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: 1262624
Sex: F
Age: 57
State: FL

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/27/2021
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: Penicillin, Avelox, Cipro, Levaquin, Zithromax, Compazine, Darvocet, Montelukast, Armour, Synthroid, Tirosint, Trokendi, Lomaira, Gadolinium, Xylitol

Symptom List: Dysphagia, Epiglottitis

Symptoms: Itching started in the mouth then spread to lips and face, then progressed to thickening of throat and difficulty swallowing.

Other Meds: None

Current Illness: None

ID: 1262625
Sex: M
Age: 67
State: NY

Vax Date: 02/05/2021
Onset Date: 03/03/2021
Rec V Date: 04/27/2021
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: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Hemolytic anemia after receipt of Moderna vaccine

Other Meds: BuSpar [buspirone] Adult Aspirin EC Low Strength [aspirin] Zegerid OTC [omeprazole-sodium bicarbonate] amlodipine 10 mg tab Oral Augmentin [amoxicillin-pot clavulanate] 500-125 mg 1 tab Oral three times a day albuterol sulfate 90 mcg/actuat

Current Illness: Hypertension, Polycythemia vera

ID: 1262626
Sex: M
Age: 67
State: MO

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 04/27/2021
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:

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

Symptoms: No noticeable symptoms on the first day. On day two, the patient experienced swelling and pain in the left arm which evolved into flu-like body aches and pains, as well as a fever not exceeding 101 F. This continued until day 3 in which symptoms were still present but much improved.

Other Meds: Methylphenidate 20mg every 6 hours Trazodone 200mg in the evening Losartan 200mg daily Hydrochlorothiazide 12.5mg daily Paroxetine 40mg daily

Current Illness: Anxiety disorder(s) Behavioral/Emotional disorder(s) Essential Hypertension

ID: 1262627
Sex: F
Age: 52
State: NY

Vax Date: 04/20/2021
Onset Date: 04/24/2021
Rec V Date: 04/27/2021
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: Mild ache, slight warmth, itchy rash.

Other Meds: daily vitamin (Centrum Silver-women's), Omeprazole 20mg qd, Lipitor 20 mg qd

Current Illness: None

ID: 1262628
Sex: M
Age: 49
State: TN

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Severe rash - covering most of back and front of trunk. ear ringing.

Other Meds: none

Current Illness: none

ID: 1262629
Sex: M
Age: 37
State: PA

Vax Date: 03/31/2021
Onset Date: 04/05/2021
Rec V Date: 04/27/2021
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: Sulfa

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

Symptoms: Tinnitis- constant high pitched noise in left ear and ear easily clogs. No wax build up and no loss of hearing.

Other Meds: None

Current Illness: None

ID: 1262630
Sex: F
Age: 22
State: FL

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 04/27/2021
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: Immediately after vaccine, L arm was in pain, 2 days after vaccine, she begin to have a swollen neck on left side and L arm pits. She had a doctors visit on 04/15/2021, no prescription but she has been taking advil 200 2 tabs, 2x daily every 8 hrs. RN recommendation. She is no longer having any swelling or pain. She asked if she should receive the second dose, RN states yes. Her adverse reaction was mild with no respiratory issues. The benefits of her second dose outweighs the possible adverse reaction. Patient is agreeable.

Other Meds: Ibuprofen

Current Illness:

ID: 1262631
Sex: F
Age: 28
State: OR

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: Day 1 - 8:50am Soreness in left arm at injection site; 12:00pm Body aches Day 2 - 5:00am Fever, Tiredness, Body aches; 8:00pm Tiredness, Body aches, Tooth sensitivity on upper left side of mouth Day 3 - 5:30am Soreness in left armpit, Tooth sensitivity on upper left side of mouth

Other Meds: Glucosamine, Allertec, Vitamin D3

Current Illness: N/A

ID: 1262632
Sex: M
Age: 68
State:

Vax Date: 03/01/2021
Onset Date: 03/26/2021
Rec V Date: 04/27/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient was seen in the ED/hospitalized within 6 weeks of COVID vaccine

Other Meds:

Current Illness:

ID: 1262633
Sex: F
Age: 44
State: PA

Vax Date: 04/06/2021
Onset Date: 04/10/2021
Rec V Date: 04/27/2021
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: prednisone

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I was menstruating at the time of the vaccine, beginning on April 2. I am still menstruating today, April 27, without ceasing. Beginning April 10, I began menstruating extremely heavy, with very large clots. I am under a physicians care and being tested for anemia and have an ultrasound scheduled as well.

Other Meds: hydroxychloroquine, multivitamin

Current Illness: I am undergoing medical testing for a possible autoimmune illness

ID: 1262634
Sex: F
Age: 40
State: MA

Vax Date: 04/10/2021
Onset Date: 04/14/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, lactose intolerance

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

Symptoms: Wed, April 14: headache, light headed, feeling of going to pass out, blurred vision, very tired, weak, diarrhea. Thur April 15 ? very light headed, feeling of going to pass out, numb pinky, very weak, very shaky, very tired. Went to ER after almost passing out they gave me fluids, did a chest xray and ekg, covid test, pregnancy test. They sent me home saying I was dehydrated. ? slept for 4 hours after ER, felt tired, hard to focus, diarrhea then that night slept all night. Fri April 16 ? a bit better in morning but vision still not right, at dinner table felt drunk (did not have any alcohol), very tired, face felt flushed (no fever), hard to focus, headache came on before bed (took 2 Aleve) Sat April 17 ? tired, went to doctor for additional blood work, slept after appointment, face flush (no fever), vision still not right. Doctor said this is likely vaccine related. Sun April 18 ? felt same as Saturday Mon April 19 ? very tired, vision still not right, hard to focus at work, want to sleep, face felt hot and tingly (no fever) Tue April 20 ? allergy type symptoms in morning. Sneezing, runny nose, slight headache. These symptoms went away. From April 21-28 - other symptoms mostly going away except vision issues. April 28th most symptoms went away but vision is still blurry, see floaters, feels like I have Vaseline over my eyes. Going to see an eye doctor ASAP.

Other Meds: Lexapro

Current Illness: none

ID: 1262635
Sex: F
Age: 39
State: TN

Vax Date: 01/30/2021
Onset Date: 02/21/2021
Rec V Date: 04/27/2021
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: sulfa sensitivity

Symptom List: Rash, Urticaria

Symptoms: Menstrual Cycle Normally I have a very mild 3 day period. In February my period was a week and much heavier. March brought on a very heavy 2 week period.

Other Meds: na

Current Illness: none

ID: 1262636
Sex: F
Age: 49
State: CT

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/27/2021
Hospital: Y

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

Lab Data:

Allergies: Morphine, Penicillin, Bactrim, Clindamycin, Erythromycin, latex

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

Symptoms: In vaccine clinic, 10-15 min after vaccine administration, c/o throat tingling. Given waters with vitals taken. given diphenhydramine 50 mg PO. Transferred to ED for throat swelling minutes after received Moderna Covid Vaccine. Reports hoarse voice and difficulty breathing. No rash, hives, diarrhea, abdominal pain or dizziness. BP 138/80 HR 110, RR 18 SpO2 96%, EpiPen, methylprednisolone, and famotidine given. No improvement within 15 minutes, so second EpiPen administered with gradual improvement in symptoms. Gradually developed chest pain approx 1.5 hours after 2nd dose Epi. Troponin ordered and EKG in setting of unchanged tachycardia HR 108-no acute ischemia. Kept overnight for observation. Discharged with shor t course prednisone and famotidine and advised to avoid 2nd vaccination. Re-presented to ED 48 hours later with c/o chest tightness that never completed resolved and increased SOB despite taking the prednisone and famotidine. Noted to have maculopapular rash on anterior chest. Treated with methylpred, around the clock diphenhydramine and famotidine. Discharged with albuterol MDI and medrol dosepak with instructions to stop prednisone, but continue famotidine. Referral to Allergy/Immunology pending.

Other Meds: Vitamin D, Multivitamin

Current Illness: N/A

ID: 1262637
Sex: F
Age: 44
State: MA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/27/2021
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: Prolonged headache (7-10 days), metallic taste in mouth, brain fog, fatigue, light fever (1-2 days after)

Other Meds: None

Current Illness: none

ID: 1262638
Sex: F
Age: 65
State: NY

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/27/2021
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: Mushrooms, penicillin, valsartan, tetracyclin, statins, sulfa

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

Symptoms: 65F with HTN, numerous drug and medication allergies, presents to ED with complaints of chest tightness and palpitations after receiving her 2nd COVID vaccination shot 10 min prior to ED arrival. Pt reports that this is how she felt after she got her flu shot and she typically takes prednisone and symptoms abate. Pt denied having any chest tightness here in ED. No fevers, no coughing, no rashes, no pruritis.

Other Meds: No active medications

Current Illness: No active problem

ID: 1262639
Sex: F
Age: 55
State:

Vax Date: 04/13/2021
Onset Date: 04/15/2021
Rec V Date: 04/27/2021
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: Fatigue, nausea, diarrhea and tachycardia 48 hours post second COVID vaccine.

Other Meds:

Current Illness:

ID: 1262640
Sex: M
Age: 68
State: SD

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Flat red rash with bumps started on back day after vaccine. About one week later shoulder and neck pain. A few days after that chills and fatigue and increased neck pain requiring emergency room visit. Had fever, elevated BP and decreased oxygen level with extreme neck pain. Treated and released with medication. Negative CT of head and neck. Next day had extremely swollen uvula and sore throat requiring sleeping elevated to breath. Throat was not examined in ER night before. Unable to get up by himself and slept for 27 hrs except for occasional trip to bathroom. He is recovering now.

Other Meds: lisinopril, levothyroxin, rosovastatin, vitamin D, tumeric, zinc, fish oil, protandim

Current Illness: None

ID: 1262641
Sex: F
Age: 23
State: VA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/27/2021
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: 0945 Client arrived at vaccination table 0949 Client received Pfizer #1 0950 Safety officer called to vaccine table as patient had lost consciousness after receiving her vaccine 0950 Client transferred to EMS area where she was monitored until symptoms resolved

Other Meds: Loestrin BCP

Current Illness: None

ID: 1262642
Sex: F
Age: 58
State: FL

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient is a Spanish speaker, per interpreter, patient is experiencing fatigue, syncope, muscle aches, runny nose, headache, lips are getting dark. No SOB voiced. Recommended to take Tylenol, stay hydrated and an OTC antihistamine, as for the lips becoming dark, I recommended for her to see a medical provider. 4/22/21- Follow Up: Patient stated she is still not feeling so well because of the cramps all her symptoms have subsided besides the nerve pain in her body. She only took tylenol and and takes it every morning and night and it has been helping. She didnt go to an ER/Urgent but she is going to see her PCP on 4/22/21. Advised to continue with the tylenol and will call back on Friday 4/23/21 to follow up and see what PCP advised.4/24/21- Follow up- patient stated she is feeling better and all her symptoms have subsided with the tylenol, no pcp/er visit.

Other Meds: metoprolol

Current Illness:

ID: 1262643
Sex: M
Age: 16
State: IL

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

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

Lab Data:

Allergies: no

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

Symptoms: periorbital petechiae

Other Meds: adderall

Current Illness: no

ID: 1262645
Sex: F
Age: 47
State: MN

Vax Date: 04/18/2021
Onset Date: 04/26/2021
Rec V Date: 04/27/2021
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: none

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

Symptoms: I have what is described online as "Covid Arm"., with a large 5 inch diameter red circle on injection site. Very itchy and painful. Happened 8 days after first injection. I have taken a photo.

Other Meds: none

Current Illness: none

ID: 1262646
Sex: M
Age: 38
State: CO

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies: Tylenol

Symptom List: Unevaluable event

Symptoms: Second dose given 7 days after 1st dose. Offender has denied any complications.

Other Meds: None

Current Illness: None

ID: 1262647
Sex: F
Age: 53
State: IA

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/27/2021
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: Cinnamon, intolerant of High Fructose Corn Syrup, Maxsult, Norco

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

Symptoms: Case reports almost exactly 24 hour post 2nd vaccine, watery diarrhea started, felt it smelled "medicinal". Is still having loose/soft stools. PCP told her she needed to call Public Health and make a report

Other Meds: Gabapentin, Percocet 5/325, meloxicam, baclofen, Vit D, collagen, super B, Probiotics,

Current Illness: Was on two different ATB in at the end of February for Sinus infection. The first ATB worked, but infection came back, was then put on Augmentin and 2 days later was in the ED with severe abdominal cramping.

ID: 1262648
Sex: F
Age: 43
State: NC

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/27/2021
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: Whey protein (dairy) - anaphylaxis/anaphylactic shock

Symptom List: Injection site pain, Pain

Symptoms: Awakened during the night (approx 2:30 am) with extreme pain in ALL joints (ankles, knees, hips, shoulders and neck). 10 of 10 on pain scale. Lost consciousness several times due to amount of pain and was not able to get up until approx 6 am. Could not think straight due to pain and took approx 25mg of liquid Benadryl (out of habit due to food allergy) at that time. By 7 am, symptoms had reduced to dull muscle and joint aches and fatigue (3 of 10 on pain scale). Temperature read at 103.2F to 103.4F from 7am to 11pm that night. Was unable to take temperature during peak of symptoms. All symptoms resolved completely by 8am on 4/18/21. Did not seek medical treatment since symptoms responded to Benadryl. Please note, for comparison I would rate a broken bone as a 6 of 10 on the pain scale. This is now the worst pain I have ever experienced in my life.

Other Meds: Vitmain D 5000 UI

Current Illness: NONE

ID: 1262649
Sex: F
Age: 78
State: FL

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: vomiting, diarrhea, n/v, metallic taste in mouth, syncope, weakness, anorexia, abdominal cramping Drinking warm ginger-ale, dried cheerios, sips of water with some relief. Recommended Mylanta to help soothe stomach. 4/23-symptoms lasted 1 week; feels improved. Still fatigues easily.

Other Meds: Synthroid

Current Illness:

ID: 1262650
Sex: F
Age: 64
State: AZ

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/27/2021
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: Tetnaus

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

Symptoms: Fever, chills, muscle twitching in left arm.

Other Meds: Tramedol, diclofenac, metformin, crestor

Current Illness: None

ID: 1262651
Sex: F
Age: 64
State: MI

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/27/2021
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 had received Moderna at Pharmacy as first Covid vaccine. Patient self-scheduled to received second dose. Patient was inadvertently given Pfizer Covid vaccine as a second dose. No adverse events resulted.

Other Meds:

Current Illness:

ID: 1262652
Sex: M
Age: 78
State:

Vax Date: 02/25/2021
Onset Date: 03/11/2021
Rec V Date: 04/27/2021
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 was seen in the ED/hospitalized within 6 weeks of COVID vaccine

Other Meds:

Current Illness:

ID: 1262653
Sex: F
Age: 36
State: WI

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 04/27/2021
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: wheat/gluten allergy, intolerant to corn/sugar/dairy

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

Symptoms: I felt drunk, and then had severe pain. My skin hurt, hair hurt, muscles and entire body hurt. Freezing shivers. The severe pain lasted about 36 hours and I had about 2 weeks of fatigue that would come and go. I still have bouts of fatigue and shortness of breath now.

Other Meds: doxycycline, womens multi vitamin, probiotic, zyrtec (all daily)

Current Illness: none

ID: 1262654
Sex: M
Age: 20
State: TX

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Light headedness, Sweating

Other Meds:

Current Illness:

ID: 1262655
Sex: M
Age: 22
State: IN

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies: No known allergies per patient.

Symptom List: Injection site pain

Symptoms: Patient experienced seizure like activity 10 minutes after receiving the vaccine. Patient tensed up and became unresponsive. He was slightly shaking. This lasted for under a minute (RN estimated 20-30 seconds). Has had one seizure in the past as a child. Currently not taking any medications for this.

Other Meds: None known, verified not on any medications for seizures.

Current Illness:

ID: 1262656
Sex: F
Age: 59
State: NC

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

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

Lab Data:

Allergies: PCN

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

Symptoms: Petechiae on leg. 4 small red dots, 7 days after vaccine.

Other Meds: Tamoxifen, fish oil, vitamin E, vitamin B, calcium, vitamin c, vitamin d, ginkgo biloba

Current Illness: None

ID: 1262657
Sex: F
Age: 68
State: FL

Vax Date: 01/28/2021
Onset Date: 02/05/2021
Rec V Date: 04/27/2021
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: iodine contrast

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

Symptoms: Intense and recurring diarrhea, abdominal cramps and bloating. Also persistent discomfort in left upper quadrant. Symptoms continuing for over 2 months.

Other Meds: synthroid omeprazole vit D Multi-vitamin

Current Illness: hypothyroid GERD lichen sclerosus

ID: 1262658
Sex: F
Age: 42
State: TX

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/27/2021
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: On 4/9, let eye turned red along with burning, itching, swelling, tearing in the eye. Swelling in the armpit. On 4/11, the pain in the eye became quite severe. Eye was also sensitive to light and touch. On 4/13, elevated ESR levels (67) were detected and Prednisone (60mg daily) s was prescribed. On 4/14, optometrist diagnosed iritis and prescribed Prednisone eye drops. On 4/19, further tests ruled out other possible causes for iritis and Prednisone was stopped.

Other Meds: Prednisone 20mg, prednisone acetate ophthalmic suspension 1%, ibuprofen 200mg, acetaminophen 500mg

Current Illness: Anemic

ID: 1262659
Sex: F
Age: 68
State: MD

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/27/2021
Hospital: Y

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

Lab Data:

Allergies: Contrast dye, Iodine, Latex, Penicillins, Except

Symptom List: Erythema, Pruritus

Symptoms: Per patient she was feeling fine with her treatment (said dose was given) till she went home and felt so tired that she couldn't eat the next day (April 13, 2021). So her daughter called ambulance and sent her to the hospital. In the hospital, a lot of tests and procedures were done including cardiac cath. One of the patient's nephrologists stated that patient admitted with possible myocarditis after her second shot of Covid but no significant intervenable disease after the cardiac catherization and it's difficult to attribute it to the shot completely. Patient got discharged from the hospital on April 17, 2021.

Other Meds:

Current Illness:

ID: 1262660
Sex: M
Age: 16
State: IL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/27/2021
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: No known

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

Symptoms: Pt had a seizure roughly 5 min after receiving the vaccine

Other Meds: N/A

Current Illness: No known

ID: 1262661
Sex: F
Age: 17
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/27/2021
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: Hives/itchiness mon upper chest, R arm&leg , self resolved in 15 min

Other Meds:

Current Illness:

ID: 1262662
Sex: F
Age: 68
State: DC

Vax Date: 04/01/2021
Onset Date: 04/26/2021
Rec V Date: 04/27/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Two weeks after 2nd dose, suddenly have ?shoosh? or ?thrum thrum? sound in right ear. In time with heartbeat. Not very loud but noticeable when quiet or trying to sleep. Hope it goes away!

Other Meds: Phenobarbital daily for epilepsy lifelong

Current Illness: Epilepsy Shingles (ended early March).

ID: 1262663
Sex: F
Age: 24
State: KS

Vax Date: 04/17/2021
Onset Date: 04/25/2021
Rec V Date: 04/27/2021
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

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

Symptoms: She explained a raised area (like a knot) on her arm at injection site occurred a couple days after vaccine. It went down after a few days and then reoccurred on day 9 and got bigger through day 10. She indicated it was about twice the size of the 1st time. Complained of tenderness, irritation, feeling nauseated and having headache. I called her on day 11 and she said she felt it was starting to subside and she felt a little better.

Other Meds: None

Current Illness: None

ID: 1262664
Sex: F
Age: 60
State: FL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/27/2021
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: Talked to PCP the day before the 2nd dose, knows about headaches after first dose. Still encouraged her to take 2nd dose. Tried to but unable to get into contact (over the phone) with PCP.Per Poisons Specialist - if taking the migraine medication (Ubrelvy) does not help with the headache, you can take tylenol (according to package instructions) and see if your headache subsides. If it does not subside, please seek a health care provider to get help with your symptoms. In regards to your blood pressure (BP) medication (Metroprolol, Losartan, Lyrica) - you mentioned you took your blood pressure measurement before you took your medication. Please measure it again, if it is still high despite already taking your BP medications please speak to your cardiologist.

Other Meds: Metroprolol 50 mg in morning and 50 mg at night - Losartan 100 mg a day - Lyrcia 100 mg 3 times a day - Ubrelvy 50 mg when needed for migraines (taken yesterday and today)

Current Illness:

ID: 1262665
Sex: F
Age: 43
State: WI

Vax Date: 04/05/2021
Onset Date: 04/12/2021
Rec V Date: 04/27/2021
Hospital:

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

Lab Data:

Allergies: Levofloxacin (Levaquin)

Symptom List: Pain in extremity

Symptoms: Mon 4/12/21 - Headaches started and have continued daily. Tue 4/13/21 - Soreness in right calf muscle, continued for 4 days. Headache continued. Wed 4/14/21 - Sharp pain in pelvis (right and left side) same location I experienced pain the day of receiving vaccine. Occasionally felt this pain 2 or 3 times / day for 2 days. Sought medical attention at ED on the advice of our Nurse Call Center. Was evaluated for blood clots, none found on this day. CT scan, ultrasound of both legs, blood tests. Returned home with directions to take Extra Strength Tylenol for headache. Thu 4/15/21 - Shooting pain in random parts of my body, mostly legs and arms. Experienced throughout this day only. As of 4/27/21, 22 days after being vaccinated, I am still experiencing headaches. More noticeable when I am exerting myself - walking outside for 1-2 minutes triggers the headache. Headaches are usually located in the lower back of my head. Before being vaccinated, I would experience less than 1 headache per month, and they go away within the day.

Other Meds: Daily multivitamin

Current Illness: Between 7 hours and 14 hours after having vaccine on 4/5/21, I had severe chills, severe headache, internal sharp pain in my pelvis (right and left side).

ID: 1262666
Sex: F
Age: 19
State: MN

Vax Date: 04/17/2021
Onset Date: 04/23/2021
Rec V Date: 04/27/2021
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: Costochondritis.

Other Meds: None

Current Illness: None

ID: 1262667
Sex: F
Age: 21
State: MT

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/27/2021
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: Patient received first dose of Moderna Vaccine on 3/8/2021 Lot 036A21A, second vaccine received on 4/5/2021 was Pfizer Dose. Patient reports no side effects, no issues with receiving two different vaccines. Patient was advised that she was fully vaccinated and no further immunizations were required.

Other Meds: None

Current Illness: None

ID: 1262668
Sex: M
Age: 40
State:

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/27/2021
Hospital: Y

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

Symptoms: Patient found unresponsive and transported to ED. Currently hospitalized and admitted with following issues: Present on Admission: ? Intraventricular hemorrhage (HCC) ? Bilateral thalamic hemorrhage ? Acute encephalopathy ? Abnormal eye movements ? Respiratory failure requiring intubation (HCC) ? Mucoid impaction of bronchi

Other Meds:

Current Illness: None known

ID: 1262669
Sex: F
Age: 31
State: MI

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 04/27/2021
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: N/A

Symptom List: Vomiting

Symptoms: Chills, muscle aches (~6 hours)/fatigue, headache (~24 hours); Advil; symptoms resolved after 24 hours

Other Meds: N/A

Current Illness: None

ID: 1262671
Sex: F
Age: 29
State: MA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/27/2021
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: MORPHINE (ANAPHYLAXIS)

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: HIVES ON CHEST, UPPER BACK, L ARM SELF-RESOLVED IN 15 MIN 2ND DOSE IN SERIES BAND-AID REMOVED FROM L ARM

Other Meds: NONE

Current Illness: NONE

ID: 1262672
Sex: F
Age: 31
State: MA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/27/2021
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: latex (no latex gloves used), shrimp, juniper

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

Symptoms: redness and hives on the face. No problems with breathing, lips, trouble swallowing. Redness to injection site.

Other Meds: escitalopram, Norethindrone Acet-Ethinyl Est 1-20 MG-MCG Tablet and Mirena IUD,

Current Illness: no

ID: 1262673
Sex: M
Age: 34
State: MD

Vax Date: 04/01/2021
Onset Date: 04/14/2021
Rec V Date: 04/27/2021
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: No

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Tnnitus

Other Meds: Np

Current Illness: No

ID: 1262674
Sex: F
Age: 58
State: IN

Vax Date: 03/23/2021
Onset Date: 04/02/2021
Rec V Date: 04/27/2021
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 allergy

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

Symptoms: I developed shingles on my neck and upper back.

Other Meds: Plaquenil, Prednisone, Restasis, Metoprolol, lisinopril, furosemide, Diclofenac Sodium, Vitamin D, Folic acid

Current Illness: Systemic lupus, Sjogren's syndrome, Reynauds

ID: 1262675
Sex: F
Age: 21
State: MA

Vax Date: 12/22/2020
Onset Date: 04/19/2021
Rec V Date: 04/27/2021
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: allergic to doxycyline

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

Symptoms: Mild cough, runny nose, loss of taste and smell, Headache, sore throat, nausea beginning on 4/20/21

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm