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: 1250776
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/24/2021
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: HEART RACING; FEVER; NAUSEA; HEADACHE; UNCONTROLLABLE SHAKING; UNABLE TO EAT ALL DAY; This spontaneous report received from a patient concerned female of unspecified age.. The patient's height, and weight were not reported. The patient's concurrent conditions included migraines, and other pre-existing medical conditions included patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805012, and batch number: 1805012 expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 15:40 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced unable to eat all day. On 10-MAR-2021, the subject experienced uncontrollable shaking. On 10-MAR-2021, the subject experienced headache. Laboratory data included: Heart rate (NR: not provided) 100 laying down and sitting down in the 90s, normally in the 50s. On 10-MAR-2021 23:00, the subject experienced heart racing. On 10-MAR-2021 23:00, the subject experienced fever. On 10-MAR-2021 23:00, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from uncontrollable shaking on 11-MAR-2021, and fever on MAR-2021, was recovering from headache, and nausea, had not recovered from heart racing, and the outcome of unable to eat all day was not reported. This report was non-serious. Version created to amend previously reported information on 11-Mar-2021. Upon review the following information was amended: Latest received date (ICH) was corrected.; Sender's Comments: Medical assessment comment not required as per standard procedure as the case is assessed as Non-serious. .

Other Meds:

Current Illness: Migraine

ID: 1250777
Sex: F
Age: 52
State: SC

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1250778
Sex: F
Age: 45
State: GA

Vax Date: 01/22/2021
Onset Date: 01/31/2021
Rec V Date: 04/24/2021
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: Severe abdominal pain with bloody diarrhea, vomiting, chills for 14 hours

Other Meds: NuvaRing, generic

Current Illness: None

ID: 1250779
Sex: F
Age: 40
State: FL

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/24/2021
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: About 24 hours after vaccination, I began feeling very fatigued and over time began having severe upper back muscle aching and pain. The next day the pain was gone but felt an overwhelming feeling of severe depression, hopelessness, thoughts of not wanting to live and crying that lasted 48 hours. It resolved on its own but was terrifying and was something I have never felt before.

Other Meds: Adderall, ambiem

Current Illness: None

ID: 1250780
Sex: F
Age: 34
State: SC

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1250781
Sex: M
Age: 43
State: SC

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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:

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

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1250782
Sex: M
Age: 60
State: MI

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/24/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Chills and body pain started evening of 30th with fever up to 102.5 and headaches. Body pain went away afterctwo days and only chills down to 89 (min.) deg. F and fevers up to 104 (max.) for next 17 days. Average low temp 95 DEG. F, average high 103 deg. F. Minor fevers and chills followed for 5 more days. Fevers always had headache. Dr. prescribed steroids and ZPak on 15th of April. Took Tylenol and ibuprofen alternate with naproxin.

Other Meds: Nature's Bounty D3 2000 IU x 2 day Rosuvastatin Calcium 5mg Jardiance 25 mg Pantorprazole Sod DR 40 mg Verapamil 120 MG x2 Ezetimbe 10 mg Pioglitazone HCL 30 mg Amway Mens vitamin pack once a day

Current Illness:

ID: 1250783
Sex: F
Age: 34
State: CA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient felt lightheaded/dizzy and fainted after receiving first vaccine dose. Paramedics were called and all vitals were stable. Patient stated she did not eat prior to receiving her vaccine and has a needle phobia, where she tends to pass out after recieving an injection. Patient was given fluids and a snack to eat. She was further monitored for another half hour before leaving the store.

Other Meds:

Current Illness:

Date Died: 03/30/2021

ID: 1250784
Sex: F
Age: 67
State: WV

Vax Date: 03/25/2021
Onset Date: 03/27/2021
Rec V Date: 04/24/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: My mother was found deceased in her home two days after receiving the first dose of Pfizer vaccine of unknown causes.

Other Meds:

Current Illness:

ID: 1250785
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/24/2021
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: DIARRHOEA; SORENESS AT THE INJECTION SITE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unk) dose was not reported, administered on 09-MAR-2021 for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On MAR-2021, the subject experienced diarrhoea. On MAR-2021, the subject experienced soreness at the injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the diarrhoea and soreness at the injection site was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1250786
Sex: F
Age: 58
State: AZ

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Systemic: Allergic: Anaphylaxis-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Additional Details: Patient said about 5 minutes into the shot that her throat was tingling and soon after that she said that her tongue was swelling up in her throat. I noticed that she had trouble speaking. She took some benadryl and said he was feeling worse and asked me to give her the Epi-Pen and her speaking was getting worse. After the Epi-Pen her speaking got better and I called for emergency personnal.

Other Meds:

Current Illness:

ID: 1250787
Sex: F
Age: 20
State: OR

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Abdominal Pain-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Headache-Medium, Systemic: Nausea-Medium

Other Meds:

Current Illness:

ID: 1250789
Sex: F
Age: 52
State: OK

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)

Other Meds:

Current Illness:

ID: 1250790
Sex: F
Age: 48
State: IN

Vax Date: 04/01/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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: No

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

Symptoms: Chills, low grade fever, legs felt like Jell-O, and ties were very cold.

Other Meds: None

Current Illness: No

ID: 1250791
Sex: F
Age: 18
State: NM

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Medium, Systemic: Nausea-Severe, Systemic: Shakiness-Severe, Systemic: Visual Changes/Disturbances-Medium, Systemic: Vomiting-Mild

Other Meds:

Current Illness:

ID: 1250792
Sex: F
Age: 64
State: CT

Vax Date: 04/11/2021
Onset Date: 04/17/2021
Rec V Date: 04/24/2021
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: Keflex

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

Symptoms: On 4/17/2021 I got extreme dizziness and could not walk because I was so unsteady and the room was spinning. Also tinnitus, nausea tired.

Other Meds: Buproprian Lisinopril Wellbutrin Lipitor

Current Illness:

ID: 1250793
Sex: F
Age: 61
State: NJ

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

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

Symptoms: Migraine headache started at 8PM on 04/22/2021. Intensity increased over next 26 hours. Took 2 Tylenol at 10PM on 04/23/2021. Headache resolved by 6AM on 4/24/2021. Body aches started at 10PM on 4/22/2021 and continued through 6 AM on 04/24/2021. Blurred vision started at 1PM on 4/23/2021 and resolved by 6AM on 04/24/2021. Mild nausea started at 8PM on 4/22/2021 and resolved by 6AM on 4/24/2021.

Other Meds: None

Current Illness: None

ID: 1250794
Sex: M
Age: 19
State: NJ

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Systemic: Numbness (specify: facial area, extremities)-Severe, Systemic: Tingling (specify: facial area, extemities)-Severe, Systemic: Vomiting-Mild, Additional Details: numbess and tingling of the right arm

Other Meds:

Current Illness:

ID: 1250795
Sex: F
Age: 63
State: DC

Vax Date: 03/27/2021
Onset Date: 03/29/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: tetracycline

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: neuropathy; tingling, pins and needles below waist and in right hand.;numbness in right foot. Appeared to re-activate long-dormant condition.

Other Meds: none

Current Illness: none

ID: 1250796
Sex: F
Age:
State: MN

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: SEVERE STOMACH CRAMPS/SHARP PAIN; SEVERE FLUSHING ON EAR, FACE AND CHEST; HIVES; SCRATCHY THROAT; SWELLING ON GROIN AREA; NODULES ON INJECTION SITE; NUMB TONGUE; BUMPS AND RASH ALL OVER HER BODY; DIARRHEA; This spontaneous report received from a patient concerned a 46 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included mast-cell activation syndrome. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029) dose was not reported, administered on 10-MAR-2021 16:00 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, treatment medications included: diphenhydramine hydrochloride. On 10-MAR-2021 30 min after vaccination the patient experienced severe stomach cramps/sharp pain. On 10-MAR-2021, 4 hours after vaccination the subject experienced multiple symptoms like severe flushing on ear, face, and chest. hives, bumps, and rash all over her body, scratchy throat, diarrhea, swelling on groin area, nodules on injection site and numb tongue. The patient was expecting to have these side effects since she has mast-cell activation syndrome an took Benadryl which seemed to help, and she did not go to emergency room (ER). The patient would follow up with her PCP. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from severe stomach cramps/sharp pain, severe flushing on ear, face and chest, hives, scratchy throat, swelling on groin area, nodules on injection site, bumps and rash all over her body, and diarrhea on 10-MAR-2021, and the outcome of numb tongue was not reported. This report was non-serious.; Sender's Comments: MAC- MAC not required per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness: Mast cell activation syndrome

ID: 1250797
Sex: F
Age: 26
State: TX

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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:

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

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe

Other Meds:

Current Illness:

ID: 1250798
Sex: F
Age: 31
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: sulfur medication

Symptom List: Unevaluable event

Symptoms: Diarrhea around 1 PM Thursday, April 22 headache 8 AM Friday, April 23.

Other Meds: Sprintec, multivitamin

Current Illness: No

ID: 1250799
Sex: M
Age: 73
State: WV

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 04/24/2021
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 known

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

Symptoms: Fatigue, headache, vomiting, roaring tinnitus. Lasted approximately 24 hours, then all symptoms dissipated. No after effects have been noticed.

Other Meds: Centrum silver

Current Illness: None

ID: 1250800
Sex: F
Age: 46
State: PA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: I?m a woman weighing under 120lbs and the entire needle was injected into my arm causing extreme pain. I told the person giving the injection that it really hurt and the entire needle shouldn?t have been injected. He replied that two other people said it hurt as well but that?s how the injection needs to be given and that I?m skinny. According to the CDC then entire needle length should not have been injected given my weight and size. I also reported this complete to the company directly.

Other Meds:

Current Illness:

ID: 1250802
Sex: F
Age: 59
State: GA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Weakness-Medium, Additional Details: All vitals were stable; eyes were responsive to light; blood sugar also when checked was stable; we called EMT and they aslo checked her vitals and still everything was within normal limits. She was taken to hospital by ambulance for more observation.

Other Meds:

Current Illness:

ID: 1250803
Sex: F
Age: 59
State: IN

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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: None

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

Symptoms: Severe headache, shoulder neck pain, nausea, fatigue 24 hours

Other Meds: None

Current Illness: None

ID: 1250804
Sex: U
Age:
State: CT

Vax Date:
Onset Date:
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: SIGNIFICANT REACTIONS; This spontaneous report received from a physician concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced significant reactions. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of significant reactions was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1250805
Sex: M
Age: 43
State: NY

Vax Date: 04/18/2021
Onset Date: 04/19/2021
Rec V Date: 04/24/2021
Hospital: Y

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: Delayed anaphylaxis

Other Meds: Omeptezole

Current Illness: No

ID: 1250806
Sex: F
Age: 44
State: NY

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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:

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

Symptoms: Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Tingling and numbness to all four limbs began within 5 minutes of vaccination, after 30 minutes of being monitored of most of the tingling went away except for her feet which she felt warmer then usual.

Other Meds:

Current Illness:

ID: 1250807
Sex: F
Age: 57
State: VA

Vax Date: 04/08/2021
Onset Date: 04/19/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Sulpha

Symptom List: Nausea

Symptoms: Extreme vomiting leading to dehydration requiring 3 L of IV saline; headache; nausea; chills; woozy feeling; all beginning 11 days after shot, leading to ER visit 14 days after shot. Still ill 15 days after shot but now have meds for symptoms.

Other Meds: Fosomax

Current Illness: None

ID: 1250808
Sex: M
Age: 37
State: NY

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Nausea-Medium, Additional Details: Patient reported dizziness and motion like sicknes after 15 minutes of vaccination, patient also reported taking Clonazepam 15 minutes after vaccination. Patient remained monitored at the pharmacy for an additional 15-20 minutes and drank orange juice and felt much better.

Other Meds:

Current Illness:

ID: 1250809
Sex: F
Age: 67
State: TX

Vax Date: 02/19/2021
Onset Date: 03/26/2021
Rec V Date: 04/24/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Onset of sudden hearing loss left ear

Other Meds: None

Current Illness: None

ID: 1250810
Sex: F
Age: 40
State: IN

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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: Tylenol

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

Symptoms: Extreme tiredness, headache & loss of appetite

Other Meds: Trelegy 100mcg/62.5mcg/25mcg, Azelastine Nasal spray, Fluticasone Nasl spray, Zyzal 5mg, Levothyroxin 25mcg, Montelukast 10mg, Duloxetine 20mg, Probiotic, Ventolin HFA 90 MCG Inhaler

Current Illness: None

ID: 1250811
Sex: F
Age: 43
State: AZ

Vax Date: 04/16/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
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: Doxycycline

Symptom List: Tremor

Symptoms: Noticeable weakness on Thursday 4/22/21 during Pilates workout also pain in the left armpit. Saturday 4/24/21 woke up around 4am with an overall ache in the whole left arm as well as swelling and pain in the upper arm immediately around the injection site.

Other Meds: Allegra, Benadryl, hibiscus tea

Current Illness: None

ID: 1250812
Sex: M
Age: 36
State: TX

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/24/2021
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: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Flushed / Sweating-Mild

Other Meds:

Current Illness:

ID: 1250813
Sex: F
Age: 54
State: NC

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
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: Bacitracin ointment, pollen

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

Symptoms: Glandular swelling and discomfort near right armpit

Other Meds: Effexor, tizanidine, centrum silver, meloxicam, turmeric, Allegra, probiotic, Sudafed, Swedish bee pollen

Current Illness: Seasonal allergies, thyroid cancer

ID: 1250814
Sex: F
Age:
State: NY

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: FLU SYMPTOMS; SKIN HURT; FATIGUE; MUSCLE ACHES; This spontaneous report received from a patient concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802072) dose was not reported, administered on 09-MAR-2021 18:00 to Left Arm for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021, the subject experienced fatigue. On 10-MAR-2021, the subject experienced muscle aches. On an unspecified date, the subject experienced flu symptoms, and skin hurt. The patient recovered from fatigue, and muscle aches, and the outcome of flu symptoms and skin hurt was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1250815
Sex: F
Age: 55
State:

Vax Date: 04/20/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Sulphar drugs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Intense itching and arm very red Prior to this from time of shot for 48 hours arm was very painful

Other Meds: Hormone replacement therapy

Current Illness:

ID: 1250816
Sex: F
Age: 25
State: MA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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:

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

Symptoms: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Additional Details: Pt received IM pfizer 1520 vaccine onset of slight itching to throat without noted swelling 1550 pt turned around in car drove back to cvs received 25 mg benadryl po at 1602 pt monitored in observation area back and neck blotching with goose bumps noted. pt speech remained clear speaking full sentences. Pt blotching to neck and anterior neck improved pt itching improved with second dose of benadryl given at 1620. Pt parents arrived has epipen at home sent with benadryl education done. pcp to cal

Other Meds:

Current Illness:

ID: 1250817
Sex: F
Age: 38
State: OH

Vax Date: 03/18/2021
Onset Date: 03/28/2021
Rec V Date: 04/24/2021
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: None

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

Symptoms: Day of vaccine arm was extremely sore and felt overall tired as if I was coming down with something. After that was fine until day 10, woke up feeling short of breath and over all not well. On day 16, began a racing heart. This has continued to current day. 3 ekgs normal, blood work done 4 times all normal, CBC, thyroid, metabolic panel, heart, etc. 3 chest X-rays normal, echocardiogram normal. But still short of breath and occasional racing heart that often wakes me from a deep sleep.

Other Meds: Baby aspirin, 1000 mg vitamin c and vitamin D3

Current Illness: No e

ID: 1250818
Sex: F
Age: 49
State: TN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: thirst dry mouth fever tired injection site pain

Other Meds: none

Current Illness: none

ID: 1250819
Sex: F
Age: 76
State: NM

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

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

Lab Data:

Allergies:

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

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1250820
Sex: F
Age: 35
State: OH

Vax Date: 04/15/2021
Onset Date: 04/17/2021
Rec V Date: 04/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Heavy period started a day after receiving the second covid-19 vaccination shot. I have an IUD and have not had a period other than light spotting for almost 5 years. This lasted ~48 hours. It was an unexpected side effect. Reporting this after reading some articles on the subject that recommended reporting to VAERS to support in aggregating women?s experiences in case there is more that can be learned about why this happens.

Other Meds: None

Current Illness: None

ID: 1250821
Sex: F
Age: 24
State: NY

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: during post vaccination observation period, patient fell to floor, never lost consciousness, immunizing tech alerted pharmacist on duty, patient was alert but lightheaded while laying on back, we elevated feet using her chair, provided ice pack for head and water bottle for hydration. Patient remained lying down with feet elevated for about 15 minutes then returned to seated position with ice pack on top of head. Patient was observed by staff and parent/friend 30 minutes before leaving.

Other Meds:

Current Illness:

ID: 1250822
Sex: F
Age: 68
State: PA

Vax Date: 04/16/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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: Tylenol with coedine

Symptom List: Vomiting

Symptoms: Within 3 days was feeling super tired and then the next day I woke up with the whole left side of my face numb

Other Meds: Pantoprazole, losartan, hydrochlorothiazide, spironolactone ,vitamin D, Tylenol

Current Illness: None

ID: 1250823
Sex: F
Age: 16
State: RI

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: patient briefly fainted post vaccination, was accompanied by mother, immunizing pharmacist assisted with care, provided ice pack for head, laid patient on back with feet elevated, patient returned to conciousness, after returning to seated position patient complained of nausea so we returned patient to laying on back feet elevated. Patient was observed by immunizing pharmacist and mother prior to leaving under own ability. BP 123/81 HR 87 at 555pm, injection was at 517pm.

Other Meds:

Current Illness:

ID: 1250824
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/24/2021
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:

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

Symptoms: CHEST TIGHTNESS; MUSCLE SORENESS; SMALL HEADACHE; NAUSEA; COLD CHILLS; FEVER; This spontaneous report received from a patient concerned an adult of unspecified sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: UKNOWN expiry: UNKNOWN) .5 ml, administered on 06-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On MAR-2021, the subject experienced chest tightness. On MAR-2021, the subject experienced muscle soreness. On MAR-2021, the subject experienced small headache. On MAR-2021, the subject experienced nausea. On MAR-2021, the subject experienced cold chills. On MAR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the muscle soreness, small headache, nausea, cold chills, fever and chest tightness was not reported. This report was non-serious.; Sender's Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1250825
Sex: F
Age: 41
State: FL

Vax Date: 03/12/2021
Onset Date: 03/20/2021
Rec V Date: 04/24/2021
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: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Shingles outbreak approximately 2 weeks after vaccination. I had never had shingles before.

Other Meds: Duloxetine 120mg daily, larin fe 1-20 daily, adderall 15mg daily, trazadone 100 mg as needed for sleep

Current Illness: None

ID: 1250826
Sex: M
Age: 69
State:

Vax Date: 01/09/2021
Onset Date: 01/20/2021
Rec V Date: 04/24/2021
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: heart attack from blood clot

Other Meds: blood pressure medication, cholesterol medication

Current Illness:

ID: 1250827
Sex: F
Age: 19
State: OH

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/24/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin

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

Symptoms: After receiving my second dose, I started to develop mouth ulcers covering the entire inside of my mouth. Throughout the weekend, they continued to develop. I went to the ER to receive pain medication, as the ulcers were so bad that I could not talk or eat. The following morning, I passed out going to pick up my medication at CVS, where I was taken back to the hospital in an ambulance and had a 103 degree fever. I was given IV fluids and was sent on my way. I was on strict bedrest for 4 days, until on Thursday 04/22/2021, I was readmitted to the ER due to worsening of the sores and lack of nutrition. For 3 days since then, I have been on IV fluids, pain medication, and taking a steroid solution to help the ulcers in my mouth lessen. The doctors here believe that it is an extremely strong reaction to the COVID-19 vaccine second dose.

Other Meds: Junel (Birth Control) Lexapro Melatonin supplement

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm