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: 1270183
Sex: F
Age: 34
State: NJ

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Fainting / Unresponsive-Severe, Additional Details: 5 Min after vaccine had difficulty swalling and was given benadryl. Symptoms kept worsening and so given adult epipen. Then 3 min later she passed out and was out 10 sec. She maintained good pulse and breathing. EMS was called and arrived. When EMS arrived patient was conscious. She did leave with EMS.

Other Meds:

Current Illness:

ID: 1270184
Sex: F
Age: 50
State: FL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/29/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Sharp pin prickly feelings in my legs and arms. Less frequent now. Also I haves experienced mild hives intermittent since then.

Other Meds: Methotrexate, Orencia , HYDROXYCHLOROQUINE, LEUCOVORIN, omega 3, synthroid, CBD oil

Current Illness: Cold virus with a sore throat no cough

ID: 1270186
Sex: M
Age: 37
State: PA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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: patient became light headed and lost consciousness momentarily

Other Meds: unkown

Current Illness: none

ID: 1270187
Sex: F
Age: 45
State: KY

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 10 hours after injection, developed some mild body aches, a slight headache, and a very small amount of nausea. 13 hours after injection, I woke with a fever (scanned 99.5-100.7), still had body aches, some bouts of chills, an elevated resting heart rate, still a slight headache and stomach upset. Took 1 ibuprofen. By 6:30 am, fever was gone and I felt improved, but still have some body aches and feeling rundown a bit.

Other Meds: Levoxyl, Flonase, Zaditor, Zyrtec, Super B Complex, Vitamin C, Flaxseed Oil, Fish Oil, Folic Acid, D3

Current Illness: none

ID: 1270188
Sex: F
Age: 35
State:

Vax Date: 04/23/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: Leg cramp/pain a few hours after injection, short heart palpatation 6 days after injection

Other Meds: Vitamin D, Vitamin C

Current Illness: None

ID: 1270189
Sex: F
Age: 45
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/29/2021
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: Macrolides incl mycins, sulfa, bees, azo dyes

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

Symptoms: Usual bp for this veteran is 110 over 70 resting and 120 over 80 ambulating with canes. Since her vaccine her bp has risen to 145 over 90 . Telehealth recommended Prazosin 2mg x 1 qod but this seems inappropriate. Pt is concerned about getting 2nd shot tomorrow since her bp problem seems connected to her vaccine dose on 210402.

Other Meds: Gabitril, 4mg x 2 qod Oxycodone 5mg/325mg Aspirin x 2 qod Allegra 24hr x 1 qod Multivitamin

Current Illness: Combat disabled veteran with chronic pain/rsd and multiple tbi

ID: 1270190
Sex: F
Age: 52
State: SC

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 04/29/2021
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: bactrim and immetrex

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fever, joint aches, muscles aches, nausea, diarrhea, headache, lymph notes now swollen, kidney are on fire, all symptoms were coming and going, now fever will not go away, headache will not go away. My doctors office wouldn't even see me, they sent me to urgent care. Everyone says the same, it will go away and its not. NO ONE IS HELPING ME. I FEEL SILO'D. I work a full time job, if I had covid, I'm covered, but because its adverse affects from the shot, I'm not.

Other Meds: Levothyroxine 125mcg

Current Illness: No

ID: 1270191
Sex: F
Age: 30
State: AZ

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Thimerosal allergy

Symptom List: Pharyngeal swelling

Symptoms: Body aches, severe chills. Did not sleep most of the night.

Other Meds: Decipramine, 20 MG Cetrizine, 10 MG

Current Illness: None

ID: 1270192
Sex: M
Age: 61
State: OH

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Dizzy spells (room spinning, nausea) for first 2 weeks. Now only having light headed and nausea spells no dizziness. Does seem to be getting less severe as time goes by but still having spells. Had an MRI done on 04/26/2021 of my head and everything came back normal.

Other Meds: PRAVASTATIN 40 MG LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG KRILL OIL CAPSULE APPLE CIDER VINEGAR TABLET ASPIRIN-81

Current Illness: NONE

ID: 1270193
Sex: F
Age: 64
State: KY

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 04/29/2021
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: Sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 12 hours later woke to feeling as cold as I have ever been in my life. Felt "fluish" for next day. Following day felt strange and began having palpitations of the heart. I have never had palpitations before. Bought a blood pressure cuff and blood pressure 160/92. I have never had hypertension. Palpitations worsened over next several days. Palpitations made me feel awful. Palpitations persisted on and off for days. Elevated blood pressure on and off over next week also. Weather wad bad, I was out of town and I was unable to get to the doctor right away. Saw cardiologist 2/18/21.

Other Meds: Pantoprazole, Fish oil, Vitamin D

Current Illness: NONE

ID: 1270194
Sex: F
Age: 47
State: SC

Vax Date: 04/01/2021
Onset Date: 04/09/2021
Rec V Date: 04/29/2021
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: Woke up 1 week after my 1st shot, both arms were numb and tingling in my right 4 fingers. Neck pain, felt like I slept on it wrong. Headache and fatigue all day. Around 5pm, left arm at injection site was extremely sensitive, warm and red. My entire upper arm and 1/2 of my lower arm felt as if it was burnt. No fever. I took tylenol and benadryl, and went to bed. Next morning fingers were still tingling and my right thumb area under my fingernail feels like I burnt it on something. Even today, 1 month later, my thumb still feels burnt and tingling in the very tips of my right 3 fingers.

Other Meds: Birth Control, propanolol, wellbutrin

Current Illness: breast biopsy 3/29/21 - benign

ID: 1270195
Sex: F
Age: 58
State: IL

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/29/2021
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: Pennicillin, Paxil, Prozac, Sulfa, Lexapro,

Symptom List: Rash, Urticaria

Symptoms: Post Vaccine ten days fatigue and hypersomnolence still having symptoms as of 4/13/21 (date of office visit). Also reports huge hive two inches from injection site that lasted for ten days.

Other Meds: Levothyroxine, bystolic, wellbutrin XL, adderrall XR,Estradiol, Asthmanex, Vit D

Current Illness: Surgery on 3/23/21

ID: 1270196
Sex: F
Age: 50
State: TN

Vax Date: 03/26/2021
Onset Date: 04/18/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Received 1st shot on 2/26/21 and on April 18 I became aware of a few small, flesh colored bumps on my forearms, about 1/8" in diameter, didn't think too much of it. Moving forward from that day , the bumps slowly became red, some of them turned into white heads, no itch to a few being mildly itchy. They came and went and still I just didn't think too much of them. On April 23, 2021 I recieved 2nd shot and I had zero typical side effects, I felt completely normal. By evening of 4/25/21 I had small, almost sand paper like, flesh colored bumps on my forehead, temples, neck, shoulders, etc. From that day until today, 4/29/21 the rash got worse, all bumps are red, mildly itchy, white heads come and go, I have them along and in hairline, forehead, temples, sides and back of neck, entire back, upper arms many, a few on forearms, my chest, a few on belly and not a single one below my waist. I'm very intune with my body and I am 100% sure this is a side effect of the vaccine and not anything I eat, drink or put on my body because nothing in these categories has changed in my life during this time. I have examined it for weeks.

Other Meds: Daily: 3mg estradiol, 400 mg progesterone.

Current Illness:

ID: 1270197
Sex: M
Age: 58
State: MN

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/29/2021
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: none

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

Symptoms: tiredness and fatigue started 8 hrs after shot, ringing in ears started 8 hrs after shot, body aches started 16 hrs after shot, tiredness and fatigue resolved 32 hours after shot, ringing in ears has continued some days are worse than others

Other Meds: multi- vitamin, vitamin D, vitamin B, spironolactone

Current Illness: none

ID: 1270198
Sex: F
Age: 71
State: FL

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/29/2021
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: CODEINE

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

Symptoms: PT REPORTED NUMBNESS OF THE TONGUE WITHIN 5 MINUTES OF ADMINISTRATION OF 2ND DOSE. SHE WAS MONITORED AND REPORTED THE NUMBNESS WAS SPREADING TO LIPS, CHEEKS AND DOWN HER THROAT. BENADRYL 50MG WAS GIVEN WITH NO BENEFIT.911 WAS CALLED. AS THE NUMBNESS SPREAD TO HER THROAT, SHE STARTED TO HAVE TROUBLE BREATHING. EPIPEN 0.3MG WAS ADMINISTERED WHICH PROVIDED QUICK IMPROVEMENT WITH PATIENT REPORTING THE TROUBLE BREATHING WAS IMPROVING ALONG WITH THE NUMBNESS RECEDING. EMS ARRIVED AND SHE WAS TRANSPORTED TO THE EMERGENCY ROOM.

Other Meds: LEVOTHYROXINE 112MCG, CLOPIDOGREL 75MG, ZOLPIDEM 10MG, CYANOCOBALAMIN 1000MCG/ML SHE USES MULTIPLE PHARMACIES. PER HUSBAND, SHE ALSO TAKES MEDICATION FOR PARKINSONS.

Current Illness: UNKNOWN

ID: 1270199
Sex: F
Age: 66
State: PA

Vax Date: 02/16/2021
Onset Date: 04/23/2021
Rec V Date: 04/29/2021
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, HCTZ, Aspirin, Liraglutide, Actos, dexamethasone, victoza, ceclor, Janumet, Jentadueto.

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

Symptoms: acute superficial thrombus

Other Meds: Glucophage, protonix, pravastatin, spironolactone, torsemide, lorazepam, propranolol.

Current Illness:

ID: 1270200
Sex: F
Age: 42
State: MI

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/29/2021
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: Penecillin

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

Symptoms: Shortness of breath 5 hours after vaccine, used inhaler and it subsided

Other Meds:

Current Illness:

ID: 1270201
Sex: F
Age: 28
State: IN

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Nka

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Shortness of breath, racing heart, dry mouth, dizziness, body felt hot, migraine

Other Meds: Admelog, abilify, ativan

Current Illness: N/A

ID: 1270202
Sex: F
Age: 55
State: NY

Vax Date: 03/21/2021
Onset Date: 03/23/2021
Rec V Date: 04/29/2021
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: Classic shingles on forehead started day after 2nd Covid vaccine

Other Meds:

Current Illness:

ID: 1270203
Sex: M
Age: 40
State: PR

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: onions, seafood (shellfish and crustaceans), and insect bites

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

Symptoms: Extreme fatigue and exhaustion. It is like my energy levels went down and can't come up, despite of food, water, and dietary supplement intake.

Other Meds: Triumeq (for HIV), Lovaza (omega-3 supplement), multivitamins,

Current Illness: HIV

ID: 1270204
Sex: F
Age: 39
State: AZ

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: Penicillin

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

Symptoms: 15 hours after the second shot- I had intense body shaking/chills, headache, diarrhea and sharp body pain in my low back and neck. Even my toes are sore! and my arm is very sore.

Other Meds: Levothyroxine, Escitalopram

Current Illness: None

ID: 1270205
Sex: M
Age: 48
State: FL

Vax Date: 02/05/2021
Onset Date: 02/25/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List: Unevaluable event

Symptoms: Tinnitus in the right ear.

Other Meds: N/A

Current Illness: N/A

ID: 1270206
Sex: M
Age: 25
State: KY

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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: woke up the day after the vaccine (2nd dose of pfizer) and had a fever, drenched in sweat, had a migraine. Got out of bed and was immediately hit with a cold shiver and started shaking uncontrollably for the next 15 minutes after i covered back up. Took a long time to make it back to sleep due to fever and sweats, but finally did. Woke up later and throughout the entire day had a fever and headache and sweats.

Other Meds:

Current Illness:

ID: 1270207
Sex: F
Age: 47
State: FL

Vax Date: 03/19/2021
Onset Date: 04/24/2021
Rec V Date: 04/29/2021
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: Sulfonamides

Symptom List: Injection site pain, Pain

Symptoms: Shingles, starting at lower back and extending around left side to mid abdomen. Spread to a wide area. Not significantly painful, but itchy and uncomfortable. Started on 4/24 and not resolved at this time. Physician prescribed methylprednisolone 4mg, dose pack and valacyclovir 1 gm TID x 7 days.

Other Meds: None

Current Illness: None

ID: 1270208
Sex: M
Age: 65
State: FL

Vax Date: 04/24/2021
Onset Date: 04/26/2021
Rec V Date: 04/29/2021
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: Around 1200 today patient began to c/o body aches, wife took his temp and was 102. Advised if this goes on longer than 3 days and/or patient develops any breathing issues would go to urgent care and/or hopital. 4/26- F/u call no answer

Other Meds: Lasix Oxybutynin Plavix Omeprazole Levothyroxine Lexapro Quetiapine Buspirone Simvastatin Enalapril ASA 81mg

Current Illness:

ID: 1270209
Sex: M
Age: 48
State: FL

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data:

Allergies: nka

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

Symptoms: Client fainted after receiving the COVID-19 vaccine as per the vaccinating nurse. Attending nurse administered an ammonia inhalant. The client woke up, Fire Rescue arrived to evaluate client. Showed symptoms of weakness, diaphoresis and paleness. Client presented hypotension and bradycardia. Client needed to be transported to a hospital as per Fire Rescue. Client was transferred to Clinic by Fire Rescue at 3:27pm.

Other Meds: none

Current Illness: n/a

ID: 1270210
Sex: F
Age: 28
State: IL

Vax Date: 04/15/2021
Onset Date: 04/20/2021
Rec V Date: 04/29/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Five days after Vaccine devoloped numbness in the left 4th finger that radiated into thumb and other fingers lasted about a minute, Also had vision disturbances.

Other Meds: Vitamin D, Yasmin OCP

Current Illness: None

ID: 1270211
Sex: M
Age: 23
State:

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
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: Patient had first vaccine yesterday around 5 PM, and today has had fever of 101. He is asking if he can take any Tylenol. RN stated he can take Tylenol, or Advil, which ever he uses for a fever He stated he is also tired, and has a headache.

Other Meds:

Current Illness:

ID: 1270212
Sex: F
Age: 35
State: IN

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
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: The next day. Exhausted, chills, head ache, muscle pains. Sore arm at injection site

Other Meds: Janumet

Current Illness: None

ID: 1270213
Sex: F
Age: 33
State: TX

Vax Date: 04/06/2021
Onset Date: 04/22/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: Adverse event: Tinnitus in R ear 16 days after shot (same side as vaccine was administered in R deltoid) Treatment: None Outcomes: Condition is ongoing no resolution to this point

Other Meds: NuvaRing Birth Control, Retin-A

Current Illness: N/A

ID: 1270214
Sex: M
Age: 48
State: MN

Vax Date: 03/26/2021
Onset Date: 03/31/2021
Rec V Date: 04/29/2021
Hospital: Y

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: Patient hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1270215
Sex: F
Age: 56
State: FL

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Augmentin, codeine

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

Symptoms: Swelling tingling upper and lower lips with fever blisters and sever pain. Oral ulcers. This has continued for over 5 weeks. I have been on two rounds of Valtrex at 2,000 mg. Per day at 7? day treatments. With no results and 2 weeks of Desonide.

Other Meds: Gordon, Wellbutrin, Topamax, Atenolol, Synthroid,

Current Illness:

ID: 1270216
Sex: F
Age: 60
State: AL

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/29/2021
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: Vacomycin, Antibiotics with sulfur, low tolerance to nitogylcerin.

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

Symptoms: Neuropathy, burning pain in legs.

Other Meds: Lisinopril HCTZ 20-12.5 MG tablet, Metformin HCL 500 MG Tablet, Ezetimibe 10 MG tablet, centrum Silver Vitamin.

Current Illness: none

ID: 1270217
Sex: F
Age: 42
State: OH

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/29/2021
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: Tremor

Symptoms: Symptoms similar to what I actually had Covid last year. Reflux, constant nausea, fatigue, occasional headaches

Other Meds: None

Current Illness: None

ID: 1270218
Sex: F
Age: 63
State: MA

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin.

Symptom List: Erythema, Pruritus

Symptoms: Tuesday, 4/27, had extreme fatigue In the middle of the night, woke up ad she could not breath. Eventually went back to sleep 4/27 in afternoon, had another instance where could not breath, then sat up and felt better. Almost went to ED, but it resolved. Then 4/29, in AM, was taking grandchildren to school and started to feel squeezing both sides of lungs. When she takes a deep breath she has pain. She feels the pain is worsening and her SOB is worsening.

Other Meds: Zyrtec, some OTC vitamins

Current Illness: None

ID: 1270219
Sex: M
Age: 54
State: FL

Vax Date: 04/15/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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: Iodine

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

Symptoms: Visual Snow Syndrome. Event started around 10pm last night. Lasted until 2:00am this morning. Also had other symptoms such as "visual trailing" associated with Visual Snow Syndrome. I had previously reported Paresthesia as another side effect of Pfizer.

Other Meds: Truvada

Current Illness:

ID: 1270220
Sex: F
Age: 34
State: MS

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 04/29/2021
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: Allergy to PCN

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

Symptoms: My arm hurt really bad that night and the next day. But then started to get better. But then I started to have unexpected pain in my arm and it hurts where the shot was administered. The pain has gotten worse and more frequent.

Other Meds: None

Current Illness: None

ID: 1270221
Sex: F
Age: 37
State: CA

Vax Date: 04/15/2021
Onset Date: 04/23/2021
Rec V Date: 04/29/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Arm began to itch where at the injection site, a few hours later the site became red and hot and slightly raised. Went away after two days. 4 days later woke up to a much larger red itchy area, takes up entire upper portion of my left arm (only on the front, does not wrap around my arm).

Other Meds: none

Current Illness: none

ID: 1270222
Sex: M
Age: 53
State: NY

Vax Date: 03/17/2021
Onset Date: 03/22/2021
Rec V Date: 04/29/2021
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: I now have a twitching face muscle in my chin. It is not constant but happens frequently every day.

Other Meds: Metformin, Invokana

Current Illness: None

ID: 1270223
Sex: F
Age: 32
State: MD

Vax Date: 04/15/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: I have developed a red rash around the injection site around 12 days after getting the shot. It is an red oval patch that is 4? x 3?. The site is warm to the touch and very itchy.

Other Meds:

Current Illness:

ID: 1270224
Sex: F
Age: 50
State: CT

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Pencilling bee stings

Symptom List: Pain in extremity

Symptoms: Chills, body aches, nausea and temperature 103.4

Other Meds: None

Current Illness: None

ID: 1270225
Sex: F
Age: 51
State: CT

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Ceftin Dilaudid

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

Symptoms: Reaction was immediate Dizzy Blurred vision Nausea Body felt very warm and overheated Heavy feeling and pressure in chest when breathing Overall uneasy feeling

Other Meds: Bupropion Vitamin C Vitamin D Multivitamin Fish Oil

Current Illness:

ID: 1270226
Sex: F
Age: 20
State: NE

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Achy feeling like I have a fever started in the middle of the night the night I got the shot, and continued into the next morning. A bit of joint achy-ness.

Other Meds: N/a

Current Illness: N/a

ID: 1270227
Sex: M
Age: 71
State:

Vax Date: 03/11/2021
Onset Date: 04/02/2021
Rec V Date: 04/29/2021
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:

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

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

Other Meds:

Current Illness:

ID: 1270228
Sex: F
Age: 34
State: MA

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 04/29/2021
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: nkda

Symptom List: Vomiting

Symptoms: rash beginning on abdomen and spread all over body

Other Meds: cholecalciferol (VITAMIN D3) 2,000 unit capsule guanFACINE (INTUNIV) 1 mg lamoTRIgine (LAMICTAL) 200 MG tablet . levonorgestreL (MIRENA) 20 mcg/24 hours (5 yrs) 52 mg intrauterine device loratadine (CLARITIN) 10 mg tablet omeprazol

Current Illness: Celiac disease Endometriosis Bipolar II disorder major depressive with melancholic features Tobacco consumption Hirsutism

ID: 1270229
Sex: F
Age: 66
State: MN

Vax Date: 03/18/2021
Onset Date: 03/31/2021
Rec V Date: 04/29/2021
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: Patient presented to the ED on 3/31/2021 and was subsequently hospitalized. She died on 4/16/2021.

Other Meds:

Current Illness:

ID: 1270230
Sex: M
Age: 51
State: MA

Vax Date: 04/26/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: I fainted while in the bathroom and then again at the ER. Notes from visit said I had 2 syncopal episodes. They cited low blood pressure.

Other Meds: Melatonin

Current Illness: None

ID: 1270231
Sex: F
Age: 59
State: IN

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
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: wasp stings

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fatigue, bones and joints hurt, chills for about 24 hours. Fatigue for about 48 hours. Took 3 ibuprofen three times a day. Drank water, Body Armour, decaf coffee.

Other Meds: Omeprazole 40mg, Latanoprost 2.5ml, probiotic, daily vitamins, calcium citrate

Current Illness: none

ID: 1270232
Sex: M
Age: 24
State: FL

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: Fever, chills, drained energy.

Other Meds: N/A

Current Illness: None

ID: 1270233
Sex: F
Age: 71
State:

Vax Date: 01/27/2021
Onset Date: 02/13/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm