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

Date Died: 04/18/2021

ID: 1271243
Sex: M
Age: 77
State: MI

Vax Date: 03/18/2021
Onset Date: 03/27/2021
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: LA

Lab Data:

Allergies: None known

Symptom List: Dysphagia, Epiglottitis

Symptoms: Symptoms of fever, nausea, and weakness started 3 days following vaccination. Denies any exposure to COVID positive person. Presented to local emergency department on 3/27/21 with nausea, fever, chills, dizziness, and confusion. Due to patient's condition, he was transferred to larger facility for further management. Patient was admitted to hospital and subsequently transferred to ICU on 4/17/21. He was intubated at that time. Patient went into multisystem organ failure and died on 4/18/21.

Other Meds: aspirin (HALFPRIN) 81 MG tablet carvedilol (COREG) 25 MG tablet cilostazol (PLETAL) 100 MG tablet clopidogrel (PLAVIX) 75 MG tablet doxazosin (CARDURA) 2 MG tablet ferrous sulfate (FEOSOL, 65 FE,) 325 (65 FE) MG tablet Glucosamine 500 MG ca

Current Illness: None known

ID: 1271244
Sex: F
Age: 32
State: MI

Vax Date: 03/26/2021
Onset Date: 03/05/2021
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: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: 2nd dose of moderna covid-19 dose given too early. was administered at only 21 days after 1st moderna vaccination.

Other Meds: NKA

Current Illness: unknown

ID: 1271246
Sex: F
Age: 28
State: CA

Vax Date: 04/01/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Vancomycin

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

Symptoms: Hallucinations, seizures, severe nausea.

Other Meds: Zonisamide, Lansoprazole, senna

Current Illness: None

ID: 1271247
Sex: F
Age: 61
State: MN

Vax Date: 02/19/2021
Onset Date: 03/29/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pt tested positive for COVID 3/30/2021, planned procedure needed to be rescheduled

Other Meds:

Current Illness:

ID: 1271248
Sex: F
Age: 38
State: FL

Vax Date: 04/20/2021
Onset Date: 04/21/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Systemic: Mensus (bleeding)-Medium, Additional Details: Patient started bleeding and feeling run down after injection for several days. She had previously had an ablation and not had a \"period\" since and was concerned.

Other Meds:

Current Illness:

ID: 1271249
Sex: M
Age: 37
State: WI

Vax Date: 04/17/2021
Onset Date: 04/17/2021
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:

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

Symptoms: After first COVID-19 vaccination, patient experienced fullness in knuckles to the point where he could not make a tight fist.

Other Meds:

Current Illness:

ID: 1271250
Sex: M
Age: 15
State: AL

Vax Date: 03/29/2021
Onset Date: 03/29/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient was 15 years and 11 months at time of prime dose.

Other Meds:

Current Illness:

ID: 1271252
Sex: F
Age: 47
State: CA

Vax Date: 04/29/2021
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: Flu Vaccine

Symptom List: Pharyngeal swelling

Symptoms: Patient received first dose of Pfizer vaccine, waited 30 minutes with EMTs and reported no adverse reaction. Patient left to car and noticed redness in face at 10:05 am. Patient returned back to EMT and assisted to anti-gravity chair. Patient given 25mg/10mL of oral Benadryl at 10:10 am. Vitals taken every 5 minutes for 30 minutes. Symptoms resolved at 10:20 am and patient drove herself home at 10:45 am.

Other Meds:

Current Illness:

ID: 1271255
Sex: M
Age: 76
State: WI

Vax Date: 02/27/2021
Onset Date: 03/28/2021
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: allergy to latex

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I am about to time out and do not have time to keep doing this form....how dumb to time me out!!!

Other Meds: Prescriptions: Aspirin 81mg; atorvastatin 40mg; D3 5000iu; cholesterol support, 1 tablet; clopidigrel 75mg.....and many others , I am about ready to get timed out!!!

Current Illness: none

ID: 1271256
Sex: F
Age: 35
State: IN

Vax Date: 04/03/2021
Onset Date: 04/18/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: patient developed shingles. we tried to explained that this is not a side effect of the vaccine and could be triggered by other things such as stress, surgery, etc. patient called CDC and was told to have the provider office report this to VAERS.

Other Meds: multivitamins

Current Illness: none

ID: 1271257
Sex: F
Age: 38
State: MO

Vax Date: 04/29/2021
Onset Date:
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: Medication error during mass vaccination event, patient received Pfizer for second dose instead of Moderna. No issues observed during monitoring period.

Other Meds:

Current Illness:

ID: 1271259
Sex: F
Age: 14
State: MN

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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient falsified DOB when registering for vaccination, stating the minor was born on different date. Guardian, consented to the vaccination. Staff verified with statistical records what the patients actual DOB is which made the vaccine a contraindication. No known adverse reactions noted.

Other Meds:

Current Illness:

ID: 1271260
Sex: M
Age: 68
State: PA

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: penicillin

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

Symptoms: About 8 hours soreness at injection site. Also joint pain in both shoulders

Other Meds: none

Current Illness: none

ID: 1271261
Sex: M
Age: 29
State: IL

Vax Date: 04/29/2021
Onset Date: 04/29/2021
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:

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

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: convulsion-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Seizure-Severe, Systemic: Shakiness-Severe, Systemic: Weakness-Severe, Additional Details: patient recieved first dose, went to go sit in observation area, few minutes later fell forward off his chair and starting having a seizure. called 911. patient was able to get up and sit in chair with feet elevated. paramedics came, patient refused hospital visit. Patient was oriented and went home after the paramedics.

Other Meds:

Current Illness:

ID: 1271262
Sex: F
Age: 31
State: NY

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: none

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

Symptoms: Soreness in left arm immediately following vaccine; 5 hours later developed a headache; went to bed; a couple hours later woke up with a severe headache, chills, severe body aches, nausea, dizziness, loss of appetite that lasted approximately 24 hours from onset; felt fatigued with headache for 10 days after that;

Other Meds: pre-natal vitamin

Current Illness: none

ID: 1271264
Sex: F
Age: 42
State: FL

Vax Date: 04/07/2021
Onset Date: 04/14/2021
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: N/a

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

Symptoms: Menstrual cycle came 2 weeks early. I am not on birth control and am very regular. The period was lighter than normal. I am approaching the normal time of my cycle and just received the my second dose yesterday.

Other Meds: Zyrtec for 3 weeks. The past few days Claritin. Motrin as needed.

Current Illness:

ID: 1271265
Sex: F
Age: 37
State: IN

Vax Date: 04/24/2021
Onset Date: 04/26/2021
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: Penicillin

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

Symptoms: Rash started on arm, by Tuesday morning had spread to right side of abdomen. Rash kept moving over parts of body, eventually reaching neck and face. By Wednesday night throat was tight, went to hospital for steroid treatment. Currently taking prednisone, and Zyrtec, still have rash, waiting for results.

Other Meds: Zyrtec, Xanax, ambien, ortho tricyclen lo

Current Illness: None

ID: 1271266
Sex: U
Age: 71
State: MI

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: 2nd dose of moderna covid-19 dose given too early. was administered at only 21 days after 1st moderna vaccination.

Other Meds: NKA

Current Illness: unknown

ID: 1271268
Sex: M
Age: 54
State: AZ

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I was very sick with a temperature going as high as 105 degrees and lost nearly 10 pounds in 3 days.

Other Meds: None

Current Illness: None

ID: 1271269
Sex: M
Age: 46
State: IN

Vax Date: 04/27/2021
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:

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

Symptoms: Flu like symptoms-fever, headaches, body aches, chills and hot and sweats began the following day after shot

Other Meds:

Current Illness:

ID: 1271270
Sex: M
Age: 28
State: CA

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: 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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1271272
Sex: F
Age: 24
State: OK

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: NKDA or NKFA

Symptom List: Unevaluable event

Symptoms: Client c/o feeling dizzy, 12she had the wherewithal to get down onto the floor. Public Health Nurse placed ice pack to back of neck, offered water and juice. Client became lethargic, pallor, cyanosis of the lips. FD and EMS was on site, provided care and was sent to hospital via EMS.

Other Meds: Unknown

Current Illness: None reported.

ID: 1271274
Sex: F
Age: 16
State: NY

Vax Date: 04/18/2021
Onset Date: 04/19/2021
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: Possible Cephalosporin antibiotic allergy.

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

Symptoms: Paresthesia in left foot upon awakening the morning after receiving the vaccination. The symptom began to subside on day three following the vaccination. By day four the symptom lessened to tingling in the toes of the left foot. By mid day on the fourth day the symptom had gone away.

Other Meds: None

Current Illness: None

ID: 1271275
Sex: M
Age: 23
State: TX

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

Lab Data:

Allergies: Avoid amoxicillin due to side effects of rash and diarrhea

Symptom List: Injection site pain, Pain

Symptoms: Extreme fatigue, pain in the arm, then swelling in the area around eyes, red-eye, and swollen red eyelids, then the onset of rapid heart rate, difficulty breathing, extreme exhaustion, and low energy first onset of massive grand mal seizure occurred approximately 24 hours after injection.

Other Meds: Concerta 54 MG ( has been on the drug since age 6 for ADD) Also took Advil for pain in the arm

Current Illness: None

ID: 1271276
Sex: F
Age: 18
State: NH

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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: amoxicillin ? rash

Symptom List: Injection site pain, Menorrhagia

Symptoms: Within 10 minutes post vaccine, she developed severe nausea and was wretching. She was diaphoretic, color very pale. I monitored her closely for 20 to 30 minutes, at this time she stated she had begun to experience tingling in her arms and hands. At that time, I suggested to her aunt(legal guardian) that she be monitored in a more appropriate setting. We offered to call paramedics, the aunt on behalf of the patient declined, stating she would bring her to the ER.

Other Meds: N/a

Current Illness: n/a

ID: 1271277
Sex: F
Age: 22
State: SC

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

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

Lab Data:

Allergies: unknown

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

Symptoms: Patient started tearing about 3 minutes after received the vaccine. Her face and lips turned really pale and fainted on pharmacist's arms for 30 seconds. She wore up but still pretty confused. WE gave her water. She stayed in pharmacy with her mom for about 40 minutes and went home.

Other Meds: unknown

Current Illness: no

ID: 1271278
Sex: F
Age: 35
State: CA

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1271279
Sex: F
Age: 28
State: MI

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 2nd dose of moderna covid-19 dose given too early. was administered at only 21 days after 1st moderna vaccination.

Other Meds: NKA

Current Illness: unknown

ID: 1271281
Sex: M
Age: 16
State: NJ

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

Lab Data:

Allergies: NKA

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

Symptoms: During a Mobile Community COVID Vaccine Clinic a 16 y/o male patient was administered the MODERNA Covid-19 Vaccine. This is an off-label use because MODERNA Covid-19 Vaccine is not authorized in this age group.. This is considered a vaccine administration error. The clinic participants immediately determined how the error occurred and implemented strategies to prevent it from happening again. After the vaccination the patient was observed for 15 minutes by a covering physician and left the clinic after.

Other Meds: None Known

Current Illness: None Stated

ID: 1271282
Sex: M
Age: 45
State: MI

Vax Date: 04/20/2021
Onset Date: 04/23/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin, Statins.

Symptom List: Nausea

Symptoms: MYOCARDIAL INFARCTION on 4/23/2021

Other Meds: Welchol. Vitamin B and D

Current Illness: none

ID: 1271283
Sex: F
Age: 74
State: CA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
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: mild latex reaction redness under adhesive of bandaids, itchy after amoxicillin, sensitive to most things a lot of foods vitamins and meds - small dose can have a big effect on me

Symptom List: Injection site pain

Symptoms: Rec'd 1st Pfizer shot on 4/14/21 1pm, by 3pm whole left leg was burning (large varicosities present) ruled out DVT 4/16/21, 4/19/21 itching ascending bilateral started in feet felt at different places all over my body but not body itching all over at one time. itching and burning persisted intermittently until 4/28/21 when burning got worse and traveled from feet to neck. no visible signs of rash or irritation.

Other Meds: Levoxyl, tylenol rarely but did take day of vaccine, vit c, d, magnesium, vegan omega-3, flax seed oil, immune defense herbal formula

Current Illness: March 1st 2021 went to ED for ongoing vertigo dizziness light sensitivity numbness on L side, ruled out stroke. no diagnosis for those symptoms as of yet. had MRI and CT scan in March 2021 with contrast dye.

ID: 1271284
Sex: M
Age: 55
State: SC

Vax Date: 04/29/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: About a week after my second dose I had severe muscle pains (legs, hips, back, and jaw) and trouble breathing. I went to my doctor and was tested for the flu and covid19 and various other things and everything came back negative. I was given prednisone and about a week later the symptoms went away.

Other Meds: None

Current Illness: None

ID: 1271285
Sex: F
Age: 31
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfur sensitivity. Believe it causes occasional numbness to lips, tongue, throat, and face.

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

Symptoms: I received my shot at about 4:15PM on April 22, 2021. Roughly thirty-five minutes or so after receiving the vaccine, I started to have numbness and tingling in my lips. It slowly spread to my tongue, the top of my throat, and on the muscles of my face--from the bottom of my chin and jaw up to my eyes. This spread took about two hours. The numbness would get stronger and fade, get stronger, and fade. The numbness lasted through the evening and was still present when I went to bed. In the morning the numbness was gone. I had a small bit of numbness start up in my lips at some point that morning, but the numbness only lasted maybe two minutes before going away completely. It did not return. My body ached quite a bit, but I had no other adverse affects: no fever, no rash, I could still swallow and breathe just fine. I did not report until now because I have a sulfur sensitivity that sometimes flares up with similar numbness symptoms. I did not know if this flare up was due to other causes, not the vaccine, and I didn't want to cause confusion. But since the flare up happened so soon after the vaccine and I had no other sources of sulfur (I ate much earlier in the day, my usual source of sulfur flare ups), it is possible that the vaccine was the cause, and my family rightfully encouraged me to report it.

Other Meds: Daily: NiteRem-5 (sleep aid; ingredients can be found on https://www.advanced-blend.com/category-s/1477.htm); 4mg Melatonin; Amino-Mag (includes 40mg chelated Magnesium); BPlex-Max (ingredients can be found on https://www.advanced-blend.com

Current Illness: Fibromyalgia.

ID: 1271286
Sex: F
Age: 52
State: KY

Vax Date: 04/23/2021
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: Augmentin, beta-blockers

Symptom List: Tremor

Symptoms: Left side of face (cheek-area) started tightening (swelling), tingling inside mouth, tingling (swelling) of tongue within 10 minutes of vaccination. Administered EpiPen and went to ER. At ER, Benadryl (50 mg), Pepcid and prednisone were administered orally. Evaluated for 3 hours, vitals good and released from hospital.

Other Meds: QNasal, Allegra-180, Singulair, Candesartan, HCTZ, aspirin, Multi-vitamin, Pro-biotic, Black Elderberry, Vitamin C, Vitamin D, Melatonin, Imiquimod cream

Current Illness: None

ID: 1271287
Sex: F
Age: 39
State: UT

Vax Date: 02/27/2021
Onset Date: 02/27/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: The patient reports dizziness, brain fog, and left ear plugging, left ear reduced hearing, and left ear pulsatile tinnitus. They began at the time of her second vaccine. After a course of Prednisone started 4/19/2021 the pulsatile tinnitus has resolved but not the brain fog and dizziness.

Other Meds:

Current Illness:

ID: 1271288
Sex: M
Age: 60
State: PA

Vax Date: 03/23/2021
Onset Date: 03/25/2021
Rec V Date: 04/29/2021
Hospital: Y

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: COVID-19 symptoms starting 3/25/21, hospital admission 4/14/21 - 4/24/21 with hypoxia, multiple pulmonary emboli

Other Meds: amlodipine, metformin, lisinopril, atorvastatin, viagra

Current Illness:

ID: 1271289
Sex: M
Age: 50
State: WI

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

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

Symptoms: Patient received Pfizer dose after having already received Janssen. Patient reported no previous COVID vaccine to clinic that provided Pfizer, and vaccine system was unable to check registry to verify this.

Other Meds:

Current Illness:

ID: 1271290
Sex: M
Age: 60
State: IA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mold, animal dander

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: After second dose 3/10/21 started having chills, myalgia. On 3/24/21 hospitalized with respiratory failure, kidney failure, heart attack, sepsis and liver malfunction. Had subsequent GI bleed

Other Meds: Asmanex, Metoprolol, Norvasc, crestor, Albuterol, Clonidine, Humalog, Lantus, furosemide, gemfibrozil, losartan-hydrochlorothiazide

Current Illness: Diabetes, asthma, hypertension, hyperlipidemia

ID: 1271291
Sex: F
Age: 45
State: MN

Vax Date: 01/22/2021
Onset Date: 04/28/2021
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:

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

Symptoms: Pt tested positive for COVID 4/28/2021

Other Meds:

Current Illness:

ID: 1271293
Sex: M
Age: 31
State: ME

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Severe, Additional Details: pt fainted for a couple of seconds, after 15 minutes \"wasn't feeling well\" 911 was notified and he was brought to the emergency room

Other Meds:

Current Illness:

ID: 1271294
Sex: M
Age: 23
State: OH

Vax Date: 04/29/2021
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: n/a

Symptom List: Pain in extremity

Symptoms: patient passed out 15 minutes after receiving shot. fell out of chair onto floor. helped up and sat in chair. pt was pale, tunnel vision and could not answer questions. gave some water and a granola bar because patient had not eaten since night before. called squad, pt refused treatment. stayed for another 30 minutes until determined ok to leave on his own volition.

Other Meds: n/a

Current Illness: n/a

ID: 1271295
Sex: F
Age: 52
State: TN

Vax Date: 04/29/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: NKDA

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

Symptoms: MODERNA VACCINE USED WAS USED AND THE RECCOMENDATION FOR THE 30 DAYS IN THE REFRIDGERATOR HAD PASSED BY 6 DAYS.

Other Meds: METOPROLOL TARTRATE, ATORVASTATIN, ZYRTEC, IRON

Current Illness: N/A

ID: 1271296
Sex: F
Age: 35
State:

Vax Date: 04/29/2021
Onset Date: 04/29/2021
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: aspirin, penicillin, fioricet, mustard

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

Symptoms: After being given the vaccine, (about two minutes later) she began to feel dizzy and shaky. He sits down, vital signs are taken, glucose test is performed, all with normal values. An oximeter is placed: pulse 82 and oxygenation 93%. Refers already feels good,

Other Meds: keppra, lamictal

Current Illness: no

ID: 1271297
Sex: F
Age: 51
State: NY

Vax Date: 04/09/2021
Onset Date: 04/14/2021
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: none

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

Symptoms: Started having period , had light bleeding and spotting for 6 days, even though I am in Menapause and did not have bleeding for 2 years. Also have few purple spots on legs, somewhat painful when touching. Went for my routine check up to my gynecologist and mentioned it, she recommend it screening for cancer, did not think due to vaccination. Did not go to the doctor for purple spots, I am keeping an eye on them.

Other Meds: levothyroxine -25 mcg

Current Illness: none

ID: 1271298
Sex: M
Age: 40
State: MD

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

Symptom List: Vomiting

Symptoms: Fatigue on 2nd day and 9 days later still have Covid arm (dull pain) in right upper arm and deltoids

Other Meds: Tizanidine

Current Illness:

ID: 1271299
Sex: F
Age: 17
State: VA

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: SYR
Vax Site: LA

Lab Data:

Allergies: Allergy to pollen (rhinitis)

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Rash, full body "measles-like", erythematous patches of about 3-4 mm, itchy appeared >5 hours after the vaccine.

Other Meds: None

Current Illness: None

ID: 1271300
Sex: F
Age: 33
State:

Vax Date: 04/08/2021
Onset Date: 04/09/2021
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: Na

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

Symptoms: Started my menstrual cycle 2 weeks early. Have now been bleeding for 20 days. I usually do not bleed because of my nexplanon implant.

Other Meds: Nexplanon implant

Current Illness: Na

ID: 1271301
Sex: F
Age: 34
State: VA

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

Lab Data:

Allergies: Latex, Zoloft

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fever, fatigue, headache, metallic taste

Other Meds: Probiotic, b-12, women?s multi vitamin

Current Illness: None

ID: 1271302
Sex: F
Age: 43
State: ME

Vax Date: 04/24/2021
Onset Date: 04/24/2021
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: RA

Lab Data:

Allergies: Amoxicillin, Salmon, Kiwi Fruit

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

Symptoms: Moderna COVID-19 Vaccine EUA I had COVID at the end of March. My quarantine and symptoms ended 4/9/2021. Per CDC guidelines, you are able to receive your first COVID vaccine 2 weeks after. I received mine on 4/24/2021. It was the sickest I ever remember being, sicker than when I had COVID. I had a fever above 100 degrees for 36 hours. My fever spiked to 102.6 and 102.7 degrees several times during that period. My body hurt so bad that you couldn't touch my skin. I could barely move for 18 hours during this period. I could only move my hands and mouth because my body hurt so bad. I could even reach for water on my own. My fever and body aches did not go away until late Monday afternoon around 5 PM. I am a very strong, active and fit 43 year old woman who exercises daily. I have never felt this poorly.

Other Meds: Vitamin D

Current Illness: COVID on 3/31/2021

ID: 1271303
Sex: M
Age: 72
State: MI

Vax Date: 03/27/2021
Onset Date: 03/21/2021
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: RA

Lab Data:

Allergies: alcohol, codeine

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

Symptoms: 2nd dose of moderna covid-19 dose given too early. was administered at only 21 days after 1st moderna vaccination.

Other Meds: alcohol, codeine

Current Illness: unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm