discomfort relieved by antihistamine (generic Zyrtec). Ibuprofen/lotion/etc had no effect. I believe it was a delayed vaccine reaction because I?ve never needed antihistamines before in my entire life - no known ?true allergies? (just significant GI issues with eurythromycin, so I avoid it).

Other Meds: Concerta, Ritalin, Viibryd, Latuda, omeprazole

Current Illness:

ID: 1238831
Sex: F
Age: 47
State: IL

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/21/2021
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: Unknown

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

Symptoms: Patient experienced sweating, blurry vision, elevated blood pressure, recovered and released

Other Meds: Unknown

Current Illness: Unknown

ID: 1238832
Sex: F
Age: 30
State: MO

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 04/21/2021
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: Latex, peanuts, coriander, sweet potatoes

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

Symptoms: Red blisters on left side of forehead, left eyebrow, eyelid. Itching, tingling, pain in the area. Blurred vision in the affected eye. 7-8 eyelashes were lost on a clump of eyelid flesh that scabbed over and detached. Symptoms began April 1st. The symptoms began to decrease about a week and a half later. As of April 21st there are still several pink bumps on my forehead but they may be becoming scars at this point.

Other Meds: Buspirone

Current Illness:

ID: 1238833
Sex: F
Age: 16
State: AZ

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
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:

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

Symptoms: Fever, chills, muscle pain, joint pain, tiredness, headache, injection site pain, injection site redness, nausea

Other Meds:

Current Illness:

ID: 1238835
Sex: F
Age: 30
State: MN

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/21/2021
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: Local site swelling, redness

Other Meds: Metformin Loestrin Mirena IUD

Current Illness: n/a

ID: 1238836
Sex: M
Age: 16
State: PA

Vax Date: 04/16/2021
Onset Date: 04/21/2021
Rec V Date: 04/21/2021
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: ? On Friday, April 16th an individual under the age of 18 received the Moderna COVID-19 vaccine as a part of a 500-dose vaccination clinic. o 16 yo male whose parent signed him up for an appointment utilizing the personal vaccination code for an appointment ? Moderna COVID-19 vaccine is indicated for ages 18 and above. The administration error was found upon review of records by the pharmacy team the evening of Friday, April 19th.

Other Meds:

Current Illness:

ID: 1238837
Sex: F
Age: 43
State: MA

Vax Date: 03/24/2021
Onset Date: 04/04/2021
Rec V Date: 04/21/2021
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: Red rash left arm

Other Meds: Wellbutrin Jurel Vitamin D

Current Illness: None

ID: 1238839
Sex: F
Age: 34
State: GA

Vax Date: 04/13/2021
Onset Date: 04/16/2021
Rec V Date: 04/21/2021
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 known of

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

Symptoms: Swollen Lymph nodes in left armpit area. Tender. Felt the vaccine work its way through my arm after injection.

Other Meds: None

Current Illness: None known of

ID: 1238840
Sex: F
Age: 27
State: MA

Vax Date: 01/12/2021
Onset Date: 04/17/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Unevaluable event

Symptoms: Petechial rash with initial onset around left and right ankle at 2pm on 04/17/21, spread over entire legs, abdomen, back, and left arm by 11pm same day. Petechial rash ceased to spread significantly by 04/18/21, with new spots appearing only intermittently on left and right hand fingers on 04/19/21.

Other Meds: Spironolactone, 150mg daily

Current Illness: n/a

ID: 1238841
Sex: M
Age: 66
State: PA

Vax Date: 03/27/2021
Onset Date: 04/02/2021
Rec V Date: 04/21/2021
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: Friday night noticed pain and a blistery rash on face and forehead. By Saturday evening, there was a blister very close to eye, so sough medical care. Definitely Shingles! Dr. checked eye to be sure there were none in eye, and there weren't. Prescribed generic Valtrex, which was begun Sunday afternoon (unable to get sooner due to pharmacies being closed). Quickly was resolved, we believe largely due to Shingrix vaccine, received in 2018. May have had mild symptoms (headache, etc.) day or so previous, but nothing major.

Other Meds: Losartan, hydroclorathiazide, Lumigan eye drops, Timolol eye drops, multivitamin, Vit. D

Current Illness: None

ID: 1238842
Sex: F
Age: 50
State: IN

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
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: penicillin, vicodin

Symptom List: Injection site pain, Pain

Symptoms: fever, chills, nausea, fatigue, body ache, swelling/lump at injection site - aches began day of vaccine, fever, chills, nausea and swelling at injection site began the following morning and lasted until morning of 04/21/2021

Other Meds: Glimepiride 2 mg metFormin HCL xR 500 mg Vitamin D 5000 IU Centrum Multivitamin

Current Illness: none

Date Died: 02/18/2021

ID: 1238843
Sex: F
Age: 88
State: MN

Vax Date: 01/23/2021
Onset Date: 02/18/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies: IV contrast

Symptom List: Injection site pain, Menorrhagia

Symptoms: per patient's family report: patient complained severe leg pain a few days before she was found dead in her apartment on 2/18./2021. It was likely she had sudden death as she did not activate her neck alert or call button in her apartment. Family request we report the incident, she was last seen on 12/15/2020 for pacemaker check, she also had medical message communication with me on 2/8 to request refill on her Percocet that she takes occ for her joint pain only at bed time. family suspect possible DVT with PE after getting more informed about vaccine side effects. however no autopsy was done.

Other Meds: levothyroxine, metformin, simvastatin, baby aspirin, gabapentin, Alendronate, multiple vitamins , calcium/vitamin D, oxycodone.

Current Illness: no acute illness

ID: 1238844
Sex: F
Age: 61
State: CT

Vax Date: 04/06/2021
Onset Date: 04/09/2021
Rec V Date: 04/21/2021
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: Sulfa

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

Symptoms: Breathkess. Cant get a deep breath heavy chest laying down

Other Meds: Losarten, norvasc, hydrochlorithiazide,vitamin D,atorvastatin, aspirin 81mg, tylenol 925mg, celebrex, lyrica, dilaudid, pantalozole, (heartburn)

Current Illness: Rt total knee replacement

ID: 1238845
Sex: F
Age: 51
State: IL

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Reported adverse effects to J&J after a horrible day/night from severe allergic reaction. We were 5 hrs from home, on a weekend, could not get vaccines in our county. Drove to County. After the 15 min when walking out of the building noticed strong metallic taste in mouth (no fillings), thought odd. Then while driving noticed red blemishes/rash on neck, swelling of my tongue. Once arrived at hotel (too far to drive back home and not feeling well), noticed red rash on front of neck, ear lobes bright red, hot to the touch and swollen. Vertigo and low fever came on along with elevated heart rate. These lasted all Saturday into Sunday. Didn't and couldn't sleep Saturday night, Sunday morning rash on face with heart rate BPM elevated all day with fever and bad vertigo. All these symptoms continued all week with exception to the rash and swollen tongue those subsided late Sunday. The vertigo, fevers, skin sensitivity and complete fatigue along with bump at injection site persisted even to today.

Other Meds: none

Current Illness: none

ID: 1238846
Sex: F
Age: 61
State: MN

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
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: Slight clough, body aches, joint pain, headache, fatigue, chills, fever 100.2, sore throat.

Other Meds: None

Current Illness: None

ID: 1238847
Sex: F
Age: 30
State: MI

Vax Date: 03/30/2021
Onset Date: 04/06/2021
Rec V Date: 04/21/2021
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: Nsaids and aspirin

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

Symptoms: Right ear tinnitus- whooshing heartbeat sound and pressure

Other Meds: Zomig 2.5mg Seasonique Vitamin d Folic acid Probiotic

Current Illness: Kidney stones

ID: 1238848
Sex: F
Age: 26
State: WI

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

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

Lab Data:

Allergies: Yes-Environmental

Symptom List: Nausea

Symptoms: Client expressed that on 4/19/2021 at 1:50 pm, received the Pfizer COVID 19 vaccine in left arm. Per Client has soreness at injection site and in Deltoid muscle area on going. On 4/21/2021 Client reports, on the left arm and hip developed a red, itchy, patchy, raised rash and applied Benadryl Gel to sites, with some improvement. Per Client, that evening on 4/21/2021, developed a new rash on right arm and right neck, so Client took antihistamine and applied Benadryl Gel to both sites. Per Client, took Ibuprofen and Tylenol for soreness in arms. Per Client no follow up with PCP for symptoms and still having mild symptoms. PHN suggested that Client follow up with PCP, continue to monitor symtoms and go to Urgent Care,

Other Meds: Yes-Sertraline, Adderall and Iron Gluconate

Current Illness: None

ID: 1238849
Sex: M
Age: 71
State: TN

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies: penicillin,sulfa

Symptom List: Injection site pain

Symptoms: Headaches getting worse every day.

Other Meds: none

Current Illness: i had cold and cough

ID: 1238850
Sex: F
Age: 46
State: CA

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/21/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: 1100.- Vaccine given, 1115- pt. felt dizzy - difficult to breathe 1118- nausea- RN with patient - 1120- B/P 198/115- HR 82- O2 Sat 99%- MD notified - 1126- B/P 187/112 - HR 80 - O2 sat 100%- M.D. with patient - eyes red- no itchy throat- no swollen throat - no swollen legs, arms, or hands- 1130- patient taken to ER via gurney, accompanied by staff

Other Meds: Tamoxifen

Current Illness:

ID: 1238851
Sex: F
Age: 17
State: DC

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/21/2021
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: ? On Friday, April 16th an individual under the age of 18 received the Moderna COVID-19 vaccine as a part of a 500-dose vaccination clinic at the vaccination site. o 17 yo female patient ? Moderna COVID-19 vaccine is indicated for ages 18 and above. The administration error was found upon review of records by the pharmacy team the evening of Friday, April 16th.

Other Meds:

Current Illness:

ID: 1238852
Sex: M
Age: 58
State: FL

Vax Date: 04/10/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
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: Tremor

Symptoms: patient stated that he noticed yesterday (4/20) that there is a lump that came up on his lower left abdomen , he felt it but didnt look at it. he drink some water and laid down . it starts going away . it was painful , on scale og 0-10 , he said the pain level was like 5.

Other Meds: n/a

Current Illness:

ID: 1238853
Sex: F
Age: 54
State: NY

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

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: I went to bed with chills and a fever came overnight. I thought that I was going to be sick and got out of bed for the toilet. After using the toilet and proceeding to wash my hands, I collapsed, hit my chin on the bathroom counter and then fell to the floor. I tried to get up again, only to fall again and hit my head in 2 places, on the tub and then the floor. I was about to fall a third time, but crawled back to bed instead.

Other Meds: Levocetirizinve dihydrochloride 5 mgs and Synthyroid 25 mcgs

Current Illness: None

ID: 1238854
Sex: F
Age: 51
State: ND

Vax Date: 03/10/2021
Onset Date: 04/03/2021
Rec V Date: 04/21/2021
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: no

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

Symptoms: Saturday, April 3, my heart rate went up and I didn't feel well. My blood pressure was a little high. I did not go into the doctor at that time. My heartrate went basically normal that night. But it was doing things like that for a few days off and on after that. Two weeks ago this Thursday, (8th) I did go to ER - my back was starting to hurt and my blood pressure was high. I was prescribed a medication for heart palpitations - Propranolol. I've taken it a couple of weeks. The heart palpitations have not gone away. I'm having them quite a bit. I have to hit the button on the Zio Patch every time I have symptoms and I've had quite a few. Note: Shingrix vaccine on April 11th, injection on my left arm; and that was dose 1 or 2 - Lot # 444M2.

Other Meds: no

Current Illness: no

ID: 1238855
Sex: M
Age: 53
State: WA

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/21/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Guest received the first dose of the Pfizer vaccine. Following this administration, the guest revealed that he had already received two complete doses of the Moderna vaccine last month. Stated that he wanted to make sure he was "really protected" from the variants. Guest stated that he felt good and was ready to go home following his 15 minute wait in observation.

Other Meds:

Current Illness:

ID: 1238856
Sex: M
Age: 43
State: WA

Vax Date: 04/08/2021
Onset Date: 04/11/2021
Rec V Date: 04/21/2021
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: amoxicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 8-10 hours of chills, body aches, and severe malaise. treated with tylenol.

Other Meds: losartan clopidogrel atorvaSTATin

Current Illness:

ID: 1238857
Sex: M
Age: 41
State: CA

Vax Date: 04/15/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
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: None

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

Symptoms: Vertigo starting on day 5 and continuing day 6. Ears ringing as well.

Other Meds: None

Current Illness: None

ID: 1238858
Sex: M
Age: 45
State: IN

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
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: N/A

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

Symptoms: Extreme pain at the injection site and upper arm. The injection site has hard knot and is a little swollen.

Other Meds: N/A

Current Illness: N/A

ID: 1238859
Sex: M
Age: 18
State: KS

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies: prior similar reaction to previous injections

Symptom List: Pain in extremity

Symptoms: Patient had syncope episode approximately 5-10 minutes after IM vaccine given- no long term adverse effect anticipated

Other Meds: Patient reported being light headed and faint, he had near syncope episode at vaccine table, he recovered within 30 minutes without adverse after effects.

Current Illness: no

ID: 1238860
Sex: F
Age: 25
State: MI

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/21/2021
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: I gave the patient her first moderna vaccine and she was a little anxious about needles but hadn't had any reactions to vaccines before. I gave her shot and she had a little blood in her band-aid so I went back into the pharmacy to get a different band-aid and cotton ball. I was only in there for 10-20 seconds but when I looked out the door the patient was sliding out of her chair onto the ground. It was only a minute or 2 after she received the vaccine. She came to pretty much right away and was a little shaken up and complained her neck hurt a little. One of the managers that came for the code white sat with her for 30 minutes until she felt ready to get up (patient was an associate that was on the clock).

Other Meds:

Current Illness:

ID: 1238861
Sex: F
Age: 73
State: NM

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 04/21/2021
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: no

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

Symptoms: Severe joint pain started about 3-4 days afeter my shot and continues until today. It is not severe as it was initially, but I have pain in both thumbs joints ( at times sore to even touch) , left shoulder, right hip, right knee, left foot joint. The vaccine appears to have aggravated places that have hurt in the past off and on from old injuries?, but never all at once. Hoping it goes away!!

Other Meds: Vitamin D2 and K2, PPQ, B's.

Current Illness: none

ID: 1238862
Sex: F
Age: 62
State: NH

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/21/2021
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: Severe migraines for 4 days. Last two day could not get out of bed. Vomiting and could not eat. Then 2 days of lower grade headaches. This has been followed with some hallucinations at night just before bedtime.

Other Meds: One a day multivitamin 65mg Feosol iron 25mg vitamin D Citracalt + D3. 12.5mg vitamin D 400mg Calcium

Current Illness:

ID: 1238863
Sex: F
Age: 35
State: PA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Large red bump under injection site. Hot to the touch. The whole area is swollen.

Other Meds: None

Current Illness: None

ID: 1238864
Sex: M
Age: 76
State: CO

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 04/21/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pulmonary embolism

Other Meds: Norvasc, Lipitor,Diovan

Current Illness: None

ID: 1238865
Sex: F
Age: 62
State: OR

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/21/2021
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: Not on file

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

Symptoms: Allergic reaction and given 50mg PO of diphenhydramine and additional monitoring and issues resolved.

Other Meds:

Current Illness: Not reported

ID: 1238866
Sex: F
Age: 41
State: MA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
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: lidocaine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 48 hours of fever, chills, malaise, headache Followed by constant dizziness, acute joint pain (knees, ankles, shoulders, and hands), brain fog, fatigue, intermittent headaches, pain in calves, backache, and locking/swollen hands - for ~8 straight days.

Other Meds: none

Current Illness: none

ID: 1238867
Sex: F
Age: 32
State: IN

Vax Date: 12/19/2020
Onset Date: 12/26/2020
Rec V Date: 04/21/2021
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: Went to ER on 12/26/20 due to change in vision in left eye (flashes and floaters). Retinal specialist did dilated eye exam and found vitreous detachment occurring. Then, on 1/2/21, lost small part of vision and returned to retinal specialist with diagnosis of retinal detachment.

Other Meds: Bupropion XL, paroxetine, Nuvaring, famotidine, calcium carbonate

Current Illness: None

ID: 1238868
Sex: M
Age: 25
State: RI

Vax Date: 04/10/2021
Onset Date: 04/17/2021
Rec V Date: 04/21/2021
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: None

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

Symptoms: Unsure if related to vaccine but timing is very suspect. I am 25 years old and in good health but developed Shingles on 4/17/2021 (diagnosed at the emergency room on 4/20). Due to the very low likelihood of shingles at the age of 25 and my good health history I figured it could be worth a submission / a data point in the event others are experiencing the same.

Other Meds: Klonopin 2mg nightly, Seroquel 25mg nightly, Venlafaxine ER 225mg daily

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm