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: 1240010
Sex: M
Age: 19
State: NJ

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Hives on my chest, neck, back and under my armpits.

Other Meds:

Current Illness:

ID: 1240011
Sex: F
Age: 56
State: CA

Vax Date: 04/06/2021
Onset Date: 04/13/2021
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: Raw garlic results in migraine.

Symptom List: Anxiety, Dyspnoea

Symptoms: One week after shot there was a consistent low faint buzzing in left ear. Ear felt a bit clogged. Buzzing is constant and has not yet resolved.

Other Meds: Vitamin C, Vitamin D3, Vitamin E, Vitamin B (twice a week) Imvexxy 10 mg (twice a week) Alendronate 70 mg ( once a week)

Current Illness: None except light depression.

ID: 1240012
Sex: F
Age: 20
State: CA

Vax Date: 04/20/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Symptoms I have felt is pain in the left arm. I have also felt fatigued and have had body aches.

Other Meds:

Current Illness:

Date Died: 04/04/2021

ID: 1240013
Sex: M
Age: 80
State: MN

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 04/21/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: not feeling well and short of breath on 2/11/21, 2/12/21 more short of breath ambulance came. Went into PEA in ambulance with CPR. They gave TPA for suspected blood clot. He initially improved. He did not recover and died 4/4/21. He spent the entire time in hospital or TCU with complications. We brought him home 4/2 to die at home.

Other Meds: chemo, acyclovir

Current Illness: multiple myeloma

ID: 1240015
Sex: F
Age: 63
State: GA

Vax Date: 04/13/2021
Onset Date: 04/15/2021
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: Latex

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

Symptoms: Redness and inflammation for 2? at injection site -> resolved in 7 days with Benadryl and Hydrocortisone cream. Chills for 1 hour - > no treatment necessary.

Other Meds: Lisinopril, ASA, Zyrtec, Vitamin D

Current Illness: none

ID: 1240016
Sex: F
Age: 39
State: PA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/21/2021
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: N/A

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

Symptoms: *First 48 hrs severe flu like symptoms- achy, stomach ache, fever, chills. *Day 3 - stomach ache *Day 4 - stomach ache, loss of feeling in hands / pins and needles / severe drop in body temperature going as low as 97 degrees / chills / chattering of teeth / freezing hands *Day 5 - stomach ache, loss of feeling in hands / pins and needles in hands and arms / pins and needles in face / freezing hands *Day 6 - stomachache, tingly hands and face, freezing / white hands *Day 7 - very mild symptoms *Day 8 - severe headache / felt like a migraine *Day 9 - severe headache / felt like a migraine

Other Meds: N/A

Current Illness: N/A

ID: 1240017
Sex: F
Age: 52
State: PA

Vax Date: 04/04/2021
Onset Date: 04/04/2021
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: Allergic to cyprofloxacin and clyndamycin - hives

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 4/4/2021 - 4/7/2021 - Low fever (99.9 degrees), but oddly only in evening and overnight; severe enough to disrupt sleep - took Tylenol 4/5/2021 - 4/14/2021 - Two canker sores appear suddenly on my bottom inside lip on the left on 4/5;extremely dry mouth; tongue is swollen and pale; feels like I have cuts on my tongue; constantly drinking water; swollen tender lymph nodes all along the left side of the neck; sores in the back left side of tongue on 4/6. Took Advil intermittently, didn't reduce swelling of either the nodes or tongue, but helped with pain. 4/5/2021 - 4/10/2021 - Fatigue, aches, and chills through these days; took nap in the afternoon on Saturday 4/10 and suddenly felt much better after 4/8/2021 - lost taste for just one day; couldn't taste sweet in the morning and then couldn't taste salty in the afternoon 4/15/2021 - 4/21/2021 - canker sores and "cuts" on tongue reducing over these days; when I look at these sores/cuts on my tongue, I can't really see any cuts or sores...just looks like little bumps or swollen taste buds 4/15/2021 - 4/18/2021 - Lymph nodes on left side of neck still swollen but no longer tender and painful 4/15/2021 - 4/19/2021 - Severe headaches that made me take two Advils every 4-6 hours. Touching hair was sensitive and coughing or sneezing really hurt. 4/19/2021 - 4/20/2021 - Number of swollen lymph nodes slowly reduced in number; not painful. 4/20/2021 - Mostly feel good. No more headaches. Tongue just had two places where it felt like it was cut. Again, can't really see anything wrong when I looked at it. 4/21/2021 - Today I was mostly good. Just only one small swollen lymph node at base of neck on left side (not painful); one "cut" on the tip of my tongue on the left (little painful).

Other Meds: Multivitamin for Women; Fish Oil; Famotidine 20mg Claritan D - 12 hour dose

Current Illness: Cold

ID: 1240018
Sex: F
Age: 40
State: GA

Vax Date: 04/13/2021
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: LA

Lab Data:

Allergies: crustaceans

Symptom List: Pharyngeal swelling

Symptoms: after a week of the first shot, still swollen and hives developed around injection site and itchy at times, lymph of the injection underarm swollen about size of penny. no other discomfort elsewhere.

Other Meds:

Current Illness:

ID: 1240019
Sex: F
Age: 38
State: OH

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Pork, turkey, red meat, egg sensitivity, hay fever,

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Severe chills, fever starting around midnight until 4am on 4/2/2021. Back pain, shoulder joint pain and neck pain. Shoulder and neck pain still persist as of 4/21/21. Headaches persist. Monthly cycle was 7 days late.

Other Meds: Losarton/hydrochlorithizide, Zyrtec, singular, vitamin c, multivitamin

Current Illness:

ID: 1240020
Sex: F
Age: 47
State: PA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
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: None. Just allergy to pollen.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 12 hours after vaccination, a really bad headache woke me up in the middle of the night. I also had fever (normally, my body temperature is below standard) and my joints hurt me. I took acetaminophen. Next morning, after light breakfast I took more acetaminophen mixed with ibuprofen and went to sleep. I kept alternating both medications every 4 to 6 hours and I got better in the next 36 hours.

Other Meds: That day and the day before I took acetaminophen for a headache. For a year now, I have taken vitamins (C, Zinc, collagen, D3). Recently, I have been taking magnesium to prevent headaches and melatonin.

Current Illness: That day and the day before I had a headache. I attributed it to the higher temperatures, bright light (very sunny) and pollen.

ID: 1240021
Sex: F
Age: 19
State: KY

Vax Date: 04/20/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Moderna Vaccine vial was removed directly from Freezer and thawed by hand at room temperature for 15 minutes then drawn up in a syringe and administered to patient.

Other Meds:

Current Illness:

ID: 1240022
Sex: F
Age: 67
State: NH

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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: codeine, dust, pollen

Symptom List: Rash, Urticaria

Symptoms: Very intense, recurring and persistent migraine-type headaches, intensity increasing for hours at a time, unaffected by sleep or wakefullness, unaffected by activity or stationary sitting; unafected by over the counter medications but somehat relieved by rizotriptan. Dose limited to two daily but entirely insufficient. Persistant, nearly constant headache has lasted for seven days following administration of the second Pfizer dose. Also, minor to significant interruptions in standing or rising balance but this was substantially worse during severe headache occurence.

Other Meds: std vitamin, metformin, doxycycline, naproxen-sodium, claritan,

Current Illness: replacement arthritic hip (7/25/2020), severe arthris of lower spine, sacroiliac joints

ID: 1240024
Sex: M
Age: 58
State: WI

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: Bee venom

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

Symptoms: Severe random headaches throughout my day every single day.

Other Meds: 10 mg warfarin daily

Current Illness: None

ID: 1240025
Sex: F
Age: 59
State: CA

Vax Date: 04/01/2021
Onset Date: 04/06/2021
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: None

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

Symptoms: I received the Johnson and Johnson vaccine (1 shot) on April 1, 2021. I felt fine for a week. A week after the shot I feel ill with a high fever, aches, and fatigue (general flu-like symptoms). I recovered, then a week later I suffered the same set back. I went to get a Covid test and it was negative. This past week I tried to resume general exercise, and I feel ill again. At this point, when I attempt to do anything physical (not overly strenuous, but light exercise) I relapse into flu-like symptoms. I am worried that I will continue to get flu-like symptoms when I try to exercise at all. I am not sure how long to remain completely at rest. It seems like 21 days should be enough. I am confused on what to do and if this fatigue and flu symptoms will continue when I try any physical activity.

Other Meds: HRT Therapy

Current Illness: None

ID: 1240026
Sex: M
Age: 57
State: IL

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: MRI - Dye Latex

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

Symptoms: Not long after leaving, I began feeling stiffness in the back of neck, similar to what I would feel prior to a migraine coming on. By the time I had arrived at the house my head was pounding. I was feeling a dizzying migraine. I have not had one of those in a while. It was also accompanied with lite nausea. I had a cup of coffee when I came home and went to bed. I was feeling so bad I had to get up and take a Sumatriptan and another cup of coffee. I laid back down for a few more hours. I awakened later, used the restroom and was feeling much better than before. Although my arm and shoulder is sore at the injection site, I?m feeling much better.

Other Meds: Gabapentin, Propranolol, Sumatriptan, Topiramate,

Current Illness: Kienbach?s Disease

ID: 1240027
Sex: F
Age: 56
State: CO

Vax Date: 04/18/2021
Onset Date: 04/18/2021
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: Contrast iodine (injected) Dermabond Benzalkonium Chloride (ophthalmic)

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

Symptoms: Tingling and numbness in left side of face and tongue

Other Meds: Cephalexin 250MG (1 capsule post-coital) Premarin cream 0.5 Gram 2x/week Rhinocort allergy nasal spray - 1 shot per nostril nightly The following every morning: Garlique - 1 a day Multi-vitamin For Her - 1 a day Vitamin C - 1000 mg per day

Current Illness: None

ID: 1240028
Sex: F
Age: 43
State: CA

Vax Date: 04/15/2021
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: none known

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

Symptoms: Raynaud's phenomenon in right hand with thumb going numb. This lasted about 30 minutes and was remedied by running hand under warm water, putting on warmer clothing and swinging arm like windmill to get blood flow back into hand. I had experienced Raynaud's previously, but that was about 20 years ago and I lived in a colder climate back then when I would experience it during the winter months. However, my fingers never went numb so the numb thumb was a new sensation.

Other Meds: none

Current Illness: none

ID: 1240029
Sex: M
Age: 61
State: NY

Vax Date: 03/11/2021
Onset Date: 03/22/2021
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: I DEVELOPED RED BLOTCHY SORES / ITCH/ 2 ON LEFT LEG/1 ON RIGHT LEG/ AFTER MORE THAN A WEEK WITH NO RELIEF, I VISITED URGENT CARE (03/29/21) / DR DIAGNOSED WITH SHINGLES. I ALSO EXPERIENCED UNEXPLAINED BACK PAIN WHICH WAS EXPLAINED TO POSSIBLY BE SHINGLES ALSO. TREATED WIT VALACYCLOVIR HCL 1 GM TABLETS FOR 10 DAYS. SORES ARE NOW DRY BUT STILL ITCHY. NOTE: I WAS VACCINATED AGAINST SHINGLES AT THE END OF 2020 ( 2 SHOT DOSE) I HAVE NOT SOUGHT FURTHER MEDICAL ATTENTION AS OF THIS DATE.

Other Meds: multi-vitamins

Current Illness: none

ID: 1240030
Sex: F
Age: 39
State: MD

Vax Date: 04/12/2021
Onset Date: 04/17/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: swollen lymph nodes

Other Meds: None

Current Illness: None

ID: 1240031
Sex: M
Age: 64
State: MD

Vax Date: 03/24/2021
Onset Date: 03/25/2021
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: Pencillin

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

Symptoms: Body aches, fever 101, loss of appetite, could not stay awake

Other Meds: Farxiga, carvedilol, zolpidem tart er, trazodone hcl, rosuvastatin, cyclobenzaprine, ropinirole hcl, lisinopril, aspirin, Humalog insUlin

Current Illness:

ID: 1240032
Sex: F
Age: 43
State: CA

Vax Date: 04/20/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Shellfish allergy

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

Symptoms: My tongue went numb, my left arm went numb, my throat tightened up, my blood pressure and heart rate went way up, I had a hard time swallowing, dry mouth, tight chest

Other Meds: Vitamins

Current Illness: Grave?s disease

ID: 1240034
Sex: M
Age: 30
State: OR

Vax Date: 04/20/2021
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 reported

Symptom List: Unevaluable event

Symptoms: patient was administered 1st dose of covid-19 pfizer 4/20/21 at 2:29 pm and was counseled to wait for 15 minutes in case of reaction. about 10 minutes later the patient began pounding on the door stating he was having a reaction and he was having difficulty breathing. I had him sit down in the counseling room. 911 was called and ems was dispatched. in the mean time store management brought him water. I asked the patient again if he was having difficulty breathing and he said no, but he felt dizzy and his heart rate was elevated. I asked him if he had any difficulty swallowing, or any swelling of the lips, tongue, mouth or throat - pt denied all symptoms. patient also denied a rash or any itching when asked. I also asked the patient if he had any nausea, which he stated he did. he continued to deny all symptoms except dizziness, and nausea when asked, and in talking to him while waiting for emt he never displayed any symptoms that would lead me to believe he was having difficulty breathing, or a true allergic reaction. when emt arrived and examined him his pulse, blood pressure and oxygen saturation was normal, and the patient stated he felt better and had a history of anxiety. patient declined to go to the hospital, waited in the pharmacy for a while longer, and had a friend come pick him up

Other Meds: none reported

Current Illness: none reported

ID: 1240035
Sex: F
Age: 32
State: WA

Vax Date: 04/12/2021
Onset Date: 04/19/2021
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: 4?x3? inch rash developed at injection site 7 days after injection. Raised and swollen, is red and warm to touch. Still present 9 days after injection. No treatment needed.

Other Meds: Probiotic

Current Illness: None

ID: 1240036
Sex: F
Age: 29
State: FL

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: Bee stings, penicillin

Symptom List: Injection site pain, Pain

Symptoms: Swollen arm, fever in arm, soreness on arm, soreness all over the body, fatigue

Other Meds: Adderall

Current Illness: N/A

ID: 1240037
Sex: F
Age: 64
State: PA

Vax Date: 04/02/2021
Onset Date: 04/04/2021
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: Cephalexin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Blood clots and blood in urine started approximately 48 hours after receiving the vaccine and lasted on and off for one week. Dr. prescribed Bactrim for 5 days.

Other Meds: Amlodipine besylate, low dose aspirin, vitamins

Current Illness: None

ID: 1240038
Sex: F
Age: 35
State: NV

Vax Date: 04/07/2021
Onset Date: 04/07/2021
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: Amoxicillin

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

Symptoms: Diarrhea for the entire evening and a bad headache for 24 hours straight, regardless of sleep or water intake. Slept a lot for two days after getting the shot.

Other Meds: Lithium, Zoloft,B-complex vitamins, Cetirizine, flaxseed oil supplement, and minocycline

Current Illness: none

ID: 1240039
Sex: F
Age: 52
State: PA

Vax Date: 02/04/2021
Onset Date: 04/08/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Increased pain and stiffness of cervical spine about 1 week following 2nd vaccine. Progressed to muscle spasms and/or contacted muscles, up back of neck, into back of head, causing headaches up the back of head. Tinnitus set in around April 7th, and continues. Nausea started on 4/12/21, and continues

Other Meds: Celebrex, omeprazole, mag, iron, vit D

Current Illness:

ID: 1240040
Sex: M
Age: 61
State: CO

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe vertigo and double vision. Ongoing since vaccination date over 1 month ago.

Other Meds: Clonidine, Losartan, Clonazepam, Amlodipine Besylate, Pramipexole, Seroquel, mult-vitamin

Current Illness: Long COVID, GERD

ID: 1240042
Sex: M
Age: 60
State: VT

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

Lab Data:

Allergies: Dexamethasone Sulfa drugs

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

Symptoms: Slight numbness in left cheek. Sensation can be described as like one had a novocain injection 3 hours earlier. It has persisted for 2 days. All functions (speech, eating, drinking, etc) are normal. No treatment.

Other Meds: Levothyroxine vitamin D B 12

Current Illness:

ID: 1240043
Sex: F
Age: 50
State: NY

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

Symptom List: Nausea

Symptoms: I am post menopausal and have not gotten my period in 2 1/2 years. I bleed heavily for 5 days after receiving the vaccine. Severe headaches

Other Meds: Levothroid Humalog

Current Illness:

ID: 1240044
Sex: M
Age: 35
State: CA

Vax Date: 04/03/2021
Onset Date: 04/14/2021
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: Injection site pain

Symptoms: Shingles developed on left side. Currently taking a 7 day course of valacyclovir to treat

Other Meds: Metformin HCL, Atorvastatin, Lisinopril, Albuterol

Current Illness: Diabetes mellitus with hyperglycemia, asthma

ID: 1240045
Sex: M
Age: 43
State: OR

Vax Date: 04/10/2021
Onset Date: 04/14/2021
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 i'm aware of

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

Symptoms: I received the shot on 4/10. First 24 hours I had a slight fever and headache. Treated with Acetaninophhen. Since that time, I had relatively mild symptoms 4/11 - 4/13. Mostly fatigue. On 4/14, I had a sudden increase in heart rate, dizziness, tingling sensation in all arms and legs and weakness in my limbs/grip. This prompted me to visit the ER. They ran numerous blood tests amd scans on me but found no abnormalities. Various unusual symptoms have continued to persist since 4/14. For brief moments I feel fine. At other times I have experience fatigue, diziness/vertigo, rapid heart rate, pins and needles feeling in my left hand and left leg. Left leg numbness/tightness and heaviness. The fingers on my left hand sometimes move involuntarily. And my anxiety has also gone up during this time. Tonight it has migratee to my left foot, where I have numbness in several of my toes. I'm looking for advice. Should I be concerned? Should these symptoms still be occurring 11 days after receiving my shot? It has been very distressing and there seem to be very few people who have knowledge on this subject. My care providers keep saying to self monitor and contact them if symptoms worsen. The problem is symptoms don't necessarily worsen, they just migrate from one area of my body to another. The numbness comes and goes in maybe 1-2 hour intervals.

Other Meds: None

Current Illness: None i'm aware of

ID: 1240047
Sex: F
Age: 31
State: WI

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin, amoxicillin

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

Symptoms: I began experiencing itching in my hands and feet in the 2-3 days after the vaccine. Around the 4th day after the vaccine, I experienced all over body itching. The itching has not subsided.

Other Meds: Dapsone and tretinoin

Current Illness:

ID: 1240048
Sex: M
Age: 45
State: MI

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Day after shot, progressively felt sicker and more sore throught the day. Had a slight fever at 4 pm. By 630 pm at a 102 fever. Very high blood sugars that I couldn't manage for the day. Night sweats and fever over night but fever broke by morning. Felt off on the third day. On the fourth day woke up with a locked neck which never happens and felt ill, tired, sore, had a cough and mild vertigo for next 4-5 days.

Other Meds: Novolog, trisiba, amlodapine, lisinipril,

Current Illness:

ID: 1240049
Sex: M
Age: 48
State: CA

Vax Date: 04/17/2021
Onset Date: 04/19/2021
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: ringing in my ear started while i was asleep. i think i woke up due to it. was difficult to get back to and stay asleep. the next day, 4/20/21, it was only noticeable when it was quiet. that night, it was very faint and didnt disturb my sleep, from 11pm to 5am. woke up with ringing at that time and was in and out of sleep til 7am. it was faint all day until about 7:30pm, now it may be as loud as it was when it started. it is 8:05pm at this time.

Other Meds: atorvastatin 20mg, vitamin D 50 mcg, ibuprofen

Current Illness: none other than mild seasonal allergy

ID: 1240051
Sex: F
Age: 46
State: AZ

Vax Date: 12/28/2020
Onset Date: 04/21/2021
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: None

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

Symptoms: On 3/17/2021, I began to have a very heavy mentrual period and it was 5 days early (which never happens). On 3/22/21 I had a nose bleed at work, which also never happens. I got home from work at an RN and took off my compression stocking and had bad petechiae all over my lower extremities and scattered throughout my body. I immediately went to the Emergency Room. My labs at the ER showed my platelets were 2000! Normal platelets are over 150,000. They admitted my for thrombocytopenia and I was hospitalized for 12 nights. I was given platelets, high doses of prednisone, IVIG infusions 8 times, rituximab infusion 4 times, bone marrow biopsy which was negative, and nplate injections. Since discharge, I have been seeing the hematology team 3 times a week at facility, labs 3 times a week, rituximab infusion every friday, nplate injection once a week. I have not been able to work since 3/22/21. My diagnosis is an autoimmune response called idiopathic thrombocytopenia.

Other Meds: Juice plus; Calicum, vitamin D, and Magnesium; Vitamin B12; Glucosamine; Fish oil; 100-300mg Gabapentin as needed at night for numbness and tingling

Current Illness: None

ID: 1240052
Sex: F
Age: 26
State: WI

Vax Date: 04/20/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Chills Severe headache Sore arm Injection site pain Muscle stiffness Tiredness Fever

Other Meds: Sertraline Propranolol Birth control

Current Illness:

ID: 1240053
Sex: F
Age: 16
State: MD

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

Lab Data:

Allergies: Allergic to amoxicillin (rash)

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pfizer-BiNTech COVID-19 Vaccine EUA: dizziness, that started the morning after the vaccine and still lasts for the 2nd day. Nausea on the morning after the vaccine. Headaches off and on.

Other Meds: N/a

Current Illness: None

ID: 1240054
Sex: F
Age: 53
State: WI

Vax Date: 04/20/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fever Chills Headache Body aches

Other Meds: Adderal Venlafaxine Klonopin Bupripon

Current Illness: None

ID: 1240055
Sex: F
Age: 30
State: AL

Vax Date: 01/20/2021
Onset Date: 01/24/2021
Rec V Date: 04/21/2021
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: Solu-medrol, Kenalog, Feraheme, Chlorahexadine, Betadine, Latex

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

Symptoms: Increased heart rate with walking, increased respiratory rate with walking in the morning. This progressed to throughout the day over the next week. Hospitalized for these symptoms, sweating, and dizziness on 03/25/21-03/27/21. High lactate levels were also present. Multiple tests for cardiac workup have been negative except for high heart rate and respiratory rate with sitting, standing, and walking but these will return to normal within a few minutes. Oxygen saturation has also been dropping as low as 74% for a few minutes after lying back down. Diagnosis of POTS was made but continued work up in progress for oxygen saturation dropping.

Other Meds: Prazosin, Luvox, Hydroxyzine, Gabapentin

Current Illness:

ID: 1240056
Sex: F
Age: 35
State: GA

Vax Date: 03/29/2021
Onset Date: 04/01/2021
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: Pain in extremity

Symptoms: Was due to get my menstrual cycle 3 days after receiving the first Pfizer dose. Still have not gotten my cycle and have received the second dose. Only time I have been late or missed a period is when I was pregnant. Am not pregnant now

Other Meds: None

Current Illness: None

ID: 1240058
Sex: F
Age: 25
State: MO

Vax Date: 04/11/2021
Onset Date: 04/12/2021
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: Tegaderm bandages

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

Symptoms: A large, painful knot developed at the site of injection on day 2 and remained for 7 days. The pain has gone away but I am left with a lump under my skin that is making my shoulder feel uncomfortable. I iced the arm for 3 days after the shot but the inflammation wouldn?t go down. It also began to itch but that has subsided.

Other Meds: Sertraline, bupropion, Emgality, L-methyl folate, vitamin D, calcium, birth control with iron, Xyzal, doxycycline

Current Illness: None

ID: 1240059
Sex: M
Age: 54
State: FL

Vax Date: 04/18/2021
Onset Date: 04/19/2021
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: None

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

Symptoms: New Onset High Ringing tinnitus in both ears equally. No treatment yet prescribed. No change or improvement by Day 3 post vaccination, shot #2 of 2.

Other Meds: None

Current Illness: None

ID: 1240060
Sex: F
Age: 27
State: IL

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: 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: Patient called pharmacy statin that she had purple discoloration and swelling between her middle and ring finger on her left hand. Vaccination was given in the left arm.

Other Meds: unknown

Current Illness:

ID: 1240061
Sex: F
Age: 33
State: TN

Vax Date: 04/20/2021
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: Penicillin

Symptom List: Vomiting

Symptoms: Large hard lump at injection site, roughly the size of an orange with pain to touch and extreme itchiness, and hot.

Other Meds: Zoloft, Allegra

Current Illness: N/A

ID: 1240062
Sex: F
Age: 29
State: CA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/21/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Chills, fatigue, muscle aches, nausea

Other Meds: none

Current Illness: none

ID: 1240121
Sex: F
Age: 55
State: ID

Vax Date: 04/08/2021
Onset Date: 04/11/2021
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: sensitivities to foods: onions, eggplant, wheat/gluten

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

Symptoms: 9 minutes after - lightheaded; 20 minutes after - lungs felt wheezy; 3 days later (4/11) - felt like respiratory illness was coming on and an ocular migraine began after dinner, around 8:15, zero sleep that night, dull head and crazy gibberish thoughts throughout night; truly thought I was having a stroke; flank pain; 4/12 - swelling, itching began on fingers; 4/14 - while seated at desk, pain upper left arm; pain and shooting pain and tingling in lower legs and calves; mild stomachache 4/12-4/14; 4/15 - fairly chilblains welts on fingers and toes, painful lesion under toe that appeared like a small blood blister; 4/16 - welts worsening; 4/19 - chilblains welts improving (much more rapidly than when I have had them after a Raynaud's attack)

Other Meds: Vitamin D (1,000 IU); Allergy supplement containing quercetin, green tea, grape seed extract, knot wood, resveratrol, grape skin extract, gingko leaf extract, maritime pine bark extract, milk thistle

Current Illness: None.

ID: 1240123
Sex: F
Age: 48
State: WV

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Accelerated heart rate, nausea, warm chest

Other Meds: None

Current Illness: UTI one week prior

ID: 1240124
Sex: F
Age: 29
State: TX

Vax Date: 04/18/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

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

Symptoms: patient experienced jolt of pain immediately upon administration down to elbow and up into jaw, described as very sharp throbbing pain level 9-10, which persisted into night, unable to sleep. Patient is taking advil, but pain level continues at level 6 and many normal movements cause sharp bouts of pain. Patient is scheduled for doctor visit but has not seen a physician at time of report.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1240125
Sex: F
Age: 54
State: IA

Vax Date: 04/05/2021
Onset Date: 04/13/2021
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: Egg whites cause indigestion

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

Symptoms: Rash around injection site. About 2? around. Expanded to 3? around. Rash cleared in the middle and a circular outline formed over 8 days and dispersed.

Other Meds: 875 mg Amox/K Clav 2x per day 100 mg Fluconazole 500 mg valacyclovir daily

Current Illness: Eye stye Oral Thrush/Lichen Planus

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm