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: 1248501
Sex: F
Age: 27
State: AK

Vax Date: 03/18/2021
Onset Date: 04/11/2021
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: latex

Symptom List: Dysphagia, Epiglottitis

Symptoms: Given vaccine on 3/18 in the left arm, then on the April 11th, a lump had a 2.5cm in size and arm and it was very sore. Improving and now smaller in size and not as painful. Then had the second dose on 4/15 on the right arm and a rash started 2 days after injection (lasted 1-2 days), had 1cm size lumps under the right arm and right chest that went away.

Other Meds: None

Current Illness: none

ID: 1248502
Sex: F
Age: 16
State: CA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 04/23/2021
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: The patient received a dose of Moderna before they have turned 18 years old. No adverse side effects were witnessed while they were on site for their shot or during their 15 minute waiting period after receiving the shot. Parental verbal consent was obtained for the second dose.

Other Meds:

Current Illness:

ID: 1248503
Sex: M
Age: 53
State: OR

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

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

Symptoms: Rash on forearms and backs of hands, started about 1 hour after receiving the vaccine. Was seen 4/23 in clinic, no obvious distress aside from mildly itchy rash which was still present. Was given antihistamine medication for itching.

Other Meds: Basaglar, novalog, lyrica, omeprazole. simvastatin, aspirin, duloxetine

Current Illness: denies any

ID: 1248504
Sex: F
Age: 29
State: PA

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: azithromycin, gluten ,nuts

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: POST VACCINE AND AFTER WAITING THE REQUIRED TIME , PER PATIENT WHEN SHE STOOD UP SHE FELT DIZZY AND HER LEGS FELT LIKE JELLO. PT STATED SHE FELT LIKE THIS AFTER HER FIRST DOSE. PT CAME TO MED OBS VITALS AS FOLLOWED: 5:06 BP 106/69 HR 70 RR 18 SPO2 100 5:11 BP 116/80 HR 86 RR 18 SPO2 100 5:26 BP 110/75 HR 87 RR 18 SPO2 100 5:29 BP 119/83 HR 82 RR 18 SP02 100

Other Meds: PEPCID, SYNTHROID

Current Illness:

ID: 1248505
Sex: M
Age: 27
State: UT

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

Lab Data:

Allergies: None as of now

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

Symptoms: Cold chilling and body doesn't feel well been very tired

Other Meds: None

Current Illness: None

ID: 1248506
Sex: F
Age: 60
State: CO

Vax Date: 04/09/2021
Onset Date: 04/11/2021
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: none known

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

Symptoms: Have had rapid heartbeat, little shortness of breath, blood pressure has been elevated. More severe than normal heartburn, little burning in chest and gallbladder pain. not sleeping well because of it

Other Meds: multi vitamin probiotic vit D zinc vit c fish oil vit b tumeric

Current Illness: none known may have covid 6-7 mos ago, adult kids had it

ID: 1248507
Sex: F
Age: 42
State: MD

Vax Date: 03/31/2021
Onset Date: 04/07/2021
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: Allegra

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Week later got covid arm. Rash, hard, hot and itchy and burning at site of injection

Other Meds: Cymbalta

Current Illness:

ID: 1248508
Sex: F
Age: 55
State:

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: reports symptoms of feeling warm, anxious, heart pounding, felt a "whoosh" come over her. Patient states she has anxiety. At 0800 this morning she had labs drawn, and at 0930 she took her prescribed Synthroid. She stated she has PTSD since her husband passed away from anaphylactic shock. Treatment/intervention : Vitals taken, patient placed in trendelenburg: 15:40 180/80 HR38 R16 98% RA 1540: 180/80 HR30 R20 98% 1550: 112/70 HR 97 R20 98% 1555: 148/90 HR 90 R20 97% 1600: 170/90 HR 90 R18 97% 1605: 160/98 HR 118 R20 97% Patient stated she felt better, vitals had improved, then patient stated she did not feel well, elevated HR, feeling "shivery." 1605 EMS contacted.

Other Meds:

Current Illness:

ID: 1248509
Sex: F
Age: 31
State: AL

Vax Date: 04/20/2021
Onset Date: 04/21/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Arm rash- painful, hot, red, swollen area about 3.5 inches in diameter on arm of injection site. Fever- fever over 100?F for 48 hours starting at 3 a.m. the night of receiving vaccine. Tylenol and Advil taken but did not lower temperature. Fever broke and has not returned on the third day after the vaccine. Headache- severe headache 72 hours after receiving vaccine. Advil has helped to treat this symptom.

Other Meds: Zyrtec 10mg, Vitamin D 200 IU

Current Illness: None

ID: 1248510
Sex: F
Age: 54
State: TX

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital: Y

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

Lab Data:

Allergies: Levaquin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: SOB, chest tightness, lower O2 levels, fatigue

Other Meds: Alprazolam as needed, meloxicam, Levothyroxine, lisinopril,simvistatin, verapamil, metformin, carvadilol, fluticasone propionate nasal spray, Aspirin, furosemide, potassium, oxycodone, Tizanidine, ondansetron, Relpax, ubrelvy, Doxepin

Current Illness: I was admitted to the ER after my first shot on March 26th. My 1st shot was March 25th. I had been just fine until my first shot. I was admitted because of chest pain and tightness radiating through to my back, SOB, low oxygen percentage, heightened troponins. I had a 5 day stay with extensive cardiac testing. No heart attack, heart in good shape, veins and arteries in good shape.

ID: 1248511
Sex: F
Age: 32
State: IN

Vax Date: 04/21/2021
Onset Date: 04/22/2021
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: Body soreness and weakness-muscles and joints Fatigue Headache Chills Slept 20 hours after symptoms started

Other Meds: Lexapro Bupropion XL

Current Illness:

ID: 1248512
Sex: F
Age: 39
State: AR

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: YEAST RELATED PRODUCTS

Symptom List: Rash, Urticaria

Symptoms: PATIENT HAD NUMBNESS ON THE RIGHT SIDE OF THE ARM/BODY, ONSET WITHIN 20 MINUTES OR SO OF VACCINE. ADVISED PATIENT TO TAKE SOME BENDARYL. FOLLOWED UP WITHIN AN HOUR AFTER BENADRYL AND PATIENT CONFIRMED SHE WAS FEELING MUCH BETTER.

Other Meds: SEROQUEL ER 150MG.

Current Illness: NON

ID: 1248513
Sex: F
Age: 51
State: NM

Vax Date: 02/27/2021
Onset Date: 03/01/2021
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: Avelox

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

Symptoms: racing heart and high blood pressure lasted for a week. Diarrhea and chills 6 hours. Nausea lasted 4 days. Headache lasted 4 days, severe back pain 1 week. fatigue lasted a month. Cough for a month. Menstrual period felt like I had another miscarriage- severe pain and heavy bleeding for 4 days.

Other Meds: Zyrtec, Multivitamin

Current Illness: Seasonal Allergies

ID: 1248514
Sex: F
Age: 46
State: GA

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: topiramate, ceterizine, sulfa antibiotics

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

Symptoms: Patient experienced sever migraine headache 10 minutes after vaccination which caused her to have shortness of breath for few minutes. EMT arrived at the scene and patient refused to go hospital once she was feeling better after 20 minutes. Patient went home by herself and was feeling better.

Other Meds: None

Current Illness: none

ID: 1248515
Sex: F
Age: 17
State: CA

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

Symptoms: The patient received a dose of Moderna before they have turned 18 years old. No adverse side effects were witnessed while they were on site for their shot or during their 15 minute waiting period after receiving the shot. Parental verbal consent was obtained for the second dose.

Other Meds:

Current Illness:

ID: 1248516
Sex: M
Age: 44
State: TX

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: 44 yo male pt c/o a rash post vaccination. The rash is localized to the vaccination site in patients right deltoid region. It is approximately one inch in size, non pruritus, erythematous, and circular with a symmetric border. Patient states that this reaction has never occurred with any previous vaccine. Pt denies SOB, CP, or headache. Pt was given 25mg Benadryl and water. Vitals were stable for patient to leave the observation site. Patient was advised to f/u with PCP. BP- Machine error (pt BP usually low normal) HR- 93 (considering anxiety from vaccination experience) SpO2 96%

Other Meds: Olanzapine

Current Illness: None

ID: 1248517
Sex: F
Age: 65
State: CA

Vax Date: 03/13/2021
Onset Date: 03/20/2021
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: Penicilline. I got rashes on my skin. I explained this at the place.

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

Symptoms: On March 20, I started with flu symtoms: sneezing, running nose, headache , pain in my body this was the first day. I stayed on bed,. The second day I had headache, and my body felt Ok. but no my head so I stay on bed. The third day I felt Ok. but since ever when I get up in the morning I felt dizziness, I would like to know if this is normal and for how long is going to be. 40% of the day I am with headache not so strong.

Other Meds: None

Current Illness: None

ID: 1248518
Sex: F
Age: 24
State: IL

Vax Date: 04/01/2021
Onset Date: 04/14/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Two weeks after the vaccine I had an extremely sore throat in the afternoon. It was hard to swallow but it was also painful all the time. I went to the doctor and got a Strep test and Covid-19 test which were negative. I just took Advil and it lessened the pain. I still have a tender throat especially in the morning and when I work out. It has been a week and it does seem to be getting better.

Other Meds:

Current Illness:

ID: 1248519
Sex: M
Age: 29
State: CO

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: pt received vaccine, told to wait 15 minutes. went to the restroom here in the store, had fainted in the bathroom. He came back to the pharmacy reported the event to the pharmacy, Upon evaluating him he had a small cut on the back of the head. One of our techs noticed a person from fire rescue in the store shopping she called him over he initially evaluated the patient and called for his emts to come and assess the pt. I know the took the pt out of the store on a gurney. they just wanted to assess him in a more private area (in the ambulance), we were in the middle of a clinicwith lots of people around. Unkown what transpired past that.

Other Meds:

Current Illness:

ID: 1248520
Sex: M
Age: 27
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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:

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

Symptoms: Pt had a dazed stare and was unresponsive. Body was rigid and had right sided shaking which lasted 5 seconds, eyes were open. Slightly diaphoretic. Patient became responsive and alert and oriented x 4 and stated he had been unaware of event, as if he had fallen asleep. V/S taken. BP 138/86 left arm, pulse 74, respirations 16 per minute, even and unlabored. Patient was obserserved for over 30 minutes, given water and a snack.

Other Meds:

Current Illness:

ID: 1248521
Sex: M
Age: 87
State: ID

Vax Date: 01/18/2021
Onset Date: 01/22/2021
Rec V Date: 04/23/2021
Hospital: Y

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: Began with slower response to questions and reaction to events. By Feb 10, was having hallucinations, hearing things that weren't there, fear, etc. Hospitalized Feb 12 when he could no longer respond or figure out what was reality and what wasn't. Within days, the doctor did not know if he would live or die. He couldn't eat, slept alot, etc. They new it was a virus in his brain, but not what kind.

Other Meds: Allopurinol, Levothyroxene, furosemide, vitamin D3, ferous sulfate, tylenol

Current Illness: gout, shingles

ID: 1248522
Sex: M
Age: 52
State: TX

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: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: itching on hands & thighs

Other Meds:

Current Illness:

ID: 1248523
Sex: M
Age: 57
State: WI

Vax Date: 03/15/2021
Onset Date: 03/21/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID hospitalization.

Other Meds:

Current Illness:

ID: 1248524
Sex: M
Age: 24
State: WI

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: SHRIMP (SWOLLEN THRAOT AND RASH), SULFA, TAMIFLU, TRAZODONE

Symptom List: Injection site pain, Pain

Symptoms: Patient vaccinated at 1035 - was in observation area for 30 minute observation. Patient reported to observation RN s/sx consistent with history of his anaphylactic allergy to shrimp - i.e. "throat closing" patient reported not feeling like he needed to get epi yet and did not want it. RN lead notified. Patient rapidly assessed as pale, slightly anxious but reserved. Patient was agreeable to taking 50mg Benadryl PO - given with sips of water. VS BP 140/80 P 92 Spo2 98%RA. - Stat team initiated - pt rapidly assessed and transferred to ED per patient request. Chart review indicates patient medicated in ER with Solumedrol, famotidine and loratadine and given a bolus of 1L of NS. VS remained stable throughout. Discharged with 2 days of 20mg Prednisone PO daily. Pt has supply of epi pens at home.

Other Meds: predniSONE (DELTASONE) 20 MG tablet Take 2 tablets by mouth daily for 2 days. cyclobenzaprine (FLEXERIL) 10 MG tablet Take 1 tablet by mouth 3 times daily as needed for muscle spasms. EPINEPHrine (EpiPen 2-Pak) 0.3 MG/0.3ML auto-injector In

Current Illness: N/A

ID: 1248525
Sex: F
Age: 59
State: CT

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: April 12-16 Injection site pain leading to generalized pain in left arm lasting several days and affecting sleep (5 days) April 13-15: extreme fatigue (3 days) April 13: fever (1 day) April 16: deafness/Tinnitus with occasional vertigo and echo (ongoing)

Other Meds:

Current Illness:

ID: 1248526
Sex: M
Age: 49
State: FL

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NO ALLERGIES NOTED

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

Symptoms: APPROXIMATELY 10 MINUTES AFTER INJECTION, PATIENT BEGAN FEELING DIZZY, SWEATING AND FELL IN THE BACK OF THE AISLE WHILE GRABBING HIS MOTHER TO SIT WITH HIM. I SAT PATIENT DOWN AND ASKED WHAT SYMPTOMS HE WAS EXPERIENCING. HE SAID HE HAD ABSOLUTELY NO TROUBLE BREATHING AND JUST FELT LIGHT HEADED, SOME FLOATERS IN HIS EYES AND SWEATY. I IMMEDIATELY TOOK HIS BLOOD PRESSURE WHICH WAS LOW AND OFFERED HIM WATER, AND GATORADE. PATIENT DID NOT WANT US TO CALL EMS BUT DUE TO LOW BLOOD PRESSURE, EMS WAS CALLED. ALL VITALS WERE CHECKED ABOUT 10-15 MIN LATER BY EMS AND EVERYTHING CHECKED OUT OK. PATIENT DECLINED SERVICES AND TRANSPORATION TO HOSPITAL AND STATED THAT HE FELT MUCH BETTER. FOLLOWED UP WITH PATIENT AN HOUR LATER VIA PHONE AND PATIENT WAS FEELING MUCH BETTER AND WAS JUST RESTING; CALLED AGAIN AT 6:30PM AND PATIENT SAID HE FELT 100% AND I COUNSELED HIM ON VISITING THE ER ASAP IF ANY SYMPTOMS, OR FEELING ILL RETURNED.

Other Meds:

Current Illness: NO SIGNIFICANT PATIENT MEDICAL HISTORY

ID: 1248527
Sex: F
Age: 51
State: CA

Vax Date: 04/20/2021
Onset Date: 04/21/2021
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: LA

Lab Data:

Allergies: cefzil, Levaquin, toradol, sulfa, omnicef, codeine, hydrocodone

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: woke in the middle of the night with body aches, fever, chills- which was expected but also chest pain- it persisted so did a video visit and they sent me to Urgent care- there did work up but cont with tacycardia and pain so admitted for further work up- took ambulance transport to hospital; spent the night on telemetry and got ECHO- LFT's are elevated and D dimer elevated; after home still with occasional chest pain - follow up needed with PCP

Other Meds: Zyrtec, Singulair, Nexium, Verapamil, Symbicort, pepcid

Current Illness: none

ID: 1248528
Sex: M
Age: 50
State: KS

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Administered Pfizer Covid vaccination outside of beyond use date and time. Removed from dry ice 04/16/2021 12:30pm. Dose given 04/23/2021 before 11:00 am.

Other Meds:

Current Illness:

ID: 1248529
Sex: M
Age: 50
State: VA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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: Amoxicillin, hydrocodone, oxycodone

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

Symptoms: Headache for 36 hours; chills, shivering, body aches, for 15 hours, fatigue for 60 hours. No medical attention needed.

Other Meds: Men's daily multivitamin, Plaquenil 200mg x2 daily, Azulfidine 500mg x4 daily

Current Illness:

ID: 1248530
Sex: F
Age: 52
State: MN

Vax Date: 02/17/2021
Onset Date: 04/21/2021
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:

Symptom List: Nausea

Symptoms: Pt. has a patient facing role as ED registration at Hospital. Pt. received 2nd dose of Pfizer vaccine on 2/17/21. Pt. had a high risk community exposure on 4/10/21. Pt. tested per hospital policy 2x after exposure. 1st test was negative but 2nd asymptomatic test taken on 4/21/21 was COVID positive despite being fully vaccinated.

Other Meds:

Current Illness:

ID: 1248531
Sex: M
Age: 35
State: WA

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Woke up at 7:30am the morning after the vaccine and had a loss of voice. It is very strained sounding while talking, voice is unrecognizable. It has not gotten better or worse throughout the day, just a perpetually strained voice.

Other Meds: None

Current Illness: None

ID: 1248532
Sex: F
Age: 42
State: WY

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

Lab Data:

Allergies: N/A

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

Symptoms: Woke up with hive-like rash on abdomen and upper legs. Received 1st dose of Pfizer on 4/22. Recommended calling PCP.

Other Meds: N/A

Current Illness: N/A

ID: 1248533
Sex: M
Age: 42
State: WA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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: Seasonal Allergies Almonds Hazelnuts

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

Symptoms: All symptoms ongoing and have not stopped Bi-lateral tinnitus (high pitched ringing) Ear Ache both ears Swollen Lymph glands in neck Fatigue Body Aches

Other Meds: Allegra-D Flonase Wellbutrin Vitamin-D Vitamin-B12 Seroquel Melantonin

Current Illness:

ID: 1248534
Sex: F
Age: 64
State: PA

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

Symptom List: Tremor

Symptoms: I because confused and unsteady. I then fell. My husband helped me up but he knew something was wrong. He called 911 an ambulance took me to the hospital but I was transferred to another hospital. In case I needed surgery. It was touch and go. I was suffering a stroke. A blood clot was also found. I was in the hospital ICU for 3 days then transferred to another room. For another day.

Other Meds: I didn?t take any of my medicine that day

Current Illness: IBD, gastroparesis, hyper contractile esophagus

ID: 1248535
Sex: F
Age: 55
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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: Penicillins Bees

Symptom List: Erythema, Pruritus

Symptoms: I have had the WORST body aches ever. My Joints hurt, even my nuckles in my hand. The pain was so bad I could not rest well. I had a hard time moving around and am still having problems. Lost my appitie for a couple of days and then feel rough.

Other Meds: Effexor 70 mg slow Iron Multi Vit Fish Oil Vit D

Current Illness: I had a viral infection similar to the flu 2 weeks prior

ID: 1248536
Sex: F
Age: 41
State:

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: Levothyrpxine, silicones tapes

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

Symptoms: Palpitations

Other Meds: albuterol metoprolol Synthroid

Current Illness: PCVs

ID: 1248537
Sex: F
Age: 45
State: GA

Vax Date: 04/20/2021
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: Fluoroquinolones (Cipro, Levaquin, Tequin) Amoxicillin

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

Symptoms: Had other benign side effects (Muscle Pain, Headache, Not Feeling Well) but that hasn't concerned me. What has concerned me is that out of NOWHERE I started my period Just 2 weeks after starting my last one - with no warning and it is heavy with cramping/pain. I have endometriosis (diagnosed at 19 and 3 surgeries since) - the only "irregularity" I have is that it is LATE a lot. I have never been "early" and it has never started without warning and heavy at onset. I usually have a day prior of spotting and migraine. This time, I went to the ladies room, had bad abdominal pain and all of a sudden - my period is here - out of nowhere. I am writing here because I do feel this is an adverse effect.

Other Meds: Fentanyl 50mcg/48 hours Oxycodone 20mg/4-6 hours

Current Illness: None

ID: 1248538
Sex: F
Age: 38
State: VA

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

Lab Data:

Allergies: Topomax, gabapentin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Hard large firm painful lump at injection site approximately 8 inches x 2 inches in size. Lower back and leg pain,Headache, weakness, and nausea.

Other Meds: Verapamil

Current Illness: None

ID: 1248539
Sex: F
Age: 58
State: IA

Vax Date: 04/09/2021
Onset Date: 04/11/2021
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: None

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

Symptoms: Started with two little itchy bumps on right forearm, in three days grew to many bumps on forearm and on Left big toe and left medial malleolus. As days progressed more bumps on entire body. The bumps grow into a rash that resembles shingles. The rash is itchy but not unbearable. Pretty ugly. but again does not cause any major changes to life style other than it has been two weeks and it will not go away and more "bumps" have appeared on the body, ie. torso, left calf, knees and right thigh. And concerned about second dose causing an even worse reaction.

Other Meds: Progesterone SR 300 mg Estradiol .5 mg/Testosterone SL 2 mg Calcium Magnesium Vitamin D Multi Vitamin

Current Illness: none

ID: 1248540
Sex: F
Age: 31
State: MO

Vax Date: 04/01/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: aspirin , salicilate , pennisilin

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

Symptoms: seizures

Other Meds: omeprasol , spironolacton

Current Illness: poliquistic ovaries

ID: 1248541
Sex: F
Age: 40
State: TX

Vax Date: 03/14/2021
Onset Date: 04/16/2021
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: Less than 24 hours after my second shot, I had a really painful arm, hurt to move it. I had a temperature as high as 102 all day. The following morning I woke up and I was scratching my stomach. I noticed I had a rash along my left arm (arm I was injected), side of my torso, and on my stomach. Red little rashes that looked like it had little head.

Other Meds: NONE

Current Illness: CONGESTION, URI

ID: 1248542
Sex: F
Age: 30
State: OR

Vax Date: 04/16/2021
Onset Date: 04/19/2021
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: None

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

Symptoms: I have unusual menstrual spotting. I'm not due for a period for 2 more months. I'm on the birth control pill. I've been spotting for over a week now.

Other Meds: Albuterol Birth Control Pill

Current Illness: None

ID: 1248543
Sex: F
Age: 56
State: FL

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

Lab Data:

Allergies: nsaids, environmental allergies

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

Symptoms: Pt felt weak in the knees, warm sensation moving up body and tongue swelling. She was given 50mg of Bendadryl and was observed. She was offered Benadryl injection and EpiPen but didn't feel she needed it. She was observed at the pharmacy for at least 45min -1hr. She felt symptoms were improving and felt ok to walk around the store and then go home. She was offered a ride or to call roommate but pt said not necessary

Other Meds:

Current Illness: no

ID: 1248544
Sex: F
Age: 30
State:

Vax Date: 04/09/2021
Onset Date: 04/16/2021
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: None known.

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

Symptoms: A slightly raised red rash appeared near the injection site a week after the first shot. The size of the rash was about 4 inches by 2 inches and expanded a little bit in the first 2-3 days after its appearance. The rash caused some mild itching. It started to fade on the 4th day and disappeared on the 6th day without any medication/treatment.

Other Meds: None.

Current Illness: None.

ID: 1248545
Sex: F
Age: 57
State: FL

Vax Date: 04/21/2021
Onset Date: 04/22/2021
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: Mango

Symptom List: Vomiting

Symptoms: Headache Fever Muscle pain Chills Fatigue Sinus watering

Other Meds: N/A

Current Illness: None

ID: 1248546
Sex: F
Age: 15
State: CA

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient is 15 years of age and was administered the COVID Pfizer vaccine.

Other Meds:

Current Illness:

ID: 1248547
Sex: M
Age: 47
State: TX

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: NKDA

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

Symptoms: Moderna COVID-19 Vaccine EUA Pt. presented with dizziness, weakness, double vision, slurred speech, nausea, vomiting, diarrhea, and unable to stand/walk. Vaccine given at 1030, patient first c/o symptoms at 1135. Symptoms progressively became worse and was sent to ER at 1650.

Other Meds: Colase, Cymbalta, Risperdal

Current Illness: n/a

ID: 1248548
Sex: F
Age: 55
State: CO

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Shot received 2:30pm. by midnight severe pain in left shoulder so got up to take 1 Aleve so I could sleep. Wave of sweats and nausea/dizziness...lasted about 10 min. Awake again 2:30 am by another nausea/dizzy wave---never actually vomited though, was able to breathe through it. Awake again at 6:30 am by wave of nausea and headache, took 1 more Aleve and had a bowl of cereal to have some food in stomach. Multiple joints beginning to ache, including hips and both arms. Muscles tightening in arms and calves. Back to bed. Awake at 8am. Headache and joints aching, however Aleve keeping it at bay enough to sleep. By 24 hour mark, nausea/dizzy spells were done. By 48 hour mark the pain in joints done...except for minor pain and tightness at location of injection.

Other Meds: none

Current Illness: none

ID: 1248549
Sex: M
Age: 79
State: ND

Vax Date: 03/24/2021
Onset Date: 03/30/2021
Rec V Date: 04/23/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ED on 3/9/21 and was admitted to the hospital. He also presented to the ED on 3/30/21 and was subsequently admitted to the hospital. He has been hospitalized ever since.

Other Meds:

Current Illness:

ID: 1248550
Sex: M
Age: 42
State: PA

Vax Date: 03/16/2021
Onset Date: 03/17/2021
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:

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

Symptoms: Severe headaches Almost every day taking Excedrin migraine

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm