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: 1258482
Sex: F
Age: 54
State: WI

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 04/26/2021
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: Sulfa, Penicillin, Latex

Symptom List: Dysphagia, Epiglottitis

Symptoms: I developed burning, pain, and a rash on my left lower back and left gluteus maximus. It was diagnosed as Shingles on 3/26/2021 and I was given an antiviral drug to clear it up. The rash has stopped progressing , but it is still visible. I also continue to have radiating pain and tingling, from my lower back to my big toe, along my sciatic nerve.

Other Meds: Armour Thyroid, Mitocore (multi Vitamin), Fish oil, Thyroid Care Plus

Current Illness:

Date Died: 04/04/2021

ID: 1258483
Sex: M
Age: 85
State: CA

Vax Date: 03/23/2021
Onset Date: 04/04/2021
Rec V Date: 04/26/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Death on 4/4/2021 from subdural hematoma

Other Meds: Levothyroxine, Omeprazole, Testosterone

Current Illness: AHSD

ID: 1258484
Sex: F
Age: 42
State: NJ

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/26/2021
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: n/a

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

Symptoms: Pfizer-BioNTech COVID- 19 Vaccine EUA: Vaccine recipient received 2nd Pfizer dose and asked for medical assistance in the observation area. Heart rate was 100 then up to 120. No medical intervention by onsite EMS. The patient did request an ambulance and was transported to the hospital. She presented to the ED with a panic attack/anxiety. Patient was discharged to home.

Other Meds: n/a

Current Illness: n/a

ID: 1258485
Sex: F
Age: 57
State: GA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: Ceclor; Gluten; Levaquin; Biaxin; Adhesive; Flu vaccine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient presented to vaccine clinic. She reported a reaction to a flu vaccine that resembled rheumatoid arthritis several years ago. No other vaccines since that time. Patient had questions regarding immune system and how the body reacts to the vaccine. Reviewed vaccine mechanism and side effects with patient. She proceeded to fill out consent and received her vaccination. After vaccine, she proceeded to the back of the room to wait her 30 minutes. Patient stable and did not alert staff to any symptoms. Afterwards, patient left waiting room and told nursing student that her tongue was swelling and she felt like her throat was closing. Nursing student alerted LPN who walked patient to urgent care. At that time, urgent care took over patient care.

Other Meds: Adderall XR; Xanax; Wellbutrin; Synthroid; Cytomel; Ambien; Restasis

Current Illness:

ID: 1258486
Sex: F
Age: 69
State: MS

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: Codeine, Morphine, Penicilin

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

Symptoms: Patient came to outpatient clinic to receive her second dose of Pfizer vaccine to complete dose 2 of 2 dose series. RN administering the dose obtained a new vial of Pfizer-BionNtech COVID 19 vaccine and drew up 0.3 ml's of undiluted vaccine. The 0.3 ml's of undiluted vaccine was administered to patient prior to discovery that the vial had not been reconstituted. Patient reported feeling a little light headed for about 15-20 minutes. No other adverse effects reported by the patient.

Other Meds:

Current Illness:

ID: 1258487
Sex: F
Age: 45
State: IN

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/26/2021
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: Latex allergy - rash (has antigen in her blood)

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

Symptoms: "Hard, size of grapefruit, red, warm, itchy," and saw her doctor. He said it was not cellulitis. Patient has an autoimmune disease and other conditions. Patient is better on 4/26/21 but still reports a sizeable, painful area on her arm.

Other Meds: Prednisone, Actemra, Sulfasalazine, Plaquimiel, Gabapentin, Pennsaid, Belbuca, Hydrachlorithiazide, Cystolic, Lisonopril, Xarerto, Solifenacin, Atrostatin, Amitriptyline, Omeprazole, Paxil, Morena (IUD), Flextor patch. Tylenol.

Current Illness: No illness.

ID: 1258488
Sex: F
Age: 57
State: MN

Vax Date: 01/13/2021
Onset Date: 02/21/2021
Rec V Date: 04/26/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

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

Other Meds:

Current Illness:

ID: 1258489
Sex: F
Age: 47
State: IA

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: Humira, Enbrel

Symptom List: Pharyngeal swelling

Symptoms: Severe site reaction. Redness, welt, rash, itchy, and painful. The welt is the size of a softball, the res portion is the size of a baseball.

Other Meds:

Current Illness:

ID: 1258490
Sex: F
Age: 27
State: FL

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/26/2021
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: Pain in the arm, nausea, bad headache

Other Meds:

Current Illness:

ID: 1258491
Sex: M
Age: 68
State: FL

Vax Date: 03/15/2021
Onset Date: 03/22/2021
Rec V Date: 04/26/2021
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: Noticed ringing in both ears.

Other Meds: diltiazem ,metoprolol ,pioglitazone hcl, triamterene, warafin, atorvastatin, and glimepiride.

Current Illness: none

ID: 1258492
Sex: M
Age: 30
State:

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
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: Patient complained of anxiety after taking vaccine. Denies SOB, dizziness, palpitations. Laid in stretcher for 15 min and stated anxiety decreased. Patient stable and released from vaccination site.

Other Meds:

Current Illness:

ID: 1258493
Sex: F
Age: 48
State: OR

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 04/26/2021
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: Sulfate

Symptom List: Rash, Urticaria

Symptoms: After my vaccine, the left half of my face went numb, hot burning sensation. It has not improved. I still have a numb, coolness to my face. I have an upcoming appointment with a neurologist and do an MRI. I have no pain, just a weird feeling on my face. I have no facial paralysis.

Other Meds: Wellbutrin 150mg

Current Illness:

ID: 1258494
Sex: M
Age: 52
State:

Vax Date: 02/12/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
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: Employee received vaccine on 01/22 and second dose was 02/12. Employee became symptomatic on 04/20. And tested positive with COVID on 04/23

Other Meds:

Current Illness:

ID: 1258495
Sex: F
Age: 44
State: SC

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/26/2021
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: N/a

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

Symptoms: Sore achy body. Fever 101.2. Starting around 8pm the night of the shot. Then nearly 24hrs later, Nausea, diarrhea. Headache and sore arm at jab site

Other Meds: N/a

Current Illness: N/a

ID: 1258496
Sex: F
Age: 19
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
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: Patient received her first COVID 19 Moderna vaccine, fainted while sitting in chair waiting 15 minutes for observation. She quickly regained consciousness and sustained no injury. Her vital signs were stable and she was d/c'd ambulatory and asymptomatic after approximately 50 minute observation

Other Meds:

Current Illness:

ID: 1258497
Sex: F
Age: 61
State: CA

Vax Date: 03/18/2021
Onset Date: 04/15/2021
Rec V Date: 04/26/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: severe bruising.

Other Meds:

Current Illness:

ID: 1258498
Sex: M
Age: 27
State: PA

Vax Date: 04/16/2021
Onset Date: 04/21/2021
Rec V Date: 04/26/2021
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: PEANUTS

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

Symptoms: RASH AND SWELLING OF HANDS AND FEET

Other Meds: NONE LISTED

Current Illness: NONE

ID: 1258499
Sex: F
Age: 65
State: FL

Vax Date: 01/20/2021
Onset Date: 02/01/2021
Rec V Date: 04/26/2021
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: Constant vertigo since 2nd vaccine on Feb 10, 2021. Have seen several different types of doctors and cause has not yet been determined.

Other Meds: None

Current Illness: None

ID: 1258500
Sex: F
Age: 58
State: FL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: developed throat fullness and tightness on left side of throat - sent to emergency department for evaluation

Other Meds:

Current Illness:

ID: 1258501
Sex: M
Age: 56
State: TX

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Onset on 4/20/2021 of flank pain the day after his 2nd moderna shot. Was seen in office on 4-22-2021 with his wife for same and had early blisters in a dermatomal distribution on his right trunk - flank and RUQ. Patient and wife hadn't seen the rash that morning when got dressed. Was treated for shingles.

Other Meds: none

Current Illness: none

ID: 1258502
Sex: F
Age: 35
State:

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/26/2021
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: thimerosal

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

Symptoms: muscle pain joint pain feverish 99.8F symptoms lasted around 8h. Took Tylenol 500 and was better after a couple of hours

Other Meds: levothyroxine 0.025mg

Current Illness:

ID: 1258503
Sex: F
Age: 49
State: CA

Vax Date: 04/16/2021
Onset Date: 04/26/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Unevaluable event

Symptoms: COVID Arm. Red, swollen, circumfrence of around 2-3 inches. Slight itchiness. Slight pain.

Other Meds: HRT

Current Illness: No

ID: 1258505
Sex: F
Age: 37
State: IA

Vax Date: 04/07/2021
Onset Date: 04/26/2021
Rec V Date: 04/26/2021
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: Irregular period. (The period, which is normally very regular, started 9 days early.)

Other Meds: none

Current Illness: none

ID: 1258506
Sex: M
Age: 54
State: NJ

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 04/26/2021
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: Bad back and arm pain from the small of my back to my shoulder, down may arm and then to my pinky finger. I went to an urgent care place and they put me on muscle relaxants and pain killers. That didn't help and then went to an Orthopedist last week and will start physical therapy.

Other Meds: Toprol XL 200mg daily Rosuvastatin 10mg daily

Current Illness: none

ID: 1258507
Sex: M
Age: 75
State: FL

Vax Date: 03/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/26/2021
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: Tinnitus in both ears increased. I've had tinnitus in both ears for decades but is was not a continuous hiss and a bit different in each ear. Now it is louder and is a continuous hiss in both ears.

Other Meds: Vitamin D3

Current Illness: None

ID: 1258508
Sex: M
Age: 28
State: NY

Vax Date: 04/14/2021
Onset Date: 04/18/2021
Rec V Date: 04/26/2021
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: Below symptoms noticeably worse - Vertigo - Migraine visual aura - Tinnitus Onset 4 days after Pfizer dose # 1. Symptoms still not much improved as of 12 days after vaccination

Other Meds: Magnesium, melatonin

Current Illness:

ID: 1258509
Sex: M
Age: 17
State: CA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/26/2021
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: unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient 17 years old, should have received Pfizer and not Moderna

Other Meds: unknown

Current Illness: unknown

ID: 1258510
Sex: M
Age: 65
State: MN

Vax Date: 03/31/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient tested positive COVID 19 and was subsequently admitted to the hospital, non ICU.

Other Meds:

Current Illness:

ID: 1258511
Sex: F
Age: 27
State: IA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/26/2021
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: Azithromycin

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

Symptoms: Patient began to feel her throat feeling scratchy and then blurry left eye and left arm tingling. Pt then began retching continuously. Vitals stable. Called 911 for transport/observation at Emergency Department as precaution. Pt did not receive any emergency medications. ? The attending physician has indicated that patient had a mild allergic reaction to the vaccine, which then transitioned to a heightened episode of anxiety about how her body was reacting to the shot. The physical reactions she exhibited could have been a direct response to either, or a combination of both of those situations, so he cannot directly pinpoint one main cause. He did advise her NOT to get the second shot. ? She is feeling much better, and the symptoms have all subsided, but she is very tired. The physician recommended she rest for the remainder of the day, so she is going home.

Other Meds:

Current Illness:

ID: 1258512
Sex: M
Age: 60
State: TX

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: Biaxin, Nuts Lactose Environmental

Symptom List: Nausea

Symptoms: 10:05: PT reported chest tightness, denies SOB. 96% o2sats. EMS called to evaluate 10:30: Pt stated he was feeling better and refused any further medical care 10:37 : pt walked to car with wife and drove off

Other Meds: Allopurinal, celebrex, ramipril wellbutrin, Phentermine

Current Illness:

ID: 1258513
Sex: F
Age: 41
State: IN

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
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: Fever, dihhearea, body aches, extreme tired. Flu like symptoms arm pain

Other Meds:

Current Illness:

ID: 1258514
Sex: F
Age: 22
State: GA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
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: Syncope (possible seizure) lasted 10 seconds, second event of syncope 30 minutes later

Other Meds: Probiotics, iron supplement, digestive enzymes, vitamin D

Current Illness: none

ID: 1258515
Sex: F
Age: 48
State:

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/26/2021
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: food allergy (shrimp)

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

Symptoms: Chill and fever (over 100 F) by the following morning, and coughing

Other Meds: n/a

Current Illness:

ID: 1258516
Sex: F
Age: 46
State: MI

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/26/2021
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: NKDA

Symptom List: Tremor

Symptoms: Dose #1 = 4.1.21 = got Moderna Dose #2 = 4.22.21 = got Pfizer Patient was scheduled for a dose 2 COVID vaccine, however, her 1st dose was Moderna and has Pfizer. Patient was given the dose of Pfizer before it was noticed she needed Moderna. Patient was originally scheduled thru a scheduling system.

Other Meds: levothyroxine, folic acid, omeprazole, methotrexate

Current Illness: abdominal pain before 1st dose

ID: 1258517
Sex: F
Age: 26
State:

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient had dizziness, nausea a few minutes after vaccine administered. Patient felt better after vomiting x1. Undigested food, no bleeding -- patient had spicey rice prior to coming to vaccine clinic. Given water. Patient stable, released from vaccination site.

Other Meds:

Current Illness:

ID: 1258518
Sex: F
Age: 54
State: CA

Vax Date: 04/02/2021
Onset Date: 04/09/2021
Rec V Date: 04/26/2021
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: Bee Venom Adhesive remover Cat hair Morphine Penicillin Azithromycin

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

Symptoms: Patient experienced unusual bilateral swelling to feet and ankles 1 week after getting 2nd Moderna Covid vaccine.

Other Meds: Dexilant Vitamin D metoprolol succinate ER25mg Alprazolam Hydroxychloroquine

Current Illness: N/A

ID: 1258519
Sex: M
Age: 65
State: NY

Vax Date: 04/12/2021
Onset Date: 04/17/2021
Rec V Date: 04/26/2021
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: Pink round skin blotch outer thigh, not itchy. Flaking, very slowly diminishing. Abdominal pain, followed by chills then vomiting. This occurred 5 days after the shot. Subsided after about 24 hours.

Other Meds: Valtrex 500mg daily Vitamin B12 Vitamin D3

Current Illness: Ocular myasthenia gravis

ID: 1258520
Sex: F
Age: 57
State: CA

Vax Date: 03/18/2021
Onset Date: 04/01/2021
Rec V Date: 04/26/2021
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: Brazil nuts, avocados

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: My tinnitus is worse that it was prior to the vaccine. The ringing in my ears is significantly louder.

Other Meds: Simvistatin, Metformin, Bupropion

Current Illness: None

ID: 1258521
Sex: F
Age: 68
State: MN

Vax Date: 03/01/2021
Onset Date: 04/13/2021
Rec V Date: 04/26/2021
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: Sulfa drugs

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

Symptoms: Pt has complained of intermittent burning sensation in ankles and wrist x 2 months since injection.

Other Meds: levothyroxine 88 mcg tablet daily zolpidem 5 mg tab prn metronidazole 0.75% gel

Current Illness: None known.

ID: 1258522
Sex: M
Age: 16
State: CA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/26/2021
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: unknown

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

Symptoms: 16 year old should have received Pfizer instead of Moderna

Other Meds: unknown

Current Illness: unknown

ID: 1258523
Sex: F
Age: 40
State: NJ

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Pain in extremity

Symptoms: Pfizer-BioNTech COVID- 19 Vaccine EUA: No vaccine injected due to left deltoid scar tissue. The dose was re-administered.

Other Meds: n/a

Current Illness: n/a

Date Died: 03/19/2021

ID: 1258524
Sex: F
Age: 77
State: NJ

Vax Date: 03/01/2021
Onset Date: 03/19/2021
Rec V Date: 04/26/2021
Hospital: Y

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: Patient passed away in between dose 1 and 2. Cause unknown.

Other Meds:

Current Illness:

ID: 1258525
Sex: F
Age: 54
State: NY

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
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: Nauseous, chills, fever, joint pain. Took an Aleve and tried to sleep it off. Finally have no fever 24 hours later.

Other Meds: Xarelto, Bupropion XL, Citalopram

Current Illness: None

ID: 1258526
Sex: F
Age: 39
State: CT

Vax Date: 04/21/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
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: N/A (seasonal allergies only)

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

Symptoms: a day and half to 2 days following the shot, I developed a cyst like nodule on my left collarbone (same side of the body shot was administered). I assume it was/is a severely swollen lymph node. In addition to this i began to experience headaches, tiredness, body pain and diarrhea for the next few days. At this point all side effects have gone away with the exception of the swollen lymph node, which has reduced in size but is still fairly prominent and painful (5 days after the first dose was administered)

Other Meds: birth control (nuva ring)

Current Illness: N/A (seasonal allergies)

ID: 1258527
Sex: F
Age: 16
State: WA

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/26/2021
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: nka

Symptom List: Vomiting

Symptoms: Patient was given the first dose of Moderna Covid 19 vaccine which is indicated for persons 18 and older. Patient and their guardian was notified and understood. Patient did not experience any side effects or symptoms after the vaccine. They were monitored for 15 minutes at the pharmacy and followed up with over phone.

Other Meds: n/a

Current Illness: n/a

ID: 1258528
Sex: F
Age: 42
State: CA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/26/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 42 yo F p/f side effects from COVID vaccine - received Pfizer on 4/8/2021. 30 mins after vaccine noted bilateral tingling on cheeks and cheeks "felt tight". This persisted for 24 hrs. She felt fine 4/10-4/11 but then on 4/12 tingling resumed and spread to posterior left scalp so she was advised to come in for visit for evaluation. Received Pfizer vaccine on R arm. Today she continues to have tingling sensation, "pins and needles, feels like right before your foot falls asleep", still bilateral. No vision changes, focal motor weakness, dysarthria or difficulty speaking, balance issues, dizziness, headache. No rash noted. No chest pain, dyspnea, palpitations.

Other Meds: None

Current Illness: None

ID: 1258529
Sex: F
Age: 49
State: FL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/26/2021
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: n/a

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

Symptoms: 11:42am Feeling dizziness and faintish, nauseous. 11:46am Left stated feelng much better. B/P 103/59, HR 76, O2Sat 98%.

Other Meds: n/a

Current Illness: n/a

ID: 1258530
Sex: F
Age: 25
State: WA

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/26/2021
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: Patient presented for a 1st dose of Moderna vaccine and while being monitored in post-vaccination observation, began hyperventilating. She reported dizziness and anxiety. Onsite EMTs were called for support. Patient was helped to lie down on cot by EMTs. Patient began to feel better and was helped to sit in a chair by EMTs. Patient called a rideshare to get her home rather than driving. EMTs approved patient departure from clinic.

Other Meds:

Current Illness:

ID: 1258531
Sex: F
Age: 44
State: PA

Vax Date: 04/16/2021
Onset Date: 04/24/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: unknown

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

Symptoms: "Moderna COVID-19 Vaccine EUA" I received the Moderna 046B21A vaccine on April 16th around 4p.m.. The only significant immediate side effect I experienced was an extreme soreness of the injected arm for the next two days . Then the evening of April 24th, I felt an itchiness on my arm and lifted my sleeve to discover a bright, red inflamed rash. I took a picture immediately, then took a single Benadryl and applied Cortisone-10 to calm the itch. Over these past two days, it has appeared to start to fade and has only been slightly itchy on and off. I did report this delayed reaction to pharmacy and was told it is common and being called "covid arm." I also contacted Moderna directly about the adverse reaction so that they could document the case.

Other Meds: Women's One-a-Day Multi, Citracal+D, D3, Zinc, Elderberry

Current Illness: None

ID: 1258532
Sex: F
Age: 31
State:

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Swelling, redness, slight itch at injection site. Fatigue for the next 48 hours.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm