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: 1248085
Sex: F
Age: 52
State: CA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
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: Penicillin, Iodine

Symptom List: Dysphagia, Epiglottitis

Symptoms: Intense headache that began the morning after the vaccine injection and has been continual, still persisting as of today, day 16 after the vaccine injection.

Other Meds: None

Current Illness: None

Date Died: 04/20/2021

ID: 1248086
Sex: M
Age: 40
State: CO

Vax Date: 02/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/23/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: lamotrigine, rifampin, tramadol

Symptom List: Anxiety, Dyspnoea

Symptoms: Moderna COVID-19 Vaccine EUA: patient underwent L1-2 corpectomy, pedicle subtraction osteotomy, and extension of fusion from T4 to the pelvis two months after vaccination. During surgery patient became thrombocytopenic and required massive transfusion. Thirteen days after surgery found to have bilateral pulmonary embolisms and deep vein thromboses and placed on anticoagulation. Patient subsequently suffered cardiac arrest and was unable to be resuscitated.

Other Meds: amoxicillin, apple cider vinegar, Excedrin migraine, atorvastatin, chlorthalidone, vitamin D3, cyclobenzaprine, doxycycline, escitalopram, ferrous sulfate, gabapentin, ginseng, ibuprofen, lisinopril, loratadine, potassium, teriparatide, Tob

Current Illness: progressive lower extremity paresthesias/myelopathies and gait/balance abnormalities, severe T11-12 stenosis (thoracic decompression 3/30/21)

ID: 1248087
Sex: F
Age: 39
State: TX

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/23/2021
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: Adhesive

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

Symptoms: Fever - broke fever Wednesday, April 14th around 3:00 PM CST Body Aches - April 12th - Sunday April 18th Chills - April 12th - April 14th Fatigue - April 12th - current Stomach Pain - April 12th - April 18th Migraines - Both sides of my head - April 12th - currently - went to hospital on April 15th High Blood Pressure - April 12th - current - went to hospital April 15th - Called cardiologist, increased my blood pressure meds to twice a day on April 19th.

Other Meds: Allegra D 24 hours Omeprazole DR 40 MG Capsule Trazodone 50 MG Tablet Zolpidem Tartrate 10 MG Tablet Alprazolam ER 0.5 MG Tablet Escitalopram 10 MG Tablet Lisinopril 20 MG Tablet Dicyclomine 10 MG Capsule Amphetamine Salts 10 MG Tablet

Current Illness: Depression, High Blood Pressure, Anxiety

ID: 1248088
Sex: F
Age: 37
State: OH

Vax Date: 03/18/2021
Onset Date: 03/26/2021
Rec V Date: 04/23/2021
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: Vaginal HSV-1 primary outbreak and left buttock Shingles outbreak with corresponding dermatome neuralgia

Other Meds: none

Current Illness: none

ID: 1248089
Sex: M
Age: 50
State: NY

Vax Date: 04/08/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
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: Back pain, severe leg pain (muscle pain) , patient wobbles when he walks. Lethargy.

Other Meds: Multivitamin

Current Illness: None

ID: 1248090
Sex: F
Age: 24
State: ID

Vax Date: 03/26/2021
Onset Date: 04/05/2021
Rec V Date: 04/23/2021
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: Tree nuts

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

Symptoms: When the patient returned for her second vaccine dose she reported an ASE and she has not filed a report. The patient reported that about 10 days after receiving her first Moderna COVID-19 vaccine her left deltoid suddenly had a rash develop overnight. The rash covered her left deltoid and upper arm, the rash did not spread down to her left elbow. The patient reported the symptoms were mild and denied itching or pain. Patient stated that symptoms resolved within 24 hours after first developing.

Other Meds: none

Current Illness: none

ID: 1248091
Sex: M
Age: 90
State: OH

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/23/2021
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: Soreness of left arm after injection 3/26/21 at injection site. Sore to touch. Sore to use. Sore to bear weight on. Was NOT sore before injection. Has remained sore to this date. 4/23/21. Muscle fatigue and mild pain in right knee 2 weeks (noted by patient and by physical therapist) after injection to this date (4/23/21). No known reason for muscle fatigue but fatigue causing right knee to collapse while upright and weight bearing.

Other Meds:

Current Illness:

ID: 1248092
Sex: F
Age: 21
State:

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Pharyngeal swelling

Symptoms: Symptoms: Decreased mobility in right arm, arm pain, fever, chills, body aches, joint pain, extreme fatigue, migraine, head pain to the touch, abdominal discomfort. Treatment: Tylenol extra- strength and fluids Time course: 5:00pm (4/20/21)- 1:30pm (4/21/21)

Other Meds: Blisovi Fe 1/20 (Birth control)

Current Illness: NA

ID: 1248094
Sex: F
Age: 72
State: FL

Vax Date: 12/17/2020
Onset Date: 12/19/2020
Rec V Date: 04/23/2021
Hospital: Y

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

Lab Data:

Allergies: None noted

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient reported that she was hospitalized for COVID-19 pneumonia (for 14 days total). She received dose #1 on 12/17/20 and was hospitalized 2 days later. (unable to access these records). Reporting per EUA requirements; unknown if this was reported by the facility where she was hospitalized.

Other Meds: Losartan 100 mg/HCTZ 25 mg PO, omeprazole 20 mg PO daily, letrozole (dose unknown)

Current Illness: Patient reported being diagnosed with shingles on 11/26/20

ID: 1248095
Sex: M
Age: 19
State: CT

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
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: Pt c/o discomfort in both calves; tingling in hands and feet; "hot feet" since receiving Moderna vaccine 1 week ago. Nothing abnormal noted on exam.

Other Meds:

Current Illness:

ID: 1248096
Sex: F
Age: 50
State: NH

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 04/23/2021
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: After her first Moderna COVID vaccine administration she had flushing, gastrointestinal ( ie abdominal cramping, diarrhea) and urinary symptoms. The patient reported this via VAERS in Feb 2021. After her second Moderna COVID vaccine administration, she developed muscle spasms, joint pain, dizziness and brain fog. Her symptoms have persisted over one month after administration of the vaccine. She has had multiple ER treatments for evaluation of her symptoms. She suspects she is having mast cell activation syndrome.

Other Meds:

Current Illness: Obesity

ID: 1248097
Sex: F
Age: 59
State: MD

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: iodine contrast media, iodine, bentyl, compazine, reglan, sulfa prednisone

Symptom List: Rash, Urticaria

Symptoms: wheezing, dizziness, lightheadedness, fatigue, GI distress, hoarseness, Stridor, muscle/joint aches, skin redness/rash, nausea, vomiting, flushed skin, blurred vision

Other Meds: asa 81mg, lipitor, tegretol, vitamin D2, erythromycin, lamictal, synthroid, linzess, zofran, protonix, mestinon, xifaxan, gas-x

Current Illness: allergic reaction, anaphylaxis to IV dye and hospitalized

ID: 1248098
Sex: F
Age: 31
State: TX

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Cephalosporin, kiwi, strawberries

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

Symptoms: Headache, dizziness, cold chills, fever

Other Meds: Postnatal vitamin

Current Illness: N/A

ID: 1248099
Sex: F
Age: 17
State: CA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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:

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

Symptoms: Fainted, BP 89/59, O2 sat 99%. Patient fell and hit her head under the chin. Patient has a history of low BP with shots. Sent to ED.

Other Meds:

Current Illness:

ID: 1248100
Sex: M
Age: 50
State: CA

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

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

Lab Data:

Allergies: None

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

Symptoms: Woke up next morning with transient dizziness x2 (05:00 and 06:30). Subsided after a few minutes.

Other Meds: Famotidine

Current Illness: None

ID: 1248101
Sex: F
Age: 26
State: PA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/23/2021
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: NKA

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

Symptoms: Syncope, Patient recovered after just a few minutes and was able to leave the pharmacy with her family.

Other Meds: Nicotine

Current Illness: No

ID: 1248102
Sex: F
Age: 62
State: FL

Vax Date: 04/21/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: Codeine, Ambien

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

Symptoms: No adverse reactions. Moderna vaccine given on 04/21/2021 (1st dose), however: patient had the Jannsen vaccine on 03/24/2021, and thought that she needed a 2nd dose.

Other Meds: Takes RX from PCP: Uses Pharmacy, some may have been filled by a different pharmacy

Current Illness: none

ID: 1248104
Sex: F
Age: 33
State: IL

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: PT COMPLAINED OF THROAT THIGHTNESS AFTER VACCINE ADMISNTRATION . PT HAD WATER WAS ANXIOUS DUE TO PREEXISTING CONDITION-GBS. PT WAS CLEARED BY DOCTOR TO RECEIVE VACCINE. PT'S BP AND PULSE WAS ASSESSED. PT FELT BETTER AFTER WAITING OUT

Other Meds: N/A

Current Illness: GBS

ID: 1248105
Sex: M
Age: 23
State: NC

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

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

Lab Data:

Allergies: n/a

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient noticed some SOB and chest tightness the evening after receiving the Pfizer COVID vaccine. A few days later his symptoms worsened to chest pain. He went to the ED and was further transferred to the hospital where he was found to have myocarditis. He is being treated with colchicine and lisinopril.

Other Meds: Occasional albuterol

Current Illness: N/a

ID: 1248106
Sex: F
Age: 58
State: CA

Vax Date: 04/10/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Tetracycline (rash)

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

Symptoms: Patient diagnosed with Bell's Palsy on 4/20/21, 10 days post-vaccine

Other Meds: Breo Ellipta, Fosamax, Albuterol

Current Illness: Hx of breast CA (2014), osteopenia, erythromelalgia

ID: 1248107
Sex: F
Age: 59
State: OH

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 04/23/2021
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: Penicillin, levaquin

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

Symptoms: Fevers, chills and sweating, joint pains, muscle aches, headaches, pins and needles in hands and feet, extreme fatigue

Other Meds: Armour thyroid

Current Illness: None

ID: 1248108
Sex: F
Age: 54
State: MO

Vax Date: 03/18/2021
Onset Date: 03/23/2021
Rec V Date: 04/23/2021
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: Unevaluable event

Symptoms: Day 5 after vaccine I got fever, chills, and loud ringing(tinnitus) in both ears. Followed by headache, fatigue, dizziness, strange ammonia like smell in my nose, shortness of breath, yellow diarrhea, intestinal pain, insomnia, and lack of appetite. Have been very sick for the last 4 weeks and continuing. Have had lowered Blood pressure, elevated fasting glucose, and kidney GFR effected also. The constant ear ringing is just horrible!!!

Other Meds: I take Lumigan eye drops, but did not take the day before vaccination or for three weeks after.

Current Illness: None

ID: 1248109
Sex: M
Age: 41
State: VA

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: Fever 99.5 F

Other Meds: None

Current Illness: None

ID: 1248111
Sex: F
Age: 63
State: MA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/23/2021
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: MSG

Symptom List: Injection site pain, Pain

Symptoms: After first dose looked like bug bites all along left side to groin ; after second dose more ?bites? got a lot worse and exploded into larger hive like eruptions that were itchy and swollen. Took six weeks from initial dose to almost be gone but there are several still raw and sore. All were only on left side. Worse symptoms however have been very bad GI upset- diarrhea, terrible air, and nausea since about the third or fourth day after second shot. It was present after first shot but much less intense. Still unable to eat two weeks after second dose.. Dr thinks vaccine caused Ileus. Also got bad chills day after second dose and was in bed for two days. My 22 year old daughter has identical symptoms and is a week behind me and is quite ill. We are both very much fearful whether this will ever go away? Wish there was some reassurance.

Other Meds: None

Current Illness: Had similar but less intense reaction to first vaccine

ID: 1248112
Sex: F
Age: 24
State: CT

Vax Date: 04/02/2021
Onset Date: 04/16/2021
Rec V Date: 04/23/2021
Hospital: Y

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

Lab Data:

Allergies: NONE

Symptom List: Injection site pain, Menorrhagia

Symptoms: Day 14 after vaccination, noticed gum bleeding and skin rash for petechia. I had 3 nose bleeds a week prior at different days.

Other Meds: Spironolactone 50 mg BID

Current Illness: NONE

ID: 1248113
Sex: M
Age: 21
State: CA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: Penicillin & shell fish

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

Symptoms: After vaccination went to observation area and after two to three minutes became light headed. Remained light headed for one hour. Felt like he was, "Mildly high." Staff responded and provided assistance. VS WNL.

Other Meds: Escitalopram 10mg for anxiety

Current Illness: No

ID: 1248114
Sex: M
Age: 21
State: IL

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/23/2021
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: Hyperesthesia affecting left side of the body from shoulder to ankle. Started a few hours after injection along with chills and malaise. The hyperesthesia has persisted along with headaches.

Other Meds: None

Current Illness: None

ID: 1248115
Sex: F
Age: 47
State: GA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/23/2021
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: Several days after 1st and 2nd dose, small filaments emerged from palms and fingers, much like splinters. Clear to white in colour. Minuscule to several millimetres in length and super fine. Spouse was vaccinated at same time and had same adverse event. Kept area clean and filaments emerged and fell out. Filaments stopped appearing in just under one week and self-resolved.

Other Meds:

Current Illness: none

ID: 1248116
Sex: M
Age: 19
State: CA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Immediately post vaccination, client slumped in car and had syncopal episode, when MD on site arrived to asses client already conscious but pale, personnel and nurses on site also attended to client, BP 121/63, pulse 70 NSR, sats O2 97% on RA; observed further at parking lot; recommended transfer to facility, client agreed and was trasported by FD ambulance @ 1236.

Other Meds: none

Current Illness: none

ID: 1248117
Sex: M
Age: 31
State: MI

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Nausea

Symptoms: 3 MINUTES AFTER RECEIVING THE VACCINE, HE FELT FLUSH AND DIFFERENT THAN EVER BEFORE. ON SITE EMS RESPONDED AND VITALS ARE BELOW. 25MG DIPHENHYDRAMINE WAS GIVEN. HE WAS MONITORED AND RELEASED TO HOME

Other Meds: NONE

Current Illness: NONE

ID: 1248118
Sex: F
Age: 30
State: MA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Sympyoms- hot/flushing, nausea, slurred speech, inability to move startes about 30 mins after receiving vaccine. Patient went to hospital and was kept there for about 3 hours severe symptoms lasted about 2 days. Patient still has side effects- headache, fever, nausea today

Other Meds: N/A

Current Illness:

ID: 1248119
Sex: F
Age: 36
State: MA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: pseudophedrine; calcium channel blockers, clorhexidine (brown dye used before medical procedures - gives me a rash)

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

Symptoms: The day after receiving my first vaccine, I began to develop a headache and fatigued. I was unable to move my left arm much higher than an inch or two. My arm pain got better after 24 hours, but the headache and fatigue persisted. I felt well enough to work on April 12, 13 and 14 and went outside my home on the 12, 14 and 15, interacting with other people while masked. On April 16, the extreme fatigue set in. I could not get out of bed. EXTREME. That entire weekend I stayed in bed with the chills and also developed nasal congestion that has persisted to the time of this writing (April 23). On April 19, I started spotting and started my period (old blood) two weeks early. That has for the most part subsided to the level of my usual discharge, though it is a bit heavier than normal. Also on April 19, the sore throat and chest pain started. I went for a COVID test today. Negative result. Chest pain is similar in location and scope to when I suffered with pericarditis years ago. Took a sick day off of work. Fatigue getting better, but very very wiped out by the end of the day. Brain is foggy. April 20 - virtual visit with my primary doctor to discuss symptoms. Chest pain continually getting worse, harder to take a deep breath, like when the doctor asks to "take a deep breath and hold it," that really hurts. Can breathe regularly fine. But just sitting on the couch I'm in pain. Laying down hurts the most. Get bloodwork, chest x-ray and covid test done. All normal. April 22 - Chest pain continues to get worse. Starting to cough. Go to Urgent Care at request of primary care doctor. Another covid test done, xray taken, flu swab., EKG. All normal. They send me to emergency room at Hospital additonal assessment. EKG, ultrasound of heart and lungs, bloodwork done, all normal. They send me home on ibuprofin and tell me to follow up with my cardiologist. They believe it to be presumptive pericarditis.

Other Meds: Kariva; frovatriptan; topamax; spironolactone; enablex; synthroid; effexor; florinef; b12 supplement; ketocozole shampoo; miralax; magnesium 500 mg supplement

Current Illness: I was sick with a cold the week of March 29-April 2 but felt better starting the week of April 5. I was grateful because I was feeling well enough in time for my vaccine.

ID: 1248120
Sex: F
Age: 59
State: CO

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Codeine IVP contrast Dye Premarin

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

Symptoms: Began with body aches, feet felt cold to the touch but rest of my body was warm with a 100 degree temp. I got up to walk around and was hit with a migraine headache (have never had one before) which included nausea, light hurt my eyes, vision was impaired with what seemed like fog in the room and humming in my ears, felt as if I was going to faint (I did not). I took 2 Advil liquigels and sat down on the floor. After about 20 minutes the migraine began to ease off to just a headache. For the next 24 hours I had low grade temp, headache, a heaviness in the frontal area of my head, minor body aches, injection arm was sore from the shoulder to just above the elbow. Continued one Advil every 6 hours up until 8pm 4/22/21. Today I have no headache, no body aches, but my thinking skills are a little fuzzy. The arm where I received the injection has the injection site plus 2 other areas on the same upper arm that are red raised and itchy.

Other Meds: Levothyroxine 100 mcg daily Dotti transdermal patch 0.05 twice a week Rainbow Light multi vitamin daily Vital Proteins Collagen powder daily Biotin 2,000 mcg daily

Current Illness: Healthy.

ID: 1248121
Sex: F
Age: 88
State:

Vax Date: 02/12/2021
Onset Date: 03/21/2021
Rec V Date: 04/23/2021
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:

Symptom List: Tremor

Symptoms: Patient had ED visit / hospitalization within 6 weeks of receiving COVID vaccine

Other Meds:

Current Illness:

ID: 1248122
Sex: M
Age: 42
State:

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/23/2021
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: Erythema, Pruritus

Symptoms: Patient received dose 2 ten days after receiving dose 1.

Other Meds:

Current Illness:

ID: 1248123
Sex: F
Age: 76
State: IL

Vax Date: 04/09/2021
Onset Date: 04/16/2021
Rec V Date: 04/23/2021
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: "Covid arm" large (3 x 3") itchy rash appeared under injection site on left arm, 9 days after vaccination. Rash /redness area increased in size, but itching subsided. Rash/redness remains after seven days.

Other Meds:

Current Illness:

ID: 1248124
Sex: F
Age: 29
State: NY

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
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: THE PATIENT FELT UNWELL AND LIGHT HEADED AFTER GIVEN THE MODERNA VACCINATION.

Other Meds: N/A NEW PATIENT CAME ONLY FOR VACCINE

Current Illness:

ID: 1248125
Sex: M
Age: 47
State: NY

Vax Date: 04/12/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: My full list of symptoms were: Pins and needle feeling as well as hypersensitivity all over my skin that originated in my lower legs but traveled up my body to include my entire legs, hips, and arms. It was more severe on the left side of my body which is the side I received the vaccine. I did not notice it on my head, face, and upper torso. I had full muscle control but I did have problems with my bladder and bowels. I'm not sure if I could not control them or did not feel them because the sensitivity was high in my hip area but I could not control them fully. No treatment was administered except to wait and see. Three days later and I am improving but not fully recovered yet.

Other Meds: none

Current Illness: none

ID: 1248126
Sex: M
Age: 16
State: IN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: No allergies

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

Symptoms: About 5 minutes after the vaccination by our pharmacy student, the patient reported that he wasn't feeling well. He said he was hot and dizzy. His hands were clammy. He said he felt like his body was numb. We had him remove his mask and got him some water. He never actually lost consciousness. Eventually we had him lay down and put his feet up. His father was contacted and came to pick him up. We spoke to his mom later and she said he was feeling much better.

Other Meds:

Current Illness: None known

ID: 1248127
Sex: M
Age: 58
State: PA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: No known allergies

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

Symptoms: Ten minutes after receiving his second Covid-19 vaccine, patient became lightheaded. As I was moving him to the ground, he started to have what appeared to be a seizure. I got him on his side to the ground and he proceeded to vomit twice, about 2 minutes apart. 911 was called and patient was transported by ambulance to the emergency room for follow up.

Other Meds:

Current Illness:

ID: 1248128
Sex: M
Age: 72
State: MS

Vax Date: 04/12/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
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: Dizziness and nausea

Other Meds: Lipitor, Metoprolol, 81mg aspirin

Current Illness: none

ID: 1248131
Sex: F
Age: 18
State: LA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Gabapentin, blackberries

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

Symptoms: For two weeks-Low grade fever, vomiting, nausea, headache, body aches, chills. 04/19/21 -Flu test, Strep Test, Covid Test, Prescribed Ala-Hist 04/21/21 Health Clinic-Covid test, bloodwork 04/21/21 Hospital Emergency Department - IV Fluids, Zofran, Tylenol and Ibuprofen , discharged with zofran rx

Other Meds: Prozac

Current Illness: None known. but had been diagnosed with Mononucleosis 12/2020

ID: 1248132
Sex: F
Age: 68
State: PA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 04/23/2021
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: Penicillin, contrast dyes, E-mycin's, ? polysorbate. Latex, rubber products, pestisides, paint thinner, environmental products.

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

Symptoms: She got the vaccine at 2:00, around 4:00 she started with fatigue with headache, dizziness, somewhat blurry vision (not extreme), chills up her full spine to her head from the bottom. She also at that time noticed a lump on her right arm and difficulty raising her arm straight out due to severe intensity of pain. She had difficulty of neurological function and paralysis and reaction of the right leg to just above the knee into her toes. She had paralysis feeling and also heavy swelling that was noticed by 6:00 that day. She also noticed that night that no position gave her comfort to be able to sleep, which kept going and she still has the paralysis, numbness, chills, fatigue. The headaches are getting sharper, more intense in her right temple area which is very sharp, which is not normal for her. The tumor she had gave her squeezing headache pain across her eyes and the to of her head but not the temples. The 2nd shot brought about 3 days of wheezing, which she does not have any lung or heart issues. She has been having difficulty with just having normal breathing patter as she does not feel it is quite right for getting oxygen as it had been prior. She went to her PCP last Friday, 4/16/21 who has ordered an MRI. He has consulted with the neuro-specialist that she had with her tumor. He will follow through with more blood work more than likely. He did mention to her about having a COVID test to double check that end of that. She did not have this done due to the fact that she had the brain tumor surgery and that is how they did that approach. She was just staring to have resolution of some of her symptoms from the 1st vaccine from the right leg when she got this one. When she got the 2nd vaccine she had intense swelling in the left leg from the knee down. There is a definite difference in the size of the legs. Her PCP said that there is definite damage from his testing at her recent appointment.

Other Meds: 81 mg aspirin.

Current Illness: None.

ID: 1248133
Sex: F
Age: 47
State: TX

Vax Date: 04/19/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Minor latex allergy

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

Symptoms: Next day: Fatigue 2 days after: Joint & muscle pain, chills, fever (101.3?), nausea, head and nasal congestion 3 days after: Joint & muscle pain, chills, fever (102.6?), nausea, head and nasal congestion 4 days after: Joint & muscle pain, chills, fever (102.0?), nausea, bad headache

Other Meds: Percocet, gabapentin, tizanidine, amitriptyline, celecoxib, Baclofen, daily vitamin, Tylenol PM, hyaluronic acid, collagen, iron, black cohosh, cal-mag-zinc, magnesium

Current Illness: NA

ID: 1248134
Sex: M
Age: 40
State:

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: nkda

Symptom List: Vomiting

Symptoms: syncope

Other Meds: unknown

Current Illness:

ID: 1248135
Sex: M
Age: 47
State: OR

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: unknown

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Woke up this AM and couldn't move. Is able to walk short distances, like to the bathroom. Has pain in all muscles and bones. Better this afternoon.

Other Meds: Meloxicam Tylenol

Current Illness: unknown

ID: 1248136
Sex: F
Age: 80
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Patient had an ED visit and hospitalization within 6 weeks of receiving COVID vaccine

Other Meds:

Current Illness:

ID: 1248137
Sex: F
Age: 25
State: MD

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: UNKNOWN

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Vaccination nurse gave dose of moderna before realizing patient was scheduled to receive 2nd dose of Pfizer. Dr, Epidemiologist at facility, notified of mistake. Dr. advised that patient does not need anything additional; patient is fully vaccinated after receiving Moderna dose post Phizer 1st dose due to vaccine's mechanism of action. Patient educated and aware. 2nd vaccine nurse checked in with patient at 3pm. Patient had no adverse reaction at that time.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1248138
Sex: F
Age: 58
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: Dose 1: sore arm for ~36h Dose 2: sore arm ~ 3h after injection. Joint pain, muscle aches, headache all started within first 12h after inj. Increased body aches, muscle aches, headaches and fever started 24h after injection. Continued for next 24h. Enlarged lymph node noted on left collarbone at 36h. Symptoms subsiding at 48h mark.

Other Meds: 12h sudaphed, buspar, crestor, baby aspirin, Flonase

Current Illness: Nothing

ID: 1248139
Sex: F
Age: 17
State: OH

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: Amoxicillin

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

Symptoms: Sore arm, chills, body aches, nausea, slight fever, tiredness

Other Meds: Mirtazapine, birth control pill, tylenol

Current Illness: No

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm