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: 1267346
Sex: F
Age: 17
State: OR

Vax Date: 02/06/2021
Onset Date: 02/06/2021
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: Unknown

Symptom List: Dysphagia, Epiglottitis

Symptoms: Medication error; Dose given prior to 18th birthday. Patient tolerated well.

Other Meds: Unknown

Current Illness: Unknown

ID: 1267347
Sex: M
Age: 33
State:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: pt received 1st dose on 4/7/2021, 2nd dose on 4/22/2021

Other Meds:

Current Illness:

ID: 1267348
Sex: F
Age: 31
State: CA

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

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

Lab Data:

Allergies: NKA

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

Symptoms: Unknown

Other Meds: Unknown

Current Illness: Unknown

ID: 1267349
Sex: F
Age: 49
State:

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

Lab Data:

Allergies: penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received the Moderna COVID vaccine (lot 016C21A, exp 5/22/2021) at 1240. The patient reported severe anxiety to RN before receiving the injection, EMT approached patient offering to have her lay in the zero-gravity chair. Patient declined. After receiving the injection, the patient bent over, leaning forward in the chair reporting nausea and trembling sensation. PHN approached, offered the client a trash to vomit into in case need be. Monitored by EMT and PHN, the patient moved to the zero-gravity chair and was positioned laying down. Allergies to penicillin. patient reported history of migraines and denied taking any medications. At 1245, vital signs: O2 99%, pulse 81, respirations 18, blood pressure 110/82. Patient reported not eating since the evening before. Symptoms included anxiety, trembling, light sensitivity, and nausea. Patient sat up and vomited into emesis bag at 1247. PHN offered patient Benadryl but patient declined. At 1255, patient changed her mind, requesting Benadryl again. When PHN told her the only oral form was liquid Benadryl not capsule, the patient stated "I just want to leave." At 1257, patient vomited into emesis bag. At 1300, patient sat up. Patient stood up reporting no dizziness. EMT accompanied patient to the parking lot. Patient left walking with steady gait at 1302. Patient's husband drove her home.

Other Meds: none

Current Illness:

Date Died: 04/28/2021

ID: 1267350
Sex: M
Age: 69
State: NJ

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:
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: Shortness of Breath Fever Body Pains - Shoulder, Hand pain

Other Meds: BP Medications

Current Illness: None

ID: 1267351
Sex: M
Age: 60
State: PA

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

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

Symptoms: 3 Areas of site reactions on left arm and shoulder - warm, red rashes measuring 3 to 4" in diameter each swollen and painful lymph nodes in left side of neck

Other Meds: none

Current Illness: none

ID: 1267352
Sex: F
Age: 32
State:

Vax Date: 03/19/2021
Onset Date: 03/21/2021
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: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I was 9 weeks postpartum at the time of my first vaccination, exclusively breastfeeding and told by my OBGYN not to expect a menstrual cycle for quite a while, maybe a year or more depending on how long breastfeeding continued. Two days after my vaccine I started my period and have had second one since then.

Other Meds: None

Current Illness: None

ID: 1267353
Sex: F
Age: 61
State: NY

Vax Date: 04/14/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: wellbutrin

Symptom List: Pharyngeal swelling

Symptoms: within 10 minutes fingers and hand on left side got extremely tingly and I felt a tad lightheaded

Other Meds: metformin, insulin, metoprolol succ er, aspirin

Current Illness:

ID: 1267354
Sex: F
Age: 31
State: IL

Vax Date: 04/11/2021
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: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient reseived Moderna 1st dose on 4/11/21 at Pharmacy. Developed some abdominal pain after 3 days on 4/14/21, and had miscarriage on 4/22/21, Estimated delivery date was 11/18/2021

Other Meds: N/A

Current Illness: N/A

ID: 1267355
Sex: F
Age: 66
State: NY

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Whole body tremors that affected ability to swallow, with fatigue and headache. Started about 12 hours after vaccine and lasted a total of 24 hours. No doctors visit was required.

Other Meds:

Current Illness:

ID: 1267356
Sex: F
Age: 29
State: DC

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

Lab Data:

Allergies: none

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

Symptoms: localized redness, swelling and itching

Other Meds: Mirena IUD

Current Illness: none

ID: 1267357
Sex: F
Age: 60
State: TX

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

Lab Data:

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: Felt flushed, SOB

Other Meds: Amlodipine, HCTZ, Zyrtec

Current Illness: none

ID: 1267358
Sex: F
Age: 23
State: TX

Vax Date: 04/23/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: EDD 11/8/21, onset of vaginal bleeding, within 3 days of 2nd dose of vaccine, pregnancy continues to be viable.

Other Meds: prenatal vitamins

Current Illness: none

ID: 1267359
Sex: M
Age: 28
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: no allergies per pt on consent form

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

Symptoms: Patient got Moderna vaccine about 2:30 pm . He indicated he was nervous and asked to have his girlfriend hold his hand while he was vaccinated. He then sat in the waiting area afterwards. Approximately 10 minutes later approached the counter and said he was not feeling well. He started to wobble and our staff sat him in a chair nearby. He said maybe he "blacked out" for a moment. He indicated he had not had much to eat that day. We gave him a water and a cookie. Seemed to be okay, talking with staff, but then started to shiver . EMTs were called and he was checked by them . Heart rate just over 100 , O2 saturation at 99% , no hives per EMT .Possible vasovagal event per EMT . Patient declined to go to hospital and left shortly after with his girlfriend driving him home.

Other Meds: Unknown

Current Illness: unknown- pt was not sick (no cold,fever,acute illness) per consent form

ID: 1267360
Sex: M
Age: 76
State: CA

Vax Date: 02/18/2021
Onset Date: 04/30/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: After the first vaccine: Leg pain, foot pain, chest pain. Four days after vaccine, the chest pain was so bad that my dad went to ER and had a Pulmonary Embolism . He was hospitalized two nights. After the second vaccine: right leg pain, weakness in both legs. Three days after the second dose, my dad had a stroke.

Other Meds: Cholesterol (Simvastatin)

Current Illness: None

ID: 1267361
Sex: F
Age: 64
State: IN

Vax Date: 01/13/2021
Onset Date: 01/21/2021
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: none

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

Symptoms: Herpes zoster developed on day 8, and resolved prior to dose 2, with generic Valtrex medication.

Other Meds: Levothyroxine & Losartan

Current Illness: none

ID: 1267362
Sex: M
Age: 15
State: WA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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 Reported

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

Symptoms: Adverse Event: Guest received his first dose of Pfizer vaccine 10 days prior to his 16th birthday. Guest mother states that she did provide consent and was onsite at the time of the first dose of vaccination. Mother was onsite today when guest received his second dose and provided consent today as well. Treatment: None indicated . Outcomes: Guest and his mother states that he had mild side effects that resolved within 24 hours.

Other Meds: None Reported

Current Illness: None

ID: 1267363
Sex: F
Age: 51
State: IL

Vax Date: 03/23/2021
Onset Date: 04/17/2021
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: Codeine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt. received first covid vaccine on March 23, 2021. Pt. developed symptoms on April 17, 2021 and tested + on 4/19/2021. Pt. had multiple exposure leading up to positive test. Pt. is currently stable and home.

Other Meds: Estradiol 0.5 mg Tablet Pantoprazole 40 mg daily. Vitamin D3 25 mcg (5000 units) daily Biotin 10,000 mcg capsule

Current Illness: None

ID: 1267364
Sex: F
Age: 55
State: UT

Vax Date: 04/08/2021
Onset Date: 04/12/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Three days after the vaccine I woke up and the back of my throat and my tongue really hurt. My throat and tongue and soft palate were covered in blisters. They were very painful and it was hard to swallow. She recommended seeing my dentist. They both thought it was a viral infection. I was prescribed a mouth rinse Chlorohexidine and recommended combination of Mylanta and Benadryl. After almost two weeks I just have one blister left on the side of my tongue but the rest are healed up. I have no more pain.

Other Meds: Topiramate 100mg Lovastatin 20mg

Current Illness:

ID: 1267365
Sex: F
Age: 33
State: WI

Vax Date: 04/13/2021
Onset Date: 04/16/2021
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: Sulfates

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

Symptoms: Nausea, vomiting, itching and swelling of skin.

Other Meds: Effexor, albuterol inhaler

Current Illness: N/a

ID: 1267366
Sex: F
Age: 53
State: TX

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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: Heart palpitations, increased heart rate

Other Meds: Synthroid, crestor, multivitamin, Vit D, Vit E, CoQ10, baby aspirin

Current Illness: None

ID: 1267367
Sex: F
Age: 29
State: TX

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: I felt fine after until a few hours later. I started having a intense pain in my neck, under my jaw around where my lymph nodes are located. For about 9 hours, any time I swallowed, talked or had movement in my neck, I had sharp pain on the right side. I took a few doses of benadryl and Tylenol to try and ease the swelling (slightly visable). After this I started sipping on hot chicken broth, since I hadn't eaten, which seemed to help ease the pain and eventually go away. During this time, I tired a heating pad then ice which neither helped. No fever during this time.

Other Meds: None

Current Illness: None

ID: 1267368
Sex: M
Age: 51
State: OR

Vax Date: 04/07/2021
Onset Date: 04/17/2021
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: Methocarbamol, Cyclobenzaprine

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

Symptoms: Onset of severe headache , slurred speech on 4/17/2021. Became aphasic with motor deficits, was not a tpa candidate at hospital due to time of symptom onset. Dx with L MCA ischemic CVA

Other Meds: Asmanex, Hydroxizine, Melatonin, Ropinirole, Disulfiram, Atorvastatin, ProAir, Lisinopril, Tramadol, Sildenafil, Metformin, Omeprazole, Tizanidine

Current Illness: Allergy symptoms, COVID exposure

ID: 1267369
Sex: M
Age: 25
State: MI

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Pain

Symptoms: Patient fainted after 5 minutes of vaccine

Other Meds: No

Current Illness: NO

ID: 1267370
Sex: F
Age: 32
State:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: 103.3 fever night of, significantly late period

Other Meds: None

Current Illness:

ID: 1267371
Sex: F
Age: 27
State: OH

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

Lab Data:

Allergies: intolerance to morphine, reaction was nausea, patient reported as allergy

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

Symptoms: about 7 or 8 min after administration patient felt pain in the back of her neck going up to the base of her head, an associate monitored her from that point, a few min later she became very woozy/drowsy and her eyes were glossy and her lips purple/blue and face pale, we moved the patient to the floor atop a mat/blanket and propped her feet on the chair, after a few min her color came back to her face and lips, at some point her forehead began to tingle and her head started to hurt, the tingling began to move down the brim of her nose and within a few min the color left her face and lips became purple/blue again, the tingling then went further down her nose and down the side of her face, at that point I called EMS in fear it may turn into an allergic reaction, afterwards she said her throat felt "numb", her state remained the same until EMS arrived, note patient never lost consciousness nor reported difficulty breathing or swelling, no medications were administered at the pharmacy, EMS took the patient to the hospital, administered something for her headache and dizziness, performed a CAT scan that showed no significance, and sent her home advising her to followup with her provider in a couple days

Other Meds: unknown

Current Illness: unknown

ID: 1267372
Sex: F
Age: 62
State: OH

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: foods, chemicals, pets, dust etc

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Nausea, dizziness, lump in throat, rapid heartbeat, suppressed breathing, headache, muscle pain, chills, joint pain, fever, injection site swollen, hot, and red size of 50 cent piece

Other Meds: vitamins, loratadine 10 mg

Current Illness: None

ID: 1267373
Sex: M
Age: 76
State: OH

Vax Date: 04/17/2021
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: RA

Lab Data:

Allergies: n/a

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: patient stated that he had to call the ambulance because he couldn't move. He vomited, was nauseous and aspirated his vomit. He was in the hospital with pneumonia

Other Meds: n/a

Current Illness: n/a

ID: 1267374
Sex: F
Age: 56
State: MO

Vax Date: 04/28/2021
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: RA

Lab Data:

Allergies: unknown

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

Symptoms: flushing, heart palpitations, shortness of breath within minutes of injection. started resolved within about 10 min . gave 25 mg benadryl PO

Other Meds: unknown

Current Illness: unknown

ID: 1267375
Sex: M
Age: 59
State: CA

Vax Date: 03/22/2021
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: RA

Lab Data:

Allergies: Diclofenac Epolamine

Symptom List: Nausea

Symptoms: is a pleasant 52 year old male, presents with complains of feeling dizzy since Monday March 22, 2021 immediately after he had his first COVID vaccine. Patient states it has been persistent since that time. He reports the dizziness occurs only when he is moves his head while sitting up or standing up, resolves when he lays down. States it is not spinning or rocking but more of j"just not feeling right" Patient reports he as been noticing difficulty with swallowing but that resolved with taking Benadryl."

Other Meds: Men's MultiPlus Vitamins, Turmeric, Collagen, Omeprazole, Tylenol and Motrin

Current Illness: None

ID: 1267376
Sex: F
Age: 76
State: HI

Vax Date: 02/02/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: No adverse event, but patient and her husband (both fully immunized) tested positive for COVID19 on 4/24/2021. Patient's symptoms started April 14 (cough only)

Other Meds:

Current Illness:

ID: 1267377
Sex: F
Age: 19
State:

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: LA

Lab Data:

Allergies: none

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

Symptoms: extreme muscle ache. fever. Excruciating back pain. loss of appetitie. flu like symtoms. Worst pain all over my body

Other Meds: none

Current Illness: none

ID: 1267378
Sex: F
Age: 46
State: AR

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: RA

Lab Data:

Allergies: sulpha and celebrex

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

Symptoms: shortness of breath and flu like symptoms

Other Meds: montelukast, Flonase, prebiotic, Allegra, women's multi vitamin, vitamin C, vitamin B12, Vitamin D3, coreg, citalopram, Detroit, Xanax, Prilosec

Current Illness: flu three weeks prior

ID: 1267379
Sex: F
Age: 47
State: CA

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

Lab Data:

Allergies: CAT

Symptom List: Tremor

Symptoms: Patient complained about dizziness, tingling of arms, and throat closing 5 minutes after the shot. Symptoms resolved after about 10 minutes and patient developed slight rash on chest.

Other Meds:

Current Illness:

ID: 1267380
Sex: F
Age: 60
State: WA

Vax Date: 04/15/2021
Onset Date: 04/18/2021
Rec V Date: 04/28/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: "excessive sweating, watery eyes, dizziness and nausea; symptoms worse 3rd day post vaccination"

Other Meds: Levothyroxine

Current Illness:

ID: 1267381
Sex: M
Age: 37
State: FL

Vax Date: 04/11/2021
Onset Date: 04/16/2021
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: no

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

Symptoms: Felt abnormal heart rhythms and shortness of breath with fatigue. Symptoms would come and go through the day.

Other Meds: no

Current Illness: no

ID: 1267382
Sex: M
Age: 61
State: MI

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: 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 received Moderna in February he missed his March appointment. He called the call center who informed him he needed to restart the series. He said in April it was his 1st dose so he received. Moderna when he came back for 2nd dose of Moderna it was explained to him he has received both doses. He was satisfied.

Other Meds:

Current Illness:

ID: 1267383
Sex: F
Age: 59
State: MA

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

Lab Data:

Allergies: Citric Acid, Cats, Dogs, Horses, trees, nuts.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Itchy, raised bumps on feet, hands, wrist. Then skin pealing.

Other Meds: Carvedilol, Pantoprazole, Claritin-D, Vitamin D3, Milk Thistle.

Current Illness:

ID: 1267384
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: 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: Acute Pancreatic attack- sharp pain in upper left stomach radiating to upper left back, pain also in left breast lasting for approx 2 hrs and then somewhat relieved after taking Tums and phazyme. After 12 hrs stomach still mildly sensitive to touch and bloated.

Other Meds: Bupropion XL 150, Adderall XR 20mg, omeprazole

Current Illness: none

ID: 1267385
Sex: F
Age: 61
State: MD

Vax Date: 04/08/2021
Onset Date: 04/19/2021
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: codeine

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

Symptoms: Rash and swelling at vaccination site (L ARM) the day after vaccine. Poison Ivy- like rash began 4/19. Bilateral upper and lower extremities. Itchy and painful, pustules, hot to touch. Unable to sleep. Spreading and worsening as of 4/28.

Other Meds: Raw calcium, biotin

Current Illness: none

ID: 1267386
Sex: F
Age: 66
State: GA

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: Latex

Symptom List: Pain in extremity

Symptoms: Patient received 2nd dose of COVID-19 vaccine in vaccine clinic (Pfizer). Patient reports a history of light-headedness/dizziness with medical procedures involving needles. Approximately 5 minutes after injection, patient reported feeling dizzy. She was alert and oriented x3, denied any difficulty breathing or swallowing, no rash or itching, pupils equal and reactive, visual tracking WNL. I elevated her legs and advised her to remain in our observation area for 30 minutes. At 1:46pm, I was advised by vaccinator that patient remained dizzy. This was approx ~20 minutes after vaccination. Patient remained stable, alert and oriented. At 2:01pm I was called by Dr and advised to come evaluate patient (I was eating my lunch at the time). Patient remained with feet elevated, alert and oriented x3 with equal and reactive pupils. HR 72 BP 138/78. Patient drank some apple juice, No SOB, rash. I went to urgent care to see if it would be possible for patient to come lay down on a stretcher there to help with dizziness. Urgent care requested that I call rapid response and 911. I advised UC that this was not a medical emergency and the patient is stable, we just don't have any area for her to lay down. Ultimately, I left UC and advised patient that they would not take her unless we call rapid response. Patient declined. I put a blanket on the floor for her and helped her to lay down on the floor. After about 10 minutes of laying on the floor, she was able to get up and go to the restroom. She walked back to the observation area and sat in chair while husband brought car around. Patient ambulated to car without difficulty or help approx 1 hour after vaccine was administered.

Other Meds: Unknown

Current Illness: None

ID: 1267387
Sex: M
Age: 40
State: FL

Vax Date: 04/23/2021
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: N/A

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

Symptoms: Shortness of breath, mild naseau, consistent bathroom urgency (not necessarily going), diarrhea when I can go to the bathroom.

Other Meds: Prilosec OTC, Fiber Pills (2 capsules), daily vitamin gummy

Current Illness: None

ID: 1267388
Sex: F
Age: 37
State: OH

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

Lab Data:

Allergies: None

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

Symptoms: 5 days after injection 2.75 inch x 4.5 inch annular erythema noticed at injection site. Not pruritic.

Other Meds: Ashwaganda, NAC, probiotic, borage oil, CLA, creatine, Neem leaf.- been taking these for months prior.

Current Illness: Ulcerative colitis

ID: 1267389
Sex: M
Age: 46
State:

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to vaccine site stating he was due for second dose of Moderna despite being informed throughout the week prior to the scheduled vaccine day that he was not due for another 2 weeks. His appointment was removed, but he ended up rescheduling the day of and showing up. Made it through the check-in process and received his 2nd vaccine, with the issue in timing being identified once it was logged into his vaccine history. He had received his first dose on 9 Apr, so just 2 weeks earlier. He developed some fevers and chills, with arm soreness. Has since recovered. No treatment required.

Other Meds:

Current Illness:

ID: 1267390
Sex: F
Age: 44
State: IN

Vax Date: 04/06/2021
Onset Date: 04/15/2021
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:

Symptom List: Vomiting

Symptoms: 9 days after the first dose I got covid arm and it was huge red, hot, and swollen at the injection site. The next morning the huge red spot trippled in size . I also got whole body fatigue but seemed worse in my legs. I was extremely exhausted and felt like I did when I had covid-19 in November 2020 only worse. I called my doctor and went in to see her that day. She said to rest and to stop taking my cholesterol meds. And take benadryl and cold medicine tylenol and ibuprofen. A week later I wasn't any better I still had covid arm and my symptoms persisted. The dr ran blood tests and a covid test. My blood work was fine and covid test was negative. Dr said to stay of the cholesterol meds and told me not to go back to work until I was feeling better. I started feeling better april 24th and today is april 28th and I still have a huge red spot on my arm it's not swollen or hot but is still very much there. I have not continued my cholesterol meds at this time.

Other Meds: Atorvastatin 40mg tablets take 1 tablet a day.

Current Illness: Cold

ID: 1267391
Sex: F
Age: 76
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Levaquin, ketek, shell fish, perfume in laundry products

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I awoke at 1:30am 0n Tuesday April 27th shaking with chills, headache and fever that went up to 100.7. I had received the second Moderna shot 16 hours before at 9:30am the previous morning (Monday April 26th 2021). I had chills and shaking until noon but had the headache and some aches in my arms and legs until about midnight when I fell asleep for the night. I woke up on Wednesday April 28th at 5am exhausted but no aches, headachce or chills. I am just taking it easy today and try and recoup my strength.

Other Meds: avorstatin 20mg 1X daily Albuterol Sulfate HFA inhaler for asthma as needed

Current Illness: none

ID: 1267392
Sex: F
Age: 45
State: CA

Vax Date: 03/17/2021
Onset Date: 03/24/2021
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: Dilantin

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

Symptoms: I have had/lived with tinnitus for a long time, but after vaccine i have had what I would describe as a flare up. The ringing I normally hear only when all is quiet, but since the vaccine the ringing is heard at all times, even in loud spaces. I noticed amplified ringing approx one week after 2nd vaccine dose, and it hasn?t stopped since.

Other Meds: Carbidopa Levadopa, Rasagelline, Amantadine, and COQ10

Current Illness: No

ID: 1267394
Sex: F
Age: 24
State: IN

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

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient reports on 04/07/2021 at 12:30 pm The injection site became very hard and red and hot inflamed with lassted 1 week. she also reports Nausea headaches and dizziness and then on 04/17/2021 she started having abdominal pain bloating and abdominal swelling which lasted one week. Also on 04/17/2021 she started having very heavy menstrual bleeding and back pain and cramping which is un normal for her since she is on Depo Provera .

Other Meds: Triamcinolone acetonide 0.5% Ointment, and Depo Provera injection 150mg/mL

Current Illness: None

ID: 1267395
Sex: F
Age: 64
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: RA

Lab Data:

Allergies: None

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

Symptoms: Flu like symptoms

Other Meds: Lisinitrol, Prevacid, Fish Oil, Calcium, Vitamin D. Asprin

Current Illness: None

ID: 1267396
Sex: M
Age: 28
State: TN

Vax Date: 03/26/2021
Onset Date: 04/23/2021
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:

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

Symptoms: The first shot left me feeling lethargic, minor body aches, and heavy soreness in the injection site. The second shot caused a fever of 101F, full body aches and chills, a moderate headache, lack of appetite, and heavy soreness in the injection site.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm