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: 1266773
Sex: F
Age: 81
State: NJ

Vax Date: 02/25/2021
Onset Date: 04/24/2021
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: Penicillin's.

Symptom List: Dysphagia, Epiglottitis

Symptoms: She got her vaccine, had no issues. She has a rash on the hairline in the center on the back of her head, neck and itchy towards the center of it. She thought perhaps a bug bit her and is spreading now around towards her face and has a tremendous itch. She went to the clinic and they put her on Kenalog cream twice a day and then they said that she should take Claritin for the itching and Benadryl at night if possible. They told her in the clinic that she has poison ivy/Dermatitis but she feels it may be related to her vaccine.

Other Meds: Benicar, 81 mg aspirin, Budesonide breathing treatment twice daily.

Current Illness: None.

ID: 1266774
Sex: M
Age: 51
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: I am allergic to Sulphur.

Symptom List: Anxiety, Dyspnoea

Symptoms: I had flue symptoms for about 36 hours.

Other Meds:

Current Illness:

ID: 1266775
Sex: M
Age: 61
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: fever 100.1 next day with headache and nausea

Other Meds:

Current Illness:

ID: 1266776
Sex: M
Age: 30
State: FL

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Systemic: Headache-Mild, Additional Details: Patient was given Tylenol and was told to hold off to monitor if the symptoms go away or they progress to more severe symptoms. patient stated the headache was going away a little before leaving.

Other Meds:

Current Illness:

ID: 1266777
Sex: F
Age: 41
State: OH

Vax Date: 04/20/2021
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: Latex - hives Celebrex - swelling in hands and feet Bees/wasps - swelling all over Sensitivity to bananas

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

Symptoms: Day of the second vaccine felt fine. Woke up with my left arm sore and injection site very sore (left upper arm). Started feeling very sluggish in the morning and then it progressed to high fever (over 100), fatigue, stuffy nose, severe headache. Took Tylenol for headache & fever.

Other Meds: Astelin Ocella (BC) Nasonex Claritin Phentermine Women's multi vitamin Vitamin C Vitamin D Calcium Flaxseed Oil

Current Illness:

ID: 1266778
Sex: F
Age: 64
State: NC

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: Duricef

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

Symptoms: Body aches, chills, fever , headache, conjunctivitis, hives No treatment

Other Meds: Estradiol 1mg , Synthroid 75mcg,, Lions Mane Cordyceps and Immune Booster all by Host Defense Vitamins C, D3, B 12

Current Illness: None

ID: 1266780
Sex: F
Age: 28
State: CT

Vax Date: 04/27/2021
Onset Date: 04/28/2021
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: no

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Numbness of face, hands, and chest

Other Meds: birth control

Current Illness: no

ID: 1266781
Sex: F
Age: 47
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Pharyngeal swelling

Symptoms: Low fever, 100.7 degrees & shivers almost 23 hrs after the shot was given. On and off for about 8 hrs

Other Meds: Lexapro, Singulair, Flonase, aimovig,

Current Illness: None

ID: 1266782
Sex: M
Age: 13
State: PA

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: LA

Lab Data:

Allergies: albuterol Wellbutrin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: vaccine given to 13 year old child

Other Meds: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhl inhaler ARIPiprazole (ABILIFY) 2 mg tablet clobetasoL (CLOBEX) 0.05 % shampoo doxycycline (VIBRAMYCIN) 100 mg capsule escitalopram (LEXAPRO) 10 mg tablet FLOVENT HFA 110 mcg/actuation inhal

Current Illness: none

ID: 1266784
Sex: M
Age: 25
State: ME

Vax Date: 04/07/2021
Onset Date: 04/07/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 10 MINUTE POST VACCINATION DEVELOPED VASALVAGAL SYMPTOMS - MOVE TO TREATMENT AREA WITH WHEEL CHAIR AND ADMINISTERED COLD PACKS SYMPTOMS RESOLVE WITHIN 15 MINUTES. PATIENT WAS ABLE TO LEAVE ON THEIR OWN RECONNAISSANCE.

Other Meds:

Current Illness:

ID: 1266785
Sex: M
Age: 29
State: VA

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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Mild, Additional Details: PATIENT RECIEVED VACCINE AND WAS WAITING IN DESIGNATED AREA AND TRIED TO MOVE AND FAINTED - RPH WAS NOTIFIED AND PT BP WAS CHECKED WNL AND PT WAS GIVEN WATER AND SPOKEN TOO AND STARTED TO FEEL BETTER AFTER 5 MINS

Other Meds:

Current Illness:

ID: 1266786
Sex: F
Age: 39
State: NY

Vax Date: 04/24/2021
Onset Date: 04/28/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Hives and swollen lip 4 days after vaccine

Other Meds: Nitrofurantoin

Current Illness: Bacterial Infection- which is why I am taking the above medication

ID: 1266787
Sex: F
Age: 36
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Fever, chills for 3 to 4 days. After 4 days developed vaginal yeast infection and hemorrhoid's with severe pain and itching. and also developed hives and rashes all over the body, head and face. the hives and rashes are growing day by day. Its also effecting the menstrual period cycle.

Other Meds: levothyroxine 100 mcg and Vitamin D

Current Illness: None

ID: 1266788
Sex: F
Age: 19
State:

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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: Lightheadedness, nausea. Blood sugar monitoring and release to home.

Other Meds:

Current Illness:

ID: 1266789
Sex: F
Age: 54
State: FL

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

Symptoms: Systemic: patient mentioned her tongue was funny. she denied any tingling sensation-Mild, Additional Details: Patient reported her tongue felt funny and wasn't going away. she requested benadryl. Even after dose dispensed she still felt that way. No other symptoms progressed. she waited for about 1 hr and was told to watch out for signs of sever reaction and continue monitoring.

Other Meds:

Current Illness:

ID: 1266790
Sex: F
Age: 42
State: IL

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: Allergic to cilantro

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

Symptoms: Itchy at injection site. Hard and swollen. Painful to the touch. Red rash.

Other Meds: Vitamin b, vitamin d, tamoxifen, venlafaxine, sertraline, glycopyrolate,

Current Illness:

ID: 1266791
Sex: F
Age: 42
State: PR

Vax Date: 03/25/2021
Onset Date: 03/31/2021
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: NONE

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

Symptoms: Fever, cough, malaise and fatigue.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1266792
Sex: M
Age: 50
State: AZ

Vax Date: 04/27/2021
Onset Date: 04/28/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Awoke to uncontrollable spasmatic shivering, ice cold feet, increased heart rate of 110, increased blood pressure 151/84. Worst of it lasting over 1 and a half hours before extreme shivering subsided with continued stress.

Other Meds: Vitamin d3 a multivitamin, a joint health compound, fish oil, co-10, prostate health tablet, medical thc; 10mg only at bedtime

Current Illness: None

ID: 1266793
Sex: F
Age: 27
State: NY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: Nuts Seeds Shellfish

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Three days after my first Pfizer dose I broke out in hives. I went to dermatologist who told me to take Benadryl for a few nights and prescribed me desonide cream. I am getting my second dose tomorrow.

Other Meds: Retinol for acne azelaic acid for acne

Current Illness: N/a

ID: 1266794
Sex: M
Age: 19
State: AZ

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:

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

Symptoms: Systemic: Fainting / Unresponsive-Medium, Additional Details: After 10 minutes of getting vaccine pt told observer he was feeling light headed. pt was sipping on water. as we put pt down on back, pt passed out. we checked for pulse and could here pt slowly breathing. gave once dose of 0.3 epi and called 911. emt arrived within 5 minutes and took it from there. pt immediately felt fine after 1 dose of epi. pt bp was stable and hr. emt took care of pt who didnt need to go to hospital

Other Meds:

Current Illness:

ID: 1266796
Sex: U
Age: 69
State:

Vax Date: 04/07/2021
Onset Date: 04/14/2021
Rec V Date: 04/28/2021
Hospital: Y

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: alveolitis in setting of pulm fibrosis

Other Meds:

Current Illness:

ID: 1266797
Sex: M
Age: 34
State: PA

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: Swollen armpit in the same arm as injection

Other Meds: Multivitamin

Current Illness: None

ID: 1266798
Sex: M
Age: 20
State: MD

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: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1266799
Sex: M
Age: 38
State: WI

Vax Date: 04/12/2021
Onset Date: 04/17/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: Venous thrombosis of proximal greater saphenous vein

Other Meds: Omeprazole

Current Illness:

ID: 1266800
Sex: F
Age: 41
State: LA

Vax Date: 04/20/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Swelling, redness, fever, and rash at injection site for a week so far

Other Meds: None

Current Illness: None

ID: 1266801
Sex: M
Age: 74
State: MA

Vax Date: 03/28/2021
Onset Date: 04/02/2021
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: mild allergy to neosporin

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

Symptoms: Hives started showing up on the neck and head. Then moved down to the upper torso. Benadryl was taken as needed to control the itching. Symptoms lasted approximately 48 hours

Other Meds: tamsulosin, ibuprofen, finasteride, acetaminophen, niacin, ...

Current Illness: none

ID: 1266802
Sex: M
Age: 70
State: NJ

Vax Date: 03/29/2021
Onset Date: 03/31/2021
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: Bee Venom

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Sharp Headaches, Short Term on left side of skull above the ear. Duration of events last about 10 to 15 seconds. Can not determine any triggers to innate. Events come any time. from a few a day to none for a few days.

Other Meds: Metroprolol 25mg Crestor 5mg Metformin vitamin D3 IU's Omerprazole 20mg One A Day Enalapril 5mg Eliquis 5mg

Current Illness: N/A

ID: 1266803
Sex: M
Age: 32
State: DC

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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Tingling (specify: facial area, extemities)-Severe, Systemic: Visual Changes/Disturbances-Mild, Systemic: Weakness-Mild, Additional Details: Numbness, tingling in hands/ mouth/ tongue. History of similar reactions with other vaccinations per patient. Patient has a phobia with needles.

Other Meds:

Current Illness:

ID: 1266804
Sex: F
Age: 58
State: AL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: Both eyes started to burn as though i was looking at the sun and could not close my eyelids. Two hours in (around 5:30pm), I could not keep my eyes open. Both eyes teared constantly yet i went through a whole bottle of dry eye relief in 24hrs as well. I went to bed at 9pm and was awoken by the eyes burning at 2am and both eyelids were puffy crusted with discharge. Cleaned eyes and then needed to wet them until 4am. Major burning and tearing reduced gradually across next 4 hours. Dry eye and morning crusting reduced daily and resolved by Sunday, April 11.

Other Meds: Levothyroxin, Losartan, Multi Vitamins, Vit D3

Current Illness: none

ID: 1266805
Sex: F
Age: 40
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Allergy to Milk (anaphylaxis) Allergy to dust mites Allergy to crustaceans

Symptom List: Nausea

Symptoms: Approximately, 2 hours after the shot experienced dizziness and/or mild vertigo. Had to lay down for 30 minutes, then sit and took it easy the rest of the evening. The next 48 hours from the vaccine injection, I experienced dizziness/mild vertigo and fatigue off and on, laying down when needed. Did not do any activities involving physical exertion, just took it easy until symptoms subsided. Then approximately one week later experienced dizziness again one evening and went to bed early. Also, had sore arm at injection site for 2 days.

Other Meds: None

Current Illness: None.

ID: 1266806
Sex: F
Age: 54
State: NY

Vax Date: 04/18/2021
Onset Date: 04/18/2021
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: shellfish, dust mites, seasonal allergies

Symptom List: Injection site pain

Symptoms: I waited 15 minutes before leaving the facility. I got out to the car and my cheeks and chin started tingling and were red, I started to have a slight reaction. On the drive home, I started to get a metallic taste and was starting to have difficulty swallowing. I advised my husband of this. The difficulty swallowing and metallic taste subsided after 2 days. It never got to the point where I needed to go to the ER. NOTE: After the first dose, the only side effect I had was tiredness for 1 day and a headache for 2-3 days.

Other Meds: singulair and Synthroid

Current Illness: none

ID: 1266807
Sex: F
Age: 66
State: NY

Vax Date: 03/18/2021
Onset Date: 03/19/2021
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 Shellfish

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

Symptoms: Severe ringing in ears started about 12 hours after shot. That lasted about 2 hours and then became loud ringing in ears and headaches.

Other Meds: Synthroid

Current Illness: None

ID: 1266808
Sex: F
Age: 49
State:

Vax Date: 04/06/2021
Onset Date: 04/27/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Pt received her first dose of COVID vaccine on 4/6 and was scheduled to receive her second dose on 4/27. However, she missed her appointment for the second dose since she had fever, cough, and shortness of breath x 4 days and presented to the ED instead. She was found to be hypoxic in the ED and was admitted for COVID treatment.

Other Meds:

Current Illness:

ID: 1266809
Sex: M
Age: 63
State: MI

Vax Date: 04/08/2021
Onset Date: 04/22/2021
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: None known

Symptom List: Tremor

Symptoms: Presented to emergency department on 4/22/21 after having an unwitnessed syncope episode at home. Was found to be in atrial fibrillation with RVR. He denies any COVID-19 exposure, but was found to be positive upon screening for admission. No COVID-19 symptoms were reported during admission.

Other Meds: Levothyroxine

Current Illness: None known

ID: 1266810
Sex: F
Age: 47
State: MD

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

Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: swelling lips- itching body- rash-headache-body ache

Other Meds: none

Current Illness: none

ID: 1266811
Sex: F
Age: 33
State: ME

Vax Date: 04/07/2021
Onset Date: 04/07/2021
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: PRESENTED LIGHT HEADED, FACE NUMBNESS, TINGLING ARMS , SWEATING BUT HANDS WERE COLD TO THE TOUCH. MOVE TO TREATMENT AREA AND LIE DOWN APPLIED COLD PACKS VITAL SIGNS WERE NORMAL. AFTER 45 MINUTES PATIENT WAS ABLE TO SIT UP AND MOVE TO THE WAITING ROOM AND LEFT ON THEIR OWN RECONNAISSANCE AFTER 10 MINUTES.

Other Meds:

Current Illness:

ID: 1266812
Sex: F
Age: 57
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: 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: Pt. feels hot, dizzy, not feeling well, headache 7/10. 134/74. 99%, 80, BG 95. Pt. Stated that she's still feeling unwell but want to go home. Pt. A+Ox3. Pt. verbalized that she will go eat. Pt. advised to call EMS if symptoms persist. Pt. advised to f/u with primary doctor. Pt. verbalized understanding.

Other Meds:

Current Illness:

ID: 1266813
Sex: M
Age: 72
State: NM

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1266814
Sex: M
Age: 45
State: OH

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: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: fatigue requiring sleep for >30 hours, swollen lymph nodes, myalgia, arthralgia

Other Meds: none

Current Illness: none

ID: 1266815
Sex: F
Age: 47
State: NJ

Vax Date: 04/19/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Round, raised, red and warm circle at injection site.

Other Meds: None

Current Illness: None

ID: 1266816
Sex: F
Age: 18
State: TN

Vax Date: 04/01/2021
Onset Date: 04/28/2021
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: Pain in extremity

Symptoms: Headache, Fever, Chills, Muscle pain and hard time breathing. Fatigue. Currently treating with Tylenol and Ibuprofen and rest.

Other Meds:

Current Illness:

ID: 1266817
Sex: F
Age: 84
State: FL

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

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

Lab Data:

Allergies: sulfa, flu vaccine, pineapple, walnut, adhesives

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

Symptoms: onset of atrial fibrillation with CHF within 3 days of vaccination

Other Meds: propranolol 80 mg ER ; lisinopril 10 mg, multivitamin, Vitamin D3/K2 5000, CBD topical, acetaminophen 500 mg prn, folate 1000

Current Illness: none

ID: 1266818
Sex: F
Age: 25
State: ME

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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: - Augmentin - Soy

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

Symptoms: The morning after (04/15/21), I woke up with soreness and slight redness. As of today (04/28/21), a red circle with the diameter of more than 1 inch, slightly tender on my left arm. Gradually increased in size over the last 2 weeks. My whole body is itchier than normal. I'm now using a body lotion daily so I have not experienced much itchiness since. I've been very fatigued & irritable. My headaches have gotten worse and I haven't had much of an appetite.

Other Meds: - FLUoxetine 20 MG Cap x3 daily - levoTHYROxine 50 MCG Tab daily - Cholecalciferol (Vitamin D-3) 125 MCG (5000 UT) Tab every other day - cetirizine 10 MG Tab - busPIRone 10 MG Tab x2 twice daily

Current Illness:

ID: 1266819
Sex: F
Age: 27
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Severe, Systemic: Visual Changes/Disturbances-Medium

Other Meds:

Current Illness:

ID: 1266820
Sex: F
Age: 67
State: FL

Vax Date: 01/22/2021
Onset Date: 01/24/2021
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: Z Pack

Symptom List: Vomiting

Symptoms: Received the injection on January 22, Friday. Rash on Left Arm by injection site on Sunday night about 10 PM and it was gone by Monday morning. I did nothing for the rash. Blood Pressure increased at night on Sunday, Monday and Tuesday At 3:30 Am Wednesday my BP went to 214/110 so I went to the Hospital. Doctor in the hospital gave me 5 mg of Amlodipine.

Other Meds: Metoprolol, Vitamin D3

Current Illness: None

Date Died: 04/24/2021

ID: 1266821
Sex: F
Age: 40
State: MD

Vax Date: 04/23/2021
Onset Date: 04/24/2021
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: Pollen Extracts- confusion. Sulfamethoxazole- confusion. Cephalexin- hives. Ciprofloxacin- nausea and vomiting. Clindamycin- nausea and vomiting. Grass Pollen. Iron- nausea and vomiting. Latex- rash. Tape Adhesive- rash. Sulfonamide Antibiotics- nausea and vomiting.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt was seen in Family Medicine on 4/23/2021. Was given her first Moderna vaccine that day. On-call doctor received phone call on 4/24/2021 that pt had expired. Death certificate states cause of death: seizure due to possible complication of COVID 19 vaccine. Conditions if any, leading to immediate cause: cerebellopontine angle tumor of brain

Other Meds:

Current Illness:

ID: 1266822
Sex: F
Age: 40
State: TN

Vax Date: 04/19/2021
Onset Date: 04/22/2021
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: Penicillin

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

Symptoms: Started my period 9 days early (this has never happened to me before)

Other Meds: B6, magnesium

Current Illness: No

ID: 1266824
Sex: M
Age: 37
State: TX

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Medium, Systemic: Hyperventilation-Severe, Systemic: Shakiness-Severe, Systemic: Tingling (specify: facial area, extemities)-Severe, Additional Details: epipen given. called 911. but the patient was ok before they get to the store after giving epipen.

Other Meds:

Current Illness:

ID: 1266825
Sex: F
Age: 35
State: AZ

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: RA

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Chest pain and pressure, elevated resting heart rate (increase from around 80 to 95 bpm) Only reporting this because all the literature seemed to only discuss elevated heart rate in the context of an immediate anaphylactic reaction

Other Meds: B12 supplements (1000mkg) Lo loestrin FE Monteleukast

Current Illness: Pernicious anemia Gastritis or intestinal inflammation (diagnostic testing in progress to determine which)

ID: 1266826
Sex: M
Age: 17
State: FL

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: None

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

Symptoms: Vaccine administered to patient under the age of 18

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm