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: 1279576
Sex: M
Age: 45
State: MA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1279577
Sex: F
Age: 61
State: CA

Vax Date: 04/20/2021
Onset Date: 04/30/2021
Rec V Date: 05/02/2021
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: Rash/hives on face, neck, upper chest, arms. Mild itching everywhere else.

Other Meds:

Current Illness:

ID: 1279578
Sex: F
Age: 31
State: NY

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/02/2021
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: Fever of 100-101, chills, headache, body aches, nausea starting in the middle of the night after receiving vaccine earlier that day and lasting for about 24 hours.

Other Meds: Loryna birth control, Zyrtec

Current Illness: None

ID: 1279579
Sex: M
Age: 24
State: CA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/02/2021
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: Systemic: syncope-Mild, Additional Details: pt was okay after shot. he blacked out and fell face down as he was lowering himself to sit in chair for observation. his face hurt and was bleeding from hitting and rubbing the carpet, and his glasses broke. he stayed on the ground for about 15 minutes, then called girlfriend to come be with him. then he called some other friends to come help drive his car back.

Other Meds:

Current Illness:

ID: 1279580
Sex: F
Age: 46
State: WV

Vax Date: 03/08/2021
Onset Date: 03/19/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: Poison ivy, cashews, mangos

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

Symptoms: Shingles

Other Meds: Wellbutrin, melatonin, biotin, Metamucil

Current Illness: None

ID: 1279581
Sex: F
Age: 26
State: IN

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/02/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Chills, headache, and fever

Other Meds:

Current Illness:

ID: 1279583
Sex: F
Age: 65
State: TX

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/02/2021
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: Site: Bruising at Injection Site-Severe, Site: Itching at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Additional Details: patient came to pharmacy friday night 4/30 stating she received a shot on monday 4/26. she said she experienced pain and swelling and now she has a large inflamed bruise on her arm. blackish red bruise she states it does not look right for a vaccine.

Other Meds:

Current Illness:

ID: 1279594
Sex: M
Age: 36
State: PR

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Pharyngeal swelling

Symptoms: Broncospasm - Solumedrol

Other Meds:

Current Illness: Asma

ID: 1279595
Sex: F
Age: 35
State: CO

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 05/02/2021
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: Ancef

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: High temperature 104.3 12/31 I am Trouble breathing Extreme chest pain still continuing 1/5/21

Other Meds: omeprazole, milk thistle

Current Illness: Covid-19 / Pneumonia Dec 1 - Dec 11

ID: 1279596
Sex: F
Age: 46
State: CO

Vax Date: 12/23/2020
Onset Date: 12/29/2020
Rec V Date: 05/02/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa(rash) , codeine(vomit)

Symptom List: Diarrhoea, Nasal congestion

Symptoms: redness titching over R deltoid

Other Meds: immunity MD, lh immune new, stress B-Complex >one capsule each

Current Illness: N/A

ID: 1279597
Sex: F
Age: 71
State: LA

Vax Date: 12/29/2020
Onset Date: 01/01/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: Hydrocodone/Codiene

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

Symptoms: 3 inch by 2 inch oval bruise (red/brown in color) with yellow border located on inner left arm. Warm to touch. Patient reports pain after injection but has since resolved.

Other Meds: ASA, Alprazolam, Temazepam, Calcium, Vitamin E&C, APAP,

Current Illness: NO

ID: 1279629
Sex: M
Age: 29
State: IL

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 05/02/2021
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: Fever, headache, chills, swollen lymph node under armpit

Other Meds: None

Current Illness: None

ID: 1279630
Sex: F
Age: 20
State:

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, peanuts, tree nuts

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

Symptoms: Headache, muscle aches, rise in temperature (not fever) for a little of 12 hours, treated with ibuprofen, cold compresses, and limited mobility through the day.

Other Meds:

Current Illness:

ID: 1279631
Sex: F
Age: 25
State: FL

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 05/02/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)

Other Meds:

Current Illness:

ID: 1279632
Sex: F
Age: 56
State: FL

Vax Date: 04/27/2021
Onset Date: 04/29/2021
Rec V Date: 05/02/2021
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: Latex

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

Symptoms: Same day: headache and dry mouth, sore injection site 2nd day: headache worsened, dry mouth worsened, site was hot to touch, red and swollen; could not sleep that night due to headache, pressure on chest and sore arm; fever began 3rd day: Fever measured at 102 in morning, skin all over very painful to touch, chest pain faded while other symptoms began - fatigue, nausea, continued headache and extremely faint (light-headed every time I attempted to stand or walk), arm redness and swelling still 4th day: Fever measured 101.4 in morning, continued symptoms as day 3, but nausea improved, new added musle (thigh aches) and joints in fingers. Inje 5th day: Fever measured 100.5 in morning, nausea gone, skin pain gone

Other Meds: Progesterone

Current Illness: None

ID: 1279633
Sex: F
Age: 36
State: MA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/02/2021
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: Bactrim [Sulfamethoxazole-trimethoprim] Cetyl Alcohol LanolinRash Sulfa (Sulfonamide Antibiotics)Other (See Comments) Weed Pollen-short RagweedOther (See Comments)

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

Symptoms: Systemic Reaction o 7/10 pain, cramping both legs described as moderate interrupting sleep, started 7hrs post vaccine. Improved by next day. o Migraine with nausea, worse with bending over, however has chronic daily migraines, improved next morning. o 3/10 abdominal pain, resolved next morning.

Other Meds: Medications (very important) New medications from outside sources are available for reconciliation betamethasone, augmented, (DIPROLENE) 0.05 % ointment Apply 1 application topically 2 (two) times a day. botulinum toxin type A (BO

Current Illness: Cardiovascular and Mediastinum Sinus tachycardia Endocrine Hypothyroidism Carnitine deficiency Rheumatology Chronic interstitial cystitis Neuro and EENT Migraine Dysautonomia Narcolepsy Gastrointestinal Gastroesophageal reflux disease Genitourinary Vulvodynia Vaginitis and vulvovaginitis Behavioral and Developmental Anxiety Attention deficit hyperactivity disorder (ADHD), predominantly inattentive type Signs and Symptoms Chronic fatigue and malaise

ID: 1279634
Sex: F
Age: 41
State: CA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 05/02/2021
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: 11 hours after injection, chills, fevers, sweat, extreme body aches, throwing up, headache, fatigue, and swelling at injection sight. I have not been that sick in 15+ years. 48 hours after, there was tightness and tenderness my throat; and swelling and pain of lymph node (right breast). Currently (2 weeks after), still swelling and soreness in lymph node (right breast).

Other Meds: Multi vitamin

Current Illness: None

ID: 1279635
Sex: F
Age: 25
State: PA

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

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

Lab Data:

Allergies: duloxetine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient reported experiencing pain, redness, and a little swelling in the injection area about 30 minutes post vaccination. She went on to have typical side effects (fever, muscle pain, injection site reaction) over the past 3 days, However today when she presented at the pharmacy she said the reaction in her left arm where the vaccine was given had continued to grow worse. She described it as hot, painful and hard to the touch, She also relayed she had been experiencing significant muscle pain only in that arm (the entire arm) as well as some numbness in her left hand and wrist. She did indicate she had previously had an issue with numbness that had since resolved and could not say definitely it was related to the vaccination.

Other Meds: methylphenidate, lorazepam, fluoxetine, amlodipine

Current Illness: none indicated but patient previously had Covid 19 in November 2020

ID: 1279636
Sex: M
Age: 26
State: OH

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 05/02/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Patient had a syncope event shortly after receiving Janssen Covid vaccine. Patient put feet up and laid back for additional 10 minutes after initial 15 minute observation. BP and Pulse were not significant (176/79 and 79). Patient recovered after 25 minutes and went home.

Other Meds:

Current Illness:

ID: 1279637
Sex: M
Age: 37
State: AZ

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Starting about 5 hours after second Moderna shot started experiencing fatigue and chills. Felt very bad all day the next day. Low fever, chills, severe body aches, and occasional waves of nausea. Symptoms disappeared after approximately 36 hours.

Other Meds: Claritin

Current Illness: Had a mild cold approximately one month prior. Confirmed not Covid-19 via testing.

ID: 1279638
Sex: F
Age: 56
State: MD

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 05/02/2021
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: Loss of Taste and Smell on April 15, 2021 the day after receiving my 1 shot. I took Benadryl.

Other Meds: None

Current Illness: None

Date Died: 01/31/2021

ID: 1279639
Sex: F
Age: 69
State: VA

Vax Date: 01/19/2021
Onset Date: 01/31/2021
Rec V Date: 05/02/2021
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: Unevaluable event

Symptoms: Sudden fatal heart attack. Patient went from a medically well person of 69 and died suddenly of PES within 2 weeks of dose. Patient reported arm pain, fatigue, and coldness to extremities

Other Meds: Pfizer dose: EL1283 Patient passed away suddenly less than 2 weeks after vaccination. Hospital marked as fatal arrhythmia, patient autopsy report showed a recent bleed prior to the event cause of death was guessed as heart attack. The only

Current Illness:

ID: 1279640
Sex: M
Age: 21
State: FL

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Shakiness-Mild, Additional Details: he fell

Other Meds:

Current Illness:

ID: 1279641
Sex: F
Age: 81
State: FL

Vax Date: 03/10/2021
Onset Date: 03/13/2021
Rec V Date: 05/02/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: Three days after injection 1 I developed a server tooth ache that lasted three days. two weeks after second shot I developed a severe toothache that has lasted five days and still persists will be seeing a dentists on 5/02.2021. ( hopefully) Is this a known symptom of the covid vacination.

Other Meds: none

Current Illness: none

ID: 1279642
Sex: F
Age: 23
State: TN

Vax Date: 04/15/2021
Onset Date: 04/28/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: Zithromax, latex, and lactose intolerant

Symptom List: Injection site pain, Menorrhagia

Symptoms: I have PCOS and only get my period every few months (approx 2-3 times a year). When it does finally come I have no bloating or breast pain, but I do get occasional cramping and very very heavy bleeding with many blood clots. My first period since the second dose has been incredibly light and the complete opposite of what it normally is. Brest pain, bloating and very light flow. No clots, no heavy flow, no cramping. I've heard lots of other girls talk about how they've had terrible periods after their second dose when they usually have normal ones so I figured I should report that I've had the opposite effect.

Other Meds: Occasional ibuprofen

Current Illness:

ID: 1279643
Sex: F
Age: 23
State: CA

Vax Date: 04/30/2021
Onset Date: 05/02/2021
Rec V Date: 05/02/2021
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: Penicillin, amoxicillin, prochlorperazine

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

Symptoms: Began getting hives at 6am on arm of injection site as well as face, right arm, and both legs. Took a Benadryl to combat hives reaction and drank lots of fluids. Took ibuprofen (400mg) to assist in pain experienced at the injection site.

Other Meds: Yasmin birth control

Current Illness: None

ID: 1279644
Sex: F
Age: 26
State: NY

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/02/2021
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: Had an allergic reaction to to Catscan contrast once. I also have an intolerance to gluten/wheat

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Immediately agter receiving the shot I broke out into a sweat and began to feel lightheaded. My eyes started to blur like I could pass out. The pharmacist/doctors at CVS gave me some water and told me to elevate ny legs. After 10 minutes they checked my termperature and blood pressure. I stabized somewhat and when home. I was sure it it was my nerves but something did feel right. I had a slight burning in my chest and felt queezy on/off throughout the day. Chills and hot flashes followed. I was anxious and paranoid about the possibility something serious coukd be wrong with me. I felt shooting pains in my lower left abdomen that nught and the next day. The following day I still felt very weak. My arm hurt. My muscles felt like jello and I?m unhappy. I wish I never got the shot and I?m worried about my body?s reaction to it.

Other Meds: None. I skipped my vivanse that day in order to keep my body clear of any other substabces. I had a smoothie for breakfast.

Current Illness: None.

ID: 1279645
Sex: F
Age: 27
State: MD

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: "feeling faint, nauseas", episode of projectile vomiting, LOC-Informed EMS she has a history of N/V and LOC R/T injections and anxiety. Pt. discharged home at 13:50 on . Recorded by RN.

Other Meds:

Current Illness:

ID: 1279646
Sex: F
Age: 63
State: FL

Vax Date: 04/08/2021
Onset Date: 04/15/2021
Rec V Date: 05/02/2021
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: Misc foods; dust; pollen; animal dander. No medications

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

Symptoms: Hot flashes; night sweats

Other Meds: Omeprasole 20mg; Progesterone 200mg; Estradiole patch .025mg; viviscal; Inositol; glucosamine/confronting; vitamins B complex, calcium, biotin, multi-complex

Current Illness: None

ID: 1279647
Sex: F
Age: 53
State: OR

Vax Date: 04/09/2021
Onset Date: 04/21/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Nausea

Symptoms: VERTIGO DIAGNOSED IN ER AS BBPV. HAD NEVER EXPERIENCED BEFORE. RESOLVED WITH EPLEY PROCEDURE. CONTINUED INTERMITTENT LIGHTHEADEDNESS WITH EXTREME FATIGUE AND MUSCLE ACHES CONTINUING SINCE INCIDENT NOW AT 11 DAYS.

Other Meds: NASALCROM ALLERGY NASAL SPRAY

Current Illness: NONE

ID: 1279648
Sex: F
Age: 31
State: CA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain

Symptoms: Hives/rash on the bottom half of both of my legs, specifically near ankles. I still have the hives as of 4/2/2021. I haven't implemented anything new, i.e. beauty products, detergents, food, medications, etc. I think it must be from the vaccine.

Other Meds: Gabapentin, omega

Current Illness: N/A

ID: 1279649
Sex: F
Age: 31
State: MN

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/02/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Body aches and headache for 2 days.

Other Meds: Latuda, lamotrogine, wellbutrin, spironolactone, multi vitamin

Current Illness: No

ID: 1279650
Sex: F
Age: 50
State: PA

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 05/02/2021
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: Penicillin

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

Symptoms: Post vaccine pt started feeling light headed and dizziness on the way out of the facility. Pt was transferred to med obs via wc. Accompanied by daughter. Pt reported feeling better after lying down on stretcher. Vitals obtained and monitored. Pt started feeling better after several minutes of resting on the stretcher. Pt released at 1408 with daughter. Vitals as follows: 1359 LYING BP 155/86 HR 99 RR 14 SpO2 99% 1406 SITTING BP 146/107 HR 81 RR 14 SpO2 100% 1407 STANDING BP 163/79 HR 81 RR 14 SpO2 100%

Other Meds: N/a

Current Illness: N/a

ID: 1279651
Sex: M
Age: 34
State: IN

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 05/02/2021
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 known

Symptom List: Tremor

Symptoms: Lymphodema in left armpit. No treatment. Symptoms resolved in a week.

Other Meds: None

Current Illness: None

ID: 1279652
Sex: F
Age: 80
State: NE

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/02/2021
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: Intense pain across the back, including both shoulders and the neck.

Other Meds:

Current Illness:

ID: 1279653
Sex: F
Age: 57
State:

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 05/02/2021
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: lisinopril

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

Symptoms: Asthma attack- symptoms of cough and perceived wheezing. steadily improved during obs period.

Other Meds:

Current Illness:

ID: 1279654
Sex: M
Age: 30
State: IN

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/02/2021
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: NA

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

Symptoms: Fatigue, soreness in most muscles

Other Meds: Mercaptopurine 100 MG daily; Multivitamins

Current Illness: NA

ID: 1279655
Sex: F
Age: 24
State: IN

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/02/2021
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: Latex

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Woke up at 2am crying from whole body being in pain. Could not stop shivering even when covered in 4 blankets but also sweating. Managed to sleep for a few hours before waking up with the worst headache- it felt like someone had wrapped something around my head and was squeezing. Moving made it worse. Could barely stand and head was foggy.

Other Meds: N/A

Current Illness: N/A

ID: 1279656
Sex: F
Age: 61
State: FL

Vax Date: 02/11/2021
Onset Date: 03/25/2021
Rec V Date: 05/02/2021
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: hydrocodone

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

Symptoms: ongoing continuous metallic pasty taste

Other Meds: Mucinex, Rhinocort Aqua NS, Allegra, Singulair

Current Illness: none

ID: 1279657
Sex: F
Age: 53
State: CO

Vax Date: 03/20/2021
Onset Date: 04/13/2021
Rec V Date: 05/02/2021
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: Amoxicillin Sulfa Tegratol

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

Symptoms: I developed Bell?s Palsy just over 3 weeks after my 2nd dose of the vaccine. I don?t know if this was due to the vaccine because I know that Bell?s Palsy can come on for unknown reasons, but because of the proximity to the vaccine and the other questionable abnormalities that are being associated with the vaccine, my doctor thought it would be useful for me to report this.

Other Meds: Vimpat 200mg 3X/day DULoxetine HCL DR 30 mg/ day Topiramate 25mg morning and 50mg at night Xiidra 5% eye drops 2X/day Estradiol 2mg tablet Progesterone 100mg capsule

Current Illness:

ID: 1279658
Sex: M
Age: 20
State:

Vax Date: 04/20/2021
Onset Date: 04/30/2021
Rec V Date: 05/02/2021
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: Pain in extremity

Symptoms: Emergence of swollen lymph node / lump on left collar bone

Other Meds: Daily Mens Multivitamin

Current Illness: None

ID: 1279659
Sex: M
Age: 15
State: MN

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: unknown

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

Symptoms: There were NO adverse events other than that Moderna vaccine was given to this person when they were 15 years old. We did NOT know this because the person gave us an incorrect birthdate which would have made them 18years old. We only found this out when our registry alerted us that this person has a different date of birth making them 15.

Other Meds: unknown

Current Illness: none

ID: 1279660
Sex: F
Age: 35
State: MI

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/02/2021
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: Penicillin, ceclor

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

Symptoms: dizziness, blacking out

Other Meds: Sertraline 125mg, vitamin D, prenatal vitamin with DHA

Current Illness:

ID: 1279661
Sex: M
Age: 61
State: OR

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 05/02/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Day 1: After 11 hours the horrible body & joint aches began, then severe shivering. I moaned and groaned all night bundled up w/ sweatshirts and blankets. Day 2: I slept most of the next day w/ shivers covered in blankets. Drank lots of liquids & had soup. That night I broke a fever. Day 3: Shivers went away. Body aches were mild but I was still very tired and napped during the day. Day 4: Aches were gone, just felt a little run down. Day 5: Okay

Other Meds: None

Current Illness: None

ID: 1279662
Sex: F
Age: 35
State: MA

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 05/02/2021
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: NKA

Symptom List: Vomiting

Symptoms: After receiving 2nd vaccine on 2/14/2021, she experienced chills and body aches for 72 hrs. No medication intervention needed.

Other Meds: None

Current Illness: None

ID: 1279663
Sex: F
Age: 33
State: DC

Vax Date: 01/31/2021
Onset Date: 02/07/2021
Rec V Date: 05/02/2021
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: About one week after vaccine (noted after both the first however worse after the second) palpitations to 120 beats per minute, shortness of breath, chest tightness and chest pain, and fatigue present intermittently daily for 2 months now.

Other Meds: Magnesium Oxide Multivitamin Vitamin D

Current Illness: None

ID: 1279664
Sex: F
Age: 24
State: PA

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/02/2021
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: 8 hours after vaccination, felt tightness in chest, chills, and nausea. 17 hours after vaccination, felt body aches and headaches for a span of 12 hours.

Other Meds: None

Current Illness: None

ID: 1279665
Sex: F
Age: 62
State: GA

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/02/2021
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: Nausea within 45 minutes, stomach cramp ing; within one hour and vomit; fell asleep for 10 minutes felt better then slep for 4 hours; 2am my surgical hand became inflammed and swollen for 4hours

Other Meds: synthyroid; zyrtec

Current Illness: no illiness-had carpel tunnel release one week prior

ID: 1279666
Sex: F
Age: 52
State: AZ

Vax Date: 03/15/2021
Onset Date: 03/22/2021
Rec V Date: 05/02/2021
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 (light allergy to dust)

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

Symptoms: Ringing in ears 1 week after 1st Moderna COVID-19 vaccination shot. 9 weeks it appears ringing is now in left ear only. Note that the shot (both shots) were on left arm.

Other Meds: None

Current Illness: None

ID: 1279667
Sex: M
Age: 33
State: MD

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 05/02/2021
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:

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

Symptoms: Pt. sitting in chair in observation area -raised his hand. RN went to his chair and assisted patient as he lost LOC. EMT on site and assisted patient back to EMT observation area. Patient stated this is not uncommon for him to have such reaction to include removing wax from his ear also will make him LOC Patient discharged home with a driver. Assisted to care via EMS. Discharged home at 12:35 p.m. Recorded by RN.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm