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: 1267085
Sex: M
Age: 65
State: VA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
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: He got his vaccine, had extreme itching on his arms and legs. He did call his doctor and talked to the person who gave the shot about 5 days later as they did not realize it was related to the shot. They felt that it would go away but it has not gotten any better and has probably gotten worse. They told him it was a normal reaction for a week to 10 days. They told him to take Benadryl and put antiitch cream on it, which he has been doing. He operates heavy machinery during the day so cannot do that, can only take at night and that's when it bothers him the most and sometimes at 3:00 AM he has to get up and reapply cream and take more Benadryl. They called the clinic back and he has an appointment to see his PCP today.

Other Meds: Tarazosin, Meloxicam, Losartan. Fish oil, garlique, neuriva, Zyflamend.

Current Illness: None.

ID: 1267086
Sex: F
Age: 17
State: CO

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient received first dose of the Moderna Covid-19 vaccine series. Patient is under recommended age of administration. No adverse reactions noted onsite after vaccination.

Other Meds:

Current Illness:

ID: 1267087
Sex: M
Age: 27
State: IN

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: None

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

Symptoms: Started 9 hours after shot: intense chills Started 12 hours after shot: 100 F fever, fatigue, headache Following morning: all of the above with some muscle pain 48 hours after shot: still was slightly feverish (99 F) and had headache

Other Meds: Vyvanse -40mg

Current Illness: None

ID: 1267088
Sex: F
Age: 23
State: ME

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: NAUSEA AND ANXIETY POST VACCINATION ? FELT BETTER AFTER AND BOTTLE OF WATER.

Other Meds:

Current Illness:

ID: 1267089
Sex: F
Age: 57
State:

Vax Date: 02/22/2021
Onset Date: 03/22/2021
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:

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

Symptoms: Head pressure and metallic taste. EMS with the patient.

Other Meds:

Current Illness:

ID: 1267090
Sex: M
Age: 23
State: IN

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

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

Symptoms: Chills, aching bones, vomiting

Other Meds: Zyrtec

Current Illness: None

ID: 1267091
Sex: M
Age: 60
State: MN

Vax Date: 03/09/2021
Onset Date: 03/15/2021
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: None.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: The patient developed thrombotic thrombocytopenic purpura (TTP), a week after the Janssen vaccine (Started having symptoms on March 15, 2021- speech difficulty, petechiae, fatigue, and easy bruising). TTP was confirmed by ADAMTS13 level < 5% and the presence of inhibitor on March 19, 2021. In addition, he had schistocytes, thrombocytopenia, and elevated lactate dehydrogenase. He was treated with PLEX, steroids, and Rituximab. He is currently closely monitored at Clinic.

Other Meds: Atorvastatin 40 mg once at night; Sertraline 50 mg once a day; Dulcolax 10 mg as needed fro constipation.

Current Illness: Healthy. No other illness.

ID: 1267092
Sex: F
Age: 61
State: FL

Vax Date: 03/29/2021
Onset Date: 03/30/2021
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: Questionable allergy to sulfa.

Symptom List: Pharyngeal swelling

Symptoms: Nausea, body aches, chills, fever. Two weeks later, hair loss started (still happening) and significant right thumb and palmar swelling.

Other Meds: Zolpidem

Current Illness: None.

ID: 1267093
Sex: M
Age: 19
State: NY

Vax Date: 04/07/2021
Onset Date: 04/14/2021
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: NA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Dizziness - Passing Out PT moved to treatment area where he was monitored by paramedic on site - PT moved via walking PT +Farther

Other Meds: NA

Current Illness: NA

ID: 1267094
Sex: F
Age: 61
State: IA

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

Lab Data:

Allergies: None known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: fever up to 99.5, chills, body aches, neck pain, head ache. Chills and body ached lasted 2 days, neck pain and headache 3 days. Feeling closer to normal 4 th day.

Other Meds: Synthroid, Transitions & Evening Primrose (for menopause)

Current Illness: N/A

ID: 1267095
Sex: F
Age: 59
State: NC

Vax Date: 03/05/2021
Onset Date: 03/11/2021
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: Pain in muscles in both legs from top to bottom of leg severe. Sometimes cannot walk the pain is so bad.

Other Meds: Zyrtec, Fish Oil, Elderberry

Current Illness: Fibromyalgia

ID: 1267096
Sex: F
Age: 17
State: CO

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient received first dose of the Moderna Covid-19 vaccine series. Patient is under recommended age of administration. No adverse reactions noted onsite after vaccination.

Other Meds:

Current Illness:

ID: 1267097
Sex: M
Age: 31
State: FL

Vax Date: 04/28/2021
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: none

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

Symptoms: couple minutes after patient received , he felt really dizzy and sweaty. Gave patient orange juice and had them have them seated for few min. Gave water and after 15 minutes patient was doing ok

Other Meds: none

Current Illness: none

ID: 1267098
Sex: M
Age: 26
State: VA

Vax Date: 04/14/2021
Onset Date: 04/28/2021
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: N/a

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

Symptoms: "Covid arm", red itchy ring around injection site two weeks after shot. Lot severe.

Other Meds: N/a

Current Illness: N/a

ID: 1267099
Sex: F
Age: 54
State: PA

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

Lab Data:

Allergies: PCN, Cipro, Soy, Tree nuts

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

Symptoms: Moderna COVID-19 Vaccine Started with every joint and muscle aching, fever, nausea, headache, hair shedding at a high rate. I was sick for over 36 hours and I am currently still loosing hair. I will not be getting the 2nd vaccine. I tested positive for COVID on December 19, 2020. I was not expecting to get so sick wit the first shot. I'm completely afraid to take the second shot.

Other Meds: Vitamin d-3, Citrical Slow release with d-3 and magnesium

Current Illness:

ID: 1267100
Sex: M
Age: 50
State: MS

Vax Date: 12/21/2020
Onset Date: 01/14/2021
Rec V Date: 04/28/2021
Hospital: Y

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

Lab Data:

Allergies: none

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

Symptoms: I received the Pfizer vaccine on 21 December 2021. On December 27 I developed a fever, cough and was diagnosed with Covid-19. About 14 days later I started to get a rash on hands and feet with burning sensation. I was evaluated and diagnosed with Covid toes. About 1 week later I developed a fever and was evaluated and diagnosed with pneumonia, pulmonary embolism, and a DVT. I continue to get worse to include arthritis in hands, wrists, feet and ankles. I was admitted to the hospital with worsening pneumonia, reactive arthritis and a rash on elbows, knees, hands and feet. I was in the hospital for about 5 days. I have been evaluated by rheumatology, pulmonary and dermatology since. The ongoing theory is I have a reactive arthritis from COVID and may have developed psoriasis/psoriatic arthritis.

Other Meds: lisinopril, hydrochlorothiazide, multivitamin

Current Illness: none

ID: 1267101
Sex: F
Age: 34
State: KS

Vax Date: 04/25/2021
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: Outdoor allergies, allergy to some scented products

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

Symptoms: Nausea beginning approximately 4 hours after injection. Vomiting beginning about 8.5 hours after injection and lasting for approximately 8 hours intermittently without being able to keep water down. Headache, body aches and in particular joint aches. Chills, cold sweats, and slight fever. Side effects lasted for approximately 36 hours.

Other Meds: Lamotrigine, Adderall, Abilify

Current Illness: None

ID: 1267102
Sex: F
Age: 49
State: MN

Vax Date: 01/05/2021
Onset Date: 03/31/2021
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: Person was fully vaccinated by 1/25/2021 and then was diagnosed with COVID infection 3/31/2021

Other Meds:

Current Illness:

ID: 1267103
Sex: M
Age: 20
State: TN

Vax Date: 04/23/2021
Onset Date: 04/25/2021
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: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt developed CP, SOA about 60 hours after vaccine administration went to campus health center and eventually ER where he was diagnosed with bilateral PEs.

Other Meds: "Alive" multivitamin

Current Illness: none

ID: 1267104
Sex: F
Age: 63
State: VT

Vax Date: 04/22/2021
Onset Date: 04/28/2021
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: Seasonal

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

Symptoms: I haven't been this sick in years: headache, neck ache, nauseous, CHILLS (I should have taken my temp but felt too lousy to move), joint aches/HIPS, extremely tired. lasting 48 hours. Continued to feel milder symptoms for 24 additional hours. No appetite for 4 days, I mostly just kept hydrated.

Other Meds: CBD, Multi Women's Vitamin, Vitamin D

Current Illness: No illness. Lacerated left pointer finger earlier in the day on 4/22.

ID: 1267105
Sex: U
Age: 28
State: ME

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: LIGHT HEADED AND TINGLING EXTREMITIES POST VACCINATION BP 138/94mmHg O2 SAT 98% HR 87 BPM TREATMENT 16 fl oz WATER

Other Meds:

Current Illness:

ID: 1267106
Sex: F
Age: 53
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: Maybe penicillen

Symptom List: Unevaluable event

Symptoms: Flu symptoms and fever

Other Meds: Fluoxatine

Current Illness: None

ID: 1267107
Sex: F
Age: 57
State: WI

Vax Date: 04/24/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None. Sensitivity to ibuprofen

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

Symptoms: Very sore left arm, and on 36 hours later a blotchy red itchy rash extending 2- 4 inches from injection site. Still active 84 hrs after the injection.

Other Meds: Ibuprofen, Tylenol, hydrocortisone cream after the shot. Nothing prior to except multivitamins

Current Illness: None

ID: 1267108
Sex: M
Age: 17
State: CO

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient received first dose of the moderna covid-19 vaccine series. Patient is under recommended age of administration. No adverse reactions noted onsite after vaccination.

Other Meds:

Current Illness:

ID: 1267109
Sex: F
Age: 45
State: PA

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

Lab Data:

Allergies: sulfa, codeine, raspberries Keflex,

Symptom List: Injection site pain, Menorrhagia

Symptoms: pt says she started itching and developed hives all her body. This includes her skin, eyes, ears, throat. Pt took Benadryl which seemed to help relieve her symptoms. The hives were gone the next day.

Other Meds:

Current Illness:

ID: 1267110
Sex: M
Age: 83
State: MI

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

Lab Data:

Allergies: Musinex

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

Symptoms: Itch and redness from shot down left arm to elbow

Other Meds: None

Current Illness: None

ID: 1267111
Sex: F
Age: 26
State: NY

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

Lab Data:

Allergies: Penicillin, amoxicillin, batrum, azithromycin, zithromax

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vasovagal syncope starting at 10 hours post vaccination- lightheadedness, fainting, urge to vomit upon standing. Resolved by laying back down and not standing up.

Other Meds: Enskyce combo birth control, one a day women's multivitamin, magnesium glycinate

Current Illness:

ID: 1267112
Sex: F
Age: 62
State: WI

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: RA

Lab Data:

Allergies: Caflex antibiotic

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Slight pressure in middle of chest, slight pain that comes and goes. Felt when sitting or laying down.

Other Meds: Lisinopril

Current Illness: None

ID: 1267113
Sex: F
Age: 52
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:
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: Starting at 1:00 a.m. and lasting for approximately 8-9 hours, I had a fever and was sweating; I could not sleep; my right arm was very painful; my entire body ached. It felt like a very bad flu. I took 800 mg of Advil, which helped, and felt well enough to go to work by noon. I had COVID-19 approximately 90 days before my vaccination. I have never had an adverse reaction to a vaccine in my life.

Other Meds: Lexapro, Simvastatin

Current Illness: None

ID: 1267114
Sex: F
Age: 73
State: PA

Vax Date: 04/11/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Developed night sweats, fatigue, myalgias, lightheaded feeling 2 weeks after vaccine.

Other Meds:

Current Illness:

ID: 1267115
Sex: M
Age: 37
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Not aware of

Symptom List: Injection site pain

Symptoms: Started with joint aches throughout whole body. Nausea, chills, uncontrollable shivering, high temp at 99 on day 1, 102 on day 2, cold sweat. Joint ache, nausea continue on day 3, temp read 97 on day 3. Patient took OTC Acetaminophen 500 mg for pain relief.

Other Meds: Prescription: Atorvastatin calcium tablets, USP 20 mg Losartan potassium 50 mg TAB Metformin HCL 500 mg tablet OTC: Equate allergy relief Diphenhydramine HCL, 25 mg Antihistamine

Current Illness: No

ID: 1267116
Sex: F
Age: 48
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: Prednisone

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

Symptoms: Received shot in upper right arm and it was painful. My arm grew more painful throughout the day. I became very tired as the day went on. Went to bed for the evening, Monday 4/26/2021 and woke up at 1:50am on Tuesday morning, 4/27/2021 in full body sweats, dripping with sweat. So weak I couldn't get up or lift my head. My husband took my temperature which was 103. Massive headaches, full body aches and pains, chills which made my body shake uncontrollably. My whole body hurt. Could not get up to use the restroom, tried and fainted back into the bed. Heart felt like it was beating out of my chest. My husband wanted to call 911 but I didn't want to. Felt like I had COVID again.

Other Meds: Pantroprazole 40MG once daily D3 2000IU 50mcg once daily B12 1000mcg once daily Ibuprofen 800mg twice daily

Current Illness: Period Menorrhagia

ID: 1267117
Sex: M
Age: 35
State: AL

Vax Date: 03/25/2021
Onset Date: 04/09/2021
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: None

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

Symptoms: DVT blood clot formed in left leg, intense pain started almost 14 days after vaccine. No history of any health concerns with blood clots, healthy 35 year old male who works out and diets. No long drives or sedentary lifestyle.

Other Meds: None

Current Illness: None

ID: 1267118
Sex: F
Age: 24
State: FL

Vax Date: 04/07/2021
Onset Date: 04/11/2021
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: N/a

Symptom List: Tremor

Symptoms: Body aches & muscular aches Developed a rash on the food - purplish and red bumps, swelling, skin drying out (looks similar to covid toes) and has progressively gotten worse

Other Meds: Birth control

Current Illness: N/a

ID: 1267119
Sex: F
Age: 21
State: NC

Vax Date: 04/18/2021
Onset Date: 04/28/2021
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: unknown- please reach out to pt to ask

Symptom List: Erythema, Pruritus

Symptoms: pt received 1st dose of moderna vaccine on 4/18/21 at store. She reports no sxs until the morning of 4/26/21. Pt woke up with red, itchy spot at injection site, reports this is her only symptom. She said she will take cetirizine to help with itching. We contacted her the next day on 4/27/2021 and she reports the spot is getting smaller and less itchy, we will continue to check in with her until this resolves.

Other Meds: unknown- please reach out to pt to ask

Current Illness: unknown- please reach out to pt to ask

ID: 1267120
Sex: F
Age: 29
State: CA

Vax Date: 03/29/2021
Onset Date: 04/12/2021
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: None

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

Symptoms: Rash on arms (Slightly Bullous), and hives spread across upper torso-arms

Other Meds: None

Current Illness: None

ID: 1267121
Sex: M
Age: 70
State: MI

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

Symptoms: Patient with COPD on 4L of 02 complained of difficulty breathing and S.O.B. Onsite EMS was called vitals HR 104 BP 148/80. EKG presented with abnormal rythm patient was transported to the hospital.

Other Meds:

Current Illness:

ID: 1267122
Sex: M
Age: 25
State: ME

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: LIGHTHEADED AND NAUSEA. BP 104/53mmHg. HR 62bpm O2 SAT 98%.

Other Meds:

Current Illness:

ID: 1267124
Sex: F
Age: 22
State: TX

Vax Date: 04/22/2021
Onset Date: 04/23/2021
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: left thigh muscle pain. Improved with walking. Palpable muscle spasm. Occurred day after vaccine, slightly improved over next 7 days

Other Meds: Prilosec, Albuterol

Current Illness: none

ID: 1267125
Sex: F
Age: 57
State: TX

Vax Date: 04/22/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: I am a healthy non immune comprised person under no stress (retired) and after the vaccine I had a shingles out break on my face.

Other Meds: Progesterone, Estradiol, L-thyroxine, citalopram, zinc, vitamin D, folic acid, calcium &magnesium, l-serine,

Current Illness: None

ID: 1267126
Sex: F
Age: 39
State: TX

Vax Date: 03/01/2021
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: none

Symptom List: Pain in extremity

Symptoms: Heavier/more painful menstrual cycle.

Other Meds: losartan, lexapro, metformin, multi vitamin, iron, vitamin d, b12, claritin

Current Illness: none

ID: 1267127
Sex: F
Age: 43
State: NY

Vax Date: 04/19/2021
Onset Date: 04/20/2021
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: Tarazol

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

Symptoms: My shoulder joint started to ache about 8 hours after injection. Stiff, shooting pains, mobility issues. It started to get better, almost normal, but on day 8 I woke up to the symptoms getting worse. It's day 9 now, and I'm in a LOT of pain (stiff, shooting pains, mobility issues again). Is this normal?

Other Meds: Apri, multi-vitamin

Current Illness: None

ID: 1267128
Sex: M
Age: 71
State: WA

Vax Date: 03/18/2021
Onset Date: 03/20/2021
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: 2 days after receiving his shot he experienced severe diarrhea. So severe, it's been 6 weeks and he still had it. He's had to have a colonoscopy just to make sure he isn't dying! He's also been diagnosed with atrial fib. Thanks for making my dad sick!

Other Meds:

Current Illness:

ID: 1267129
Sex: F
Age: 61
State: SC

Vax Date: 04/14/2021
Onset Date: 04/21/2021
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: shellfish, crustaceans, formaldehyde, quaternium 15,pollen,dogs

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

Symptoms: On day 7, my left arm began itching intensely at the site of injection. The next day two dime-sized red spots appeared that felt like knots. The redness expanded to the size of an egg over the next few days then began to recede. The edge of the redness had a line similar to Ouchterlony. Today, day 14 after vaccination, there are still the two dime-sized spots that are pink but visible from several feet. There was no soreness associated with this reaction and the itching was gone after two or three days.

Other Meds: none

Current Illness: none

ID: 1267130
Sex: F
Age: 51
State: FL

Vax Date: 04/06/2021
Onset Date: 04/07/2021
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: Lisinopril

Symptom List: Vomiting

Symptoms: Headache and achy the next two days. Day three swollen lymph nodes in left armpit for next three weeks. Third week, swollen lymph nodes in both armpits and groin area. Vomiting, nausea , headache and severe fatigue since vaccine and still continues.

Other Meds: Atorvastatin, amlodipine, chlorthalidone, 81 mg aspirin

Current Illness: None

ID: 1267132
Sex: F
Age: 63
State:

Vax Date: 04/15/2021
Onset Date: 04/24/2021
Rec V Date: 04/28/2021
Hospital: Y

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: diarrhea, blood in stool/blackish in color, bloated abdomen, SOB, weakness

Other Meds:

Current Illness:

ID: 1267133
Sex: F
Age: 38
State: TX

Vax Date: 01/22/2021
Onset Date: 01/25/2021
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: Augmentin

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

Symptoms: After receiving the first dose of the Covid vaccination, I had Amenorrhea for three months. I have had regular menstruation since I was 11 years old and have never missed a period prior to receiving the Covid vaccine. When I finally started my period again in April, it was the heaviest period I have ever experienced. It lasted for 4 days and was shockingly heavy for all 4 days.

Other Meds: Vimpat, Escitalopram, Ventolin Inhaler

Current Illness: Asthma, Epilepsy

ID: 1267134
Sex: F
Age: 53
State: MI

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Lower back/hip pain down through left leg all that night Fatigue next morning into evening

Other Meds: Hydrochlorothiazide Advil ( when needed) Nexium

Current Illness: None

ID: 1267136
Sex: F
Age: 23
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: RA

Lab Data:

Allergies:

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

Symptoms: On the day of the vaccine, intense pain in the arm that was injected and tiredness. On the next day, same pain in the arm, migraine, body ache, fever, nauseas and extreme tiredness. Treatment: Panadol 500mg every 4 hours. Results: symptoms were decreasing as days passed by. However, the more persistent symptoms were headache and the arm.

Other Meds:

Current Illness:

ID: 1267137
Sex: F
Age: 31
State: NH

Vax Date: 04/28/2021
Onset Date: 04/28/2021
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: NKA

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

Symptoms: Pt developed tingling, heart racing, and flushing several minutes after injection. HR 120 BP 150/80, SP02 99%. No signs to suggest anaphylaxis. Symptoms improved after several minutes without intervention. Repeat HR 90. EMS services were not required and pt drove home.

Other Meds:

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm