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: 1242094
Sex: M
Age: 58
State: CA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pain in left arm, left knee, left ankle Back spasm in left intercostal muscles Pain moderated after five days, then reoccurred at day seven, then moderated at day ten

Other Meds: Valtrex, Levothyroxin, Claratin

Current Illness:

ID: 1242095
Sex: F
Age: 36
State: NY

Vax Date: 02/26/2021
Onset Date: 03/05/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: I had my first vaccine (Moderna, V00120) on February 26. About a week after, I started feeling paresthesia, numbness in the right side of my body, specifically in the right leg and arm, and I started having difficulties walking. Since the symptoms persisted, I went to the Dr. on March 23. I told him that I thought my symptom were out of the blue and I linked them to the vaccine, so I was visiting him to see if I should put my second vaccine in those circumstances, few days after. Doctor said that there was no relation between nerve damage and the vaccine and he recommended me to put it. He sent me test thinking that could be multiple esclerosis. I did my brain MRI on Thursday 25 and on Friday March 26 I put my second dose. About a week after the second dose my symptoms were dramatically aggravated. I first started experiencing a sudden fatigue that didn't even allow me to hold the cellphone or a spoon and I had to lie down. I couldn't hold my 8 months daughter because I felt such a strong weakness. This fatigue didn't allow me to work. This happened few days in a raw for few hours. On April 8th I started to feel needles and strong neuropathic pain that I had never experience in my whole life. On April 9th in the evening I had a massive crisis. I started to feel a sudden having a lot of cold, starting shivering and then chattering teeth and strong headache. (Same reaction I had 12 hours after putting the second dose of the vaccine). I had to lie down in bed and my husband had to cover me with a jumper and eiderdown, but I still was cold. I couldn't stop shivering. Then I had difficulty swallowing. And the worst part started when I felt all over my body an intense pins and needles, burning, electricity, very profoundly and spread all over in a very intense way., I thought I was dying. I started panicking, I didn't have control over my body. I had difficulty breathing and such a weakness that didn't make me speak because I couldn't stop chattering my teeth. Was the worst life experience ever until that moment. The situation lasted about 90 minutes and then went away. The next day, Sunday April 10th, I spent the whole day in bed to rest, but at night time I experienced the same crisis as the night before. It started with the sudden cold as well. After that I didn't have more crises but the pins and needles pain remains and it made it difficult to sleep because of the pain and discomfort and I wonder if I would have it my entire life. I returned to the doctor. To a different one specialized in multiple esclerosis. Brain MRI came out negative but it was done one day before the second dose, so we cannot be sure. I did 3 MRI of my whole spine and some muscular tests to check the response of the nerves. They also took 8 tubes of blood. We are waiting for the results but doctor think is Guillain Barrel syndrome. She thinks I am suffering peripheral neuropathy.

Other Meds:

Current Illness:

ID: 1242096
Sex: F
Age: 63
State: IN

Vax Date: 04/17/2021
Onset Date: 04/18/2021
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: shellfish, latex, metals

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

Symptoms: Sunday morning woke up feeling slight weak, did my routine Sunday walk, later noticed chest feeling like a lump was in the middle, thought it was gas and drank a small coke. Later my chest felt more painful especially while lying down on my stomach. I felt it would eventually go away. It was feeling less painful on Tuesday and Wednesday of this week. However, I decided to do stomach crunches this morning and my chest area (mail middle and slightly towards the right) felt very painful afterwards making it difficult for me to bend forward to get dressed and put my shoes on. It seems like it's taking my breath away when experiencing the pain.

Other Meds: HCTZ 12.5 mg daily; Spiralactone 12.5 mg daily, Atorvastatin 20 mg qhs, Multi vitamin, Vit C, Fish oil, Timolol eye drop BID each eye

Current Illness: n/a

ID: 1242097
Sex: F
Age: 42
State: MO

Vax Date: 03/15/2021
Onset Date: 03/19/2021
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: Skin irritation of face, mostly around eyes and eyelids. Dry, itchy and scaly eyelids, similar to eczema, and eventual swelling. I believe the side effect (my immune response) is connected to the vaccine because I had the exact same skin issues arise about two weeks after a positive COVID test (mid Sept 2020). The symptoms lasted a little over two months (early January 2021) after COVID.

Other Meds: None.

Current Illness: None.

ID: 1242098
Sex: M
Age: 28
State: MD

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: None

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

Symptoms: Pt contacted health clinic on Apr 22 at approximately 0900 stating he was experiencing numbness and tingling in his right arm/hand, no other symptoms/side effects stated. Pt indicated that symptoms started yesterday morning, Apr 21 and got worse this morning when he woke up which prompted him to contact the clinic. Pt was instructed to f/u at urgent care/er to rule out other medical conditions.

Other Meds: Descovy, mucinex

Current Illness: None

ID: 1242099
Sex: M
Age: 59
State: LA

Vax Date: 04/20/2021
Onset Date: 04/21/2021
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: none

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

Symptoms: Minor swelling and itching of my left hand and wrist, the bottom of my feet, and my lower lip, including numbness of the latter.

Other Meds: none

Current Illness: none

ID: 1242100
Sex: F
Age: 31
State: IL

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

Lab Data:

Allergies: NA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I started my period early (13 days since the start of my last period). I know it could be stress but 13 days is too short of a cycle. I'm not sure yet if it was heavy spotting for the one day or if it's going to keep going. It seemed like day one of my cycle last night but it's light again this morning. I don't normally have spotting at all.

Other Meds: Sertraline

Current Illness: NA

ID: 1242101
Sex: F
Age: 42
State: OH

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: Demerol and Neosporin

Symptom List: Pharyngeal swelling

Symptoms: With the first Pfizer dose on 02/16/21, I experienced immediate pain at the injection site. This pain increased and became increasingly severe and extremely intense within 5 hours of the vaccine. At that time other symptoms began to develop, including a very severe headache (crown/back of head), swollen glands and stiff neck, rapid heartrate, shortness of breath. These symptoms lasted at an intense level for 2 days, and at a moderate level for a total of 14 days (last symptoms were observed on 02/23/2021). Please also note that I started my period that month on 02/17/2021. My second Pfizer dose was on 03/9/2021, 1:40pm. (COVID19 Pfizer~BioNTech, Lot EN6205, intramuscular, left arm). I experienced mild pain at the injection site within 5 hours of the vaccine. 24 hours after the second dose I began to develop moderate/severe symptoms including headache (crown/back of head), swollen glands and stiff neck, rapid heartrate, shortness of breath. These symptoms lasted at a moderate level for a total of 14 days (last symptoms were observed on 03/23/2021. Please note that I started my period that month on 03/17/2021. This month I started my period 2 days later than usual on 04/14/2021. In addition to my regular menstrual symptoms (including migraine temporal headache and mild cramps), I experienced additional symptoms starting on 04/15/2021. These included moderate/severe headache (crown/back of head), swollen glands and stiff neck, rapid heartrate, and shortness of breath. These symptoms are still present at a moderate level today, 04/22/2021.

Other Meds:

Current Illness: no illness, but started my period on 02/17/2021, 03/16/2021, and 04/14/2021

ID: 1242102
Sex: M
Age: 33
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, Amoxycillin, and Warfarin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Red, circular rash at injection site - slightly warm to touch, irritated/puffy skin, slightly itchy and about 3-4 inch diameter

Other Meds: 1. Eliquis 5mg tablet twice daily 2. Daily men's multivitamin 3. Aspirin 80mg once daily

Current Illness:

ID: 1242103
Sex: F
Age: 47
State: CT

Vax Date: 04/02/2021
Onset Date: 04/06/2021
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: 4 days after my first pfizer shot I began experiencing pain and weakness in my hips and legs. I was feeling fine during the day, normal exercise, and by nighttime I couldn't walk down my stairs and it has persisted ever since. It's pain and discomfort in the front of my hips and down my legs causing weakness - walking is very difficult. I have about 30% leg strength.

Other Meds: evening primrose oil

Current Illness: Residual tension from a flu vaccination I got in November 2020, but mostly healed from severe symptoms.

ID: 1242104
Sex: F
Age: 24
State: NY

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: Acetaminophen, resin

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

Symptoms: Pain at injection site (48+ hours, onset 2 hours after injection) Muscle aches (28 hours, onset 6 hours after injection) Headache (18 hours, onset 8 hours after injection) Fever fluctuating between 99.9 and 101.4 (18 hours, onset 11 hours after injection)

Other Meds: Norethindrone - 0.25mg Sertraline - 50mg Omeprazole - 20 mg Meloxicam - 15mg Fludrocortisone - 30mg Amitryptaline - 25mg

Current Illness: N/A

ID: 1242105
Sex: F
Age: 37
State: TN

Vax Date: 04/13/2021
Onset Date: 04/13/2021
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: Codeine

Symptom List: Rash, Urticaria

Symptoms: Systemic itchiness - no rash, but I was very itchy all over my body for 2 days following the injection Left eye burning sensation intermittently for 2 days following the injection

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

Current Illness: None

ID: 1242106
Sex: F
Age: 57
State: CA

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: LA

Lab Data:

Allergies: None

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

Symptoms: Vomiting & chills. 4 hours continuous, very intense vomiting from 2am to 6am. Chills lasted 24 hours.

Other Meds: None

Current Illness: None

ID: 1242107
Sex: F
Age: 43
State: NC

Vax Date: 04/01/2021
Onset Date: 04/07/2021
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: Sulfa, Tylenol, amoxicillin

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

Symptoms: Within hours started having a seizure. I went on to have seizures for 8 days straight, often time having several seizures per day. Posturing, memory loss. Had a CRPS flare for several days after the shot. Hands were swollen and were red and purple looking, I broke out in hives around my jaw line.

Other Meds: Morphine Sulphate 100mg ER, oxycodone 30mh IR, gabapentin 300mg

Current Illness: None

ID: 1242108
Sex: M
Age: 35
State: FL

Vax Date: 04/12/2021
Onset Date: 04/19/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Starting at 48 hours after the shot, I began having severe flu symptoms - fever, sore throat, congestion, painful cough. Then, starting at 1 week after the shot, a severe rash started. I have red, raised, hive-like rash all over my body. It started in both arms and has spread to my back, stomach, chest, legs. It has gotten worse each of the last 3 days (including today). It is a bit painful and fairly itchy.

Other Meds:

Current Illness:

ID: 1242109
Sex: F
Age: 50
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Chills, joint aches, and body aches

Other Meds: Thyroid medicine

Current Illness:

ID: 1242110
Sex: M
Age: 41
State: PA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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: Tramadol

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

Symptoms: Tinnitus in both ears one day after first injection of Pfizer Covid vaccine.

Other Meds: Gabapentin 600mg 3x/day Amitriptyline 1x/day

Current Illness: None

ID: 1242111
Sex: F
Age: 54
State: VA

Vax Date: 02/19/2021
Onset Date: 03/26/2021
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: n/a

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Shingles - started with extreme pain in left neck, shoulder, arm, wrist, hand; skin painful to touch; rash developed within 5 days - relatively minor with dry skin, blisters on left shoulder, forearm, and hand/fingers. Extreme fatigue. Symptoms lasted so far for 3.5 weeks.

Other Meds: Lexapro 20mg; Wellbutrin XL 300mg; Mirapex .125mg x3; Ginkgo Biloba 120mg; Ocuvite; Collagen; Multivitamin; Melatonin 5mg; Magnesium Citrate 325mg

Current Illness: n/a

ID: 1242112
Sex: F
Age: 33
State: NH

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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: Laytex and penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pain & soreness at injection sight extending from neck/shoulder to elbow, full body muscle aches, headache, nausea & vomiting, fever of 101.9- fever and nausea subsided by next morning (within 12 hours).

Other Meds: Multivitamin

Current Illness:

ID: 1242113
Sex: M
Age: 33
State: OH

Vax Date: 04/18/2021
Onset Date: 04/18/2021
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: Patient said that he had not received a covid vaccine previously. After we contacted him in subsequent days to solve insurance billing issues, he reported that he received the J&J vaccine on 3/8/21

Other Meds: n/A

Current Illness: none

ID: 1242114
Sex: M
Age: 32
State: IN

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: Fever dizziness pounding headache body aches, weak lethargic

Other Meds: Tylenol

Current Illness: None

ID: 1242115
Sex: F
Age: 35
State: MA

Vax Date: 02/26/2021
Onset Date: 03/03/2021
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: Doxycycylene/Mynocyclene = Vertigo

Symptom List: Unevaluable event

Symptoms: 11 days after initial vaccination Patient (Self) experienced a delayed, local, topical skin reaction (large, swollen red splotch measuring 11cm tall by 8 cm wide ). Reaction included itchiness and irritation and lasted for 48 hours, decreasing in size as time went on, before completely disappearing. This reaction did not reoccur after the second dose in the series (administered 3/26/2021). First pregnancy, due 06/27/2021

Other Meds: Prenatal vitamins

Current Illness:

ID: 1242116
Sex: F
Age: 23
State: IN

Vax Date: 04/20/2021
Onset Date: 04/21/2021
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: Penicillin, Peanut

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

Symptoms: Was completely fine the first day, only experienced soreness in right arm where i had got the shot. The next day I noticed my body was achy, nothing too terrible, but there was some discomfort as well as feeling like my energy was completely depleted. By the evening the aches became terrible and I had also had chills badly. I had at some dinner, was fine at the time, woke up mid night and was extremely nauseous and ended up throwing up. By the middle of the night I had woke up completely drenched in sweat. Next day after I am fine, but still slightly achy.

Other Meds: Blood Pressure Medicine

Current Illness: N/A

Date Died: 04/16/2021

ID: 1242117
Sex: M
Age: 33
State: CO

Vax Date: 04/09/2021
Onset Date: 04/16/2021
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: Healthy male, no substance use, no symptoms reported made plans to go hiking with a friend the following Sunday (4/18/21) on 4/16/2021 in afternoon. This was last known contact, patient stopped responding to phone after text and was found deceased in home on 4/22/2021, appearing to have passed away in sleep, likely 4/16/2021 in evening.

Other Meds:

Current Illness:

Date Died: 04/09/2021

ID: 1242118
Sex: F
Age: 77
State: NJ

Vax Date: 03/13/2021
Onset Date: 03/26/2021
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: Iodine, penicillin (no reactions listed for either)

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient presented after being found down next to toilet found to have COVID-pneumonia and sepsis needing intubation for ARDS and CRRT for hyperkalemia and oliguria. Hospitalization complicated by GIB s/p rectal artery embolization by IR and GNR bacteremia requiring cefepime. Due to worsening hypoxia and shock, patient was made comfort care/hospice by family and passed away on 4/9.

Other Meds: aspirin EC 81 mg daily, metformin ER 500 mg BID, atorvastatin 40 mg daily

Current Illness: fall/trauma with rib fractures

ID: 1242119
Sex: F
Age: 77
State: FL

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

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

Lab Data:

Allergies: none known

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

Symptoms: Ischemic Stroke on 4/15/2021; Extensive and closely adjoining foci of acute infarction in left, extending from parietal operculum through insula and external capsule to eat ependymal margin of left lateral ventricle;

Other Meds: Amlodipine Besylate 10 mg; Atenolol 25 mg Baby Aspirin Gemfibrozil 600 mg Hydroxychloroquine 200mg Paroxetine 20 mg Simvastatin 20 mg Triamterene HCTZ 37.5-25mg Leflunomide 10mg Lorazepam .5mg Ropinirole 1 mg

Current Illness: none

ID: 1242120
Sex: F
Age: 59
State: WA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/22/2021
Hospital: Y

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: Closed windpipe, unable to breath. Hospitalized for 11 days

Other Meds: None

Current Illness: None

ID: 1242121
Sex: M
Age: 35
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe migraine for 2 days

Other Meds: None

Current Illness: None

ID: 1242122
Sex: M
Age: 38
State: NC

Vax Date: 03/18/2021
Onset Date: 03/19/2021
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: Gadobenate Dimeglumine

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

Symptoms: Vivid dreams/nightmares first couple of days, disrupted sleep/dreams continuing through Day 35 post vaccine (possibly some hypnagogic hallucinations) Fever of approx 100 degrees for 1 day Sore arm for a couple of days Fatigue for a couple of days

Other Meds: Tylenol

Current Illness: None

ID: 1242123
Sex: F
Age: 36
State: IL

Vax Date: 04/16/2021
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: NA

Symptom List: Nausea

Symptoms: Low grade fever and chills that lasted approximately 14 hours. Muscle aches and weakness and extreme fatigue that lasted approximately 36 hours. Confusion/foggy brain started at time of other symptoms, still present one week after vaccination, also present is slight fatigue.

Other Meds: Norco 2 times daily

Current Illness:

ID: 1242124
Sex: F
Age: 54
State: PA

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

Symptom List: Injection site pain

Symptoms: Sudden chest pain with exercise - exercise daily and never had this before. Pain increased in intensity with exercise for over a week. Stopped exercise when pain appeared. Pain subsided within 30 - 45 minutes after stopping.

Other Meds: Multi Vitamin

Current Illness: None

ID: 1242126
Sex: F
Age: 72
State: UT

Vax Date: 02/21/2021
Onset Date: 03/29/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Right side of face inflamed with raised areas of irritation, noted blisters on face and inside mouth, enlarged lymph nodes Diagnosed as Shingles Treated with antiviral medication (Variflex?) and ibuprofen time course approximately 3 weeks

Other Meds:

Current Illness:

ID: 1242127
Sex: F
Age: 58
State: OH

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: nka

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

Symptoms: pt says she started getting a sore arm a couple of hours after taking the vax. She has headache and fatigue. Within in a couple of hours after getting into her shift at work after going back to work on 4/19/21 she started having throbbing left arm pain. she said the pain was shooting down from her shoulder to her fingertips. She went to her doctor on 4/20/2021 and she was told she had developed tendonitis from getting the vax. She was prescribed naproxen and was told to apply heat. The heat seems to help but once removed the pain comes back. naproxen has not helped much for the pain and she has to be careful taking ibuprofen and other pain meds due to her fatty liver. She is going to request FMLA papers to fill out to try to be able to take off from work to give her arm time to heal and recover from taking the vax.

Other Meds: Centrum, Biotin, Cranberry extract, calcium + D, valsartan, Tizanidine,

Current Illness:

ID: 1242128
Sex: F
Age: 38
State: MI

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

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: Patient walked to observation area and within 5 minutes fainted while sitting in a chair, hit her head on a shelf and immediately came to. She began to sit up and looked gray. She said that she didn't eat or drink anything the day of the vaccination. We had her lay down for 15-20 minutes, gave her some juice, a granola bar, water and some ice packs.

Other Meds: none

Current Illness: none

ID: 1242129
Sex: F
Age: 34
State: VA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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: Bactrim

Symptom List: Erythema, Pruritus

Symptoms: 18 hours after injection, began feeling joint and muscle aches. At about 19 hours post-injection, the aches became nearly unbearable and remained this way until about 36 hours post-injection. Also around 19 hours post-injection, became severely nauseous and vomited, almost fainted. Vomited a second time over the course of the symptoms, frequent bouts of mild to severe nausea. Severe headache. Severe fatigue throughout symptoms. Joint/muscle aches moved from all over to focus on hips, then neck and shoulders where patient has chronic pain, then middle back. Fever began at about 19 hours at 100.6; highest recorded at 101.7 around 24-28 hours, declined to 99.1 by 36 hours, no fever by about 40 hours. Full recovery from bouts of nausea, headache, lack of appetite, mild to severe fatigue, general malaise did not occur until approximately six (6) days after injection.

Other Meds: Albuterol, Escitalopram 20 mg, Symbicort, Alprazolam .5 mg, Azelastine, Bupropion 75 mg

Current Illness: N/A

ID: 1242130
Sex: F
Age: 42
State: MO

Vax Date: 04/12/2021
Onset Date: 04/18/2021
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: None.

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

Symptoms: Skin irritation on face, head, and eyelids consisting of dry, scaly, itchy patches. Eyelids red, itchy and swollen (mostly right eye). Scaly and itchiness progressed to scalp. The issues began 5 days after the first dose, and progressed to much worse about 6-7 days after the 2nd dose. I had the same issues occur after being diagnosed with COVID in mid-September 2020, and that is why I'm connecting this immune response to the vaccine. During the two (plus) months I had these issues after COVID, the only real relief occurred while temporarily taking a steroid.

Other Meds: None.

Current Illness: None.

ID: 1242131
Sex: F
Age: 63
State: FL

Vax Date: 04/02/2021
Onset Date: 04/07/2021
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: Aloe vera Iodine

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

Symptoms: Rash with red spots on the lower legs, itchy. started 5 days after vaccination. starting to self resolve now with purpura that are fading.

Other Meds: Duloxetine 60 mg capsules fluticasone 100 c/actuation blister powder for inhalation omeprazole 40 mg daily synthroid 50 mcg vitamin D3 1000 U capsules metoprolol succinate ER 25 mg tablet daily

Current Illness: none

ID: 1242132
Sex: F
Age: 29
State: NC

Vax Date: 04/06/2021
Onset Date: 04/08/2021
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: None known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Spotting, bleeding, clotting, and cramping not associated with a regular menstrual period, lasting for two weeks.

Other Meds: Junel 10 mg (birth control)

Current Illness: None.

ID: 1242133
Sex: M
Age: 31
State: IN

Vax Date: 04/14/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Baseball sized, red rash around injection site 8 days after injection. The rash doesn't itch or hurt in any way, just visibly noticable.

Other Meds: None

Current Illness: None

ID: 1242134
Sex: F
Age: 46
State: AZ

Vax Date: 04/20/2021
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: Slight allergy to eggs

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

Symptoms: Very sore, aching arm. So bad it woke me up the first night. Next day, all over body aches, lethargy, some nausea. Fever of 101. Stayed home, went to bed. Day three, left arm still aches, I'm still tired.

Other Meds: Flonase for allergies

Current Illness: None

ID: 1242135
Sex: M
Age: 63
State: NC

Vax Date: 04/09/2021
Onset Date: 04/12/2021
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: Pain in extremity

Symptoms: patient stated his daughter found him ?unconscious and he was rushed to the hospital, he stated he still has facial paralysis and is experiencing difficulty eating?. I attempted to contact patient and voicemail was full. Alternate number was given and wife answered the phone. interpreter use during call. Wife reported her experience with vaccine and reported husbands as well. States, her husband is at work and cannot talk on the phone, he may be home late?. Wife states her husband received Pfizer vaccine on a Friday 4/9 and then woke the following Monday with a ?crooked mouth, migraine headaches, very sleepy and heavy arm?. Wife states he did not loss consciousness but was take the Hospital on Monday 4/12/21 and was not given an answer to what was wrong with him. Advised wife I cannot share any medical information about her husband with her, that he could return my call.

Other Meds: Unknown

Current Illness: Diabetes, high blood pressure, high cholesterol per wife

ID: 1242136
Sex: F
Age: 53
State: MA

Vax Date: 04/08/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: none

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

Symptoms: initial side effects chills, achy, fatigue lasting approximately 48 hours. 4/8-4/10/2021 startled awake from sleep with feeling of vomit in throat that was gagging me that I was able to swallow back down. the nauseous wasn't going away so went to bathroom and vomited around 12am Thursday 4/22/2021 for about 15 minutes, woke up with rash on my face and neck

Other Meds: advil

Current Illness: none

ID: 1242137
Sex: F
Age: 70
State: MN

Vax Date: 02/17/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
Hospital: Y

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 known

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

Symptoms: Completed COVID vaccine series on 02/17/2021; tested positive for COVID 04/21/2021

Other Meds:

Current Illness:

ID: 1242138
Sex: M
Age: 43
State: DE

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: Ceclor

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

Symptoms: Moderna COVID-19 Vaccine Nausea, Diarrhea, Muscle Aches and Tightness, Fatigue, Flush/Low Grade Temperature, Pain in Neck and Joints

Other Meds: Omeprezole

Current Illness: COVID-19 in Jan 2021

ID: 1242139
Sex: M
Age: 58
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Chills,fever,body aches,headache,and nausea,,sweating

Other Meds:

Current Illness:

ID: 1242140
Sex: M
Age: 53
State: MO

Vax Date: 04/05/2021
Onset Date: 04/08/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Mild Vertigo/dizziness tilting head back or standing up quickly. Started 3 days after 2nd shot. Continues through today

Other Meds: Musinex, cialis, naproxen

Current Illness:

ID: 1242141
Sex: M
Age: 72
State: FL

Vax Date: 04/06/2021
Onset Date: 04/18/2021
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: penicillin

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

Symptoms: Acute gastro intestinal cramps for 12-18 hours Joint pain in kidney, bank and left hip joints Both reactions were acute on the first day experienced then on more modest basis 2 days later

Other Meds: Atorvastatin, Lisiniprol and CERC as medications Vitamins B-12, C, D-3, CO Q 10, K, Multivitamin, Pectasol_-C , Glucosomine-Chrondritin, probiotic

Current Illness: None

ID: 1242142
Sex: F
Age: 25
State: NY

Vax Date: 04/19/2021
Onset Date: 04/21/2021
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: Rash all over body swollen face swollen lip can?t feel face

Other Meds: None

Current Illness: None

ID: 1242143
Sex: M
Age: 61
State: MD

Vax Date: 04/20/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Superficial thrombophlebitis of the left lower extremity over the medial calf.

Other Meds:

Current Illness:

ID: 1242144
Sex: F
Age: 59
State: MO

Vax Date: 04/01/2021
Onset Date: 04/08/2021
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: right arm intermittent numbness and tingling down to them, index and middle finger

Other Meds: estradiol .5 mg daily

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm