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: 1266517
Sex: F
Age: 57
State: NY

Vax Date: 04/01/2021
Onset Date: 04/13/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: Sulfa and Penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: When I initially received the shot with in 15 minutes my pointer finger on my right hand became stiff and swollen. The following week, I experienced headache & neck soreness - approximately 7 days after the vaccine. On Friday, I went to the see my doctor for for abdominal pain on my left side. I was diagnosed with Diverticulitis. I was able to take medication and required no hospitalization. Once on meds the swelling and stiffness in my finger subside but returned once meds were stopped. I assume this was due to the anti-inflammatory effect from antibiotic. Please note, I received a full check up and blood work two weeks prior to getting my vaccine. I have had diverticulitis twice before: First occurance: 8/18 - hospitalized 4 day , Second occurance: 4/19 - meds only / no hospitalization. I believe the vaccine caused extreme inflammation in my body and

Other Meds: NONE

Current Illness: None

ID: 1266518
Sex: M
Age: 33
State: IL

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: vaccine was administered and then a few minutes later he fainted. Patient fell out of chair bite his lip and hit head on privacy screen. He did not want me to call ambulance and refused to go to ER. His wife came to pick him up to ensure he is ok.

Other Meds:

Current Illness:

ID: 1266519
Sex: F
Age: 22
State: IN

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: Chills, body aches, headache, and vomiting. All lasting about 20 hours

Other Meds: Effexor 75 MG

Current Illness: N/A

ID: 1266520
Sex: F
Age: 57
State: NY

Vax Date: 04/25/2021
Onset Date: 04/26/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Dizziness / Lightheadedness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: other-Severe, Systemic: Headache-Severe, Systemic: Nausea-Severe, Systemic: Unable to Sleep-Severe, Systemic: Weakness-Severe.

Other Meds:

Current Illness:

ID: 1266521
Sex: M
Age: 44
State: IN

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Total body soreness. Today it has gotten much better. First noticed the day after the second shot. Had nothing from the 1st shot. It has been getting better the longer out from the 2nd shot.

Other Meds: None

Current Illness: None

ID: 1266522
Sex: F
Age: 54
State: TN

Vax Date: 04/13/2021
Onset Date: 04/16/2021
Rec V Date: 04/28/2021
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: Fatigue, rash, itching, soreness at injection site

Other Meds:

Current Illness:

ID: 1266523
Sex: F
Age: 57
State: NY

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Additional Details: patient described weird taste, felt like tongue may be swelling, took benadryl, patient felt fine after that

Other Meds:

Current Illness:

ID: 1266524
Sex: F
Age: 69
State: MA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: MOUTH AND FACIAL AREA

Other Meds:

Current Illness:

ID: 1266525
Sex: F
Age: 66
State: NC

Vax Date: 04/01/2021
Onset Date: 04/21/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Tingling numbness in right arm. Arm goes to sleep. Started to occur at night 3 weeks after completion of second dose. 04/28 arm continues to feel tingly during the day.

Other Meds: Muli-vitamin

Current Illness: None

ID: 1266526
Sex: F
Age: 47
State: CA

Vax Date: 04/19/2021
Onset Date: 04/26/2021
Rec V Date: 04/28/2021
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: N/A

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Covid arm. Red raised circle around injection site. Hard and itchy.

Other Meds: N/A

Current Illness: N/A

ID: 1266527
Sex: F
Age: 49
State: IN

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Fever Chills Body aches Headache Nausea Vomiting

Other Meds: Levothyroxine Sertraline Atavastatin

Current Illness: None

ID: 1266528
Sex: F
Age: 55
State: NY

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Systemic: Black raised bruise with red spots around it on the inner thigh-Mild, Additional Details: patient woke up with black raised bruise with red spots around it on inner thigh. Unsure if it is related. Advised her to contact her doctor.

Other Meds:

Current Illness:

ID: 1266529
Sex: M
Age: 33
State:

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Sore arm Fever Sore throat

Other Meds:

Current Illness:

ID: 1266530
Sex: F
Age: 33
State: MA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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:

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

Symptoms: Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1266531
Sex: F
Age: 30
State: IA

Vax Date: 04/01/2021
Onset Date: 04/07/2021
Rec V Date: 04/28/2021
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: Augmentin. Aspirin. Ibprofen Xolair

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

Symptoms: 4 days after vaccine. Body covered in hives every morning. No relief from any combination of medications.

Other Meds: Pepcid 40mg. Allegra x2 singulairx2

Current Illness:

ID: 1266532
Sex: F
Age: 62
State: HI

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: \"weird taste\" in throat-Mild, Additional Details: Vaccine Admin at roughly 10:18 am. Patient waited 15 min in store, then left. Returned reporting a slight tightness in throat and a 'weird taste\" in her mouth. when questioned further, reported slight itchiness on arm. Called EMS, they examined patient. Per EMS, appears to have aggrevated patient's asthma. patient declined to be taken to hospital for further care.

Other Meds:

Current Illness:

ID: 1266533
Sex: M
Age: 51
State: KY

Vax Date: 01/12/2021
Onset Date: 04/26/2021
Rec V Date: 04/28/2021
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:

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

Symptoms: Tested positive after immunity date

Other Meds: ferrous sulfate 325 (65 FE) MG tablet lisinopril (PRINIVIL) 20 MG tablet

Current Illness:

ID: 1266534
Sex: M
Age: 54
State: IN

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: A very strong pain around the shot spot on my arm. It was a lot more than the first shot. I could not sleep comfortably at night because of it. Interestingly, that was the only adverse effect I had and I was expecting more because everybody on line said the second shot side effects were to be more serious than the first one. I am glad sore arm was the only thing I experienced. I took Ibuprofen for it and it helped a little but did not do away with the pain completely. When I woke up the second day after the shot, the pain was almost completely gone.

Other Meds: Metoprolol, amlodopine, metmorfin, victoza, pentoprazol

Current Illness:

ID: 1266535
Sex: F
Age: 39
State: CT

Vax Date: 04/26/2021
Onset Date: 04/28/2021
Rec V Date: 04/28/2021
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: Nausea and vomiting

Other Meds: phentermine 37.5 mg tablet

Current Illness: None

ID: 1266536
Sex: F
Age: 28
State: TX

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: Lithium, Depakote

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

Symptoms: Woken in the middle of the night to njection site pain, headache, profuse sweating for 8 hours+, nausea, projectile vomiting.

Other Meds: Cetirizine Hydrochloride, diphenhydramine hydrochloride, desvenlafaxine ER, montelukast sodium, quetiapine fumarate, guaifenesin, pseudoephedrine, albuterol

Current Illness: Persistent pneumonia (8 months +)

ID: 1266537
Sex: F
Age: 27
State: TX

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Systemic: Dizziness / Lightheadness-Mild, Additional Details: Patient fainted in chair for a few seconds. She knew her name and was responsive but felt dizzy. She said things looked green and hazy. EMS came and checked vitals/assessed pt. She declined going to the ER.

Other Meds:

Current Illness:

ID: 1266538
Sex: F
Age: 40
State: FL

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Unevaluable event

Symptoms: Chills began at 0200 on 4/27/21 followed by, Fever, Headache, Muscle Aches that remained for the rest of that day. Symptoms were treated with Tylenol. Symptoms were gone by 6AM on 4/28/21.

Other Meds: Multi-vitamin, Vitamin C, Vitamin D3, Cranberry Pills, CBD/Melatonin

Current Illness: n/a

ID: 1266539
Sex: M
Age: 17
State: VT

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: unknown

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

Symptoms: This Pt was permitted to create an acct, make an appt prior to this clinic date and get the vaccine before the system stopped due to the age. It was not caught until check out when Pt 2nd shot appt was being made. They showed up on the list of people WITH scheduled appts in and were NOT added at the time of the clinic.

Other Meds: unknown

Current Illness: unknown

ID: 1266540
Sex: F
Age: 43
State: NJ

Vax Date: 04/20/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Hives with penicillin

Symptom List: Injection site pain, Pain

Symptoms: Itchy rash developed at injection site yesterday. It was small - similar to a mosquito bite. When I woke up this morning it had expanded to about 1-2 inches and is hard, a little painful but not itchy just yet.

Other Meds: Lexapro and xanax

Current Illness: None

ID: 1266541
Sex: F
Age: 24
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Nausea-Mild, Additional Details: Patient reported slight nausea and lightheaded feeling. We offered water to the patient and had her remain seated. She stated that she thought she might also be hungry but it began after shot. BP was normal at 124/84. Patient reported feeling better after sitting for additional time and drinking some water. Confirmed with patient she felt 100% better prior to leaving the pharmacy and she confirmed- stated she was going to eat as soon as possible in case due to low blood sugar.

Other Meds:

Current Illness:

ID: 1266542
Sex: F
Age: 50
State: VA

Vax Date: 04/14/2021
Onset Date: 04/16/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: For the first 2 days, I only had a sore arm. Starting on day 3 after the vaccination, I started having joint pain, chills, loss of appetite and headache. This continued for 3 straight days, but only at night. It went away for a few days, but returned and has continued, 2 weeks past my vaccination date. Symptoms remain predominantly at night and are bad joint pain, especially in hips in legs; chills and inability to get warm; headaches.

Other Meds: Probiotics, apple cider vinegar gummies, vitamin C, vitamin D, turmeric, nettles

Current Illness: None

ID: 1266543
Sex: M
Age: 23
State: PA

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient reported painful testicles, tried ibuprofen with no resolution. Pharmacist recommended he go to urgent care for medical attention and he left the pharmacy. Pt has no pcp.

Other Meds: unknown

Current Illness: none known

ID: 1266544
Sex: M
Age: 28
State: CA

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 04/28/2021
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: Itching at Injection Site-Mild, Systemic: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Additional Details: PATIENT STATES HE GOT HIVES ABOUT 1 HOUR AFTER HIS COVID VACCINE. HIVES BEGAN ON HIS SCALP/HEAD AND SPREAD THROUGHOUT HIS BODY. PATIENT TOOK A BENADRYL AND THAT TOOK DOWN HIS SWELLING. NO ANAPHYLAXIS. PATIENT STATES ON 4/27/21 (THE DAY AFTER) THAT HE'S FEELING FINE TODAY WITH NO MORE HIVES. STATES CONCERN REGARDING HIS SECOND DOSE AND THINKS HE MIGHT NEED TO GET SECOND DOSE AT MEDICAL FACILITY IN CASE SOMETHING MORE SEVERE OCCURS. PATIENT STATES HE JUST WANTED TO REPORT AND LET PHARMACY KNOW.

Other Meds:

Current Illness:

ID: 1266545
Sex: M
Age: 42
State: MS

Vax Date: 04/12/2021
Onset Date: 04/17/2021
Rec V Date: 04/28/2021
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: Right side tingling past 10 days. Reports tingling to right face and right arm feels like intermittent pins and needles. Received Janssen COVID vaccine on 4/12/21 at an outside facility. Diagnostic workup revealed Cerebral Vascular Accident (CVA).

Other Meds: Amlodipine Atorvastatin Isosorbide Mononitrate Lisinopril Metformin

Current Illness: none

ID: 1266546
Sex: F
Age: 69
State:

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: erthyromycin IV dye Motrin

Symptom List: Nausea

Symptoms: affected area was right knee which was replaced last September. Swelling, pain, both of which were more severe than after the 1st shot. The pain has remained and has not decreased to the point of waking me up during the night. The swelling has decreased. I am seeing the orthopedic surgeon for regularly scheduoed checkup on the knee, but I will ask him about the effects

Other Meds: none

Current Illness: none

ID: 1266547
Sex: F
Age: 53
State: MI

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: hayfever, may be lactose intolerant, not positive yet

Symptom List: Injection site pain

Symptoms: Moderna COVID-19 vaccine EUA - flu like symptoms, fever, chills, hot, body aches, headache, fatigue, very tired, sore around vaccine site, achiness in the entire arm of the vaccine. Aspirin and ibuprofen and rest. Felt the onset about 8 hours after the vaccine, felt bad all day the following day, felt good the next day.

Other Meds: Allegra, multivitamin, zinc, D3, C, melatonin, psyllium husk, probiotic, flonase

Current Illness: n/a

ID: 1266548
Sex: M
Age: 31
State: MS

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Site: Itching at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Additional Details: After 15 minutes he was walking out and his arm started itching. He said he already had a little bit of a sunburn. We gave him 25mg benadryl and got him to wait another 30 minutes.

Other Meds:

Current Illness:

ID: 1266549
Sex: F
Age: 17
State: VT

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/28/2021
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: Unknown

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

Symptoms: This Pt was permitted to create an acct, make an appt in TVRS prior to this clinic date and get the vaccine before the system stopped due to the age. It was not caught until check out when Pt 2nd shot appt was being made. They showed up on the list of people WITH scheduled appts in TVRS and were NOT added to TVRS at the time of the clinic.

Other Meds: Unknown

Current Illness: Unknown

ID: 1266550
Sex: F
Age: 50
State: TX

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/28/2021
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: Penicillin, preservatives in past vaccine, tetna diptheria injection.

Symptom List: Tremor

Symptoms: Started experiencing body itching all over 3hr after injection. Lasting 3 days. Doctor was contacted via vdo appt, medicine was called in to help with side effects. Itching diminished in 4 to 5 days. No upper respiratory issues were experienced.

Other Meds: Nasaquart, Estradiol, Armour Thyroid, Vitamin D, Evening Primrose, Probiotic

Current Illness:

ID: 1266551
Sex: F
Age: 56
State: PA

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/28/2021
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: Amoxicillin

Symptom List: Erythema, Pruritus

Symptoms: My throat felt sore and my lips were swollen. I took Benadryl all day and that seems to help. Went to see my doctor on Monday and he gave me Zyrtec. Back to normal in three days. I will not be getting the second shot

Other Meds: Flonase Align Probiotic

Current Illness: none

ID: 1266552
Sex: F
Age: 33
State: FL

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Systemic: Flushed / Sweating-Medium

Other Meds:

Current Illness:

ID: 1266553
Sex: F
Age: 18
State: IN

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: 101 fever, headache, heartburn, dizziness, pain at injection site, muscle aches, weakness, fatigue

Other Meds:

Current Illness:

Date Died: 04/25/2021

ID: 1266554
Sex: M
Age: 93
State:

Vax Date: 04/14/2021
Onset Date: 04/25/2021
Rec V Date: 04/28/2021
Hospital: Y

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: Received 2nd shot on April 14. He was functioning normally until he woke up on April 25. Symptoms were chest pain, trouble breathing, lethargic, very pale, cold to the touch, vomiting with blood in vomit. PT was taken to the ER where he passed away later that night.

Other Meds:

Current Illness:

ID: 1266555
Sex: F
Age: 35
State: NY

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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:

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

Symptoms: Site: Pain at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1266556
Sex: F
Age: 35
State: PA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/28/2021
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: No

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

Symptoms: Shot received at 5pm on the 27th of April. Same night full headache began. Some Point in the middle of the night into the day 28APR21 flu like symptoms began. Severe muscle ache and fatigue. Still with headache. Feels like a truck hit me.

Other Meds: No

Current Illness: No

ID: 1266557
Sex: M
Age: 16
State: MA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: No e

Symptom List: Pain in extremity

Symptoms: Numbness, dizziness, blurred vision

Other Meds: None

Current Illness: No e

ID: 1266558
Sex: M
Age: 38
State: NH

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Seasonal allergies to pollens, molds and dust. Some fruits cause a tingling of mouth and tongue

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

Symptoms: Within 5 minutes of shot my jaw and tongue started feeling numb, so I called them back over to ask if it was normal. Within a few minutes after that I told them my throat was starting to close up, I was having trouble breathing and both arms went numb. They said I was very pale, horse when talking and that they were going to start treating me for anaphylaxis due to my throat and airway issues. They immediately called for ambulance and gave me 10 ml of liquid Benadryl and prepped an epi-pen. Within maybe 5-10 minutes the Benadryl help stop the throat closing and I asked them to not inject the epi-pen until the EMT arrived since the symptoms held and didn?t get worse.

Other Meds: loratadine albuterol inhaler

Current Illness: No

ID: 1266559
Sex: F
Age: 35
State: VA

Vax Date: 04/03/2021
Onset Date: 04/06/2021
Rec V Date: 04/28/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Eye twitching/spasm

Other Meds:

Current Illness:

ID: 1266560
Sex: F
Age: 37
State: FL

Vax Date: 04/13/2021
Onset Date: 04/16/2021
Rec V Date: 04/28/2021
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 stated she recieved the vaccine on Tuesday 4/13/21 @830am and a few days later she started to experience redness on right arm and swelling/soreness, hot to touch. No fever, body aches, or chills, sob or chest pain. Patient stated she took Tylenol (taken on 4/21 at night and on 4/22 in am) and Claritan and neither helped, she also placed an ice pack on arm and it helped with the hotness but not with the swelling. On 4/22 in am patient also took Loratadine. Patient has PCP appt on 4/28/21 for other reasons but if symptoms continue she will let PCP know. Advised patient that she can continue with Tylenol or she can take Ibuprofen, also recommended that she can take Benadryl or apply Benadryl cream/Hydrocortisone to help with the itchiness. Also advised to continue applying the ice pack to help with the hotness and informed her if she feels her arm is getting worse and swelling is not subsiding then to see her pcp as soon as she can. Will follow back up on Monday 4/26 to see if symptoms subsided. Called pt 4/26 and 4/27- no answer

Other Meds: none

Current Illness:

ID: 1266561
Sex: M
Age: 52
State: NY

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/28/2021
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

Symptom List: Vomiting

Symptoms: Roughly 21 hours after vaccine was administered: Fever 100.3, Chills, Sweats, Extreme Fatigue Treated with Tylenol 500ml every 6 hours. Felt better the next day after sleeping most of the day after vaccine administered. As of 4/28 still experiencing extreme fatigue randomly/ previously not experienced Very active, goes to gym every day, eats healthy otherwise.

Other Meds: Vitamin D3|50mcg

Current Illness: None

ID: 1266562
Sex: M
Age: 30
State: OH

Vax Date: 04/25/2021
Onset Date: 04/26/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Swollen lymph-nodes in armpit

Other Meds:

Current Illness:

ID: 1266563
Sex: M
Age: 30
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/28/2021
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: Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1266564
Sex: M
Age: 36
State: IN

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 04/28/2021
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: Over the last two days I?ve had a fever, cold chills, weakness in muscles, irritable skin to the touch, diarrhea, cough, and upset stomach.

Other Meds:

Current Illness:

ID: 1266565
Sex: F
Age: 45
State: FL

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: IBroophen

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

Symptoms: Nauseous 9:50am Patient left feeling much better. 122/86, HR 68, O2Sat 100

Other Meds: Levothyroxine

Current Illness: n/a

ID: 1266566
Sex: F
Age: 67
State: NJ

Vax Date: 01/20/2021
Onset Date: 04/12/2021
Rec V Date: 04/28/2021
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: On April 12th I experienced severe pain in my right arm, which progressed to my right leg and eventually my left arm. I went to a local ER where they ruled out a stroke. The pain continued and on April 18th I went to the ER. They admitted me and ordered a catscan and MRI. They diagnosed me with Transverse Myelitis and recomme//nded that I see a neurologist to get a definitive answer to whether this is MS or just a one time occurrence. while there i was treated with steroids for 3 days which alleviated the pain. i was also taken off all statins, given B12 and blood thinners.

Other Meds: rosovastatin 20mg 1 tablet per day telmisarten 20 mg 2 tablets per day hydrochlorothiazide 12.5 mg 1 tablet per day baby aspirin 81 mg 1 tablet per day zolpidem 5 mg (as needed for sleep)

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm