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: 1266567
Sex: F
Age: 59
State: FL

Vax Date: 03/26/2021
Onset Date: 03/27/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: tennitis and possible hearing loss

Other Meds:

Current Illness:

ID: 1266568
Sex: M
Age: 40
State: FL

Vax Date: 04/01/2021
Onset Date: 04/20/2021
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: Peanuts

Symptom List: Anxiety, Dyspnoea

Symptoms: Severe breathing problem.

Other Meds: None

Current Illness: None

ID: 1266569
Sex: F
Age: 37
State: IL

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

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1266570
Sex: F
Age: 51
State: NY

Vax Date: 04/25/2021
Onset Date: 04/25/2021
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: Penicillin Pineapple

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fever, chills, soreness subsided after 48 hrs Redness & heat on arm below injection still going

Other Meds: Estradiol 2x weekly, probiotics, vit d, vit c, omeprazole 1x day, ashwaganda, iodine, black cohosh

Current Illness: None

ID: 1266571
Sex: M
Age: 73
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: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Extreme chills, fever and fatigue

Other Meds: Lisinopril, Simvastatin, vitamin D, aspirin

Current Illness: None

ID: 1266572
Sex: F
Age: 47
State: NY

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: NKA

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

Symptoms: See previous page. With the first shot, I developed Covid a room and was put on antibiotics eight days after the first shot. With second shot they developed fever, chills, severe shaking, body aches, massive headache, severe fatigue, and diarrhea. Was unable to get out of bed for 48 hours. After 36 hours developed a heaviness in tightening in my chest which made breathing feel restricted. Was very weak and fatigued and unable to go to work for a full five days after receiving the second dose of Moderna Covid vaccine.

Other Meds: Birth control

Current Illness: Developed ?COVID arm? 8 days after first COVID shot which was given on 12/29/20 16 hours after 2nd shot on 1/26/21, developed fever, chills, violent shaking, massive headache, body aches, diarrhea, weakness. About 36 hours after shot, I developed heaviness in my chest and a tightness that made breathing feel restricted. These symptoms strongly persisted For 48 hours, during which time I could not do anything but sleep. By the third day the symptoms started to lesson but were still there and I was able to stay awake for some hours of the day, but could not work. It was a total of 5 days before I was feeling well enough to leave the house. I rarely get sick and this was the sickest I have ever been in my entire life. I received the Moderna vaccine.

ID: 1266573
Sex: F
Age: 55
State: TX

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266574
Sex: M
Age: 84
State: FL

Vax Date: 02/17/2021
Onset Date: 04/17/2021
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: Severe pain on right side of body, rash. Took Tylenol to help relieve pain, went to see primary provider today and was diagnosed with shingles, MD prescribed Valtrex by mouth to help alleviate symptoms.

Other Meds: Eliquis, Lipitor, Aricept, Flomax

Current Illness:

ID: 1266575
Sex: F
Age: 41
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: Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever, body aches, extreme soreness at injection site, extreme headache

Other Meds: Tramadol

Current Illness: None

ID: 1266576
Sex: F
Age: 41
State: NY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Within 4 hours had nausea, headache. Lasted for about a day. 12 days later vertigo, nausea, headache resumed. Went to primary who detected a drop in oxygen levels, was then sent to ER where many tests were done. Included chest scan, to look for clots. None were found. Took dramamin for vertigo which helped. Symptoms of nausea, headache, vertigo continue to persist off and on. On Friday 4/23 I died my hair. Within 2 minutes an allergic reaction too place: sudden nausea, some shaking, headache. Took benedryl which help. At this point, I have continued bouts of nausea and no appetite. Its been close to a month and I'm really scared for my health. I was completely healthy before.

Other Meds: None

Current Illness: None

ID: 1266577
Sex: F
Age: 34
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: Penicillin

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

Symptoms: Body chills, aches started the night of the vaccine, then I ran a fever for starting at the 24 hour mark after the injection and it lasted about 6 hours. I was able to reduce it by taking Tylenol and drinking fluids. Most symptoms cleared up after about 24 hours after they initially started. 36 hours later, I'm still a little tired, but not other side effects. This is my first pregnancy, with a due date of Oct. 8, 2021.

Other Meds: Prenatal vitamins, Xyzal

Current Illness:

ID: 1266578
Sex: M
Age: 61
State: TX

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266579
Sex: F
Age: 51
State: VA

Vax Date: 02/24/2021
Onset Date: 03/01/2021
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: Cephalexin

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

Symptoms: Within 1 week extreme dizziness was diagnosed with high blood pressure on 3/18/21 of 150/100.

Other Meds: Multivitamin, stool softener, vitamin D3

Current Illness: Diverticulosis

ID: 1266580
Sex: M
Age: 30
State: TN

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266581
Sex: F
Age: 63
State:

Vax Date: 03/12/2021
Onset Date: 04/01/2021
Rec V Date: 04/28/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1266582
Sex: F
Age: 21
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mango, fire ants, pollen, trees, grass

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

Symptoms: Patient complained almost immediately of a burning sensation on her entire arm, which progressed quickly into itching on the left arm. She denied any SOB or itching of throat or mouth, however within a few minutes the itching progressed to her right side and onto her chest. She then complained of her eyes watering and then stated her chest was growing tight. EMS arrived at this point and took her to the ER

Other Meds: none

Current Illness: none

ID: 1266583
Sex: F
Age: 47
State: MI

Vax Date: 04/24/2021
Onset Date: 04/24/2021
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: Systemic: Nausea-Severe, Systemic: Vomiting-Medium, Additional Details: extreme tiredness from the day of vaccine which didnot go away even after 4 days and patient complains of not able to go to work

Other Meds:

Current Illness:

ID: 1266584
Sex: F
Age: 43
State: ME

Vax Date: 04/27/2021
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: I am allergic to antibiotics such as cipro, penicillin, and sulfa. I also have reacted to Propofol, contrast dye, and the flu vaccine. In addition, I suffer from numerous IgE verified food allergies such as egg, beef, pork, and soy. I have reacted to latex in the past.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I started experiencing throat swelling within the first five minutes of receiving the vaccine. within ten minutes, my vision was blurry and I started to experience light headedness and vertigo. I tried to notify the staff within 15 minutes but had to wait 5 minutes before being acknowledged.

Other Meds: On a daily basis, I take Keppra (an anti-convulsant), Ativan, Flonase, Qvar, Zyrtec, Tylenol, and an OTC multivitamin. Yesterday, I decided to pretreat to minimize an allergic reaction. I took 25 mg of Benadryl at 6 a.m., 10 mg of Predniso

Current Illness: I have been battling recurrent infections in my left breast. I discontinued an antibiotic, Keflex, a day prior to receiving the vaccination per the recommendation of a breast care specialist.

ID: 1266585
Sex: F
Age: 78
State:

Vax Date: 02/07/2021
Onset Date: 02/11/2021
Rec V Date: 04/28/2021
Hospital: Y

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 had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1266586
Sex: M
Age: 28
State: TN

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

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

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266587
Sex: F
Age: 57
State: VA

Vax Date: 04/01/2021
Onset Date: 04/25/2021
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: none

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

Symptoms: Blood pressure started increasing on 4-26-21. It steadily rose over a 2 day period to 226 / 125 -- I sought medical help at 197/115. Finally, I was given lotenopil by IV and it came down to 150 over 100 within 4 hours at ER.

Other Meds: Hydrochlorathiazide 25 mg - standard prescription, been on it for years, no problems......ALSO took baby aspirin on day problems started

Current Illness: none

ID: 1266588
Sex: M
Age: 51
State: TN

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266589
Sex: F
Age: 78
State:

Vax Date: 02/03/2021
Onset Date: 03/05/2021
Rec V Date: 04/28/2021
Hospital: Y

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

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1266590
Sex: M
Age: 54
State: MI

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Patient received the vaccine then reported to the observation area. After a few minutes in the observation area the patient stated he was light headed and dizzy and might pass out. A few moments later the patient passed out. He passed out from his chair to the floor where he was assessed by pharmacists and a nurse. He was sweating and was coming in and out of responsiveness. Patient never stopped breathing. 911 was called and patient was taken away by EMS. Patient was still in and out of responsiveness when EMS arrived.

Other Meds:

Current Illness:

ID: 1266591
Sex: M
Age: 17
State: VT

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: Site: Pain at Injection Site-Medium, Systemic: Tingling (specify: facial area, extemities)-Mild

Other Meds:

Current Illness:

ID: 1266592
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 9;:05am nausea, headache. 9:27am Patient reported that she was feeling much better. EMS informed patient if still experiencing symptoms to call 911 or contact primary care physician. Patient verbalized understanding. (Patient is alert x3.) B/P 150/84, HR 78, O2Sat 98%, BS 88.

Other Meds:

Current Illness:

ID: 1266593
Sex: F
Age: 47
State: TN

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266594
Sex: F
Age: 49
State: TN

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: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266595
Sex: F
Age: 43
State: GA

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: RA

Lab Data:

Allergies: None Known

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

Symptoms: Next morning (4/27/2021) after receiving the shot (@ approx. 8:00 AM), tenderness was felt in the left armpit (same side shot was received). After examining armpit with fingertips, I felt what appears to be swollen lymph nodes.

Other Meds: Lovastatin 20 mg/day Nifedipine ER 90 mg/day

Current Illness: None

ID: 1266596
Sex: M
Age: 50
State: TN

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: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266597
Sex: F
Age: 63
State: NH

Vax Date: 04/17/2021
Onset Date: 04/19/2021
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: None

Symptom List: Injection site pain

Symptoms: Black and blue mark, itching under skin not relieved by hydrocortisone cream, swelling and feeling of hardness with the swelling, slight warmth. At the point of feeling the warmth, took one Benadryl tablet at night. By the next morning, swelling and hardness had started to dissipate but then a slight rash and redness extending in a circle started to about 3.5 to 4 inches in diameter. Benadryl cream and/or hydrocortisone (whichever I had available at the time) started to relieve the itching. Today, 11 days out from the shot, it is still improving.

Other Meds: Claritin, multivitamin, calcium with vitamin D, krill oil, vitamin C, joint supplement, bilberry, Kaprex, Amberen

Current Illness: None

ID: 1266598
Sex: M
Age: 49
State: FL

Vax Date: 04/24/2021
Onset Date: 04/25/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Tinnitus in both left and right ears. Onset was 18 hours after vaccine dose. Continuing unresolved tinnitus at 4 days after dose administered. Separate Headache and hangover symptoms have resolved and started 18 hours after dose and subsided 42 hours after.

Other Meds: Triumeq, Bystolic

Current Illness: None

ID: 1266599
Sex: F
Age: 19
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Gluten and dairy

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

Symptoms: Fever Joint pain Headaches Sore arm

Other Meds: N/a

Current Illness: Multiple sclerosis

ID: 1266600
Sex: F
Age: 37
State: TN

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266601
Sex: M
Age: 50
State: FL

Vax Date: 04/25/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Swollen gland on right side of throat through swelling could not breathe

Other Meds: Insulin R , insulin Lantice , fish oil, vitamin c

Current Illness: None

ID: 1266602
Sex: F
Age: 34
State: IN

Vax Date: 04/26/2021
Onset Date: 04/26/2021
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: Headache, chills, nausea, tired, body aches

Other Meds:

Current Illness:

ID: 1266604
Sex: M
Age: 39
State: TN

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: 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: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266605
Sex: M
Age: 34
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore arm, fever (99.5-100.1 F) , muscle ache, night sweats and chills. Symptoms started about 9 hours after receiving the vaccine; persisted for the next 24 hours.

Other Meds: None, but Ibuprofen (2 tabs) to aid fever relief on onset of symptoms

Current Illness:

ID: 1266606
Sex: F
Age: 20
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: SYR
Vax Site: LA

Lab Data:

Allergies: Trees weed eggs chicken

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

Symptoms: Head Body sick

Other Meds: None

Current Illness:

ID: 1266607
Sex: M
Age: 30
State: TN

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

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

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266608
Sex: F
Age: 56
State: NC

Vax Date: 04/07/2021
Onset Date: 04/15/2021
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: Sulfa drugs Erythromycin

Symptom List: Pain in extremity

Symptoms: Started w/small red itchy bump at the injection site that I thought was a bug bite. Hot to the touch and with slight discomfort. Redness and raised area spread down my arm and stopped about halfway between injection site and elbow. Continued to be itchy, red, hot and sore. It looks like the typical allergic reaction hive. Redness, itching and raised area is slowly reducing, but still present.

Other Meds: Fluoxetine levothyroxine omeprazole bupropion

Current Illness: none

Date Died: 04/24/2021

ID: 1266609
Sex: M
Age: 84
State:

Vax Date: 02/16/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Death

Other Meds:

Current Illness:

ID: 1266610
Sex: M
Age: 66
State: ME

Vax Date: 04/08/2021
Onset Date: 04/09/2021
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: Diarrhea x 3 weeks, Bristol scale 7.

Other Meds:

Current Illness:

ID: 1266612
Sex: M
Age: 22
State: TN

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

Lab Data:

Allergies:

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

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266613
Sex: M
Age: 58
State: NY

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

Symptom List: Vomiting

Symptoms: raynauds phenomenon both forearms lasting 15 minutes

Other Meds: atorvastatin 80mg doxycycline 50mg eliquis 5mg

Current Illness: none

ID: 1266614
Sex: M
Age: 25
State: KS

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

Lab Data:

Allergies: Latex, seasonal allergies, Hepatitis A vaccine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Redness at injection site, pain when moving injected arm, high level of fatigue, inability to get restful sleep, body aches, crying with no recognized physical or emotional cause

Other Meds: 500mg Valacyclovir taken by mouth once daily, Fexofenadine HCl 60mg and Pseudoephendrine HCl 120mg Extended-Release Tablet USP (12 hour)

Current Illness: Seasonal Allergies

Date Died: 04/24/2021

ID: 1266615
Sex: M
Age: 81
State:

Vax Date: 03/18/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Death

Other Meds:

Current Illness:

ID: 1266616
Sex: F
Age: 39
State: FL

Vax Date: 03/05/2021
Onset Date: 04/20/2021
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: Cats

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After having my second Moderna Vaccine I had the usual side effects of fever, chills, arm pain etc. in addition to that it has caused a significant delay in my period along with significant cramping and bloating and discomfort. I am very regular on my cycles and am NOT pregnant as am sterilized. The Moderna Vaccine has caused chamgeses and delays to my menstruation.

Other Meds: IB prophin Cetrizine Allergy Pills

Current Illness:

ID: 1266617
Sex: M
Age: 24
State: TN

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: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1266618
Sex: F
Age: 46
State: IN

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Zero. Just cats.

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

Symptoms: In left clavicle swollen lump or gland about the size of a quarter. Same arm as shot. Knot is warm and appeared a few hours after shot. Thank you. Stiff in nature. Sore. Not fluid filled?a little firmer.

Other Meds: Zero.

Current Illness: Zero

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm