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: 1242042
Sex: M
Age: 30
State: OH

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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: Pt received his vaccine at 1:22PM and he went to sit down and was noticed to turned light in color. Skin sweaty. Pt asked to lie down. BP 90/60, RR 18, OxSat 95% Pt remained alert, talkative, and hes color return to normal. BP 121/74, HR 68, RR 18. Pt stated he felt much better. he was asked to stand up, and he did it w/o symptoms. Pt was D/C.

Other Meds: None

Current Illness: None

ID: 1242043
Sex: F
Age: 18
State: NC

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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: n/a

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient got dizzie and light headed. Pt was seated in a chair directly in front of pharmacy. Cold pack was applied to patients chest and back of neck. Pt was monitored for about 20 minutes and she stated she felt better and left with her mother who was with her. Followed up with patient via phone approx 1 hour after administration and patient stated she was feeling fine.

Other Meds: n/a

Current Illness: n/a

ID: 1242044
Sex: F
Age: 34
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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: warm flushing, headache, itchy throat. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1242045
Sex: F
Age: 44
State: FL

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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: Patient was feeling nervous and then had a seizure. Caregiver that was with her said that she has many seizures and believes it was brought on by her nerves. Patient was fine after seizure.

Other Meds: N/A

Current Illness: Epilepsy

ID: 1242046
Sex: F
Age: 54
State: RI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: unknown

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

Symptoms: one cm mass/bump subcutaneous identified below deltoid, reported at second vaccination on 4/22/2021. patient reports reaction to skin in the shape of band-aid at site with potential reaction to band-aid in addition to 1 cm lump. Mild outline of band-aid silhouette still noticeable. no rash, no red streaking, small lump in muscle at site. patient reports hx of "thin blood that does not clot easily". requested to not use band-aid this time. held site for a minute or two and no bleeding at site in deltoid for second shot, no lump this time. appears that vaccine was provided below deltoid, laterally , just above the middle of the arm. pt states lump is getting smaller but still there 22 days later. because lump is still there, i that that the patient has not fully recovered.

Other Meds: unknown

Current Illness: unknown

ID: 1242047
Sex: F
Age: 48
State: MO

Vax Date: 04/08/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
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: ALLERGIC TO DIPYRONE AND PENICILLIN

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

Symptoms: CHILLS ,FEVER, TIRED AND RIGH NOW TODAY 22APRIL VEIN VERY INFLAMED LIKE A CORD AND IT HURTS A LOT OF TO RAISE AND LOWER MY ARM LEFT I AM VERY AFRAID THAT IT IS A THROMBUS.

Other Meds: NO

Current Illness: NO

ID: 1242048
Sex: M
Age: 18
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: SYNCOPAL EPISODE, SEIZURE ACTIVITY. Evaluated by EMS-Refusal to transport.

Other Meds:

Current Illness:

ID: 1242049
Sex: F
Age: 38
State: PR

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: No allergies

Symptom List: Pharyngeal swelling

Symptoms: A itch in the bust area, it started with 1 small Rash and today 22 it almost reaches my neck and arms.

Other Meds: Synthroid

Current Illness: Thyroid

ID: 1242050
Sex: F
Age: 62
State: NC

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
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: Jitteriness in the evening, total insomnia that night, but no fatigue the next day.

Other Meds: Escitalopram 20mg 1X/day Lamotrigine 150mg 1x/day Trazodone 50mg 1x/day Calcium supplement 1200mg Vitamin K supplement 6090mcg Probiotic Vitamin C supplement

Current Illness: None

ID: 1242051
Sex: F
Age: 22
State:

Vax Date: 04/13/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Small, splotchy, red area around the injection site. Hot to the touch. About two inches by three inches. Light red with darker red perimeter. Fading slowly over the course of the day.

Other Meds:

Current Illness:

ID: 1242052
Sex: F
Age: 61
State: IN

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: hampsters, bee, cats

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

Symptoms: 101 temp, chills, no energy, sore arm took Tyenol and rested

Other Meds: meloxicam. hydrochlorothiazide, levothyroxine, oxybutynin

Current Illness: asthma

ID: 1242053
Sex: F
Age: 43
State: CO

Vax Date: 04/16/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
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: N/A

Symptom List: Rash, Urticaria

Symptoms: First day and second day with chills, body aches Third day fine Fourth and fifth day felt little dizzy and weak Six day full vertigo. Had to go to the doctor

Other Meds: N/A

Current Illness: N/A

ID: 1242054
Sex: M
Age: 53
State: TX

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Headache Sore arm Nausea Fatigue/Tired

Other Meds: NA

Current Illness: None

ID: 1242055
Sex: F
Age: 24
State: FL

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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: n/a

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

Symptoms: Patient felt nausea and dizziness after immunization paramedics were called and cleared patient.

Other Meds: n/a

Current Illness: n/a

ID: 1242056
Sex: F
Age: 22
State: IN

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
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: N/A

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

Symptoms: Fever of 102.6 for 48 hours, no break, intense body aches, headache. All treated with Tylenol and ibuprofen, helped with aches and pains nothing helped with fever

Other Meds: Buspirone 20 mg, Amitryptyline 50 mg, Venlafaxine 150 mg, birth control, ibuprofen, apple cider vinegar tablets, Tylenol, excedrine

Current Illness: Ear infection

ID: 1242057
Sex: F
Age: 76
State: NM

Vax Date: 03/17/2021
Onset Date: 03/23/2021
Rec V Date: 04/22/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: 03/17: Got 2nd dose of Pfizer vaccine 03/23: Pain started in chest and leg 03/24: Pain forced her to go to ER where it was discovered that she had a clot in her lungs and leg. Now on Xarelto

Other Meds: metoprolol for irregular heartbeat and simvastatin for cholesterol

Current Illness: None

ID: 1242058
Sex: F
Age: 88
State: GA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 04/22/2021
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: Lisnopril and Penicillin

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

Symptoms: Inability to walk, talking and cognitive abilities declined - Same day as the shot by 7:00 pm unable to really walk. We had to wheel her on her walker.

Other Meds: Prescription: 1) Timolo Maleate Ophtalmic Soultion, USP 0.5% (2) Latanoprost Ophthalmic 0.005% Over the counter: Vitamin D-3; Calcium; and Garlic

Current Illness: None

ID: 1242060
Sex: F
Age: 58
State: PA

Vax Date: 03/11/2021
Onset Date: 04/02/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Aspirin, CT dye, Penicillin, Levaquin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: April 2, 2021 Friday morning I had a severe nose bleed. I had my son drive me to the ER. They packed my nose and sent me home. That evening around 4:00 pm it was still seeping so I went back to the ER. They didn?t want to do anything with it because they had it almost stopped. It stopped the next day. Packing stayed in all weekend until Monday morning when I returned to the ER to have it removed as per instruction. I followed up with Dr. that Thursday and he cauterized two spots in my nostril.

Other Meds: Pantoprozal, prevastatin, Invokana, Levothyroxine Sodium, Losartan Potassium Cozaar, vitamin E, Vitamin D3, Tums, Multivitamin, Metoprolol, Ester C, Jentadueto

Current Illness: None

ID: 1242061
Sex: F
Age: 63
State: MD

Vax Date: 04/09/2021
Onset Date: 04/15/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Many!

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Began Thur., 4/15/2021 --nausea,increased pain level, feeling ill, tired, weak. Began needing to nap each afternoon lasting 2-3 hours. Not finding food that would sit on stomach. Vomiting probably every other day. Headaches that feel like the top of my head was going to blow off the rest of the head. This has been going on now for 8 days, with low grade fever over the past 3 days. Called Primary Care Dr to ask if this was me or reaction to injection--she said reaction to vaccine and to rest and take small amts to not add to nausea. Try to keep hydrated. Taking Acetaminophen for fever. Trying to rest. Not driving as do not feel safe to.

Other Meds: Many!

Current Illness:

ID: 1242062
Sex: F
Age: 40
State: WI

Vax Date: 04/13/2021
Onset Date: 04/15/2021
Rec V Date: 04/22/2021
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: Tinnitus. I had a very mild case prior to last week due to side effects of migraine medications in the past; unless in absolute silence, I usually forgot I had it. The volume has increased by at least 3 or 4 times; it is now shrill and ever-present.

Other Meds: None

Current Illness: None

ID: 1242063
Sex: M
Age: 58
State: FL

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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: Upon getting second vaccine dose, patient immediately lost consciousness and appeared to be having a seizure and difficulty breathing. Patient became responsive and was talking to EMS upon their arrival. Pt then lost consciousness for second episode and EMS transported to local ER.

Other Meds:

Current Illness: None

ID: 1242064
Sex: M
Age: 32
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: After about 2 hours, I felt a pull in my shoulder which led to excruciating pain throughout my shoulder and arm. I couldn?t sleep, so I contacted a dr online at 6 in the morning. I was able to see my doctor later that day, and she said the vaccine was injection too high (in my shoulder) opposed to in the deltoid muscle. I am now taking oral steroids and have an orthopedic appointment tomorrow.

Other Meds: Vitamin D

Current Illness:

ID: 1242065
Sex: F
Age: 28
State: TX

Vax Date: 04/10/2021
Onset Date: 04/15/2021
Rec V Date: 04/22/2021
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: First shot of Pfizer COVID vaccine on Sat 4/10/2021, appx 2:15pm. Developed mild stinging and burning sensation Thurs 4/15/2021. Developed pink edematous eruption Sun 4/18/2021. Eruption became more erythematous and developed vesicles late evening Tues 4/20/2021. Started oral valacyclovir in morning of Wed 4/21/2021.

Other Meds:

Current Illness: Had COVID 12/28/2020.

ID: 1242066
Sex: F
Age: 63
State: OH

Vax Date: 03/25/2021
Onset Date: 04/04/2021
Rec V Date: 04/22/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Patient stated rash started 10 days after injection. The rash was red and 1 inch x 4-5 inches long. It was 2-3 inches lower than the injection site and went around the arm. It was slightly warm and not itchy and disappeared without any treatment 2-3 days later.

Other Meds:

Current Illness:

ID: 1242067
Sex: F
Age: 53
State: IL

Vax Date: 04/17/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: 5 days after 1st dose: tinnitus in right ear

Other Meds: Multivitamin,probiotic

Current Illness: None

ID: 1242069
Sex: F
Age: 32
State: DE

Vax Date: 04/16/2021
Onset Date: 04/18/2021
Rec V Date: 04/22/2021
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: Codeine allergy, soy

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

Symptoms: Rash began two days after injection. Red raised rash from injection site wrapping to the bicep. Hot to the touch, itchy and tender. I can wrap my hand around the rash. It's been 5 days and the rash is still visible. Not as tender or hot. Still itchy but less red.

Other Meds: Atenolol, ozempic, Zyzal, Vitamin D, Hair Skin & Nails Supplements

Current Illness: NA

ID: 1242070
Sex: F
Age: 69
State: MA

Vax Date: 03/04/2021
Onset Date: 03/28/2021
Rec V Date: 04/22/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 21 days after receiving vaccine I started to have symptoms of what was later diagnosed to be shingles. My skin was very sensitive to even wearing clothes and I thought I had bites on the back of my neck into my hairline because we had been on Nantucket. But I could not see it. I was feeling very fatigued and had pain from my left ear down my left arm and side. I did not think it could be shingles because I received the Shingrix vaccines in 2019. Finally I had my husband take a picture of it and sent it to me PCP ON 4/8/2021. She informed me it was shingles and put me on a prescription (not sure of name for 1 week). Because nerve pain in neck and ear still continues I was prescribed Gabapentin which I am still taking.

Other Meds: Methotrexate Hydroxychloroquine Mesalamine Lisinipril Levothyroxine Simvistatin Folic acid

Current Illness: None

ID: 1242071
Sex: F
Age: 34
State: UT

Vax Date: 03/17/2021
Onset Date: 03/23/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Swollen Lymph nodes in left arm 1 week later and persist 1 month later

Other Meds: Dexilant 60mg Sertraline 75mg Aurovela Fe 1/20

Current Illness:

ID: 1242072
Sex: F
Age: 68
State: ID

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 04/22/2021
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: Erythromycin

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

Symptoms: The patient had a big flare up of Lupus. She had a little flare up after the 1st dose of the Moderna shot, but after the 2nd dose she has had a larger flare up requiring 2 courses of prednison to help with the flare up. It has taken about 1 month for the flare ups to be controlled for both doses of the vaccine. She is feeling better now after getting 2 rounds of prednisone.

Other Meds: Hydroxychloriquine, Albuterol, Cymbalta, Flonase, Atrovent, and Evista

Current Illness: Asthma and Seasonal Allergies

ID: 1242073
Sex: F
Age: 18
State:

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
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: near syncope, fatigue

Other Meds:

Current Illness:

ID: 1242074
Sex: M
Age: 30
State: MO

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
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: Got fever and chills but then started vomiting non stop. Had to go to urgent care about 6 hours of vomiting and they gave me zofran and fluids and i felt better

Other Meds: Adderall

Current Illness: none

ID: 1242075
Sex: F
Age: 36
State: TN

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Codeine

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

Symptoms: Headache, fatigue - 3/15/2021-3/17/2021. Irregular menstrual cycle - period started on 3/19/2021, after only a 23 day cycle; next period started on 4/11/2021, after another 23 day cycle. Both periods were very early for me, more painful, but lighter flow. They also lasted a couple of days longer than normal.

Other Meds: Abilify, Azelastine, Claritin, Errin, Flonase, Prilosec, Propranolol, Rizatriptan, Montelukast, Spironolactone, Trelegy Ellipta, BuPROPion

Current Illness: None

ID: 1242076
Sex: M
Age: 46
State: IN

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
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: Headache, chills, body aches

Other Meds: Synthroid Aller-tec

Current Illness:

ID: 1242077
Sex: M
Age: 58
State: NC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/22/2021
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: Tremor

Symptoms: Headaches, loss of appetite, diarrhea, chills going on two weeks

Other Meds: Blood pressure medicine

Current Illness: no

ID: 1242078
Sex: F
Age: 39
State: VT

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/22/2021
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: nsaids/tylenol/tramadol

Symptom List: Erythema, Pruritus

Symptoms: first 24 hours: fever, headache, lethargy, abdominal pain, nausea, constant leg pain symptoms continued for five days, then largely subsided all returned except fever on 8th day, still continue

Other Meds: asthma inhalers: pro air, wixela (2x day), Montelukast multivitamin and calcium supplement flonase

Current Illness: none

Date Died: 03/28/2021

ID: 1242079
Sex: M
Age: 64
State:

Vax Date: 03/15/2021
Onset Date: 03/22/2021
Rec V Date: 04/22/2021
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: diarrhea. No fevers. Occasional cough. No loss of taste or smell.

Other Meds:

Current Illness:

ID: 1242080
Sex: F
Age: 60
State: TX

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/22/2021
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: Penicillin, sulfa drugs

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

Symptoms: A few hours after the shot I began experiencing vision problems in my left eye and flashing lights that were diagnosed later in the week as a torn retina.

Other Meds: Zyrtec-D, Nasonex nasal spray

Current Illness: None

ID: 1242081
Sex: F
Age: 38
State: NY

Vax Date: 03/27/2021
Onset Date: 03/29/2021
Rec V Date: 04/22/2021
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: Motrin (mild)

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Hives, started on legs radiating to torso and upper extremities.

Other Meds: Unknown

Current Illness: Unknown

ID: 1242082
Sex: M
Age: 17
State: PA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/22/2021
Hospital: Y

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: Started Saturday, April 17 around 9am with nausea, abdominal pain and vomiting bile (this started 23-24 hours after the vaccine; no other side effects). The focus of the pain was on the lower right side of his abdomen, and when he tried to stand up straight the pain increased in intensity and he felt like it was "pulling". With all the vomiting the pain spread to most of the abdomen, but after getting Zofran and resting that additional area subsided. He was evaluated at Medical Center and ultimately transferred to hospital for appendectomy on April 17 around 5pm. Appendectomy was done early morning Sunday, April 17 and he was discharged home that afternoon

Other Meds:

Current Illness:

ID: 1242083
Sex: F
Age: 63
State: FL

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
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: Allergy to poison ivy

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

Symptoms: Redness and itching at injection site, itchy rash patches on right arm and right side of torso.

Other Meds: Premarin Norethindrone Zinc Glucosamine Lotradine

Current Illness: None

ID: 1242084
Sex: F
Age: 45
State: IN

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Dairy, Gluten, Amoxicillin, Augmentin, Cephalosporins, Allergies: Hydrocodone, morphine, Mucor, penicillium, penicillin & derivatives, zithromax, ash, alternaria, aspergillus, birch, bleach, cats, ceftin, chemical inhalants, cigarette smoke, cocklebur, corn pollen curvularia, mold, dogs, racemosus, mulberry, oat trees, notatum, perfume, ragweed, raspberries, russian thistle, skunks

Symptom List: Pain in extremity

Symptoms: Fever 101.6, chills, sweating Racing heart while resting Chest tightness Congestion muscle aches dizziness weakness fatigue brain fog

Other Meds: Zolpidem, Zyrtec,

Current Illness:

ID: 1242085
Sex: M
Age: 53
State: MI

Vax Date: 03/29/2021
Onset Date: 04/03/2021
Rec V Date: 04/22/2021
Hospital: Y

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: Within 6 days of 2nd Pfizer vaccine, admitted to hospital for emergency appendectomy. I know of 1 other individual who also had emergency appendectomy 5 days after 2nd Pfizer vaccine

Other Meds: Multi vitamin, Vitamin C, D, Amino Acid, Ibuprofen, Magnesium

Current Illness:

ID: 1242086
Sex: F
Age: 19
State: TN

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: I woke up in a cold sweat in the middle of the night. I was dehydrated, I had a headache, and I nearly threw up. We later confirmed that I have a fever of 101. I've been very lethargic, as well.

Other Meds: Lamotrigine, 200mg, once daily

Current Illness:

ID: 1242087
Sex: F
Age: 57
State: NC

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/22/2021
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: Prednisone and adhesives

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

Symptoms: patient reports at 8:20am she began to feel "off balance". Staff spoke with patient for 15mins, at 8:42am her symptoms resolved.

Other Meds: ASA, dipyridamole, Gabapentin, Topimate, Baclofen, Lipitor, Diazepam

Current Illness:

ID: 1242088
Sex: F
Age: 29
State: GA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
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:

Symptom List: Vomiting

Symptoms: EE to EH for Covid Vaccine afterwards stated she was feeling nauseaus. B/p 135/87, p-116, R-20, Temp 97.8. 02 sat 98%Crackers and juice given observed for 30 minutes no emesis, EE declined further evaluaion in the ED. EE states she is ready to go back to work. VAERS report and IR completed RN

Other Meds:

Current Illness:

ID: 1242089
Sex: M
Age: 55
State: NC

Vax Date: 03/17/2021
Onset Date: 03/31/2021
Rec V Date: 04/22/2021
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: Sulfa-drug antibiotics

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Internal Vibrations (tremors)

Other Meds: Amlodipine 5mg daily, multi-vitamin, cinnamon tablets

Current Illness: None

ID: 1242090
Sex: M
Age: 48
State: WI

Vax Date: 03/31/2021
Onset Date: 04/13/2021
Rec V Date: 04/22/2021
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: NKDA

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

Symptoms: Developed symptoms of pain, redness, swelling to left anterior shin on 4/13, symptoms worsening so presented to clinic for evaluation. Has multiple varicose veins in this area.

Other Meds: cyclobenzaprine 10 mg TID prn muscle spasm

Current Illness: None

ID: 1242091
Sex: M
Age: 67
State: PA

Vax Date: 02/19/2021
Onset Date: 02/21/2021
Rec V Date: 04/22/2021
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: First shot resulted in shingles less than 2 days later. Second shot resulted in severe gastrointestinal issues-diarrhea for 2 days and nausea.

Other Meds: Anti-seizure for epilepsy

Current Illness: None

ID: 1242092
Sex: F
Age: 50
State: MD

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

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

Symptoms: Chills, body aches, fever, headache, dizziness, numbness in face

Other Meds: None

Current Illness: None

ID: 1242093
Sex: F
Age: 33
State: CA

Vax Date: 04/14/2021
Onset Date: 04/21/2021
Rec V Date: 04/22/2021
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: Hard lump and pain at injection site on day 7 after receiving first dose. Started feeling pain at the site on day 7, woke up on day 8 with a hard lump about 2 in. in diameter around injection site.

Other Meds: melatonin, ibuprofen, naproxen

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm