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: 1273651
Sex: M
Age: 63
State: OH

Vax Date: 04/22/2021
Onset Date: 04/27/2021
Rec V Date: 04/30/2021
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: raw tomatoes, grapefruit, liver

Symptom List: Dysphagia, Epiglottitis

Symptoms: Sudden, sever vomiting, chest & heart pain, mild fever, pain/discomfort in both shoulders, increased shakiness.

Other Meds: HydrAlazine, Isosorbide, Mononit Er, Amlodipine Besylate, Carvedilol, aspirin, acetimenophen, Ageless Male, Neuriva, fish oil, biotin, Glucosamine, vitamin D3

Current Illness: None.

ID: 1273652
Sex: M
Age: 41
State: GA

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/30/2021
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: He got the vaccine, had no reaction. The following morning around 4:00 he felt real dizzy and his arm real sore, and still feels nauseous and felt like vomiting but did once. He is trying to work with this continued reaction. He did run fever of about 100 for 2 nights, but most things seem to give him nausea. He has not taken anything for the reaction.

Other Meds: None.

Current Illness: None.

ID: 1273653
Sex: F
Age: 41
State: CO

Vax Date: 04/17/2021
Onset Date: 04/29/2021
Rec V Date: 04/30/2021
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: Menstruation delay 2 days

Other Meds: smartypants multivitamins olly probiotics

Current Illness: none

ID: 1273654
Sex: F
Age: 53
State: NY

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 04/30/2021
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: Rash at vaccination site after 2nd dose chills arm pain very tired

Other Meds:

Current Illness:

ID: 1273655
Sex: M
Age: 37
State: IN

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: Fatigue, muscle weakness, chills, fever

Other Meds: Claritin

Current Illness: No

ID: 1273656
Sex: F
Age: 47
State: WA

Vax Date: 02/19/2021
Onset Date: 03/05/2021
Rec V Date: 04/30/2021
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: Sulfa, Penicillin

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

Symptoms: Arm to fingers tingles constantly or goes numb. I have to raise my arm into the air for relief

Other Meds: NONE

Current Illness: NONE

ID: 1273657
Sex: F
Age: 34
State: CO

Vax Date: 04/06/2021
Onset Date: 04/09/2021
Rec V Date: 04/30/2021
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: Three days the vaccine I got very short of breath with confusion, dizziness and light headed and disoriented. I felt like there was pressure in my chest and I had some brain fog. I felt like I had water in my lungs. My right arm bicep was contracting and twitching. I had Vertigo which made it very hard to sit down without feeling off balance. I was unable to drive. I tried to hope it would pass but I went to the ER on 4/14/2021. The dizziness was getting worse after five days and the pressure on my chest was unbearable. I was advised to drink some water and take Tylenol. My blood pressure was lower than normal. I finally felt better on 4/21/2021. I could finally get out of bed and not feel like I was going to fall down. I could not drive for about two and a half weeks. I still feel a little out of breath and my brain is a little foggy but it has gotten a little better.

Other Meds: Topamax Armor Thyroid

Current Illness:

ID: 1273658
Sex: F
Age: 34
State: CA

Vax Date: 03/12/2021
Onset Date: 03/16/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: strawberry, tomato, kiwi, pineapple, eggplant latex Sulfa drugs

Symptom List: Pharyngeal swelling

Symptoms: Rash on neck within seconds of getting the vaccine and increase in heart beat. These symptoms went away after a couple of hours. Five days later difficulty breathing. It got so bad that I was choking at night in sleep. My doctor put me on 7 days period of steroids and gave me two types on inhalers (1-Albuterol sulfate HFA 2- Breo ellipta) The symptoms lasted a month.

Other Meds: Probiotics, hydraulic acid, vitamin B3, collagen, counter attack, Allegra

Current Illness:

ID: 1273660
Sex: F
Age: 36
State:

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/30/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: muscle aches, body fatigue, fatigue, headache began around 18 hours after shot, subsided the following day treated with Tylenol and Advil

Other Meds:

Current Illness:

ID: 1273661
Sex: F
Age: 49
State: WA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/30/2021
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: Bee stings, topical allergy to rubber gloves

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Sore arm, fatigue, weakness, muscle pain, joint pain, back pain, chills, sweats nausea

Other Meds: Tylenol, Spring Valley Hair Skin &Nails 5,000mcgBiotin Collagen Support, Vitafusion Women's Energy, Metabolism and Bone support gummy vitamins

Current Illness:

ID: 1273662
Sex: F
Age: 51
State: MD

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

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

Symptoms: stomach irritation; arm soreness; mild shortness of breath Normal vital signs; reassurance; monitoring total 60 minutes after vaccine; improved and released

Other Meds: none

Current Illness: none

ID: 1273663
Sex: M
Age: 31
State: IN

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/30/2021
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: Fever, chills, injection site soreness, swollen lymph nodes in neck, body aches, headache, and dizzyness. Went away after 12 hours.

Other Meds:

Current Illness:

ID: 1273664
Sex: M
Age: 48
State: MI

Vax Date: 04/13/2021
Onset Date: 04/17/2021
Rec V Date: 04/30/2021
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: Rash developed over torso. No treatment. Still unresolved.

Other Meds: One-a-Day Men's vitamin daily

Current Illness: None

ID: 1273665
Sex: F
Age: 29
State: AZ

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/30/2021
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: First day: vaccinated on Monday at noon Arm hurt Tired 12 hours later - Tuesday - fever, chills Fever all day Tuesday and body aches Went to bed Tuesday night with a 101.7 fever Broke fever at about 36 hours Wednesday - Woke up feeling pretty normal but had really sensitive teeth As the day persisted my lungs started hurting. It felt like I smoked 2 packs of cigarettes or was on the verge of an asthma attack. Thursday - teeth less sensitive, lungs hurt but nothing as bad as Wednesday At 8:00pm found a golf ball size swollen lymph node on my left side where I got the vaccine. Also have a few swollen lymph nodes in my throat Friday (today) - swollen lymph node still present and large, Still having difficulty breathing.

Other Meds: None

Current Illness: None

ID: 1273666
Sex: F
Age: 25
State: IL

Vax Date: 04/09/2021
Onset Date: 04/19/2021
Rec V Date: 04/30/2021
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: seasonal allergies, allergic to cashews and cranberries

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

Symptoms: 4/19 I developed severe hives/rash all over my skin and inside my throat. I felt weak and tired. My throat was also swollen. This reaction is still continuing today 4/30, and I do not know when it will end. I have been to urgent care twice for steroids, I have taken Benadryl, and Zyrtec but nothing will fully get rid of the reaction. I visited an allergist on 4/29 and she believes that I am having an adverse reaction to the vaccine. She prescribed several antihistamines to counter my reaction to the vaccine, including bendaryl, famotidine, fexofenadine, zyrtec, and an epipen incase my throat starts to close.

Other Meds: Zyrtec, Birth control, multivitamin

Current Illness: n/a

ID: 1273668
Sex: F
Age: 66
State: NC

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 04/30/2021
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: I'm allergic to soy sauce

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

Symptoms: I have had a DAILY dull headache at the top of my head plus an ache at my lower neck since receiving my second vaccine shot. On April 29, I had a nightmare during which I screamed in my sleep--I woke up with an aggravating headache. It seems as though my stress hormones are triggered with the least bit of stress--even in a sleep state. I'm wondering whether the ingredients in the pfizer vaccine are similar structure as the hormone cortisol.

Other Meds: One-a-Day multi vitamin

Current Illness: None

ID: 1273669
Sex: F
Age: 55
State: WA

Vax Date: 03/11/2021
Onset Date: 03/30/2021
Rec V Date: 04/30/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

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

Symptoms: Starting around 03/30/2021 - sinus pressure, head pressure, ear pressure, ear ringing April 13 - ear vertigo, very dizzy, whooshing April 27 - ear vertigo Sinus pressure, head pressure, ear pressure, ear ringing continue to this day

Other Meds: Liquid turmeric, marine collagen

Current Illness: None

ID: 1273670
Sex: M
Age: 19
State:

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 11:38 PSO298% pulse 113 reports throat feels tight and pain down his left arm to his elbow. 11:42 pain down left arm to wrist at this time. At vaccine site arm is blotchy red. Throat is feeling better. 11:52 left arm vaccine sight it itching at this time. Throat tightening is almost not noticeable. Ready to leave. PSO2 99% pulse 91. Informed to seek medical attention for further problems and to report the issue for today.

Other Meds:

Current Illness:

Date Died: 03/28/2021

ID: 1273671
Sex: F
Age: 63
State: MS

Vax Date: 03/21/2021
Onset Date: 03/27/2021
Rec V Date: 04/30/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: There are no known allergies.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Husband stated that she died of an aneurysm on March 28, 2021. He will provide details later.

Other Meds: Her husband will provide information later.

Current Illness: Her husband will provide information later

ID: 1273673
Sex: F
Age: 52
State: OR

Vax Date: 03/04/2021
Onset Date: 03/11/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: I have been in menopause for 2 years, after the vaccine I got a period. I called the nurse, she said that wasn't normal and referred me to an ob/gyn. They did pap, sdt and biopsy of the uterine wall. All tests came back negative. I suggested that it was a side effect of the Coved vaccine and was told "that can't be it". I have had another period sense then.

Other Meds: none

Current Illness: none

ID: 1273674
Sex: M
Age: 51
State: NY

Vax Date: 04/15/2021
Onset Date: 04/18/2021
Rec V Date: 04/30/2021
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: I had ?normal? side effects from vaccine starting 20 hours after shot. I would say it was on the severe side. 40 hours after the shot the maxillary zone of the left trigeminal nerve turned exactly that portion of my face numb. I?ve had trigeminal neuralgia for 22 months but never this symptom. I am convinced there is a correlation here. I didn?t go for any treatment. The numbness went away after 10 hours. Just thought someone should know.

Other Meds: Lamotragine 150mg 2X Vitamin E, B12, multi vitamin Horse Chestnut seed extract

Current Illness: None

ID: 1273675
Sex: F
Age: 51
State: CA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: ASPIRIN

Symptom List: Unevaluable event

Symptoms: LIKE I SAID EARLIER, AFTER MY FIRST SHOT, I HAD NERVE TWINGES IN MY LEFT ARM (INJECTION ARM FOR FIRST SHOT). THE SECOND SHOT, I HAD IN MY RIGHT ARM TO NOT AGGRAVATE LEFT ARM MORE. ON THE NIGHT OF MY SECOND VACCINE, I STARTED HAVING NERVE PRICKS AND TWINGES THROUGHOUT MY ENTIRE BODY. THEY FEEL LIKE ELECTRIC SHOCKS HAPPENING INTERMITTENTLY - EVERYWHERE IN MY BODY. AS OF TODAY, APRIL 30, ALMOST TWO WEEK LATER, THEY HAVE NOT STOPPED.

Other Meds: VITAMINS: B12, C, B COMPLEX, BIRTH CONTROL, LAVENDER PILL, MULTI,

Current Illness: I HAD NERVE STUFF GOING ON IN MY LEFT TRICEP (INJECTION ARM FROM FIRST VACCINE). I THOUGHT MAYBE I HAD INJURED MYSELF. I NEVER CONSIDERED IT COULD BE FROM THE FIRST SHOT.

ID: 1273676
Sex: F
Age: 60
State: FL

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/30/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: The "Moderna Arm" described on the internet. Woke up with golf ball size lump on arm but not much pain. By 2pm a rash had developed (approx. 4"x3" blotch) and my arm was on FIRE! The pain reminded me of incision pain from major surgery. Within 24 hours, the redness had decreased and the pain was the normal pain you would expect from the vaccine. The lump took another 2 days to go down and then I just had the normal hardness at injection site.

Other Meds: Gabapentin, Lisinopril, Dicyclomine, Famotidine, Multivitamin, Vitamin C, Vitamin D, and Zinc.

Current Illness: None

ID: 1273677
Sex: M
Age: 41
State: LA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/30/2021
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: Egg intolerance (not allergic).

Symptom List: Injection site pain, Pain

Symptoms: Weakness, muscular aches and pains, fatigue, headache, fever & Chills, nausea. Really sore injection site. Worse than the first dose. First dose gave me no side effects other than the sore arm.

Other Meds: None

Current Illness: None.

ID: 1273678
Sex: F
Age: 60
State: DC

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: Dilaudid

Symptom List: Injection site pain, Menorrhagia

Symptoms: VS: HR: 70s BP: 131/74 O2: 95% Symptoms: Felt mildly SOB. Did not feel anything like her MI, nor her allergic reaction to Dilaudid. No N/V/Diaphoresis. No itchiness, throat closing, tongue swelling sensations. Normal exam. Pt feeling better and wanted to just go home with her family member driving. Aware that if feels worse or any concerns to go to the nearest hospital. Will take antihistamine H1+H2 blocker as a precaution when gets home.

Other Meds: Medications for heart and blood pressure (unsure of names)

Current Illness: denies

ID: 1273679
Sex: F
Age: 70
State: PA

Vax Date: 04/22/2021
Onset Date: 04/25/2021
Rec V Date: 04/30/2021
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: penicillin, clavulanic acid

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

Symptoms: Patient received her second dose of moderna on 4-22-21. On 4-25-21, patient states she began to experience chest pain when she took deep breaths. On 4-28-21, patient states she went to the emergency room. She states the hospital did a chest x-ray, a scan, and a heart echo. She was diagnosed with a lung clot. Patient states she was put on a blood thinner. On 4-29-21, the patient was discharged with a prescription of Eliquis.

Other Meds:

Current Illness:

ID: 1273680
Sex: M
Age: 83
State: MD

Vax Date: 02/10/2021
Onset Date: 03/22/2021
Rec V Date: 04/30/2021
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: Penicillins

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 1 hour after completion of an IVIG infusion (his 17th dose in the past 22 months) the patient experienced severe chills, altered mental status, temperature of 103.0 and was unable to stand or ambulate. His wife called 911 and the patient was admitted to the hospital.

Other Meds: Patient received IVIG in our infusion clinic and began to experience serious side effects within 1 hour of the infusion. The patient began treatment in May of 2019 and had previously received 16 doses of IVIG with no reaction. Therefore, th

Current Illness:

ID: 1273681
Sex: F
Age: 31
State: CA

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/30/2021
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: Muscle pain and headache a day after the vaccination Swollen collarbone lymph the day after

Other Meds: N/A

Current Illness: N/A

ID: 1273682
Sex: M
Age: 54
State: OR

Vax Date: 04/15/2021
Onset Date: 04/19/2021
Rec V Date: 04/30/2021
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: sulfa antibiotics

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

Symptoms: Had period of major depression from 4/29-4/27. Extreme fatigue, slowed thought and movement, poor concentration, negative thought patterns.

Other Meds: aripiprazole, sertraline, metformin, atorvastatin, fenofibrate, Vit D, Vit B-12

Current Illness: none

ID: 1273683
Sex: M
Age: 49
State: IL

Vax Date: 04/06/2021
Onset Date: 04/26/2021
Rec V Date: 04/30/2021
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 known

Symptom List: Nausea

Symptoms: Shingles Diagnosis, itchy rash on right side of neck and both forearms, no nerve pain to date. Prescribed Valtrex: 1gm, Triamcinolne .01% Cream, Sarna OTC lotion to relieve itching, benedryl gel to relieve itching

Other Meds: Advair 50/100 Flonase (seasonally) Alegra-D as needed

Current Illness: none

ID: 1273684
Sex: M
Age: 52
State: IN

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Fever up to 101.9 lasting 12hrs Joint pain: Hands, elbows, shoulders, neck Swollen Lymph nodes under left armpit Injection Site pain Headache

Other Meds:

Current Illness:

ID: 1273685
Sex: U
Age: 49
State: PA

Vax Date: 12/21/2020
Onset Date: 12/23/2020
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: Ace InhibitorsCoughing

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

Symptoms: symptomatic

Other Meds: ASPIRIN ORAL blood sugar diagnostic strip cholecalciferol, vitamin D3, (D3-2000) 50 mcg (2,000 unit) capsule empagliflozin (JARDIANCE) 25 mg tablet tablet glipiZIDE (GLUCOTROL XL) 5 mg 24 hr tablet losartan (COZAAR) 50 mg tablet metoprolol

Current Illness: none

ID: 1273686
Sex: F
Age: 68
State: NJ

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 04/30/2021
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: Sulfa lactose

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

Symptoms: First my upper arm felt like it had a 5 pound brick in it. and then I couldn't raise my arm above horizonal to floor. It did resolve but took 12 weeks to get back to normal. Two weeks after my shot I developed an ache in my vagina. It seemed to resolve in 12 hours but now continues to com back intermittently for short periods of time.

Other Meds: synthroid restasis chlorabetasol creme Estrace cream

Current Illness: no

ID: 1273687
Sex: F
Age: 17
State: CA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Patient is 17 years old and should not recieve Moderna vaccine per EUA guideline

Other Meds:

Current Illness:

ID: 1273688
Sex: M
Age: 75
State: TX

Vax Date: 03/30/2021
Onset Date: 04/05/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Rash starting at top of head, right arm, both sides of right leg and top of right foot

Other Meds: glipizide Metformin, atorvastatin, farxiga

Current Illness: None other than following my second shot; a rash has started at the top of my head, inside of my right arm, both sides of my right leg and right side of my right foot.

ID: 1273689
Sex: F
Age: 32
State: MN

Vax Date: 03/09/2021
Onset Date: 04/28/2021
Rec V Date: 04/30/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Patient is currently positive for Covid 19

Other Meds:

Current Illness:

Date Died: 04/19/2021

ID: 1273691
Sex: F
Age: 71
State: KS

Vax Date: 03/11/2021
Onset Date: 03/24/2021
Rec V Date: 04/30/2021
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: Unknown

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

Symptoms: Patient tested positive for COVID 19 on 03/21 after a symptom onset of 03/19/21. She was admitted to the hospital on 03/24 and passed away 04/19. Cause of death is listed as multi-organ dysfunction secondary to hemorrhagic shock, other contributing factors: COVID-19 pneumonia.

Other Meds: Unknown

Current Illness: Unknown

ID: 1273692
Sex: F
Age: 37
State: CA

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 04/30/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore arm has persisted since 3/12/2021. Cannot do usual activities without pain (lift arm, sleep on left side, reach for toilet paper, change clothes, and cannot do many of my usual yoga postures). At the time of injection, the shot hurt more than usual flu shots.

Other Meds: n/a

Current Illness: n/a

ID: 1273693
Sex: F
Age: 35
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 04/30/2021
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: NKA

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

Symptoms: pt developed nodules on breast, swollen nodes, dime sized lesions which opened and then subsequently healed, but leaving a acar at the 11 o'clock, 12 o'clock, and 3 o'clock

Other Meds: None

Current Illness: None

ID: 1273694
Sex: M
Age: 71
State: NC

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 04/30/2021
Hospital: Y

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: no known allergies

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

Symptoms: Chills, dizziness started within 24 hours of second injection. By Sunday, 6 days after second injection, he was hospitalized with nausea, vomiting. Day 7 he had a stroke and NSTEMI heart attack. He required ventilation twice and several modes of respiratory assistance. Currently, he is on 4 liters of oxygen and battling end stage renal disease related to diffuse disease from hypovolemic shock and infection. He remains hospitalized and deconditioning.

Other Meds: victoza, metformin

Current Illness: type 2 diabetes

ID: 1273695
Sex: M
Age: 34
State: IN

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: No known

Symptom List: Pain in extremity

Symptoms: Joint pain; treated with Ibuprofen

Other Meds: None

Current Illness: No known

ID: 1273696
Sex: F
Age: 36
State: IN

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Received vaccine at 4:00 pm on 4/28. Approximately 10 hours later, I woke up in early morning hours of 4/29 with muscle pain, mostly in my arms (even in non-vaccinated arm). Went back to sleep. Woke up a few hours later for the day feeling very ill. Headache, body soreness, fever, and lethargy. Took temperature with a digital thermometer throughout day. Temperature ranged from 99.6 to a high of 100.1. Today, 4/30, (approx 42 hours after vaccine), my temp has hovered around 99.5. Still experiencing headache and lethargy. However, I feel better than yesterday. Have treated fever and pain with Tylenol.

Other Meds: Albuteral inhaler taken as needed.

Current Illness: On 3/18/2021, I began experiencing COVID-19 symptoms. I tested on 3/22/2021. On 3/24/2021, I received my PCR result, which was positive for COVID-19. I recovered from COVID-19 around 4/2/2021.

ID: 1273697
Sex: F
Age: 61
State: GA

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: LARGE RED SWOLLEN SHOULDER THAT FEELS WARM AND HARD TO TOUCH, DOESNT RESPOND TO IBUPROFEN

Other Meds:

Current Illness:

ID: 1273698
Sex: F
Age: 35
State: CO

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 04/30/2021
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: Medications: Lamictal, MRI contrast, Food: Peaches

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

Symptoms: Patient had difficulty breathing, throat starting to swell, difficult to swallow, EpiPen given X 2

Other Meds: Albuterol Inhaler Stratera 60 mg, PO QD Adderall 20 mg PO QD

Current Illness: No

ID: 1273699
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/30/2021
Hospital: Y

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: Pain spine cord, trouble breathing Neurosarciddosis

Other Meds:

Current Illness:

ID: 1273700
Sex: F
Age: 60
State: CA

Vax Date: 04/01/2021
Onset Date: 04/28/2021
Rec V Date: 04/30/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Covid arm. Fever and headache

Other Meds: None

Current Illness: UTI 4/4/2021

ID: 1273701
Sex: F
Age: 70
State: NY

Vax Date: 03/12/2021
Onset Date: 04/02/2021
Rec V Date: 04/30/2021
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: extensive drug and food allergies

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

Symptoms: swelling, hives, itching an and off for the past 3 weeks. Face, Lips, groin area, hands arms, legs on and off different places different times

Other Meds: Diltiazem 180mg pulmacort inhaler vitamin D 4000

Current Illness:

ID: 1273702
Sex: F
Age: 33
State: NJ

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 04/30/2021
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: Pain in left arm, soreness around the area of injection.

Other Meds: Motrin

Current Illness: None

ID: 1273703
Sex: F
Age: 68
State: WI

Vax Date: 03/15/2021
Onset Date: 03/29/2021
Rec V Date: 04/30/2021
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: Amoxicillin Penicillin

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

Symptoms: She presented for pain to her right arm. She notes Monday night (3/29/21) she couldn't sleep well, so she decided to lay on her right side, with her arm up and tucked beneath the pillow. She woke up about 1-1.5 hours later with a "Charlie horse" in her bicep area, pain was so intense that she was crying/in tears. Notes that her right hand has been colder than her left and with numbness since Monday. Use of the right arm causes pain, such as brushing her hair. She does have DDD, and notes some pain/issues with her right shoulder - so she's wondering if she has a pinched nerve. At this time she is having some numbing pain near the right side of her neck. She received COVID vaccine on 3/15/21 according to immunization registry.

Other Meds: diclofenac (VOLTAREN) 1 % gel ? lisinopril-hydroCHLOROthiazide (ZESTORETIC) 20-12.5 MG per tablet ? metoPROLOL tartrate (LOPRESSOR) 100 MG tablet ? atorvastatin (LIPITOR) 20 MG tablet ? Budeson-Glycopyrrol-Formoterol (Breztri Aerosphere) 16

Current Illness: None

ID: 1273704
Sex: M
Age: 46
State: OH

Vax Date: 03/21/2021
Onset Date: 04/02/2021
Rec V Date: 04/30/2021
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: None

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

Symptoms: Stroke

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm