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: 1257000
Sex: F
Age: 26
State: VA

Vax Date: 04/13/2021
Onset Date: 04/21/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Increased menstrual bleeding following the vaccine. All typical menstruation symptoms which usually are not bad are now excessive.

Other Meds: Birth control, sertraline

Current Illness:

ID: 1257001
Sex: F
Age: 50
State: VA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Chills 3 days, upset stomach 3 days, Itchy and hot injection site 4 days so far

Other Meds: Losinopril, tylenol sinus, advil

Current Illness: None

ID: 1257002
Sex: F
Age: 76
State: OH

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

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

Symptoms: Eye stye developed due bacteria infection

Other Meds: None

Current Illness: None

ID: 1257003
Sex: M
Age: 47
State: MA

Vax Date: 03/23/2021
Onset Date: 04/01/2021
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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Bilateral new onset tinnitus started about 1 week following dose 1. It has continued, with slight improvement after 4 weeks. No treatment has been attempted.

Other Meds: None

Current Illness: None

ID: 1257004
Sex: F
Age: 26
State: IN

Vax Date: 04/17/2021
Onset Date: 04/25/2021
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: Nickel

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

Symptoms: "COVID Arm"; heat and minor raised skin rash, approximately 1.5" in diameter. Noticed 8 days after first dose.

Other Meds: N/A

Current Illness: N/A

ID: 1257005
Sex: M
Age: 48
State: MI

Vax Date: 03/01/2021
Onset Date: 04/01/2021
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: N/A

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

Symptoms: Swollen clavicle lymph nodes left side, noticed about 5 days after 1st dose

Other Meds: Lisinopril, amlodipine, loratadine, D, zinc

Current Illness:

ID: 1257006
Sex: F
Age: 27
State: PA

Vax Date: 04/23/2021
Onset Date: 04/25/2021
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: Acute short term memory loss

Other Meds: Syeda - birth control

Current Illness: None

ID: 1257007
Sex: M
Age: 40
State:

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Pins and needles, tingles in fingers, both hands, arms, and sometimes other parts of the body, including neck, feet. The sensation comes and goes multiple times per day, sometimes severe, and feels strong during the night / morning.

Other Meds:

Current Illness:

ID: 1257008
Sex: M
Age: 63
State: NY

Vax Date: 03/17/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Tinnitus, Dizzines

Other Meds: Vitamin C, Vitamin D, Saw Palmetto, Glucosamine

Current Illness: None

ID: 1257009
Sex: F
Age: 70
State: NY

Vax Date: 03/17/2021
Onset Date: 03/25/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient is a 70y/o female with dementia. She was escorted by her sister-in-law to a vaccination at Pharmacy on 3/17/2021. She then participated in a vaccine event at her residence on 3/25/2021. She did not experience any extreme side effects, but did complain of fatigue and myalgias to her case worker for about 2 weeks. We have instructed the patient to not get any more COVID vaccines at this time.

Other Meds: PrednisoLONE Acetate 1 % Suspension 1 drop into affected eye Ophthalmic Twice a day Aspirin 81 MG Tablet Chewable 1 tablet Orally Once a day Atorvastatin Calcium 40 MG Tablet 1 tablet Orally Once a day One-A-Day 50 Plus NIFEdipi

Current Illness: Past Medical History detatched retina (L eye) - 1980s - legally blind left eye. High cholesterol. Hypertension. Cardiac Arrhythmia (NOS). Memory problems (r/o alzheimers)

ID: 1257010
Sex: M
Age: 51
State: AZ

Vax Date: 04/14/2021
Onset Date: 04/21/2021
Rec V Date: 04/25/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Week after vaccine developed shortness of breath and pain breathing. Trip to ER and admitted to hospital. Diagnosed with Pulmonary Embolism. Blood clots both lungs.

Other Meds: Hum along, tresiba for type 2 diabetes.

Current Illness: None

ID: 1257011
Sex: F
Age: 54
State: AZ

Vax Date: 04/08/2021
Onset Date: 04/11/2021
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: none known

Symptom List: Rash, Urticaria

Symptoms: Left arm that received injection continued to feel weak off and on over the next 2 weeks. Would not describe it as painful, but more like a dead arm and very weak. In the early morning of April 25, it was painful. It has remained sore and weak all day. The pain is not by the injection site, but in the bicep.

Other Meds: vitamins A, B, C, D3, E, zinc, selenium, folic acid, glucosamine, fish oil

Current Illness: none

ID: 1257012
Sex: F
Age: 30
State: CA

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

Symptoms: Caused an outbreak of genital HSV-1 after about 8-10 hours

Other Meds: Emergen-C, ibuprofen, women's multivitamin, omega 3

Current Illness:

ID: 1257013
Sex: F
Age: 47
State: OH

Vax Date: 04/15/2021
Onset Date: 04/17/2021
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: None

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

Symptoms: Shingles outbreak on upper left lip and face, extreme ear and facial nerve pain, burning and tingling, migraine for 4 days, and severe fatigue for 7 days

Other Meds: Adderall XR, Xanax, Zoloft, Gabapentin, Imitrex, Advil, Aspirin, and Womens multivitamin

Current Illness: Recurrent shingles, migraines, seasonal allergies

ID: 1257014
Sex: M
Age: 53
State: CA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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: maybe penicillin

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

Symptoms: I tested positive for covid on 1/08/21. I had the Moderna vaccine 1st dose 4/12/21 at 8:30am. No significant immediate reaction to the vaccine. Pain worsened at the injection point, but never significant, slight headache, tired, mild flu symptoms grew through the day. At 9:30PM I experienced Fever(101.6 at around midnight after fever had broke was probably higher between 9:30PM and 11:30pm). I experienced chills and violent shaking from approximately 9:30pm to 11:30pm, as bad or worse then the original covid from January. I was unable to sleep and finally took 2 Advil 200mg each at 3:00am. Advil helped and eventually fell asleep around 3:30am. Online information suggests that the 2nd dose generally has more severe reactions. I am concerned how much worse it will be and considering not getting the 2nd dose scheduled for May 10. Tuesday April 13 I experienced slight headache, body aches and exhaustion in the afternoon. Took Nyquil severe cold and flu Tuesday evening and sleep well. Wednesday experienced lesser symptoms. Thursday had lower back and kidney area soreness. Friday april 15 back to normal.

Other Meds: Propecia, topical salve (ketamine,Ketoprofen,, Lidocaine,Gabapentin in DMSO) applied to elbow

Current Illness: none

ID: 1257015
Sex: M
Age: 64
State: MD

Vax Date: 03/24/2021
Onset Date: 03/29/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: About a week after 1st injection an intensely loud ringing in my ears commenced. The ringing has continued - non-stop - since its onset. My hearing was considered excellent before the ringing started, as I was a professionally-trained ornithologist who could identify bird species by their vocalization - even very faint or distant calling. Now, I have to concentrate to discern the identify of singing birds due to confounding din from the tinnitus. Unfortunately, I did not realize that my recent onset of tinnitus could be related to the covid-19 vaccine I had a week earlier, and I got my 2nd vaccination shot last Wednesday (4/21). The ringing has continued unabated, and I am aware of it every waking moment.

Other Meds: none

Current Illness: none

ID: 1257016
Sex: F
Age: 54
State: NY

Vax Date: 04/18/2021
Onset Date: 04/21/2021
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: no

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

Symptoms: I have Genital herpes for about 30 years with very few outbreaks. The 2nd does of the vaccine caused an outbreak. I have on hand the medication to treat it so I did not go to the doctor but started on acyclovir and it is clearing up.

Other Meds: Pro-biotic, collagen, multi vitamin, xiidra

Current Illness: none

ID: 1257017
Sex: M
Age: 50
State: VA

Vax Date: 04/24/2021
Onset Date: 04/25/2021
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: mussels

Symptom List: Ear pain, Hypoaesthesia

Symptoms: About 24 hours after receiving the shot I am experiencing some swelling and extreme itching in hands and fingers. As time has progressed the swelling has gone away entirely but I am now experiencing itching along with visible hives on both wrists, inner thighs, and inner arms at the elbow.

Other Meds: losartan, prozac, wellbutrin,

Current Illness: none

ID: 1257018
Sex: M
Age: 74
State: NH

Vax Date: 03/23/2021
Onset Date: 04/12/2021
Rec V Date: 04/25/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I have developed ringing in my ears. I have an appointment with an ent doctor May 10,2021

Other Meds: Linsinopril Escitalopram

Current Illness:

ID: 1257019
Sex: F
Age: 21
State: NC

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

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

Lab Data:

Allergies: Naproxen

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

Symptoms: Chills, fever of 104 lasting a few hours, dizziness, nausea, muscle and joint pain.

Other Meds: Benadryl

Current Illness: N/A

ID: 1257020
Sex: M
Age: 21
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: 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: Light-headed, diaphoretic, briefly lost consciousness. Provided snack, water. Did not eat prior to visit.

Other Meds:

Current Illness:

ID: 1257021
Sex: F
Age: 28
State: AZ

Vax Date: 04/15/2021
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: No

Symptom List: Unevaluable event

Symptoms: Got the vaccine and a week later noticed a little puffy swollen spot on my arm where the shot was given around 2-3pm. By 9pm that night noticed more redness and puffiness. Took a Benadryl went to sleep. Woke up and saw it had spread to about 2in x 2in. Was tender and hurt to touch and itched a little. Took another Benadryl that night, seems to be going down. Keeping an eye on it. Never had a reaction like this ever.

Other Meds: Propranolol Venlafaxine ER Levonor/ETH Estradiol Phentermine

Current Illness: No

ID: 1257022
Sex: M
Age: 46
State:

Vax Date: 04/11/2021
Onset Date: 04/24/2021
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: None

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

Symptoms: He was in his usual state of excellent health until yesterday. He noticed a small blister over his left upper gum. This burst and was clearly filled with blood. Over the ensuing 24 hours, he has had multiple such blisters and came to the Emergency Room for fear of a reaction to the COVID vaccine that he had had 13 days ago. This was Johnson and Johnson. He had no major reactions to it. On coming to the Emergency Room today, he noticed significant petechiae forming over the lower extremities as well as scattered petechiae forming elsewhere. He presented to the Emergency Room and there was noted to have a CBC showing hematocrit of 51, 4000 platelets, and a white count of 7.7 with an unremarkable differential. INR is 1.1. D-dimer was 0.33. Chemistries were limited, but were within normal limits.

Other Meds: None

Current Illness: None

ID: 1257023
Sex: F
Age: 44
State: MD

Vax Date: 04/10/2021
Onset Date: 04/11/2021
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: Red circular rash at infection site (approximately 2 weeks after injection) Breast tenderness day after (lasted two weeks relief once menstral cycle started) Swollen lymph node in armpit and groin area on side of injection (left side) started day after injection and still present Fatigue since injection Back ache since injection

Other Meds: Levothyroxine Vitamin D Vitamin B 6 and 12

Current Illness:

ID: 1257024
Sex: M
Age: 60
State: TX

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: NONE

Symptom List: Injection site pain, Menorrhagia

Symptoms: Immediately got hyper dehydrated. Then felt like I was going to passout soon. I ate a banana and drank pint of water. That helped 36 hours later my throught 1/2 of it, got very sore, like pins sticking inti it like a tonselitious maybe. Same time my mid/right side back started to hurt. Thought it might be gastral. Continious to this day and wordened up until today. Maybe Kidneys? or?? I was thinking again was gastral, but now I know it is not. Same pain when pressure put on it by bending, sitting in my truck against seats etc... Now I am worried. NEVEER had something like this other than a Gal Blagger which was removed.

Other Meds: NONE

Current Illness: NONE

ID: 1257025
Sex: F
Age: 27
State: UT

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: SYR
Vax Site: LA

Lab Data:

Allergies: unknown

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

Symptoms: Fever and chills after three hours, body aches within one hour, sore throat, tight lungs, all lasting for more than 24 hours after injection of first dose of vaccine

Other Meds: Tri-Sprintec birth control

Current Illness: none

ID: 1257026
Sex: F
Age: 59
State: TN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Around 6:05 PM after my first shot on Aptil8,2021 I experienced extreme muscle pain in my left shoulder area, then days later I noticed a big black bruise on the back of my right elbow and more arm muscle weakness and soreness. My second shot is due on May 5, should I still take it or not?

Other Meds: ( 1 ). Losartan/HCTZ 100/25 mg., (2). Oxcarbazepin 150 mg., ( 3). Vitamin D 25 mg, ( 4 ) . Fish Oil 1,000 mg. ( 5 ). Nature Bounty Hair, skin, & nails

Current Illness: None, but the Moderna Vaccine caused me to have muscle weakness in my right arm and a dark bruise on my elbow

ID: 1257027
Sex: F
Age: 68
State: CO

Vax Date: 04/11/2021
Onset Date: 04/12/2021
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: SULFA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: ON 4/25/21, PT STOPPED AT PHARMACY COMPLAINING OF ADVERSE REACTIONS SHE WAS HAVING DUE TO THE JOHNSON AND JOHNSON VACCINE SHE GOT. SHE C/O NAUSEA AND HANDS SHAKING. I TOLD HER I WOULD SUBMIT A REPORTAND FOR HER TO SEEK TREATMENT FROM HER PCP. I ASKED THAT SHE CONTACT ME WITH ANY CONCERNS OR SHARE COMMENTS THAT DR SHARES WITH HER.

Other Meds: IBUPROFEN 800MG, GABAPENTIN 100MG, TRIMETHOPRIM100MG, ONDANSETRON 8 MG, TRAZODONE 150MG, ATORVASTATIN 40MG , DIAZEPAM 5 MG, PEPTOBISMOL

Current Illness: UNKNOWN

ID: 1257028
Sex: F
Age: 28
State: CA

Vax Date: 04/16/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Symptoms: severe Tonsil swelling (left and right), Injection site swelling, injection site pain and rash, fatigue. Treatment with antihistamine made rash better. Treatment with ibuprofen against pain when swallowing.

Other Meds: Skyla IUD

Current Illness:

ID: 1257029
Sex: F
Age: 63
State: MI

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: Bactrim, Keflex, Amoxicillin, Flomax, Corn, Milk, Almonds, Strawberries

Symptom List: Nausea

Symptoms: A few hours after receiving vaccine, I had throbbing headache, Temp. 103, fever , chills, body ache. That subsided after 3 days. Now it is over 1 month later and I am still very tired, my joints seem to ache more than usual, left arm hurts most of the time ( joints and muscles), and injection sight still itches. I am hoping that these symptoms go away before my next check up at Dr. office on May 27. If not, I may have to have him do some blood tests to see what's going on.

Other Meds: Amitriptyline, Buspirone, Clonazepam, Hyoscyamine, Sertraline, Estradiol Patch, Acidophilus

Current Illness: None

ID: 1257030
Sex: M
Age: 39
State: WA

Vax Date: 03/19/2021
Onset Date: 03/26/2021
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

Symptom List: Injection site pain

Symptoms: I began to feel a little dizzy on 03-25. This light lack of equilibrium steadily grew for the next couple days. I found my limbs had apparently began to lose strength. breathing became difficult as if I could only take 1/4 breaths unless I actively forced myself to inhale deeply. I developed sleep apnea about this time. Driving became difficult. I was walking and driving as if I was drunk. When walking, it felt as if I was on a swaying ship. Driving felt like my workvan was in a constant crosswind that I wanted to correct from. At this point, I stopped driving. That was on 03-25. On 03-26 I suddenly developed up-beat nystagmus in my vision that continues to this day, making me functionally blind. I visited multiple urgent care facilities. Received full panel blood work, urine tests and a MRI. All tests came out completely normal. Doctors are baffled. I was given Valium to help with my eyes and that does help a little. However I'm still unable to see adequately to function without assistance.

Other Meds: Multi vitamin.

Current Illness: None

ID: 1257031
Sex: F
Age: 42
State: LA

Vax Date: 04/01/2021
Onset Date: 04/10/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Extreme lethargic, chills, weakness , body aches, soreness from Saturday 04/10 -- 04/13

Other Meds: Tylenol

Current Illness: none

ID: 1257032
Sex: F
Age: 62
State: OH

Vax Date: 04/15/2021
Onset Date: 04/24/2021
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: LODINE, CABBAGE, IODIDES

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

Symptoms: PATIENT STATED THAT NOTICIED YESTERDAY AFTERNOON HER LEFT ARM WAS SWOLLEN, RED AND ITCHY AROUND THE SITE OF INJECTION.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1257033
Sex: M
Age: 52
State: NY

Vax Date: 03/09/2021
Onset Date: 04/21/2021
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: Bell's Palsy

Other Meds: Xarelto, Metoprolol, Candesartan

Current Illness: None

ID: 1257034
Sex: F
Age: 54
State: CA

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Dizziness, offered juice, water, crackers.

Other Meds:

Current Illness:

ID: 1257035
Sex: M
Age: 73
State: OR

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

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

Symptoms: PAIN IN THE ARM CONTINUES JUST AS BAD AS IT HURT THE DAY AFTER THE VACCINATION. REPORTING BECAUSE IT DOES NOT SEEM NORMAL.

Other Meds: ALLOPURINOL, ATORVASTATIN, LISINOPRIL, FLOMAX, KRILL OIL, TURMERIC, MULTI-VITAMIN, LOW DOSE ASPIRIN, VITAMIN D

Current Illness: NONE

ID: 1257036
Sex: M
Age: 18
State: MA

Vax Date: 04/23/2021
Onset Date: 04/25/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Patient experienced general malaise for a day then threw up several times the night after. No fever or chills.

Other Meds: Lactaid

Current Illness: None.

ID: 1257037
Sex: F
Age: 61
State: TX

Vax Date: 02/24/2021
Onset Date: 02/26/2021
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: ringing in the ears

Other Meds:

Current Illness:

ID: 1257038
Sex: F
Age: 50
State: NV

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

Lab Data:

Allergies: None listed

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

Symptoms: Patient reported itching in mouth s/p 5 min vaccination. Patient had a visible rash around mouth w/o swelling of tongue. Pt was given 50mg of liquid Benadryl which resolved the rash after 30min.

Other Meds: Benadryl 12.5mg/5ml liquid 20ml dispensed (50mg)

Current Illness: None listed

ID: 1257039
Sex: F
Age: 32
State: AZ

Vax Date: 04/24/2021
Onset Date: 04/24/2021
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: Amoxicillin

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

Symptoms: After the second dose, within an hour and a half, severe muscle cramps, nausea, headache, nightmares, insomnia, lack of anti anxiety meds working, no appetite, feverish, restless, chills, legs would not stay still out of pain. Took pain reliever, but not as effective as usual. This is referring to 04/24/21 vaccine. 04/1/21 vaccine had very short term mild flu symptoms that went away.

Other Meds: Dexedrine, Lamictal, Klonopin

Current Illness: None

ID: 1257040
Sex: M
Age: 65
State: IL

Vax Date: 03/16/2021
Onset Date: 03/23/2021
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: Pain in extremity

Symptoms: Ringing in ears

Other Meds: Atorvastatin, losartan

Current Illness: None

ID: 1257041
Sex: M
Age: 33
State: CA

Vax Date: 04/25/2021
Onset Date: 04/25/2021
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: none

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

Symptoms: Situation: 33M s/p vaccination had c/o nausea, dizziness and became diaphoretic. Background: Patient here for first dose vaccine and was monitored for 15 mins after being vaccinated. Assessment: ? 1530: patient stated he felt dizzy. RN assessed patient was diaphoretic. ? 1532: 78/40 (sitting). Juice given. Placed on gurney. Ambulance called. ? 1536: 105/67 (lying flat) ? 1540: 104/69 (sitting). Patient refused ambulance and cancelled. ? 1556: 108/76 (sitting, feet dangling) Recommendation: The patient improved after closer monitoring. No further recommendations.

Other Meds: none

Current Illness: none

ID: 1257042
Sex: M
Age: 60
State: GA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
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: No

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

Symptoms: Had severe headaches and joint aches the first 8 to 12 hours which was on April 14th on a Wednesday. On Thursday April 15th I had a fever of 103.5 which took several hours to ever break below 103. On Friday April 16th early a.m. in the morning I my temp had drop to low grade around 99 F. Saturday April 17th I noticed a 3 to 4" diameter big red lump on the injection site which itched and hurt. Note! I used to give myself allergy injection in my twenties, the reaction was very similar to those reactions but bigger. It's been a week later I still not 100 percent and feel very tired all the time. But I know it was better than getting Covid.

Other Meds: No

Current Illness: Njo

ID: 1257043
Sex: F
Age: 42
State: WI

Vax Date: 04/24/2021
Onset Date: 04/25/2021
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: Shortness of breath and feeling of chest tightness and cinjestion. Coughing and feeling as though coughing is necessary to breathe fully.

Other Meds: Benedryl and birth control

Current Illness:

ID: 1257044
Sex: F
Age: 45
State: FL

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: Lyrica

Symptom List: Vomiting

Symptoms: Seizure

Other Meds: Vitamin B12, B12 complex, multivitamin, CLA, calcium, iron, zanex, zoloft

Current Illness:

ID: 1257045
Sex: F
Age: 26
State: TX

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

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Nausea, severe vomiting, head ache, high fever, fatigue, body aches, chills, running nose, cough, shortness of breath

Other Meds:

Current Illness:

ID: 1257046
Sex: F
Age: 63
State: CA

Vax Date: 04/15/2021
Onset Date: 04/16/1921
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Ringing in ears progressively getting worse.

Other Meds: Thyroid, Progesterone, Estrogen

Current Illness: None

ID: 1257047
Sex: F
Age: 45
State: TN

Vax Date: 04/10/2021
Onset Date: 04/11/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Migraine that lasted for 27 hours. Migraine symptoms included severe headache with throbbing pain, nausea, sensitivity to light & sound & smell. Had to remain in bed for the full 27 hours.

Other Meds:

Current Illness:

ID: 1257048
Sex: F
Age: 66
State: CA

Vax Date: 04/24/2021
Onset Date: 04/25/2021
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: penicillin and other cillins, corticosteroids, mango ski and poison oak, excessive dairy products, mods, insect bites, responsive to wheat

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

Symptoms: 1:25 am 4-25-21 Temperature 97.5 (0.2 degrees lower than normal on the testing equipment) Right front lower gut pain. (not usual for me) both elbows in pain shot in arm in pain dry mouth heat in arm, in and around area of shot urine darker yellow and more profuse than expected 98/73 blood oxygen some stomach nausea. Nausea is not usual for me. 3:14 am 4-25-21 98.1 temp (my usual temp is 97.5-ish 3"35 am 4-25-21 Temperature 98.4, nearly one degree higher than usual. Feeling feverish. Heat in throat. Possibly starting on a sore throat. Extreme nausea. Actually vomited. (It was all water or water-ish). Vomiting for me is highly unusual. Through-out all 3 of these times, I was severely impacted by extreme fatigue; inability to think, move or do things. 11:53 am 4-24-21 Temp 99.5 (this is two degrees higher than my normal temp taken by the same equipment. Extreme fatigue, sore ears, mild head ache (back of the head on both sides. Another bout of chills. 16:38 pm 4-25-21 99.9. My head doesn't feel hot, but my cheeks do. I don't feel nauseated. I do feel like I want to sleep, so I'm going to. I've successfully sat up to type into this report, which is more than I could do this morning. So, when I wake up, I'll take note of how I feel then.

Other Meds: None.

Current Illness: High Blood Pressure (taking hydrochlorothizide 25 mg tab daily); permanently disabled (neurological radiculopathy) combined with other words I cannot remember right now, as my brain isn't functioning on all cylinders, due to the fever and other symptoms I have brain fog acting up.

ID: 1257049
Sex: M
Age: 39
State: NJ

Vax Date: 04/24/2021
Onset Date: 04/25/2021
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: None

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

Symptoms: lymphadenopathy Left armpit

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm