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: 1277726
Sex: M
Age: 16
State: MA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: NONE REPORTED

Symptom List: Dysphagia, Epiglottitis

Symptoms: SYNCOPE WHILE UNDER SUPERVISION

Other Meds: NONE

Current Illness: NONE

ID: 1277727
Sex: M
Age: 27
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever of as high as 102 degree Fahrenheit and intermittent headache. These symptoms have existed since they first appeared. They have not receded as of Saturday 12 pm.

Other Meds:

Current Illness:

ID: 1277728
Sex: F
Age: 49
State: TN

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: no

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

Symptoms: Subconjunctival hemorrhage on left eye

Other Meds: no

Current Illness: no

ID: 1277729
Sex: M
Age: 23
State: CA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approx. 5 minutes following vaccine administration the patient developed a transient loss of consciousness resulting in a fall causing a small abrasion to his left forehead. The patient regained consciousness immediately. He was alert and oriented. No witnessed convulsions were reported. He denied any further neurological symptoms. He reported that he did eat breakfast. He denied symptoms of anaphylaxis or severe allergy symptoms. By this time, paramedics arrived and the his blood pressure (and orthostatics), pulse, blood sugar, pulse oximetry, EKG findings were all within normal limits. He refused to be taken to the Emergency Room as well as treatment for the head abrasion. There were no physical signs of fracture. The patient ambulated out of the clinical without difficulty, accompanied by his girlfriend. S/sx of concussion were discussed w/ patient and he or his family members are instructed to call 911 should he development further syncope or other neurological symptoms.

Other Meds: none

Current Illness: none

ID: 1277731
Sex: F
Age:
State: CA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: DIZZINESS, CHEST PRESSURE, SWEATY, HX OF LONG ALLERGY, VSS, SYMPTOMS IMPROVED, REFUSED TRANSPORT.

Other Meds:

Current Illness:

ID: 1277732
Sex: F
Age: 50
State: NJ

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
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: Headache - 29APR21 5:00pm - 30APR21 3:00pm Swollen lymph nodes (most notably in neck/throat area and under arms) 30APR21 2:00 AM - 01MAY21 9:00 AM Overall body aches/pains 30APR21 2:00AM - 01MAY21 09:00AM Fever/Chills - 30APR21 2:00AM - 01MAY21 9:00AM All resolved; no treatment taken

Other Meds: None

Current Illness: None

ID: 1277733
Sex: F
Age: 40
State: NY

Vax Date: 04/01/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Extreme fatigue, headache, fever, body ache, very sore arm, red rash on arm, diarrhea, thirst, lack of appetite on day after vaccine. Much better but not 100% day 2, energy is back

Other Meds:

Current Illness:

ID: 1277734
Sex: F
Age: 73
State: FL

Vax Date: 03/11/2021
Onset Date: 03/14/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Pharyngeal swelling

Symptoms: Ringing in Right ear

Other Meds: Candesarten , Amlodapine Metroprol

Current Illness:

ID: 1277735
Sex: F
Age: 41
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: The first shot my entire left arm was extremely sore for about 24 hours. Second shot I received my arm was sore for about three hours and then the following day I I began to get a headache. At the moment it is two days after my injection and I still have a headache. My left side of my chest hurts also.

Other Meds:

Current Illness:

ID: 1277736
Sex: M
Age: 59
State: TX

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 05/01/2021
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: Robaxin sulphur based antibiotics ( rash)

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fever of up to 102, extreme chills and shakes, night sweats of large amounts, headache for 30 hours have now a lingering cough

Other Meds: bystolic 81 mg aspirin enalipril hydrochlorothizide

Current Illness: none

ID: 1277737
Sex: M
Age: 61
State: CA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: N/a

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

Symptoms: In the past I had a bicep injury. They gave me stem cell treatment. Beyond the normal shoulder pain, I had pain in the specific area of the original injury much more than anywhere else

Other Meds: Testosterone .7 ml weekly, flomax daily, vit D daily

Current Illness: N/a

ID: 1277738
Sex: F
Age: 43
State: NJ

Vax Date: 02/28/2021
Onset Date: 03/03/2021
Rec V Date: 05/01/2021
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: I experience tachycardia and severe anxiety 3 days after the vaccine. My heart rate went up to 187 on my apple watch. By the time I got the ER, I was at 160 and the rate would not drop below 120 for at least an hour if not more. Initially I had attributed that to anxiety but doctors did not believe it was anxiety as I was obviously not anxious (after a while, I was scared when I arrived at the ER)

Other Meds:

Current Illness:

ID: 1277739
Sex: F
Age: 31
State: MN

Vax Date: 04/28/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Several hours after the shot on 4/28, I started to feel nauseated and fatigued (not bad enough to impair functioning, so I ignored it). Nausea and fatigue improved on 4/29 so I forgot about it. On the morning of 4/30, fatigue and nausea were back much worse, and I noticed a rash on my lower back: a small red patch that hurt to touch, mildly itchy. On this patch, there were several blisters that stung. I have had shingles before and I'm pretty sure I recognize it, and this rash in the exact same place that I've had the shingles rash before. Today, 5/1, the rash isn't any worse, but the nausea is quite bad (enough to keep me home).

Other Meds: Mestinon 30 mg daily Adderall 5 mg daily Vyvanse 30 mg daily Desvenlafaxine 25 mg daily Wellbutrin 300 mg daily Naltrexone 6 mg daily

Current Illness: none

ID: 1277740
Sex: F
Age: 30
State: WV

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/01/2021
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: Neosporin, polysporin

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

Symptoms: 2 hrs after shot--pain at injection site, mild headache 12 hrs after shot--chills, muscle pain, fatigue 3rd day--chills and muscle pain fade, fatigue remains 4th day--less fatigue, but dizziness starts 5th day (today)--dizziness increases

Other Meds: Centrum multivitamin, magnesium supplement, Seed probiotic, NOW super enzyme supplement

Current Illness: None

ID: 1277741
Sex: F
Age: 56
State: CA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: C/O SHAKY, NERVOUS/ANXIOUS, HAS HX DM, HTN, ANXIETY. BS=95, SYMPTOMS RESOLVED, REFUSED TRANSPORT.

Other Meds:

Current Illness:

ID: 1277742
Sex: M
Age: 62
State: FL

Vax Date: 04/07/2021
Onset Date: 04/27/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Singles outbreak.

Other Meds: Hypertension meds

Current Illness: None

ID: 1277743
Sex: M
Age: 26
State: TX

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
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: Dairy, Egg, some fish

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

Symptoms: Vitals dropped and lost consciousness about 5 minutes after injection. I wasn't anxious nor dehydrated. Afterwards I couldn't sleep because of a racing heart rate when I returned home after about an hour. Heard rate stabilized and I was able to nap after another hour. I had a serious brain fog, vertigo, dizziness, wandering eyes (can't focus them, going cross-eyed a lot), memory loss (unsure if I completed a task or not), and faint hearing (this improved on day 2). I'm currently on day 3 and I am trending upward but not 100% yet.

Other Meds: Vitamin D, Zinc, Omeprezole, Flovent Hfa

Current Illness: None

ID: 1277744
Sex: F
Age: 34
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs and kiwi fruit

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Lymph node swollen and tender on same arm where vaccine was given

Other Meds: Wellbutrin, celexa, tri-sprintec, vitamin d, nexium, Claritin

Current Illness:

ID: 1277745
Sex: F
Age: 30
State: OH

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
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: Hives - 8 hours after the shot. treated with antihistamine . Went away 8 hours later. Fever, body aches, chills- 10 hours after the shot. treated with ibuprofen . Went away 48 hours later

Other Meds: None

Current Illness: None

ID: 1277746
Sex: F
Age: 68
State: PA

Vax Date: 02/18/2021
Onset Date: 02/28/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: penicillin, thyroxine

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

Symptoms: hives

Other Meds: pantoprazole, levothyroxine

Current Illness: ceiliac disease, hypothyroidism

ID: 1277747
Sex: F
Age: 16
State: MA

Vax Date: 04/29/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: Allergic to white potato

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

Symptoms: Fainted 48 hours after shot, sweats, slumped over. Luckily I was there to catch her. Complete loss of color. Came on very suddenly. Could have been catastrophic if she was driving.

Other Meds: None

Current Illness:

ID: 1277748
Sex: M
Age: 39
State: MN

Vax Date: 04/08/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Unevaluable event

Symptoms: Injection site seemed fine and pain free in subsequent days after vaccination. Injection site became sore on 4/30/2021 (22 days later) as if the vaccination had just occured.

Other Meds: NA

Current Illness: NONE

ID: 1277749
Sex: M
Age: 21
State: AZ

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
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: On 4/29/21 around 9 PM, I started feeling chills, fever, severe headache, muscle aches all over my body. I felt weak and tired throughout the night of the 29th. By morning most side effects subdued but still felt weak and tired.

Other Meds: N/A

Current Illness: None

ID: 1277750
Sex: F
Age: 55
State: IL

Vax Date: 04/22/2021
Onset Date: 04/27/2021
Rec V Date: 05/01/2021
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: Ceclor, Augmentin, Amoxicillin, Ibuprofin

Symptom List: Injection site pain, Pain

Symptoms: Vaccine was 4/22/21. On 4/27/21 my menstrual cycle began - I am 4.3 years post-menopausal and 55 years old! On 4/25 I began to have sore lower back, cramps, abdominal bloating, and sore breasts. I have not had these symptoms for 4.3 years. The period began on 4/27/21 and is still active.

Other Meds: Losartan, multi vitamins, probiotics, vitamin D, vitamin C

Current Illness: none

ID: 1277751
Sex: F
Age: 25
State: PA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient stated she felt light headed and dizzy. She put her head down on the table and was sweating. She did not lose consciousness. She was able to respond to questions. She refused the offer of an epi pen or call to 911. She did not want to have someone called to pick her up. I gave her a bottle of water and M&M's. when the dizziness passed, she ate the M&M's, had some water. She started to fell better after about 6 minutes. I stayed with her until she able to leave on her own.

Other Meds:

Current Illness:

ID: 1277752
Sex: F
Age: 35
State: IN

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 05/01/2021
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: Sulfa allergy

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

Symptoms: Metallic taste in mouth - like having pennies on my tongue. Occasional Tingle/numbness of lips

Other Meds:

Current Illness:

ID: 1277753
Sex: F
Age: 47
State: OR

Vax Date: 04/23/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: Sulfa

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Red, swollen area at injection site. Warm and slightly firm to the touch. Round shape, approximately 1.5" diameter. First noticed 8 days after injection, but may have appeared earlier. No treatment.

Other Meds: None

Current Illness: None

ID: 1277754
Sex: F
Age: 36
State: PA

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: Cephalexin, pencilins, sulfa, moxifloxican, metoclorpramide, erothamicine, amoxicilin, kiwi

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Swollen lips, Severe headache, chills, weak, body aches

Other Meds: Ventolin, welbutrin, singulair, albuterol, Zyrtec, protonix, initrex, celexa, topamax, Lyrica, Elavil, Vitamin d2, Mobic,

Current Illness:

ID: 1277755
Sex: M
Age: 42
State: MT

Vax Date: 04/26/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Slight allergy to some hot peppers

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

Symptoms: Vertigo and dizzy spells starting 4 days after 2nd dose

Other Meds: Lotrimin AF cream

Current Illness: Ring worm infection

ID: 1277756
Sex: F
Age: 62
State: NY

Vax Date: 04/06/2021
Onset Date: 04/14/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: Blue dye in Zoloft

Symptom List: Nausea

Symptoms: Shingles developed on April 14,2021- eight days after vaccination. Burning pain through left side back to left breast with rash left breast, enlarged lymph nodes left side and left neck, extreme pain which was treated with valtrex, gabapentin, two courses prednisone, Advil, capzacin cream. May 1,2021 pain continues. Seen in Hospital ER April 20,2021 for confirmation diagnosis.

Other Meds: Trazadone 50mg daily Omeprazole 20 mg daily Vitamin D 5000 IU daily Vitamin B12 1000 mcg daily

Current Illness: None

ID: 1277757
Sex: F
Age: 62
State: WV

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: Cardiazem,

Symptom List: Injection site pain

Symptoms: Egg shaped knot, hot and itchy next day and is still swollen and itchy 4 days later. Applied ice.

Other Meds: Xanax, Hydrodiurel, Prilosec, Lopressor, CQQ10,Vitamin D, Vitamin C, Vitamin E. Multivitamin, and Aspirin.

Current Illness: No

ID: 1277758
Sex: F
Age: 17
State:

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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 allergies

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

Symptoms: Immediately after administration of vaccine, patient fainted. Patient assisted in to wheelchair and wheeled to private observation area. Patient assisted to gurney. Patient has cool compress to forehead. Patient also nauseous, pale, and sweaty. Patient mother reports patient did not eat today. Given water and apple juice. Patient declined granola bar. Vital signs as follows: 0950-BP 88/59, P 86, RR 20, 95% RA, no pain. 0955-BP 92/60, P 69, 99% RA. 1000-BP 96/67, P 75, 100% RA. Education given to patient and mother regarding eating/drinking before next dose and to tell the vaccinator that patient passed out at last vaccine and to lay on gurney before second dose is given. Patient and mother acknowledged understanding. Patient back to baseline at 1010.

Other Meds:

Current Illness:

ID: 1277759
Sex: M
Age: 44
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Not trying to be funny but I felt like I was tripping. I had all the side effects listed per my research. I had a vivid dream like when I used the patch to stop smoking. It was a surreal experience that started happening about 12 hours after the shot.

Other Meds:

Current Illness:

ID: 1277760
Sex: M
Age: 44
State: MA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 05/01/2021
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: Sulfa medications Benzoil Peroxide

Symptom List: Tremor

Symptoms: joint swelling and pain both ankles and right wrist, resulting in reduced mobility.

Other Meds: Lithium Carbonate 300 mg X2 day.

Current Illness: n/a

ID: 1277761
Sex: F
Age: 30
State: VA

Vax Date: 02/02/2021
Onset Date: 02/17/2021
Rec V Date: 05/01/2021
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: Extreme fatigue that comes in waves, was having really stiff knees and my eye was twitching but after a few weeks that has stopped, periods have become almost non existent for the last 4 cycles

Other Meds: Oral birth control

Current Illness: n/a

ID: 1277763
Sex: F
Age: 68
State: MN

Vax Date: 04/02/2021
Onset Date: 04/18/2021
Rec V Date: 05/01/2021
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: N/A

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

Symptoms: Dizziness, light headed, serious fatigue, nausea, vomiting, loss of appetite, constipation, low heart rate, rash

Other Meds: Wellbutrin, Atenolol, hydrochlothiazide, aspirin

Current Illness: N/A

ID: 1277764
Sex: F
Age: 69
State: MD

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 05/01/2021
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: Linop[isil (sp). Blood pressure medicine caused me to cough

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

Symptoms: Diarrhea for about 4 days

Other Meds: None

Current Illness: None

ID: 1277765
Sex: F
Age: 49
State:

Vax Date: 04/26/2021
Onset Date: 04/28/2021
Rec V Date: 05/01/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Presented to ED with swelling to right leg. Had ultrasound and has a DVT. Normal cardiopulmonary exam with LCTAB and HRRR. No swelling to R calf. R calf is warm to touch, red, and TTP. Patient is well appearing, non-toxic and in no acute distress. Patient's US of the RLE that revealed a R calf DVT involving mid calf posterior tibial vein from her Dr.'s office. BMP was unremarkable. Prescribed the Patient Xarelto and she received her first dose in the ED today. Follow-up with PCP in the next 2-3 days. Return to the ED for new or worsening symptoms.

Other Meds:

Current Illness:

ID: 1277766
Sex: M
Age: 34
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Aches and pains, fever and headache. Excessive tiredness. It's been 2 days so far but it seems to be getting better. I had minimal reaction to the first injection only a very sore arm the first time.

Other Meds: Flonase

Current Illness:

ID: 1277767
Sex: F
Age: 49
State: FL

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: Adverse Reaction Notes 1. 49 y/o female c/o nausea and headache 2/10 15 mins after receiving the second dose of the vaccine, had no reaction to 1st dose. She reported hx of HTN years ago but not on any meds. She was assessed and monitored by NP, EMT, and paramedic. BP -152/98, 144/92, HR - 88, resp -14, temp - 96.7, 100% on RA, has mild anxiety. She was taken outside for fresh air, given H2O. She was kept at site until she reported that her nausea was gone, her headache 1/10. Instructed to take Tylenol 650mg Q6h PRN headache, monitor her BP and parameters to notify her PCP and to get rest today. She was given the Vaccination information sheet, reinforced instructions on ADRs/ SEs to call 911 and go to the ED, follow up with her PCP. She was with her husband, both verbalized understanding and willingness to comply. She left site in no acute distress, awake, alert, oriented to person, place, time and, situation.

Other Meds:

Current Illness:

ID: 1277768
Sex: M
Age: 82
State: CA

Vax Date: 04/20/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital: Y

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

Lab Data:

Allergies: PCN

Symptom List: Pain in extremity

Symptoms: Pt presented to my office on 4/30 after being vaccinated on 4/20 with left arm swelling. Outpatient stat DVT study in LUE showed extensive thrombosis in veins of LUE and subobcclusive thrombosis in BL Internal Jugular veins. I referred pt to hospital for inpatient admission.

Other Meds: SINEMET, ESOMEPRAZOLE

Current Illness: Parkinsons, AFlutter, AFib

ID: 1277769
Sex: F
Age: 38
State: CA

Vax Date: 04/23/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: Swollen, slight erthyma, and warmth around injection site (about 6cm diameter), appeared 8 days after injection. Discomfort when raising/moving arm. Currently unresolved

Other Meds: None

Current Illness: None

ID: 1277770
Sex: F
Age: 38
State: TX

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Uncontrollable shaking for 3 hours as if having a very high fever. But, I never have a fever. I took Tylenol every 4 hours and would start sweating an hour after taking it.

Other Meds: 50 mg of progesterone/once per day

Current Illness: N/A

ID: 1277771
Sex: M
Age: 59
State: FL

Vax Date: 04/29/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: Nkda

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

Symptoms: Angioedema. Resolved with medications

Other Meds: Lisinopril, uloric

Current Illness: Denies

ID: 1277772
Sex: F
Age: 23
State: PA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/01/2021
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: cat

Symptom List: Vomiting

Symptoms: Fever (Night of 4/27) - fever peaked at 100.4 Nausea (Night of 4/27, day 4/28) Headache (4.28-4.30) Rash (4.28- ongoing/spreading) - rash on arms/stomach, back, and legs - itchy Vivid fever dream

Other Meds: zytrec

Current Illness: none

ID: 1277773
Sex: M
Age: 68
State: NY

Vax Date: 02/19/2021
Onset Date: 03/15/2021
Rec V Date: 05/01/2021
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: Patient reports shoulder pain since receipt of first SARS COV2 vaccine on 1/29/2021. About 4 weeks after receipt of second dose pain became significantly worse . Evaluated by NP on date 3/22/2021 who reported in her note: "Left upper arm below the injection site with hematoma, site warmer than the right arm, no redness."

Other Meds: Current Outpatient Medications on File Prior to Visit: ? ammonium lactate 12 % Lotion, Apply 1 Application topically Daily. ? Atenolol-Chlorthalidone 100-25 MG Tablet, Take 1 tablet by mouth Daily. Indications: High Blood Pressure Disord

Current Illness: None

ID: 1277774
Sex: M
Age: 65
State: IL

Vax Date: 03/08/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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:

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

Symptoms: About 4 weeks after receiving the 2nd vaccine, I performed antibody titers on the patient. There was not antibody response to his TWO Moderna vaccines. He is presently undergoing chemotherapy for Adenocarcinoma of the Lung and this is likely the reason. Problem: What do I recommend from here? A third booster? CDC says to do nothing. I think that's a mistake. Please advise. The patient had no side effect or medical problem with the vaccine - just failure to develop adequate antibodies.

Other Meds:

Current Illness:

ID: 1277775
Sex: F
Age: 31
State:

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: shellfish, gluten, soy, nuts, ibuprofen

Symptom List: Injection site swelling, Limb discomfort

Symptoms: throat itchy, tight, lightheadedness, tingling in hands

Other Meds: Thyroid

Current Illness: NA

ID: 1277776
Sex: F
Age: 29
State: TX

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: On April 22 at 3 pm, I got the vaccine. Then around 5 pm, I feel sleepy. At night I have a low fever and I could not sleep well. On April 23, I feel a little bit pain at the injection area (it swells a little) and feel sleepy sometimes. On April 24, the pain is gone but my arm is still swell a little and a little itchy at the injection area. On April 25-26, the symptoms are gone. On April 27, I start having a hive/rash/itching on my legs/arms/shoulders. I put Calamine lotion to help with the itching and went to sleep. On April 28, when I wake up in the morning, the hive/rash/itching are gone. But it comes back again at night. I take Zyrtec antihistamine. On the morning of April 30, it is gone. But my arm at the injection area started to swell and a bit itchy again .

Other Meds:

Current Illness:

ID: 1277777
Sex: M
Age: 54
State: IN

Vax Date: 03/22/2021
Onset Date: 04/01/2021
Rec V Date: 05/01/2021
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: NKA, NKDA

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

Symptoms: When patient presented to his neurology appointment, patient states approximately 2 weeks after 2nd moderna injection c/o numbness in all fingers.

Other Meds: 1) ALBUTEROL 90MCG (CFC-F) 200D ORAL INHL INHALE 2 PUFFS ACTIVE BY MOUTH AT BEDTIME AS NEEDED FOR SHORTNESS OF BREATH 2) AMLODIPINE BESYLATE 10MG TAB TAKE ONE TABLET BY MOUTH ACTIVE EVERY DAY

Current Illness: 1. Sleep Apnea 2. Benign essential hypertension 3. Diabetes Mellitus 4. Depression 5. Hyperlipidemia 6. Obesity 7. Primary Aldosteronism 8. Disorder of Infancy, Childhood, or Adolescence NOS Asthma - says he outgrew it 9. Personal History of Surgery to other Organs Cholecystectomy 10. Visual Disturbance Myopia Refractory Errors Presbyopia Astigmatism, Regular 11. Meralgia paresthetica 12. Insomnia * 13. Drug Dermatitis Nos 14. Benign neoplasm of skin of eyebrow 15. Myopia 16. Presbyopia 17. Flatfoot * 18. Arthralgias 19. Umbilical hernia without mention of obstruction or gangrene 20. Vertigo 21. Migraine with aura 22. Drug Induced Headache, not Elsewhere Classified 23. Hyperlipidemia 24. Hypokalemia 25. Non-alcoholic fatty liver 26. Allergic rhinitis 27. Arthritis 28. Obstructive sleep apnea syndrome 29. Type 2 diabetes mellitus 30. Cervicalgia 31. Migraine without aura 32. Depression 33. Seizure 34. Aldosteronism 35. Perianal abscess

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm