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: 1258588
Sex: F
Age: 19
State: IL

Vax Date: 04/25/2021
Onset Date: 04/26/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Moderna vaccine given 04/25/2021 at approximately 15:20. At 04/26/2021 at 0200 developed chills and fever. Tmax 104, relief with Tylenol reduced to 100.3. Still with Headache and chills.

Other Meds: None

Current Illness: None

ID: 1258589
Sex: F
Age: 73
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
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: Chills, Dizziness, High Blood Pressure, "Numb," Falling, Nausea, Vomitted x 1, Sore Arm, Body Aches.

Other Meds: Breo Ellipta, Benazepril, Metoprolol Succinate, Bayer Low dose aspirin, Ventolin HFA, Equate Nasal Spray, Equate Suphendrine PE, Equate One Daily Women's Health, Aleve, Gas Relief, Cetirizine,

Current Illness: None

ID: 1258590
Sex: F
Age: 37
State: CA

Vax Date: 04/17/2021
Onset Date: 04/23/2021
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: none

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

Symptoms: Tinnitus, sudden hearing loss

Other Meds: birth control

Current Illness: none

ID: 1258591
Sex: F
Age: 31
State: PA

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient had started feeling tingling in the hands and rest of the body, SOB, and chest tighten after vaccination. She was taken to Med OBVs at around12:40 and upon arrival had rapid breathing. VS at 12:45 were: HR: 117, RR: 25, BP: 140/84, SPO2: 100. Patient was given an emesis bag to help breathing. VS at 12:56 were: HR: 90, RR: 18, BP: 135/79, SPO2: 98. Patient's hyperventilation started subsiding and at 1:04 VS were: HR: 84, BP: 132/84, SPO2: 98. Patient was released at 1:16 and went home with others.

Other Meds: N/A

Current Illness: N/A

ID: 1258592
Sex: F
Age: 38
State: WI

Vax Date: 01/22/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Doxycycline, wellbutrin, penicillin, prednisone

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

Symptoms: Patient experienced nasal congestion, runny nose and sore throat with onset date of 4/25/2021

Other Meds: albuterol inhaler, amitriptyline, baclofen, gabapentin, hydroxyzine, lorazepam, triamcinolone, venlafaxine

Current Illness: s/p robotic hysterectomy 1/11/21,

ID: 1258593
Sex: M
Age: 36
State: CT

Vax Date: 04/26/2021
Onset Date: 04/26/2021
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:

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

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild

Other Meds:

Current Illness:

ID: 1258594
Sex: M
Age: 65
State: CA

Vax Date: 02/09/2021
Onset Date: 02/01/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Moderate tinnitus developed within two weeks of first vaccine dose. Tinnitus persisting unchanged eleven weeks after first dose. Second dose received March 2, 2021.

Other Meds:

Current Illness:

ID: 1258595
Sex: F
Age: 23
State: FL

Vax Date: 04/18/2021
Onset Date: 04/18/2021
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: latex allergy

Symptom List: Pharyngeal swelling

Symptoms: Large red itchy lump swollen pain on a large area of the arm but outside the band aid area-still occurring adv that this type of delayed rash has been seen with <1% of patients with this shot, also could be caused by or exacerbated by the bandaid due to latex allergy. Either way, try OTC DPH, topical hydrocortonse, warm compress, or cold compress/ 10 min ice at a time (whatever helps relieve symptoms, should start resolving after a few days. Seek emergency medical attention if trouble breathing/swelling in airway but reassured caller based on time of the injection this would be highly unlikely. PCC will FU later, provided

Other Meds: no medications

Current Illness:

ID: 1258596
Sex: F
Age: 56
State: CT

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

Lab Data:

Allergies: epinephrine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Skin has a red circle, about 2 1/2 inches in diameter, radiating out from shot injection location on left arm. Sometimes itchy. (Note: after the first Moderna shot, the injection location was sometimes itchy, but I did not get a red circle like I did with the second shot.) I got the second shot Friday, April 23, 2021 at ~3:50pm, and the red circle is still present today, Monday, April 26, 2021 at ~2pm.

Other Meds: daily vitamin

Current Illness: none

ID: 1258597
Sex: F
Age: 48
State: CA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: codeine, cyclobenzaprine, depakote, gabapentin, ibuprofen, lyrica, meclizine, paroxetine, penicillins, quetiapine fumarate, trazadone.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient states that on Friday 4/2/2021 she received her first dose of a moderna Covid vaccine at around 1 PM. She was started having a hard time swallowing her dinner around 5 pm. She administered her epi-pen and went to the ER. This patient is not 100% sure if it was due to covid vaccine because 4 days later 4/6 she had another anaphylactic reaction similar to the one on 4/2 but states throat felt tight and itchy along with itchiness on her body.

Other Meds:

Current Illness:

ID: 1258598
Sex: M
Age: 65
State: TN

Vax Date: 03/31/2021
Onset Date: 04/05/2021
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: beef

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

Symptoms: Hiccups constantly for 4 days

Other Meds: claritin

Current Illness: none

ID: 1258599
Sex: F
Age: 65
State:

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

Lab Data:

Allergies: No known allergies

Symptom List: Rash, Urticaria

Symptoms: Pt reported dizziness at 1210. Patient vitals were taken: BP 160/80 mmHg, HR 80 bpm, and SpO2 97%. Patient reported history of high blood pressure and hypothyroidism (currently taking medication for only hypothyroidism). Patient given pretzels and water. Patient advised to wait for further observation. Pt reassessed at 1236. Vitals were BP 170/75, HR 78 bpm, and SpO2 98%. Pt reported feeling much better. At 1237, pt left facility to self with unlabored respirations and steady gait.

Other Meds: Unspecified thyroid medications for hypothyroidism

Current Illness: None

ID: 1258600
Sex: M
Age: 22
State: TX

Vax Date: 04/19/2021
Onset Date: 04/19/2021
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: at 10:35, 7 minutes after receiving the vaccine, pt stated feeling faint and heart pounding. Color pale, lips pale, forehead cold and clammy. 98%pulse Ox, 41-46 HR reg and clear. BP WNL 127/72 and no respiratory distress. pt C/o nausea and did vomit 60 cc yellow cloudy emesis. EMS notified and came at 10:50 , full assessment and HX done. no medications or pertinent medical HX. pt monitored until symptoms went away. no more N/V, pts skin color improved. not clammy . pt was discharged at 11:39 in stable condition. stated he felt much better and didnt need any further medical attention

Other Meds:

Current Illness:

ID: 1258601
Sex: F
Age: 60
State: CA

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: 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: Approximately 1 1/2 hours after injection, ears began ringing very loudly. It is now 72 hours after injection and ears are still ringing. Does not come and go, but is constant.

Other Meds: Synthroid 88 mcg Atenolol 25 mg Pravastatin Sodium 40 mg CoQ10 100 mg

Current Illness: none

ID: 1258602
Sex: F
Age: 55
State: CA

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

Lab Data:

Allergies: No

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

Symptoms: Fever, cough, muscle ache, flu

Other Meds: No

Current Illness: No

ID: 1258603
Sex: F
Age: 24
State: TX

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

Lab Data:

Allergies:

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

Symptoms: Site: Bruising at Injection Site-Mild, Additional Details: patients arm immeditately became swollen 2cm around injection site. patient denies any pain stating "i didnt even feel the shot". Patient denies any other side effects immediately following injection. Patient remainded seated in store for 15 minutes post injection and continues to deny any pain, difficulty breathing, or other side effects.

Other Meds:

Current Illness:

ID: 1258604
Sex: F
Age: 22
State: IA

Vax Date: 12/29/2020
Onset Date: 01/10/2021
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: Minocycline

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

Symptoms: New onset hypertension lasting for 2 months post vaccination

Other Meds: Keppra, levothyroxine

Current Illness: None

ID: 1258605
Sex: M
Age: 39
State: TX

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt reported that slight itching started on 4/22/2021, after he got the vaccine. This continued to progress into extreme itching and rash with swelling all over his body, including his face and eyes. He went to the emergency room on 4/25/2021. He was given medication in the ER, and was given a prescription for Prednisone to take for 1 week at home.

Other Meds:

Current Illness:

ID: 1258606
Sex: F
Age: 49
State: NJ

Vax Date: 04/14/2021
Onset Date: 04/14/2021
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: n/a

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: During post-observation period, vaccine recipient complained about anxiety. Their lip and tongue was cyanotic. They were monitored by EMS and the pulse ox was 98%. Symptoms resolved.

Other Meds: n/a

Current Illness: n/a

ID: 1258607
Sex: F
Age: 49
State: MN

Vax Date: 03/30/2021
Onset Date: 04/05/2021
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 known.

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

Symptoms: Severe headache, body aches, chills x 2 days. Upper R calf cramp like pain x 1-5 days post vaccine

Other Meds: bupropion 150 mg tabs cetirizine 10 mg tabs Adderall 20 mg tabs Flonase nasal spray Vienva 0.1-20 mg-mcg tabs Voltaren 1% topical gel

Current Illness: None.

ID: 1258608
Sex: M
Age: 18
State: WA

Vax Date: 04/11/2021
Onset Date: 04/12/2021
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: n/a

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

Symptoms: He has had the following symptoms from the 4/12/2021 till present time: constant headache and fatigue. Intermittent low fever (99F). On 4/21/2021, his primary care doctor recommended that we take him to Emergency Room because she was concerned about thrombosis as side effects from the vaccine. His legs had some red patches on the back of the ankles area. At ER, doctor did blood test for blood clot and result was negative. He got an IV injection less headache.

Other Meds: n/a

Current Illness: n/a

ID: 1258609
Sex: M
Age: 32
State: CA

Vax Date: 04/05/2021
Onset Date: 04/17/2021
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: Unevaluable event

Symptoms: Continuous 24h Tinnitus (high pitched hissing in both ears)

Other Meds: Finasterid 1mg

Current Illness:

ID: 1258610
Sex: F
Age: 78
State: NY

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

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

Symptoms: Was given shot very high up right below my shoulder. Am still in a lot of pain. Am now able to use that hand but unable to sleep in bed. And unable to lift my arm above shoulder height without experiencing extreme pain. This is 2 weeks after receiving the shot.

Other Meds: MontelukastSodium10MG, Glipizide ER 5MG TER, Aller-tec 24 hour Vitamin D3 , Vit C, Zinc Gluconate

Current Illness: None

ID: 1258611
Sex: F
Age:
State: FL

Vax Date: 04/17/2021
Onset Date: 04/18/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Pain in the left calf that goes to the knee. Pt described it as a muscle pain saw physician 4/19/21; advised to use heat and rest. taking advil which is helping. no pain with rest. only pain with movement. no trauma. no birth control use. no SOB/no CP. +smoker. PMD recommended getting a venous doppler ultrasound if symptoms do not resolve by Friday. Will call next week to follow up on symptom resolution/outcome. Advised patient to monitor symptoms and if she develops CP/SOB then to go to the emergency room. -DG

Other Meds:

Current Illness:

ID: 1258612
Sex: F
Age: 49
State: IL

Vax Date: 04/13/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Had an adverse effect to a medication I have taken before

Other Meds: I have take sulfameth/trimethoprim 800 /160 mg tablet twice a day for 3 days. I started taking on Friday 4/23 and on 4/24 I started itching like crazy. I than saw that I broke into a rash. I have never reacted to any medicine like this.

Current Illness: None

ID: 1258613
Sex: F
Age: 61
State: MO

Vax Date: 04/02/2021
Onset Date: 04/05/2021
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: Linzess, Lovastatin, Sulfa antibiotics, sulfonimide

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

Symptoms: Hand, Lip, and Leg Swelling

Other Meds: Famotidine 20mg tabs

Current Illness: No Known

Date Died: 04/26/2021

ID: 1258614
Sex: F
Age: 26
State: OH

Vax Date: 04/01/2021
Onset Date: 04/25/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient presented to ED for 2 syncopal episodes and went into cardiac arrest 5 minutes prior to ED arrival in ambulance. She received ACLS measures and alteplase was mixed and administered for pulmonary embolism concern.

Other Meds: Vienva

Current Illness: Appendicitis, fall from 12 foot ladder resulting in fracture of olecranon process of left ulna requiring admission to skilled nursing facility

ID: 1258615
Sex: F
Age: 24
State: TX

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Site: Bruising at Injection Site-Mild, Additional Details: Patient immediately had swelling ~2cm around injection site. Patient denied any other side effects. Patient remained seated for monitoring for 20 minutes and reported back with no side effects. Swelling had significantly decreased. Patient denied any pain during immunization stating \"i didn't even feel you giving it\".

Other Meds:

Current Illness:

ID: 1258616
Sex: M
Age: 29
State: IN

Vax Date: 04/24/2021
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:
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: Fainted 10 minutes after administration. High fever (102.4 measured t+2 hours after 1000MG of tylenol), aches, severe muscular cramps, chills, diarrhea, nausea lasting in varying severity for 40 hours after injection.

Other Meds:

Current Illness:

ID: 1258617
Sex: F
Age: 15
State: IA

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: IM
Vax Site: RA

Lab Data:

Allergies: NA

Symptom List: Nausea

Symptoms: Patient received vaccine prior to 16th birthday. Called patient/parents and no report of adverse effects post-vaccination.

Other Meds: NA

Current Illness: NA

ID: 1258618
Sex: F
Age: 72
State: VA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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: Administration error: Notable loss of vaccine while injecting/retracting needle. Vaccine running down arm. Consulted with Doctor. Another dose given immediately.

Other Meds:

Current Illness:

ID: 1258619
Sex: M
Age: 62
State: MO

Vax Date: 04/21/2021
Onset Date: 04/22/2021
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: Arm Pain - Lasted 2 days, No treatment Headache - Mild to Medium Headache lasted 36 hours. No treatment, no medications taken Fever - Slowly rose to a high of 101.2. Fever last 36 hours. No treatment, No medications taken

Other Meds: None

Current Illness: None

ID: 1258620
Sex: F
Age: 51
State: OH

Vax Date: 04/13/2021
Onset Date: 04/15/2021
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: None

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

Symptoms: Chills and then Hot Flashes that are continuous after the second dose of moderna vaccine

Other Meds:

Current Illness: None

ID: 1258621
Sex: M
Age: 32
State: ME

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

Lab Data:

Allergies: NKDA

Symptom List: Tremor

Symptoms: Syncopal episode with spontaneous recovery. Second syncopal episode associated with 15 seconds of asystole on cardiac monitor.

Other Meds: None

Current Illness: None

ID: 1258622
Sex: F
Age: 28
State: CA

Vax Date: 04/14/2021
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: Pears

Symptom List: Erythema, Pruritus

Symptoms: I had a migraine for 4 days, body aches, chills, sore arm where I got my vaccine, tiredness, and now after a week of the injection I have a red rash on my arm where the vaccine was given its very swollen and I'm in a bit of pain.

Other Meds:

Current Illness:

ID: 1258623
Sex: F
Age: 72
State: MN

Vax Date: 04/15/2021
Onset Date: 04/22/2021
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:

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

Symptoms: Erythema around injection site, itching, warmth

Other Meds:

Current Illness:

ID: 1258624
Sex: M
Age: 55
State: CO

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

Lab Data:

Allergies:

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

Symptoms: As the client was exiting the vaccination hallway, the client informed a vaccinator that he felt tingling in his mouth, was experiencing an indescribable taste and his eyes hurt. The client looked flushed. The client was instructed to lay on a mat on the floor. Client drank some juice and ate some pretzels. After 20 minutes he reported that he was no longer experiencing any symptoms. As the client was standing up he reported that he felt dizzy but this resolved as he walked around the room. He then wanted to sit outside so two nurse's went with him . After 40 minutes he reported that all of his symptoms had resolved. We followed up with the client on 4/25/21 and the client reported that he had not experienced any additional symptoms.

Other Meds:

Current Illness:

ID: 1258625
Sex: F
Age: 44
State: TN

Vax Date: 11/19/2019
Onset Date: 11/30/2019
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 known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: About a week and a half later I began to notice soreness in the shoulder joint. It continued and was then met with stiffness in the joint. Stiffness and soreness continued through December and January. By the end of January I was unable to lift my left arm over my head. By February I ceased my yoga practice as I could no longer utilize my left arm. In March my shoulder was so painful I often used a sling to keep the joint still. I contacted my doctor in March and began the process of being referred to a shoulder specialist. April 7, 2020 I had a telemedicine call with Dr. about my shoulder. It is about to time me out; so I will send.

Other Meds: buproprion

Current Illness:

ID: 1258626
Sex: M
Age: 37
State: ND

Vax Date: 04/22/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Allergic to Penicillin.

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

Symptoms: About 11 hours after receiving the COVID-19 Moderena first injection (2 a.m. Friday), I began to have body pains, insomnia, lethargy and general cold/flu symptoms. These symptoms worsened over the course of the day, worsened at times and lasted until late in the evening on Saturday. The worse points included fevers of 101.5 at about 3:30 p.m. Saturday (48 hours after injection) and 100.9 at 7 p.m. (51.5 hours after injection). My fever seemed to break in the middle of the night between Saturday and Sunday. On Sunday morning, I woke up feeling nearly 100%.

Other Meds: None.

Current Illness: None other than brief cold/cough symptoms.

ID: 1258627
Sex: F
Age: 58
State: CA

Vax Date: 04/18/2021
Onset Date: 04/19/2021
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:

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

Symptoms: Site: Bruising at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1258628
Sex: F
Age: 67
State: TX

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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: Lisinopril, Tramadol, Benzonate, Nitrofurantioin Monohyd Macro,

Symptom List: Pain in extremity

Symptoms: Since my second vaccine, I am having very loud tinnitus in both ears.

Other Meds: Synthroid 88 mcg Amlodipine Besylate 5 mg

Current Illness: Very mild tinnitus since 2017, after neck surgery.

ID: 1258629
Sex: F
Age: 68
State: IL

Vax Date: 03/14/2021
Onset Date: 04/22/2021
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: Advil, metronidaz, amlodipine, fessalon, hydrocodone-norco, nadolol, lisinopril, spriospirondactone.

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

Symptoms: Blood clots in the left leg and in the lungs.

Other Meds: Vitamin D

Current Illness: None

ID: 1258630
Sex: F
Age: 48
State: MI

Vax Date: 03/26/2021
Onset Date: 03/27/2021
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: contrast dye, penicillin, septra, Rituxin

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

Symptoms: Small somewhat superficial slightly less than quarter sized palpable firm tissue overlying the right deltoid at the site of vaccine injection. No erythema, no tenderness, no swelling. Improving but not fully recovered yet.

Other Meds: mycophenolate, pyridostigmine, vilazodone

Current Illness: n/a

ID: 1258631
Sex: M
Age: 16
State: TX

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

Lab Data:

Allergies:

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

Symptoms: Patient received his first dose and fainted in the chair immediately after, when he saw a drop of blood trickle down his arm. Patient regained consciousness right after. Patient was monitored closely in observation and left the vaccination site in stable condition.

Other Meds:

Current Illness:

ID: 1258632
Sex: M
Age: 62
State: PA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Yellow dye

Symptom List: Vomiting

Symptoms: reported tingling in bilateral arms post vaccine , set of vitals were in normal range after comfort measures were taken discharged to home

Other Meds: Glipizide,Losartin,Hydrochlorothiazide,Meclizine

Current Illness:

ID: 1258633
Sex: M
Age: 43
State: PA

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

Lab Data:

Allergies: n/a

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: painted fainted, woke up in under a minute, checked by EMS, refused to go to hospital because said was ok

Other Meds: unknown

Current Illness: none

ID: 1258634
Sex: F
Age:
State: FL

Vax Date: 04/16/2021
Onset Date: 04/17/2021
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:

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

Symptoms: Neck pain started last night, right side of neck, putting ice on her neck.

Other Meds: none

Current Illness:

ID: 1258635
Sex: F
Age: 38
State: AZ

Vax Date: 04/05/2021
Onset Date: 04/11/2021
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: Penicillin and mussels

Symptom List: Injection site swelling, Limb discomfort

Symptoms: On day 6 after I had trouble with my concentration my right arm started trembling with uncontrollable tremors and my speech started to slur and I couldn?t get my words out. My friend came over that?s a nurse and talked to me we didn?t think it was a stroke or if it was it was a mini one because I could start to tak and came back to normal with in a couple of hours. By wednesday the symptoms started again. I went to the Emergency Room. They determined that it has to be neurological and I am following up with my primary care. I have an MRI scheduled May 3rd

Other Meds: Curcumin, cysteine, vitamin D, vitamin C

Current Illness: N/A

ID: 1258636
Sex: F
Age: 52
State: CO

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: RA

Lab Data:

Allergies: coconut, morphine, opioids, wasps, betadine, cephalosporins, iodine, lidocaine, strawberry, codeine, penicillins

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: shortly after receiving vaccination patient reported tongue and throat itching but able to swallow. Administered diphenhydramine 25 mg. Vital signs: pulse 100 beats per minute, blood pressure 136/78 mmHg, respirtory rate 21 breaths per minute, and pulse oximetry 95% on room air. Patient observed, symptoms improved, and patient discharged to home stable.

Other Meds: albuterol, cyclobenzaprine, diclofenac topical, Epi-pen, fluoxetine, fluticasone-umeclindinium-vilanterol, hydroxyzine, ibuprofen, loratadine, metformin, naproxen, nedocromil, omeprazole, varenicline

Current Illness: allergic rhinitis, allergic conjunctivitis

ID: 1258637
Sex: F
Age: 52
State: GA

Vax Date: 04/16/2021
Onset Date: 04/19/2021
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: Latex

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

Symptoms: 4 days after shot blood glucose elevated up to 400 and higher. Memories decreased.. at first thought maybe I forgot to give my injection. Had a friend help me with it. No, nothing ,I was doing. Had forgotten I had The vaccine until my friend told me we had it together . Then was told needed to report issues, just Incase. Increase memory loss and elevated Blood sugar. Returning on migraines .

Other Meds: No

Current Illness: Diabetic-1989 Brain injury 2015?

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm