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: 1262729
Sex: F
Age: 43
State:

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

Symptom List: Dysphagia, Epiglottitis

Symptoms: near syncope, refusal to EMS

Other Meds:

Current Illness:

ID: 1262730
Sex: F
Age: 54
State: MO

Vax Date: 03/25/2021
Onset Date: 04/26/2021
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: Bananas, honey, peanuts, eggs - all of these foods give severe stomach cramps - haven't been tested for allergy to them, I just stay away from them because of how they make me feel.

Symptom List: Anxiety, Dyspnoea

Symptoms: After 16 months without a period, I am now bleeding again, 4 weeks after my first shot.

Other Meds: One a day women's vitamins; AZO bladder control/Probiotic supplement

Current Illness: NONE

ID: 1262731
Sex: M
Age: 44
State: AZ

Vax Date: 04/21/2021
Onset Date: 04/24/2021
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: none

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

Symptoms: Tender left shoulder, with a cyst or lump on collar bone. very tender to touch.

Other Meds: none

Current Illness: none

ID: 1262732
Sex: F
Age: 49
State:

Vax Date: 04/01/2021
Onset Date: 04/10/2021
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: I have Bells Palsy I know at least one other person who lives near me with the same How can this be so rare ? I'm so afraid to get the second shot Please tell me something

Other Meds: none

Current Illness: sore throat

ID: 1262733
Sex: F
Age: 75
State: NY

Vax Date: 04/19/2021
Onset Date: 04/19/2021
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: Penicillian Sulphur

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

Symptoms: Heart palpitations and Heaviness in chest. Lasted through the evening and for a few hours the next day.

Other Meds: Timolol Maleate 0.5%

Current Illness: N/A

ID: 1262734
Sex: M
Age: 68
State: NV

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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: MRT5

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

Symptoms: No adverse reaction. Patient received 3rd dose.

Other Meds:

Current Illness:

ID: 1262735
Sex: F
Age: 82
State: FL

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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 10 days later pt called to say arm still hurts, swollen and hard to the touch, has worsened since receiving vaccine

Other Meds: pantoprazole, prednisone, folic acid, trazodone, hydroxyzine, gabapentin, methotrexate, simvastatin, alendronate, albuterol

Current Illness: unknown

ID: 1262736
Sex: F
Age: 25
State: MA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nka

Symptom List: Pharyngeal swelling

Symptoms: needle malfunction, less than 50% of dose administered, patient re-dosed

Other Meds: odc

Current Illness: n/a

ID: 1262737
Sex: M
Age: 27
State: CA

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

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: ANXIETY, DIZZINESS TX: HYDRATE, SNACK/REPOSITION/COLD COMPRESS SX: RESOLVED NO TRANSPORT

Other Meds:

Current Illness:

ID: 1262738
Sex: M
Age: 71
State: FL

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nka

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Nursing home, contacted CHD to administer COVID vaccines to 18 individuals who had not received the vaccine yet. was one of them. Upon return to the CHD to put dose in flshots, the nurse realized the patient had in fact received two doses of the Pfizer vaccine previously. The nursing home was called and advised to monitor closely for three days . No adverse side effects were seen. Measures were put in place to prevent this from happening again.

Other Meds:

Current Illness:

ID: 1262739
Sex: M
Age: 24
State: VT

Vax Date: 04/26/2021
Onset Date: 04/26/2021
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: Allergic to medication in the cillin family

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

Symptoms: A few hours after receiving the vaccine the patient felt dizzy. It subsided and the patient fell asleep. Upon waking up it was much worse and resulted in the patient almost falling down the stairs.

Other Meds: Alleve

Current Illness: None

ID: 1262740
Sex: F
Age: 60
State: NY

Vax Date: 04/09/2021
Onset Date: 04/12/2021
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: Celebrex

Symptom List: Rash, Urticaria

Symptoms: Woke up in the middle of the night with ringing ears - still ringing

Other Meds: atorvastatin, 20 mg

Current Illness: none

ID: 1262741
Sex: F
Age: 59
State: PR

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: penicilline, sulfa and hydrchloritiazide

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

Symptoms: Tiredness, headache, muscle pain, chills, fever, stomach pain, redness, pain and swelling in area

Other Meds: none

Current Illness: none

ID: 1262742
Sex: F
Age: 36
State: WI

Vax Date: 04/05/2021
Onset Date: 04/22/2021
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: Beta-lactam antibiotics, mercaptopurine analogues

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

Symptoms: Patient received vaccine on 4/5/21. She presented to her PCP on 4/22 with swelling and redness in the inside upper area of her right arm. Determined to be a superficial thrombosis. Patient has not history of VTE, but does smoke. Uses a Mirena IUD for contraception as well. Platelet count remained normal during this time, and was never affected.

Other Meds:

Current Illness: N/A

ID: 1262743
Sex: M
Age: 56
State: FL

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: LA

Lab Data:

Allergies: Toradol (severe - heart attack, palpitations, sweats).

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

Symptoms: Left arm pain, hard area-lump, decreased range of motion of left upper extremity. Symptoms started within a few hours after vaccination and have worsened over the past 6 weeks. Symptoms still present.

Other Meds: Allopurinol, amlodipine, diclofenac, duloxetine, ergocalciferol, furosemide, iron, Jardiance, Lantus, lisinopril, metformin, metoprolol tartrate, mupirocin, Novolog, simvastatin, tizanidine

Current Illness: N/A - no acute problems.

ID: 1262744
Sex: M
Age: 17
State:

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

Lab Data:

Allergies:

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

Symptoms: Syringe Fail

Other Meds:

Current Illness:

ID: 1262745
Sex: F
Age: 61
State: FL

Vax Date: 04/21/2021
Onset Date: 04/22/2021
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: I took all of my medications around 9pm on 4/21/2021 (was fatigued, went to bed early). I woke up on 4/22/2021 with continual brain synapse misfirings (brain zaps) which occurs from anti-depressant withdrawal. It's as if the venlafaxine was not absorbed by my body. I became despondent, severely depressed, anxious, cried non-stop with the brain zaps occurring non-stop. I felt as though I was having a nervous breakdown. I went to sleep that evening (took all my medication per usual) and work up the next morning fatigued but the brain zaps were gone and emotionally I was feeling much better.

Other Meds: Venlafaxine HCL ER 150 mg Q.D. Valsartan 80 mg Q.D. Exemestane Tabs 25 mg Q.D.

Current Illness: none

ID: 1262746
Sex: M
Age: 29
State: CO

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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: Divalproex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Offender given 2nd dose 8 days after first dose. Offender states nausea and vomiting pain in head and sides. SOB, Epinephrin 1mg IM offender states that helped.

Other Meds: None

Current Illness: None

ID: 1262747
Sex: F
Age: 17
State: VA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
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: NONE

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: CLIENT RECEIVED FIRST MODERNA VACCINE AND CLIENT WAS 17 YEARS OLD. CURRENTLY MODERNA IS ONLY INDICATED FOR 18 YEARS AND OLDER.

Other Meds: NO NE

Current Illness: NONE

ID: 1262748
Sex: M
Age: 30
State: MA

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

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

Symptoms: NEEDLE RETRACTED AFTER IN ARM MOST FLUID FELL ON PATIENT ARM. LESS THAN 50% VOLUME ADMINISTERED. PT. REDOSED W/O FURTHER ISSUE

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1262749
Sex: F
Age: 46
State:

Vax Date: 04/20/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Swelling/pain at site of injection

Other Meds: none

Current Illness:

ID: 1262750
Sex: F
Age: 61
State: OR

Vax Date: 03/24/2021
Onset Date: 03/28/2021
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: Doxycycline, levofloxacin, prednisone

Symptom List: Unevaluable event

Symptoms: Eczema flare, nausea, dizziness, itching

Other Meds: Amlodipine, atorvastatin, benadryl, biotin, calcium, Flonase,

Current Illness: None

ID: 1262751
Sex: F
Age: 39
State: NJ

Vax Date: 04/22/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: flu-like symptoms for about 32 hours including low-grade fever, muscle and joint pain, overall discomfort at about an 8 of 10 reduced to about a 5 w/ 400 mg Tylenol. Still experiencing "brain fog" on day 4 post vaccination

Other Meds: Vitamin C, Vitamin D, Adderall 15 mg QD / PRN

Current Illness: n/a

ID: 1262752
Sex: F
Age:
State: MA

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Anything with iodine, clams, oysters, scallops

Symptom List: Injection site pain, Pain

Symptoms: Became dizzy when she bent into the freezer and remains with "vertigo". Unable to walk without a cane or walker.

Other Meds: Vit D, Met Formin

Current Illness: none

ID: 1262753
Sex: F
Age: 59
State: RI

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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: sulfas, penicillin, most antibiotics, tetanus

Symptom List: Injection site pain, Menorrhagia

Symptoms: generalized itchiness, no rash at 08:50. Benadryl 25mg given with good effect. Itch resolved

Other Meds: herbal supplements, vitamins

Current Illness:

ID: 1262754
Sex: F
Age: 65
State: NY

Vax Date: 03/08/2021
Onset Date: 03/10/2021
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: E-MYCIN, CITRUS, CODINE

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

Symptoms: JOINT, HAND, ARM AND SHOULDER PAIN. SEVERE NAUSEA, LEG TINGLING AND PAIN. CHEST PALPITATIONS. GENERAL WEEKNESS AND TIREDNESS.

Other Meds: COZAAR, REPAGLINIDE, INOSITOL, AMERICAN GINSENG

Current Illness: NONE

ID: 1262755
Sex: M
Age: 52
State:

Vax Date: 04/11/2021
Onset Date: 04/11/2021
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: syringe failure with first dose, no vax administered, second dose adminstered with no failer

Other Meds:

Current Illness:

ID: 1262756
Sex: F
Age: 17
State: MA

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: needle malfunctioned, less than 50% of vaccine administered, patient re-dosed

Other Meds: qvar inhaler-regular

Current Illness: none

ID: 1262757
Sex: F
Age: 56
State:

Vax Date: 02/19/2021
Onset Date: 03/21/2021
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: none

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

Symptoms: Shingles - confirmed via Health care provider

Other Meds: none

Current Illness: none

ID: 1262758
Sex: F
Age: 50
State: FL

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Ibuprofen

Symptom List: Nausea

Symptoms: 50 y/o female, past medical history of Adult Onset Diabetes and Hypercholesterolemia who presents with dry throat and itchy rash to her neck and abdomen onset post vaccination. Patient states that this is her second dose in 2 dose series. Patient denies previous reaction to vaccinations. NP and Paramedics at patient side. A red, macular rash was noted to the anterior neck. Patient provided a bottle of water and 25mg of Benadryl PO x1. Patient vitals obtained, patient noted with slightly elevated BP (157/94) and all other vitals within normal limits (99% RA, 87 HR, 12 Resp). Glucose was noted to be 165, patient discloses that she didn?t eat or take her Metformin this am. Patient provided with a protein bar and took her pending dose of Metformin. Patient was observed by the NP and Paramedics for 20 minutes with resolution of symptoms, rash resolved and no further complaints of throat irritation. Patient cleared to go home and aware of concerning signs and symptoms that would necessitate further evaluation by emergency providers.

Other Meds: Metformin Omega Fatty Acids

Current Illness:

ID: 1262759
Sex: F
Age: 84
State:

Vax Date: 02/19/2021
Onset Date: 03/16/2021
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: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

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

Other Meds:

Current Illness:

ID: 1262760
Sex: F
Age: 39
State: MI

Vax Date: 01/18/2021
Onset Date: 04/26/2021
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 known

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

Symptoms: Received Pfizer-BIONet COVID vaccines on 12/26/20 and 1/18/21. On 4/18 /21 developed body aches, headache, and nasal congestion. Tested positive for COVID.

Other Meds: chaste tree oil, vitamin D3, cyanocobalamin, ferrous sulfate, milk thistle, multivitamin, zinc oral

Current Illness: none

ID: 1262761
Sex: F
Age: 30
State:

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Patient presented to Immunizations clinic for Covid Vaccine (Pfizer LOT EW0175 EXP 08/2021) Dose 2. Patient received vaccine and moved to post-vaccination observation area. After 15 minutes, patient went to leave clinic. Shortly after patient returned and informed lobby staff that she was not feeling well. Nurse on staff went to escort patient back to observation area when patient complained of feeling weak. Nurse held patient and patient had syncope episode. NUrse was able to guide patient to floor without impact to floor. Patient was alert and oriented when placed on floor. Patient denies history of syncope and/or vasovagal after injections. Patient returned to baseline and stayed for additional 20 minutes for further observation then released.

Other Meds:

Current Illness:

ID: 1262762
Sex: F
Age: 33
State: CO

Vax Date: 04/26/2021
Onset Date: 04/27/2021
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:

Symptom List: Tremor

Symptoms: Extreme abdominal cramping, akin to contractions during labor (experienced this at first shot as well). Blisters in mouth. Full body weakness, barely able to move.

Other Meds: Adderall and anti-inflammatory medicine for car accident pain. I ask take a multivitamin and probiotic daily.

Current Illness:

ID: 1262763
Sex: F
Age: 29
State: CO

Vax Date: 04/06/2021
Onset Date: 04/17/2021
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: allergic to sulfa, amoxicillin and macrobid antibiotics; celic disease - allergic to gluten

Symptom List: Erythema, Pruritus

Symptoms: At 14 weeks pregnant, woke up with worst headache. Tried treating with tylenol and water but it did not improve. OBGYN recommended going to ER. Blood pressure was fine and ultrasound showed that baby was okay. They treated me with fluids and sent me home a few hours later. Don't know if it was vaccine related - doctor thought it was dehydration and/or pregnancy hormones.

Other Meds: Prenatal vitamin, vitamin b6 + unisom for morning sickness, wellbutrin + lexapro for anxiety

Current Illness:

ID: 1262764
Sex: F
Age: 50
State: FL

Vax Date: 04/06/2021
Onset Date: 04/18/2021
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:

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

Symptoms: caller had first dose of her vaccine on 4/6th and the next is due on 4/29th. On the given card it does not say if it was Moderna or Pfizer. 2 days ago, pt noticed swelling on the upper palm of her left hand, applying ice helps. Also c/o uncomfortable gas on her sternum, taking omeprazole has helped. Now it comes and goes. She has not changed any eating habit changes. She is afraid of blood clots in her system. Health Authority: described delayed effects are unlikely to be related to the Vaccine. Seek md/attention if symptoms persists. Since the next dose is scheduled after 23days after her 1st dose, it suggests she was given the Pfizer vaccine. When going for the 2nd dose make sure you get name and LOT# written on the card. Call back w/q.

Other Meds: lisinopril metformin hydrochlorothiazide lovastatin

Current Illness:

ID: 1262765
Sex: F
Age: 70
State: MA

Vax Date: 02/26/2021
Onset Date: 03/31/2021
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: Sulfur drugs, ACE inhibitors

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

Symptoms: 2 days after receiving the first Moderna vaccine I developed seasonal - allergy - like symptoms. My allergies are ONLY fall allergies. No OTC or RX meds taken for this. Then I received the 2nd dose of Moderna on 3-30-21. The next morning I could not smell or taste. The same seasonal-like-symptoms continued until approximately 4-18-21. On 4-16-21 I took 1 Sudafed PE hoping that relieving the allergy symptoms would allow my taste/smell to return. It did not, therefore I did not take anymore Sudafed. On 4-6 -21 I had negative COVID test. On 4-23-21 I experienced a fleeting, slight sense of taste which occurs randomly but not every day. Living without a sense of taste or smell is horrible

Other Meds: AM: Synthroid; PM: Losartan, Ambien, Vit D, Colace, Mobic

Current Illness: None

ID: 1262766
Sex: F
Age: 49
State: MD

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: patient continues to have severe left arm pain at the site of the injection, no redness, no swelling, reports a nerve like pain, hot compresses are improving, has full use of arm

Other Meds:

Current Illness:

ID: 1262768
Sex: F
Age: 54
State: CT

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: SYR
Vax Site: LA

Lab Data:

Allergies: penicillin as well as other medications, not listed but verbally per pt. History of anaphylaxis.

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

Symptoms: Pt received her first dose of the Moderna vaccine with no problem however about 20 minutes after the vaccination the pt reported tingling and pain in her arm which she received the vaccine in. Tingling progressed down her arm and was not resolving. Pt has a history of anaphylaxis to Penicillin as well as other medications including injectables. While pt was waiting in observation she reported the tingling had then moved to both of her hands. At that point in time pt began to get nervous. Pt was offered EMS evaluation to which she agreed. BP 128/90 HR 76 RR 16 O2Sat 98%. Normal neurovascular exam. EMS arrived and did their evaluation. Pt was feeling better at that point and signed a refusal for transport with. Pt was given ED precautions to which she verbalized understanding.

Other Meds: None listed

Current Illness: None

ID: 1262769
Sex: M
Age: 21
State: NM

Vax Date: 04/25/2021
Onset Date: 04/27/2021
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: None

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

Symptoms: Woke up with severe chest pain and chills, couldn't continue laying down had to go outside. Pain lowered to mild within 3 hours

Other Meds: Allegra once daily

Current Illness: None

ID: 1262770
Sex: F
Age: 18
State: TX

Vax Date: 04/21/2021
Onset Date: 04/22/2021
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: Coconut Walnuts Advil Neosporin Ibprophen

Symptom List: Pain in extremity

Symptoms: Swollen lymph nodes Swollen and red feet

Other Meds: LoLoestrine Zyrtec Centrum women?s multivitamin Fish oil Monolukast Flonaise Magnesium

Current Illness:

ID: 1262771
Sex: F
Age: 77
State: MN

Vax Date: 03/26/2021
Onset Date: 03/30/2021
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: Sulfa drugs

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

Symptoms: Within four days after receiving second Moderna injection, my right hip, leg and left hip began aching. This would start early evening and progress into and through the night. I met with my doctor in his office, had an x-ray of the areas involved. Nothing noteworthy appeared on the x-ray. His suggestion was to take ibuprofen and acetaminophen throughout the day and evening. The pain in my hips and right leg is still considerable. I will be seeing my doctor again about this problem.

Other Meds: Synthroid, levothyroxine, Calcium, vitamin

Current Illness: none

ID: 1262772
Sex: F
Age: 59
State: FL

Vax Date: 04/26/2021
Onset Date: 04/27/2021
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: Metallic taste in my mouth. Arm very sore like someone punched me.

Other Meds: Air borne, Calcium 600mg with vit D

Current Illness: none

ID: 1262773
Sex: M
Age: 29
State: WA

Vax Date: 04/15/2021
Onset Date: 04/26/2021
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: None

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

Symptoms: Developed face and neck urticaria 11 days after Moderna vaccine. No other identified triggers. No prior history of urticaria or allergies. Standard treatment for urticaria with antihistamines, advised to get second COVID-19 as normally recommended.

Other Meds:

Current Illness: None

ID: 1262774
Sex: M
Age: 26
State: MN

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

Lab Data:

Allergies: none known

Symptom List: Vomiting

Symptoms: First dose Moderna Immediately after being vaccinated, while still at vaccine station began to feel nauseated, warm and "a little faint". Was walked over by vaccinator (MD) to a private waiting area to lie down. Was offered water, juice and snacks which he declined. reported tingling of hands bilaterally x 10 min then fully resolved. Vitals: 245: 110/60 and 3 pm 108/54 Pulse 64. Felt fully improved before leaving about 20 minutes later. advised to seek medical care if symptoms return or worsen.

Other Meds: unknown

Current Illness: none known

ID: 1262775
Sex: M
Age: 53
State: AR

Vax Date: 04/15/2021
Onset Date: 04/17/2021
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: ba

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: On the 17th through the 19th, I experienced a very scant and dull headache, with cold-sweats, aching muscles, and chills. The mild dull headache has come and gone in intensity, but has not gone away for any duration longer than 12 hours u[ to this day and time 4/27/2021 at 9:45 AM.

Other Meds: na

Current Illness: ba

ID: 1262776
Sex: F
Age: 33
State: GA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: None

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

Symptoms: For three days following the vaccine, I had fatigue, severe headache, dizziness, low-grade fever and a very sore arm. On day 4, pain in arm began to subside but I developed swelling of large lymph node in my armpit.

Other Meds: None

Current Illness: None

ID: 1262777
Sex: M
Age: 59
State: MA

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: needle inserted and vaccine leaked out around hub, less than 50% injected. inspected device and needle had not been completely screwed on

Other Meds:

Current Illness:

ID: 1262778
Sex: F
Age: 24
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKDA, NKA

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

Symptoms: SYNCOPE

Other Meds: NONE

Current Illness: NONE

ID: 1262779
Sex: F
Age: 30
State: VA

Vax Date: 04/22/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: High fever, nausea, and vomit after 12 hours of injection. The symptoms were gone after 72 hours. Only the nausea is still last forever. I can't eat anything and feel nausea all the time. Today is the 5th day. I feel so weak because I can't eat anything. Drinking only water make me feel nausea too. I have a bit of grape jam (2 tablespoons a day) and 200 ml of water.

Other Meds: 1000 mg vitamin C

Current Illness: PCOS

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm