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: 1255961
Sex: M
Age: 38
State: IN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Brain fog, lack of ability to focus thoughts. 24ish hours and then it faded. Pain near injection sight. Onset about 8 hours and lasted for 30ish hours then faded over a few hours. Felt like someone hit my arm with a ball peen hammer. Very localized acute pain. Extremely tired

Other Meds: Amoxicillin

Current Illness: Infected tooth

ID: 1255962
Sex: F
Age: 43
State: NY

Vax Date: 04/16/2021
Onset Date: 04/22/2021
Rec V Date: 04/25/2021
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: no

Symptom List: Anxiety, Dyspnoea

Symptoms: Sensation in the right lower leg b/w knee and ankle, a throbbing sharp pain/ sensation, constant she is unable to walk and bear weight on leg w/o the sensation

Other Meds: Multi vitamin no prescribed medications

Current Illness: no

ID: 1255963
Sex: M
Age: 34
State: TX

Vax Date: 04/03/2021
Onset Date: 04/05/2021
Rec V Date: 04/25/2021
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: For over 2 weeks: Knuckle pain, trigger finger like symptoms, knee pain, knee radiating heat, tendon pain in knee

Other Meds: Allegra

Current Illness: None

ID: 1255964
Sex: F
Age: 27
State: IN

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, lilacs, corn pollen

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Besides a sore arm (which I always have with vaccines), instead of being more tired, I am incredibly awake. My usually insomnia is much worse and I?ve had incredible trouble napping and sleeping.

Other Meds: Desvenlafaxine, hydroxyzine, losartan

Current Illness: Cold/sinus infection

ID: 1255965
Sex: M
Age: 62
State: KY

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
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: patient's wife called 4-24-21 to inform clinic that patient was taken to the ER for "breathing issues and inability to walk"; was treated by ER and sent home

Other Meds:

Current Illness:

ID: 1255966
Sex: M
Age: 59
State: IN

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/25/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Became very ill..Extreme fatigue..Nausea, fever bodyaches leg cramps..Threw up from nausea..Could only lay down..Extreme headache and huge reaction from injection site..Blood sugars would not come down..Remained stubbornly high..Sleep...Wake up..have extreme leg cramps and body aches..Made way to bathroom brvause of nausea..Nearly threw up..Ended up just lying on the floor and going to sleep again...Got up ..Went into bedroom. Sip of diet soda..Back to sleep...Finally got up at 3pm...Signs of being able to come through..Was very close to going to Urgent Care but physically would have been too challenging to go...Had food at 10pm ...Slept through 5am...Soreness in arm has become much less..Signs of survival...Seriously have second thoughts about ever having another vaccine in future unless they improve the process...

Other Meds: Type1 diabetic insulin pump ..Diclofenac, tylenol

Current Illness: None

ID: 1255967
Sex: F
Age: 58
State: MI

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/25/2021
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: tired on Friday after shot, extremely tired and feeling almost depressed all day Saturday, not as tired Sunday but still almost depressed. Friday and Saturday cold, but no fever Cold sores erupted

Other Meds: Fosmax 70mg once a week.

Current Illness: none

ID: 1255968
Sex: F
Age: 54
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 04/25/2021
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 known

Symptom List: Pharyngeal swelling

Symptoms: Blister herpes off lip on cheek. Diagnosed as Shingles. Treatment 1 gram 3x day for 7 days

Other Meds: 30 mg Vyvance. 5 mg de tramphetamines. Daily Claritin. Daily multi vitamin. 250 /50 Advair inhaler

Current Illness: None

ID: 1255969
Sex: F
Age: 21
State: IA

Vax Date: 12/31/2020
Onset Date: 01/04/2021
Rec V Date: 04/25/2021
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: nka

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Now in with syncopal episodes. Has had a loop recorder in place Jan 2021. dx with POTS

Other Meds: NKA

Current Illness: Pt was exposed to COVID-19 but never tested + and never displayed any symptoms Sept 2020. also was exposed to Epstien-Barr Oct 2020 and did have symptoms

ID: 1255970
Sex: M
Age: 66
State: FL

Vax Date: 04/01/2021
Onset Date: 04/22/2021
Rec V Date: 04/25/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Bells Palsy

Other Meds: Lisinipril;

Current Illness: Gout

ID: 1255971
Sex: F
Age: 38
State: NY

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: swelling of throat, chest pain,tingling in right arm and hand, treated at ER with epinephrine, decadron, diphenhydramine, famotadine, on Saturday pm

Other Meds: synthroid 75mcg

Current Illness: none

ID: 1255972
Sex: F
Age: 44
State: IN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
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: No

Symptom List: Rash, Urticaria

Symptoms: Fever, muscle pain and poor appetite

Other Meds: Victoza, Novolog, Levemir

Current Illness: Non

ID: 1255973
Sex: F
Age: 53
State: PA

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 04/25/2021
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: Light vaginal spotting/bleeding. Occurs randomly. Still occurring as of today.

Other Meds: Iron 65mg, 2 pills. Multivitamin

Current Illness:

ID: 1255974
Sex: M
Age: 24
State: MD

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/25/2021
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: Lightheaded, sweating Seen by onsite EMT ICE pack on neck, pt. laying on stretcher Pt. released at 09:28 A.M. recorded by RN

Other Meds:

Current Illness:

ID: 1255975
Sex: F
Age: 32
State: IN

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/25/2021
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: Fever of 99.7 to 100.2; body chills with fever; body aches; headache. Treatment was Tylenol in the first 24 hours and ibuprofen after the first 24 hours. Treatment had a small effect on symptoms; however it did not totally take them away.

Other Meds: Sertraline, 150mg; Claritin, 1 tab

Current Illness: None

ID: 1255976
Sex: F
Age: 26
State: MN

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/25/2021
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: Flu shot with eggs anaphylaxis, vaccines without eggs are fine multiple foods (pt didn't state what ones) Anaphylaxis Oral pain medication anaphylaxis

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

Symptoms: The Patient has an anaphylactic history to an oral pain medication she didn't know the name of, food allergies, and to the flu vaccine (with eggs). She has gotten the flu shot without eggs and been fine. The administering RN asked the med led to further assess. We discussed that she is at a higher risk for anaphylaxis than most people given her allergy history. She said that she was not Allergic to any component of the covid 19 vaccine when shown the list, and this was double checked. We discussed that if she gets the vaccine and has a reaction, she will need emergency room treatment and that she may want to consider being vaccinated at a hospital where they have more resources. However, given she did have known anaphylaxis to a component of the vaccine we will give it to her if she so chooses. It was explained that if she gets the vaccine, we will monitor her for 45 minutes, and if she has a reaction, she will be treated and sent to the E.R. She verbalized consenting to getting the vaccine after being thoroughly educated. She was vaccinated at 1337 with 0.5 ml of Moderna Vaccine in the left deltoid. I was not present upon the administration. I was informed shortly after administration that she had cold sweaty palms and felt a little lightheaded. She was placed in a wheelchair and taken to a private observation tent to be further assessed. Initially in the tent she was not showing alarming signs of anaphylaxis and appeared stable. She had clear lung sounds and her oxygen level was 99% with no respiratory distress or airway compromise. At 1405 she felt her lips and throat get tingly and slightly bigger, although upon assessment they did not appear swollen. She was fasting and refused to swallow water or Benadryl when offered. She was able to swallow her spit with no issues. We explained to her that we are going to keep monitoring her, but if things change at all we are going to have to call 911 and administer epinephrine. She kept saying she is fine and that she did not want it and that her boyfriend would take her home. Currently her VS were BP 94/70, HR 72, O2 99%, RR 22. She was rubbing her back and her lungs were clear. At 1410 her bp was 90/62, HR 74, o2 98% and RR 24. Again, she was rubbing her back. Her lungs sounded clear. At 1415 her BP was 84/60, HR 80, O2 93%, and RR rate of 30. She had small expiratory wheezes when listening to her breath sounds. She appeared to be in respiratory distress as she was coughing and rubbing her chest. She stated her chest felt back, neck, and chest felt tight. She still stated she was fine, and she did not have insurance. She was informed that this was a life-threatening emergency At this time 911 was called as it was determined she was having an anaphylactic reaction needing epinephrine. Her Emergency contact was notified as he was on the phone with her. At 1417 0.3 mg of epinephrine was administered into the left deltoid, which is where I was informed, she had received the vaccine. At 1420 her VS read 118/74, HR 122, O2 99%. Her respiratory distress appeared to be improving, and her VS improving. She stated she felt better, and she wanted to go home, but per policy she was taken to EMS in a wheelchair. She was handed off to EMS around 225 and verbal report was given. She was transferred to her emergency contact was present for transfer and filled in of the events.

Other Meds: Unknown

Current Illness: None stated

ID: 1255978
Sex: F
Age: 34
State: IN

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/25/2021
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: Morphine, demeral, latex

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

Symptoms: Muscle spasms unable to lift limbs, sore arm, fatigue, chills, swollen lymph nodes, migraine headache, fever, breathing trouble mild, pain throughout body

Other Meds: B12, D3, gabapentin, singular, voltaren, hydroxychlor, Nuvigil, pristiq, Buesperon, brovana, impatropium bromide, budesonide, combivent,

Current Illness:

ID: 1255979
Sex: F
Age: 53
State: NH

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

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Initially I only had a sore arm, but by evening started to feel mentally foggy. During the night, I did not have a fever, but experienced chills. On the second day, I continued to feel mentally foggy, and was unable to work. I wasn't nauseated, but felt like I was at the tail end of the flu -- achy, tired, occasional chills, etc. On the third day, I awoke with a low-grade fever (99 degrees), and was very tired. I lay down briefly, and slept six hours without waking up. Most of my symptoms were gone when I awoke, but the brain fog is still with me on the morning of Day 4. I'm still not comfortable driving or making important decisions.

Other Meds: Wellbutrin XL 300MG Zoloft 250MG Lamictal 25MG

Current Illness: none

ID: 1255980
Sex: U
Age: 53
State: IA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/25/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: aki and anca vasculitis . Cr 6.6 K 5.7

Other Meds: None recorded

Current Illness: Pulmonary nodules - CKD - Proteinuria - Depression - Anxiety

ID: 1255981
Sex: F
Age: 31
State: IL

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, cilantro, Iodine glue

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

Symptoms: Moderna COVID-19 Vaccine EUA. Sore arm for the first two days (3/30/2021 and 3/31/2021). Headache on the third day (4/1/2021). Took Tylenol on 3/31/2021 and 4/1/2021.

Other Meds: labetalol, prenatal, pepcid

Current Illness:

ID: 1255982
Sex: M
Age: 75
State: OH

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/25/2021
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 / Pantoprazole

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

Symptoms: Muscle Pain / Elevated Heart Rate / Elevated Blood Pressure / No Appetite / Loss of Weight / Fatigue - Lasted for 10 days

Other Meds: Lansoprazole / Aspirin /Metoprolol / Losartan / Brilinta / Alfuzosin / Tamsulosin / Astorvastatin / Zolpidem

Current Illness:

ID: 1255983
Sex: F
Age: 31
State: IN

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/25/2021
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: Blurry vision and tight neck muscles on right side

Other Meds:

Current Illness:

ID: 1255984
Sex: M
Age: 67
State: CA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
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: COVID-19 Vaccine EUA Day 1; pain at injection site, chills, and fatigue; Day 2; pain at injection site, joint pain(arthralgia), muscle & body aches(myalgia), fatigue; Day 3; pain at injection site, joint pain, body aches, chills, low fever (97.1)

Other Meds: Trazodone, Gabapentin, Multi-Vitamin, Folic Acid, Thiamine

Current Illness: I tested positive for Covid on Jan,11 2021 and again on Feb, 21 2021 and was feeling like the Covid symptoms had returned the week prior to getting first COVID Vaccine.

ID: 1255985
Sex: M
Age: 80
State: FL

Vax Date: 02/01/2021
Onset Date: 04/25/2021
Rec V Date: 04/25/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Ringing in right ear, loss of hearing.

Other Meds: Atorvastatin, lisinopril, famotidine, atenolol, metformin, vitamin B, D, baby aspirin, naproxen.

Current Illness: None

ID: 1255986
Sex: F
Age: 31
State: MI

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: Gluten and dairy

Symptom List: Injection site pain, Menorrhagia

Symptoms: Long-lasting headache within 30-minutes after receiving vaccine. Low-grade fever and fatigue the night of the vaccine. Loss of taste and smell the morning after. Lasted about an hour or so.

Other Meds: Grape Seed extract, red raspberry leaf extract

Current Illness: Seasonal cold 1-week before vaccination

ID: 1255987
Sex: F
Age: 63
State: CO

Vax Date: 04/21/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
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: I have blood blisters on right palm and right leg. I have had no known injury that would have caused theses

Other Meds: None

Current Illness: None

ID: 1255988
Sex: M
Age: 30
State: MD

Vax Date: 04/03/2021
Onset Date: 04/22/2021
Rec V Date: 04/25/2021
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: Doxycycline - ?hives

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Body aches, joint pain, sore throat, fever, vomiting diarrhea, chest pain, starting several days before admission. Possible acute myopericarditis

Other Meds: NONE REPORTED

Current Illness: About 1 week ago, he started having some body aches and some fever, he had some joint pains, soreness, followed by GI symptoms of nausea, vomiting, diarrhea and emesis. He then started having some chest pain and left-sided, what sounds like pleuritic pain, and he also got a little short of breath that brought him to the hospital. A week ago, he had gone to the urgent care center where he had a COVID test and Streptococcus A test that was negative. His sore throat eventually resolved. When he came to the hospital on the 21st, that was yesterday, his temperature initially was 98.3. Vital signs were normal. His temperature a few hours later went up to 101.9 at home. Patient has been taking some Tylenol and Motrin. His white count on admission was 32,000. Troponins were elevated. He had some EKG changes with T inversions. He was seen by Cardiology, which was not thought to be an acute cardiac event. Echocardiogram was done to rule out cardiomyopathy. Otherwise no illnesses

ID: 1255989
Sex: M
Age: 39
State: MD

Vax Date: 04/13/2021
Onset Date: 04/20/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Hives at many locations over the body. Looks like chicken pox in some ways. Started as itchy skin iterations but is progressively getting worse.

Other Meds:

Current Illness:

ID: 1255991
Sex: F
Age: 53
State: VA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/25/2021
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: None

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

Symptoms: Left arm hurt like hell for 3 days could not use it, raise it and throbbed from shoulder to elbow , couldn?t sleep without pain medication

Other Meds: Synthroid, Bupropion, Duloxetine, Buspirone, Montelukast, Atorvastatin, Linzess, Baby Aspirin, Omeprapozole , B12, Flonase, Allegra

Current Illness: Depression

ID: 1255992
Sex: F
Age: 30
State: IN

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: Adhesive

Symptom List: Nausea

Symptoms: Fever, headache, brain fog, dizziness, weakness, body aches, loss of taste and smell

Other Meds: Levothyroxine, vitamin d, testosterone, sertraline, trazodone

Current Illness: Na

ID: 1255993
Sex: F
Age: 29
State: TX

Vax Date: 04/16/2021
Onset Date: 04/19/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Injection site pain

Symptoms: On Monday morning April 19th, 2021, at around 9am I noticed that I was having irregular heart beats accompanied with low heart rates. I went to the urgent care on 04/24/21 and EKG showed bizarre readings. I was immediately referred to the ER.

Other Meds: None

Current Illness: None

ID: 1255994
Sex: M
Age: 39
State: MN

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/25/2021
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 known

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

Symptoms: He received the vaccine and 5 to 10 minutes later got very hot, passed out, was communicating somewhat with the nurse who gave injection.EMS called and arrived minutes later. Pulse and oxygen level checked and ok. He stated had not had any food just coffee

Other Meds: none known

Current Illness: none known

ID: 1255995
Sex: F
Age: 40
State: MO

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/25/2021
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: None

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

Symptoms: Muscle soreness and a ?catching? in the muscle when arm is lifted that has lasted 3 weeks. Pain is severe enough to interfere with sleeping

Other Meds: Advil for pain

Current Illness: None

ID: 1255996
Sex: F
Age: 29
State: IN

Vax Date: 03/13/2021
Onset Date: 03/21/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: 3 menstrual cycles within 6 weeks.

Other Meds: Lexapro-10 mg/daily, Spironolactone, Olly Women?s multivitamin

Current Illness: Spring allergies

ID: 1255997
Sex: F
Age: 37
State: NY

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Dizziness, headaches, and nausea since the day after first vaccination. I have felt light headed/dizzy or off balance, daily since vaccination. It comes and goes throughout the day.

Other Meds: None

Current Illness: None

ID: 1255998
Sex: F
Age: 50
State: CT

Vax Date: 03/11/2021
Onset Date: 03/14/2021
Rec V Date: 04/25/2021
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: NA

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

Symptoms: fever, chills, naseau for first 2 days then on day 4 swollen lymph node in left clavical area. the lymph node is painful and hasn't gone away . It got worse after second dose received on 4/13/21, batch #019B21A. After second dose, fever of 101, chills, aches, naseau. Lymph node got more swollen and painful. Received first does on 3/11 and on 4/25, I still have swollen and painful lymph node.

Other Meds: Amlodipine, Januet, chlortholidone

Current Illness: NA

ID: 1255999
Sex: F
Age: 57
State: NC

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/25/2021
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: Nka

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

Symptoms: Please has had temperature for 8 days. To 102.7 . Substantial confusion and weakness . Temperature has been present every day since about 15.hrs post inj. Acet/Asa used q4h.

Other Meds: Zolpidem, oxycodone

Current Illness: None

Date Died: 04/07/2021

ID: 1256000
Sex: F
Age: 80
State: NY

Vax Date: 03/12/2021
Onset Date: 03/20/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pallor, Fatigue, loss of vitality, diarrhea, profuse rectal bleeding, coughing up blood, death 25 days after vaccine

Other Meds: Cardedilol, Enestro, Cartia, Elquis, Asprin, Flower, Ameprazole, Latanopost, Calcuim, Vitamin D, Furosomide

Current Illness:

ID: 1256001
Sex: F
Age: 71
State: NJ

Vax Date: 04/03/2021
Onset Date: 04/16/2021
Rec V Date: 04/25/2021
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: I developed shingles

Other Meds:

Current Illness:

ID: 1256002
Sex: M
Age: 48
State: CA

Vax Date: 04/12/2021
Onset Date: 04/21/2021
Rec V Date: 04/25/2021
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: Herpes zoster without complication. Symptoms appears ~8-9 days after vaccination. Rash and pain located in back and upper on right side only

Other Meds: Flonase, Advil

Current Illness: none

ID: 1256003
Sex: F
Age: 25
State: NY

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Pain in extremity

Symptoms: My arm was sore a couple hours on the first day, the next day I woke up achy with my arm more sore. I went to work and later started feeling pain under my eyes in my sinuses where I also noticed swelling. It is now the next day (2 days after the vaccine) and the pain and swelling has not gone away.

Other Meds: Birth control, vitamin c, adderall

Current Illness: N/a

ID: 1256004
Sex: F
Age: 56
State: NY

Vax Date: 02/16/2021
Onset Date: 02/23/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: penicillin shellfish

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

Symptoms: I HAD A NORMAL REACTION TO DOSE 2 INCLUDING A LOW FEVER AND CHILLS. ONE WEEK LATER, TINNITUS STARTED OUT OF NOWHERE. I AM WORKING REMOTELY, NO LOUD EVENTS, NOTHING TO PRECIPITATE SUDDEN ONSET OF EAR RINGING

Other Meds: none

Current Illness: none

ID: 1256005
Sex: F
Age: 36
State: MA

Vax Date: 04/05/2021
Onset Date: 04/10/2021
Rec V Date: 04/25/2021
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: allergic to shellfish

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

Symptoms: tinnitus (buzzing in the left ear) ear pain

Other Meds: no

Current Illness:

ID: 1256007
Sex: F
Age: 62
State:

Vax Date: 04/01/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
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: About 35 hours after the 2nd dose, during the night, I woke up with a terrible ringing in my ear. Earlier in the day I did have clogged ears but thought it was due to allergies. The ringing went most of the night but when I woke in the morning, it was gone. At this time however, I noticed enlarged lymph nodes under my injection arm. I still have the enlarged lymph nodes but don't seem to have any other side effects.

Other Meds: Vitamin D

Current Illness:

ID: 1256008
Sex: M
Age: 19
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
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: Shellfish

Symptom List: Vomiting

Symptoms: Mouth ulcers.

Other Meds: None

Current Illness: None

ID: 1256009
Sex: F
Age: 28
State: MA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/25/2021
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: latex

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: PT reports receiving covid vaccine Pizer dose 1 around 11 am at a vaccine site. Around 3 Pm she began feeling dizzy and like the room was spinning Shave continued for about 2 hours, No trouble breathing, rash. SOB no vomiting, but she does report nausea. Pt reports no new medications change in health, Pt was advised to increase fluid intake and be evaluated urgently. She will have family take her or will call 911- She was advised not to drive.

Other Meds:

Current Illness:

ID: 1256010
Sex: F
Age: 28
State: IN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
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: Upset stomach Sore arm Chills Fatigue

Other Meds: Sertraline

Current Illness:

ID: 1256011
Sex: M
Age: 60
State: IL

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/25/2021
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: Citric acid

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chills, Dizzinesss and Weakness 5-10 minutes after invection. Cough and sore throat 12 hours after injection.

Other Meds: Atenelol, Glimepiride, Famotidine, Vitamin A, B Complex, C and D.

Current Illness: None

ID: 1256012
Sex: F
Age: 48
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: extremely painful muscle spasm left side of neck for 7 days

Other Meds: Mesalamine, Imuran

Current Illness: N/A

ID: 1256013
Sex: F
Age: 74
State: MD

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 04/25/2021
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: Succinylcholine Zosyn Avelox

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

Symptoms: 1st Dose: fever, aches, very painful joints, could not walk for one day due to severe knee pain. 2nd Dose: COVID arm, sharp stabbing pain beginning in left armpit to left breast nipple and entire breast, Dramatic increase in heart palpitations. Both of the latter two symptoms lasted until April 1st @ 1pm when the both subsided at the same time. I visited my breast care center and 6 weeks after the vaccination an ultrasound was completed revealing a swollen lymph node at level 3 - still within normal limits. A second ultrasound is scheduled 1 month after the first ultrasound. No further palpitations other than what I usually experience - very few.

Other Meds: Atenolol 25mg x2/day Evista 50mg 1/day Aspirin 81 1/day Magnesium 500 2x/day Vit. D3 1000u/day Calcium 1200/day Balance of Nature Fruits/Vegs 6/day

Current Illness: None.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm