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: 1274638
Sex: F
Age: 52
State:

Vax Date: 04/12/2021
Onset Date: 04/17/2021
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: Penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Post menopause period and extremely sore breast tissue

Other Meds: Calcium floride

Current Illness: None

ID: 1274639
Sex: F
Age: 90
State: OR

Vax Date: 03/26/2021
Onset Date: 04/09/2021
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: keflex metoprolol clindamycin codeine sulfa cipro

Symptom List: Anxiety, Dyspnoea

Symptoms: swelling and pain in feet

Other Meds: Eliquis estrace flonase digox diltiazem docusate immodium ipratropium levetiracetam levothyroxine loratadine losartan melatonin potassium chloride proair torsemide trospium spironolactone

Current Illness: none

ID: 1274640
Sex: M
Age: 31
State: GA

Vax Date: 02/24/2021
Onset Date: 02/27/2021
Rec V Date: 04/30/2021
Hospital: Y

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: Carrots, watermelon, food of the peach family (mild)

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

Symptoms: Heart attack symptoms resulting from cardiac event, leading to hospitalization for 4 days. Diagnosed with Myocarditis.

Other Meds: None

Current Illness: None

ID: 1274641
Sex: F
Age: 28
State: PA

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Post vaccine pt became dizzy and felt lightheaded. Pt was instructed to lay supine on floor and was transferred to med obs via litter. Pt reported feeling better after laying on stretcher. Vitals obtained and monitored. Pt had no complaints of chest pain. Pt had no complaints of SOB. Pt released at 17:49. Vitals as follows: 1738 LYING BP 114/73 HR 86 RR 18 SpO2 100% 1747 SITTING BP 105/73 HR 80 RR 18 SpO2 98%

Other Meds: Doxepin

Current Illness: N/A

ID: 1274642
Sex: F
Age: 48
State:

Vax Date: 04/24/2021
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: LA

Lab Data:

Allergies: novocaine penicillin

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

Symptoms: eye swelling, pain irregular menstruation admitted to hospital with htn urgency - however also reports not taking her meds

Other Meds: Proventil prinzide Procardia XL

Current Illness: no

ID: 1274644
Sex: M
Age: 41
State: IN

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

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

Symptoms: Felt extremely tired around 7:30pm. Went to bed. Woke up at 6:00am to get kids ready for school, felt intense headache joint pain, and intense cold feeling to the point of shaking. Went to bed again around 7:45 am. Slept most of the day with headache getting worse. Next day symptoms lessened slightly still bad headache and brain fog which I still have as of today but getting better.

Other Meds: Effexor, Advair Singular, zyrtec

Current Illness: None

ID: 1274645
Sex: M
Age: 50
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: High fever 101+ Discomfort Muscle stiffness and soreness

Other Meds: Atorvastatin 80 MG Amlodipine benazepril 5-20 Multi vitamin Vitamin D Aspirin 81mg Fish oil

Current Illness: None

ID: 1274646
Sex: M
Age: 28
State: CO

Vax Date: 02/28/2021
Onset Date: 02/28/2021
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: nkda

Symptom List: Pharyngeal swelling

Symptoms: 28 y/o male with hx of papular rash starting after receiving 2nd dose of Moderna Covid 19 vaccine. Rash located to the bilateral chest and around the left cheek and eye. No hive, no urticaria, no angioedema

Other Meds: none

Current Illness: None reported

ID: 1274647
Sex: F
Age: 34
State: MI

Vax Date: 04/23/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: One day following the initial vaccine, experienced fatigue, nausea, painful swelling below the injection site, loss of appetite, and acne. One week following the vaccine, arm broke out in a rash in the same area where swelling was present the week prior.

Other Meds: Zyrtec over the counter allergy medication

Current Illness: None

ID: 1274648
Sex: M
Age: 43
State:

Vax Date: 04/22/2021
Onset Date: 04/24/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: painful, itchy rash on arms and legs

Other Meds:

Current Illness:

ID: 1274649
Sex: F
Age: 27
State: CA

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

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

Symptoms: The dose for the Moderna vaccine is .5 mL. The patient inadvertently received an extra 0.01 to 0.02 mL. The manufacturer instructed us to contact the patient to inform them that the increased dosage could potentially lead to side effects that could be local or systemic. No adverse events were reported by the patient.

Other Meds: unknown

Current Illness: unknown

ID: 1274650
Sex: F
Age: 35
State: CA

Vax Date: 04/01/2021
Onset Date: 04/16/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Shingles treated with anti-virals. Lasted for one week from 4/16 through 4/23.

Other Meds: Birth control

Current Illness: None

ID: 1274651
Sex: F
Age: 17
State: TX

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: Penicillin

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

Symptoms: Stiffness around nech and pain in Jaws

Other Meds: None

Current Illness: None

ID: 1274652
Sex: M
Age: 37
State: MN

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

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

Symptoms: 10 minutes post innoculation I became very dizzy and lightheaded. Nurses layed me down and took my pulse. It was between 40 and 46BPM. Nurses provided me water and checked my blood sugar which was approximately 140mg/dl. I layed for about 30 minutes before nurses checked my pulse and determined it was back to normal. I felt no pain, no soreness, or other symptoms than nearly passing out.

Other Meds: Insulin(novolog), atorvastatin, levothyroxine

Current Illness: NA

ID: 1274653
Sex: M
Age: 72
State: NY

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

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

Symptoms: Early morning of 4/12/21 (4th day following second shot of Moderna vaccine), I woke to be very dizzy. I had to lean against the wall to reach the bathroom. I had to be very careful sitting down and standing up from the toilet. That day dizzyness was severe. Next day moderate, Third day mild. Fourth day slight. Fifth day, recovered. Looking online, I found a couple of sites where other people reported similar symptoms? only for some of them, the dizzyness persisted for days and weeks. Since that fifth day, I've had no recurrence.

Other Meds: Latanoprost, Metoprolol, Eliquis

Current Illness: none

ID: 1274654
Sex: M
Age: 26
State: VA

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

Lab Data:

Allergies:

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

Symptoms: Patient immediately felt dizzy after injection. He then passed out in his chair and we put him down on the floor. He then had a seizure lasting a couple seconds. The entire episode lasted less than a minute and he then regained consciousness and was responsive. Emergency services was contacted at the first sign of the seizure and upon arrival, they checked that he was alert and oriented x4. Patient did not go to the hospital but he did go home with a family member.

Other Meds:

Current Illness: Patient was fasting for Ramadan

ID: 1274655
Sex: M
Age: 39
State: IN

Vax Date: 04/30/2021
Onset Date: 04/30/2021
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:

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

Symptoms: hot, flush, dizzy, and briefly fainted roughly 5 min after shot was administered, gave ice pack and pt felt better after 10 minutes

Other Meds:

Current Illness:

ID: 1274656
Sex: F
Age: 50
State: CA

Vax Date: 04/20/2021
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: Macrobid

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Redness and swelling started 9 days after injection at injection site.

Other Meds: Calcipotriene, Dexamethasone cream and lotion, Xiiadra, Vag Estrogen, Benadryl, Taurune, Vit D, Calcium, Magnesium

Current Illness: Seborrhea, Excema, Insomnia, Dry Eye, Hashimotos

ID: 1274657
Sex: F
Age: 20
State:

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: significant enlarge axillary and supracervical lymph node swelling on injection side left

Other Meds:

Current Illness:

ID: 1274658
Sex: F
Age: 64
State: RI

Vax Date: 03/20/2021
Onset Date: 03/24/2021
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: Shell fish, contrast dye, tetracycline , erythromycin , papaya, mango

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

Symptoms: Immediately post injection severe stinging occurred. Three days later night sweats bodyaches low-grade fever diarrhea intense headache which lasted three weeks. Headache and bodyaches continued with night sweats for an additional two weeks.

Other Meds: HRT

Current Illness: None

ID: 1274659
Sex: F
Age: 34
State: WA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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: Sulfa, amoxicilin

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

Symptoms: Muscle pain in shoulder of injection site that often radiates to the elbow. Continued through the month wait between injections, and continues to linger after shot #2 (4/22/21).

Other Meds: Ritalin, prozac

Current Illness: None

ID: 1274660
Sex: F
Age: 68
State: NY

Vax Date: 04/19/2021
Onset Date: 04/20/2021
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: Not known

Symptom List: Unevaluable event

Symptoms: Itching and hives on body one day after. Took Benadryl. Symptoms have continued to present.

Other Meds:

Current Illness:

ID: 1274661
Sex: M
Age: 58
State: TX

Vax Date: 04/29/2021
Onset Date: 04/30/2021
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: Received my second shot on the late morning of yesterday (Thursday). My arm was getting pretty sore by the time I went to bed (I could not sleep on my left side). When I woke up, started feeling fuzzy and got the chills. Took three 325 mg Acetaminophen in the morning. Was running a low grade fever by lunch time (99.9 degrees) and was feeling like I had the flu. Joints are sore, head still fuzzy, feel a little light headed when I move around too much. Took three more 325 Acetaminophen after lunch. No appetite, stomach feels queasy. Tired but can't sleep. Intend to take more acetaminophen this evening before bed. Hopefully tomorrow my symptoms will start to go away.

Other Meds: Trazadone (100 mg nightly for sleep) Montelukast (10 mg daily for severe seasonal allergies) Miconazole Nitrate 2% Topical (apply small amount daily to toenails) Loratadine (10 mg daily for seasonal allergies) Fish Oil (2000 mg daily) Diclo

Current Illness: Sleep apnea with CPAP, trouble sleeping and depression being treated at time of vaccine.

ID: 1274662
Sex: F
Age: 80
State: TX

Vax Date: 03/06/2021
Onset Date: 03/27/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: reports having severe headache

Other Meds:

Current Illness:

ID: 1274663
Sex: F
Age: 31
State: IA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
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: anectin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Nausea/Dizziness, Lightheaded, Muscle and Joint pain. Next morning with severe muscle and joint pain. Fever and racing heart along with Nausea and Joint Pain.

Other Meds: none

Current Illness: none

ID: 1274664
Sex: M
Age: 49
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies: none stated

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

Symptoms: Patient received 2nd dose in Moderna COVID19 vaccine series late as per FDA EUA/Manufacture guidance. Original dose in series received on 1/18/21 from another agency (102 days between doses)

Other Meds: none stated

Current Illness: none stated

ID: 1274666
Sex: F
Age: 38
State: PA

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

Lab Data:

Allergies: penicillins

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: patient says her arm is red, warm, and painful, has talked to her doctors office already, i assured her it is a common reaction but both i and her doctors office advise that she follow up with them if it continues to worsen or doesnt get better. i advised and doctors office already advised her to take ibuprofen and benadryl, and she has been using those.

Other Meds: unknown

Current Illness: unknown

ID: 1274667
Sex: F
Age: 59
State: CO

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: RA

Lab Data:

Allergies: Shellfish, seasonal allergies

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Mild rash (fewer than 50 tiny blisters) on front/back of torso, plus one in the crook of left elbow. They're mildly itchy. Also had fatigue, headaches and body aches which started about the same time (morning of April 29, 2029) The head/body aches and tiredness lasted about 12 hours.

Other Meds: Aleve, Tylenol, Cetirizine, Vit D3, B Complex, Welchol(cont'd), Omeprazole, Aspirin, Garlic, Iron, Magnesium, Vitamin A, Potassium, Trazadone, Biotin.

Current Illness: None

ID: 1274668
Sex: M
Age: 37
State: CA

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

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

Symptoms: The dose for the Moderna vaccine is .5 mL. The patient inadvertently received an extra 0.01 to 0.02 mL. The manufacturer instructed us to contact the patient to inform them that the increased dosage could potentially lead to side effects that could be local or systemic. No adverse events were reported by the patient.

Other Meds: unknown

Current Illness: unknown

ID: 1274669
Sex: F
Age: 21
State: LA

Vax Date: 04/09/2021
Onset Date: 04/24/2021
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:

Symptom List: Nausea

Symptoms: She developed red dots (petechiae) and bruising on Saturday. She also developed vaginal bleeding on Saturday that was heavy and had clots. Her period was ending on Saturday and had been normal up to that point. She continues to have heavy vaginal bleeding. Went to PCP and routine labs revealed thrombocytopenia. She has never had thrombocytopenia before. Was sent to ED for blood transfusion and was admitted to hospital. Dishcarged home 4/27 after platelet infusion.

Other Meds: otc fish oil, collagen peptide powder

Current Illness: athralgia of wrist

ID: 1274670
Sex: F
Age: 30
State: PA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NONE

Symptom List: Injection site pain

Symptoms: pt feeling anxious and nervous prior to coming for her vaccine c/o lightheadedness, tunnel vision immediately after vaccination. pt was place in trendelenburg with significant improvements. pt sat up with no symptoms. started eating graham crackers and water. pt dispo home with husband and child and walked outside with no distress. vitals: T-burg 1749 118/79; rr 18; 77; 118/79; 98% sitting 1753 125/81; rr 18; 71; 100% standing 1803 134/92; 72; 100%

Other Meds: BP CONTROL,

Current Illness: NONE

ID: 1274671
Sex: F
Age: 32
State: OH

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: Lactose intolerant, sulfae, allergic to dogs

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

Symptoms: Covid arm big large swollen red rash that is sore and itchy. Got the same thing with my first does in left arm. Both appeared within 24-48 hours. The first shot post 4 weeks and I still have a small mark.

Other Meds: Paxil, Giavani (birth control), generic adderall, melatonin

Current Illness: no

ID: 1274672
Sex: F
Age: 51
State: NY

Vax Date: 03/13/2021
Onset Date: 03/20/2021
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:

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

Symptoms: Body aches, fever, nose blister, headaches swollen and arm diarrhea. 0n 3/2021 I statdetedbtonget pain on my left foot and calf. I went to the hospital and on 3/22/2021 I had a ultrasound and the results showed that I have a blood clot.

Other Meds:

Current Illness: Hiatal Hernia and sciatic nerve and endometriosis

ID: 1274673
Sex: F
Age: 56
State: PA

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

Lab Data:

Allergies: NKDA

Symptom List: Tremor

Symptoms: Pt. had minor swelling and itch and rash developing on face, arm and legs. Gave 2 tablets of diphenhydramine 25mg. Seemed fine after about 30 minutes.

Other Meds: Unknown

Current Illness: None

ID: 1274674
Sex: F
Age: 20
State: CA

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: History of anxiety, clammy, dizziness, syncope. BPs 142/92 (pulse 97), 134/88 (pulse 123).

Other Meds:

Current Illness:

Date Died: 04/23/2021

ID: 1274675
Sex: F
Age: 67
State: TX

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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: No know drug allergies

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

Symptoms: Vaccine was administered at 1215, patient was monitored for 15minutes per CDC guidelines with not adverse reactions noted. Approximately one hour after administration of vaccine patient noted to be moaning, fingerstick BS at 59mg/dL, Dextrose administered, pt proceeded in to cardiac arrest, CPR was initiated and EMS activated. Pt expired approximately 4 hours after incident at ER.

Other Meds: Humalog Lactulose 20 gram/30 mL solution Lumigan (bimatoprost) 0.01% drops Midodrine 10 mg tablet Rena-Vite Renvela 800 mg Sertraline 50 mg tablet

Current Illness:

ID: 1274676
Sex: M
Age: 55
State: NV

Vax Date: 03/23/2021
Onset Date: 03/25/2021
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: none

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

Symptoms: Developed tinnitus 2 days post vaccine-

Other Meds: omeprazole

Current Illness:

ID: 1274677
Sex: F
Age: 19
State:

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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe Headache, nausea, fatigue, lightheadedness, muscle weakness in left arm and arm pain in left arm, chills Fatigue started in the morning and other symptoms started to emerge after a few hours. Severe headache started midday. Symptoms made it hard to focus and get work or anything else done. Took ibuprofen which helped headache, but it did not go away completely and lasted in to the next day

Other Meds: Cerdelga, Vybriid, Lo loestrin Fe

Current Illness: None

ID: 1274678
Sex: F
Age: 66
State: NY

Vax Date: 04/24/2021
Onset Date: 04/24/2021
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: none

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

Symptoms: Developed rash, hives on face, neck, chest and scalp since 3 1/2 hours after receiving 2nd dose of Moderna vaccine. I still am experiencing same for 7 days now with no sign of ending.

Other Meds: amlodipine, letrozole, calcium, omegs3, vitamin d3

Current Illness: none

ID: 1274679
Sex: F
Age: 42
State: TX

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/30/2021
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: n/a

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

Symptoms: Severe pain in left shoulder that radiates down the arm. Did not have mobility first few days. Can move my arm but still have severe pain an unable to have feel range of motion. Prescribed medications and ointment but pain has not improved.

Other Meds: n/a

Current Illness: n/a

ID: 1274680
Sex: F
Age: 46
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: Penicillin

Symptom List: Pain in extremity

Symptoms: Arm was sore and had a knot at the sight of injection and was red. The next afternoon started feeling achy and couldn't get warm. Headache. Then, the next morning woke up and left arm pit is very sore.

Other Meds: Lo Loestrin MG-10 and Aspirin 81mg

Current Illness: No

ID: 1274681
Sex: F
Age: 23
State: IL

Vax Date: 04/30/2021
Onset Date: 04/30/2021
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: Fainted and fell onto ground 5 min after receiving vaccine. 911 was called, I turned down the ambulance and had family take me to the hospital.

Other Meds: Lexapro, hydroxizine Neither were taken within 24 hours of the vaccine.

Current Illness: None

ID: 1274682
Sex: M
Age: 48
State: MI

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

Lab Data:

Allergies: Watermelon (throat/tongue itching ,burning), Morphine, Doxycycline

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

Symptoms: Patient received vaccine at 1:23pm 4/30/21. He came back to the pharmacy at 4:45pm 4/30/21 reporting that his throat and tongue were burning, itchy, and felt swollen. He had excessive thirst and nausea. His symptoms were getting worse during the 10 minutes he were talking with him. The patient refused Benadryl and Epipen at the pharmacy as he wasn't sure he needed it. An ambulance was called and he was transported to the hospital.

Other Meds: none

Current Illness: None

ID: 1274683
Sex: F
Age: 67
State: TN

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

Lab Data:

Allergies: Augmentin

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

Symptoms: Excessive wheezing not normally experienced. Headache, arm pain for over 2 weeks. On the 3rd day, I experienced extreme diarrhea 8-10 hours per day for 10 days. Diarrhea occurred about every 15 minutes for 8-10 hours each day for 10 days. Double doses of Imodium or any other anti-diarrheal after each bowel movement had NO effect whatsoever. Vomiting in the morning after eating nothing at all the previous day. I called my NP to see if I should report this extreme diarrhea and the nurse agreed.

Other Meds: Hydrocodone, Clonazepam, Omeprazole, Amlodopine Besylate, Multivitamin 50+, Melatonin, Anoro, Linzess

Current Illness: None

ID: 1274684
Sex: F
Age: 44
State: MD

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Tired Nausea Muscle Aches Injection Site Pain

Other Meds: Gabapentin Mirtazapine

Current Illness: None

ID: 1274685
Sex: F
Age: 75
State: PA

Vax Date: 02/16/2021
Onset Date: 03/25/2021
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: dicloflenac e-mycin parafon forte dsc soma lisinopril sulfa valium

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: received the 1st dose 1/26/2021, second dose 2/16/2021 then presented to the hospital with ble weakness, syncope, and fevers on 3/25/2021 and again on 4/26/2021 Both presentations she had leukocytosis with lymphopenia. both resolved within 24 hours. infectious workup was negative. CT a/p/chest unrevealing

Other Meds: Norvasc asa Lipitor celexa b12 flexeril ferrous sulfate gabapentin synthroid, omeprazole, Januvia, maxzide losartan, slo mag, metformin, Toprol xl

Current Illness: no

ID: 1274686
Sex: F
Age: 61
State: OH

Vax Date: 03/20/2021
Onset Date: 03/23/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: I have developed eczema, dry earlobe, and a crust on my scalp that is making my hair fall out

Other Meds: Rx: Micardis HCT 80/25 once a day

Current Illness: None

ID: 1274687
Sex: M
Age: 61
State: MD

Vax Date: 04/01/2021
Onset Date: 04/08/2021
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: 7 days after vaccine - rash on underside of right fore arm and on right side of body.- rash did not cross midline of body. Itchy- looked like Shingles. Rash cleared up after 2 weeks. Treated with cortisone cream and calamine lotion and Benadryl. But Health Dept. Denied 2nd shot because of rash.

Other Meds: Multi vitamin

Current Illness: None

ID: 1274688
Sex: F
Age: 59
State:

Vax Date: 04/21/2021
Onset Date: 04/27/2021
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: Codeine, Peach, Shellfish, Kiwi, Mango, ACE inhibitors, Penicillin, Pineapple

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

Symptoms: Dizzy when ambulating to bathroom, fell, hit head, had subsequent seizure-like activity

Other Meds: Tylenol, ASA, Lipitor, Wellbutrin, Coreg, Vitamin D, Flonase, HCTZ, Insulin aspart, Lantus, Victoza, Cozaar, Metformin, Protonix, Effexor, Norvasc

Current Illness: HTN, HLD, anxiety, DM

ID: 1274690
Sex: F
Age: 52
State: WA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
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: RA

Lab Data:

Allergies: nkda

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

Symptoms: muscle cramps and pain

Other Meds: magnesium, warfarin

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm