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: 1280550
Sex: M
Age: 16
State: WA

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: Vaccine administered by volunteer to an individual less than 18 years of age.

Other Meds:

Current Illness:

ID: 1280552
Sex: F
Age: 32
State: FL

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: Penicillin, amoxicillin, anything in the Oxy- family of pain killers. (Hydro is fine)

Symptom List: Anxiety, Dyspnoea

Symptoms: Tingling and numbness, pins and needles in my hands and lower arms. Not weakness. Just asleep all the time. Started day after vaccine and is still ongoing. It has not gotten any better, if anything it?s worse.

Other Meds: Adderall, advare, Vintolin, singulair, Pramipexole, Low-ogestrell-28, zophenex

Current Illness:

ID: 1280553
Sex: F
Age: 60
State: MD

Vax Date: 04/05/2021
Onset Date: 04/13/2021
Rec V Date: 05/02/2021
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: hypersensitivity reaction to ceftaroline, feline allergy, codeine, terramycin

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

Symptoms: Hives, swelling, pain at injection site eight days after injection; started taking Benadryl; went on to get hives on body 24 hours later then started with severe migraines; was sick for five days. Six days later I noticed a blind spot in my left eye field of vision which was diagnosed to be Optic Neuritis for which I have been hospitalized and treated for and have been very ill since.

Other Meds: CoQ-10, vitamin D,C, zinc

Current Illness: No

ID: 1280554
Sex: M
Age: 46
State: MA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Extreme lethargy and feelings of general malaise.

Other Meds: Montelukast sodium 10mg

Current Illness: None

ID: 1280555
Sex: F
Age: 27
State: NC

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

Lab Data:

Allergies: None

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

Symptoms: I am a 27 year old female with no medical conditions. Received my first Moderna shot Friday 5:30 pm, and I felt fine immediately afterwards but developed a sore arm (at injection site) within 2-3 hours, which intensified Saturday. No redness nor swelling in the arm, just the pain. Saturday I had stronger arm pain accompanied by constant neck pain, lymph node pain and headache. I also experienced random intermittent pains in the left chest (I have occasionally experienced chest pain in the past), side (left), and lower back. After these appeared I experienced what felt like an anxiety attack, with uncontrollable crying, shortness of breath and worry. My partner helped calm me. Today, Sunday, body aches are gone minus the sore arm, for which the pain is about 75% reduced.

Other Meds: 28 day birth control (norgestimate and ethinyl estradiol), Kirkland multivitamin gummies (2/day), iron supplement 65 mg (1 time dose morning day of vaccination. Not a regular supplement)

Current Illness: None

ID: 1280556
Sex: F
Age: 16
State:

Vax Date: 04/30/2021
Onset Date: 04/30/2021
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: Headache, fatigue, fever (100)

Other Meds: Birth control,

Current Illness:

ID: 1280557
Sex: F
Age: 41
State: NY

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: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient c/o heat beating fast. On initial assessment she was noted to be tachycardia at 111. Benadryl was given. Pulse went down to 103- sent home. Advised to go to ER if she feels worse

Other Meds: None

Current Illness: None

ID: 1280558
Sex: M
Age: 16
State: WA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: A volunteer at a mass vaccination site inadvertently administered this vaccine to a 16-year-old

Other Meds:

Current Illness:

ID: 1280559
Sex: F
Age: 33
State:

Vax Date: 03/24/2021
Onset Date: 03/28/2021
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: patient received covid vaccine while breastfeeding. infant developed mild congestion 4 days after mother received both doses of vaccine. Infant's symptoms self resolved over several days. no medications needed.

Other Meds:

Current Illness:

ID: 1280561
Sex: M
Age: 79
State: MI

Vax Date: 04/06/2021
Onset Date: 04/09/2021
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: Has multiple allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 20-30 blisters on right and left arm

Other Meds: Unknown

Current Illness: none

ID: 1280562
Sex: F
Age: 44
State: CA

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

Lab Data:

Allergies: None per client

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

Symptoms: Client received Pfizer-BioNTech COVID-19 Vaccine with lot number ER8731 EXP. 7/2021 at 1632 on 04/09/2021. Client reported to EMT complaints of dizziness, dry tongue, and tachycardia. EMT noted heart rate to be accelerated on initial assessment. Medical history was reviewed and client disclosed history of hypotension. Client was unable to move from seat/seated position in observation area to zero-gravity chair. While remaining seated and upright, client was given water, Gatorade and ice pack for chest; client was alert and oriented to person, place, time and situation. Vital signs at 1705 were blood pressure of 140/98 and heart rate of 64. Client disclosed that had not taken hypotension medication today. Vital signs at 1713 were blood pressure of 128/82, pulse of 64, and client then noted that symptoms had resolved. Vital signs at 1738 were blood pressure of 130/86 and pulse of 64. Client then contacted husband to pick client up. Client denied EMS offer, staff educated to follow-up with health care provider regarding if should receive second Pfizer dose and about further medical care if symptoms returned or escalated. No medications or other interventions were indicated. Client then stood up and ambulated independently out of site, stating client was feeling fine and would like to wait for husband in her car.

Other Meds: None per client

Current Illness: None per client

ID: 1280563
Sex: M
Age: 58
State: VA

Vax Date: 04/20/2021
Onset Date: 04/28/2021
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: Zyrtec (causes joint swelling)

Symptom List: Rash, Urticaria

Symptoms: Swelling and pain in left foot with a dark red lesion on the left pinkie toe. Difficult and painful to put pressure on the foot when first standing, but will gradually subside enough to walk with a limp. Started as a sore pinkie that gradually increase in soreness. Lesion and swelling was very pronounce on 4/30/2021. Swelling hit a peak on 5/01/2021, appears to be significantly less on 5/02/2021.

Other Meds: Vitamin D (1,000 iu /day)

Current Illness: None

ID: 1280564
Sex: M
Age: 16
State: WA

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:

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

Symptoms: A volunteer at mass vaccination site inadvertently administered vaccine to a 16-year-old (ineligible to receive Moderna vaccine)

Other Meds:

Current Illness:

ID: 1280565
Sex: F
Age: 38
State: CA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin, Amoxicillin and Clyndimycin

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

Symptoms: Numb tongue, side of face and arm all on right side. Coming and going.

Other Meds: Oral contraceptive

Current Illness: Tick bite on 4/9, took antibiotic preventative no further symptoms

ID: 1280566
Sex: F
Age: 27
State: NY

Vax Date: 04/25/2021
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: N/a

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

Symptoms: On Monday I had chills which were expected and no big deal, but on Tuesday, I experienced severe nausea, loss of appitite, and lightheadedness to a point where I had to call an ambulance. The side effects of nausea, loss of appitite, and lightheadedness havent gone away, but they are not as bad as Tuesday. The symptoms are at their worst during the mid day.

Other Meds: Metformin

Current Illness: No

ID: 1280567
Sex: F
Age: 39
State: CO

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

Lab Data:

Allergies: Dilantin

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

Symptoms: Significant constipation, moderate nausea (no vomiting), mild headache (I never get headaches), moderate fatigue and weakness.

Other Meds: Humira, Hydroxychloroquine, Sertraline

Current Illness: None

ID: 1280569
Sex: F
Age: 34
State:

Vax Date: 04/30/2021
Onset Date: 05/01/2021
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: Anything with sulfates or sulfate like compound.

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

Symptoms: My entire back felt like it had a sunburn. Sensitive and slightly painful when touched. Balance issues when walking or standing. Slight brain fog.

Other Meds: Birth control

Current Illness:

ID: 1280570
Sex: F
Age: 40
State: IN

Vax Date: 04/24/2021
Onset Date: 04/25/2021
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: Arthramyesin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Break out of cold sores....5 in all. Which is unusual since I have a break out once a year when I get a cold and it is only one blister not 5.

Other Meds: Lithium, Adderall, latuda

Current Illness: None

ID: 1280571
Sex: F
Age: 39
State:

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: The patient was vaccinated and said that she feels dizzy, nervous. The patient sat on the chair ,passed out and had a seizure.

Other Meds:

Current Illness:

ID: 1280572
Sex: M
Age: 50
State: IN

Vax Date: 04/30/2021
Onset Date: 04/30/2021
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: Zoloft, toradol, morphine

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

Symptoms: Headache, fever, chest pain, body aches, tiredness, muscle spasms in stomach area.

Other Meds: Tylenol, Prozac, Valium, Trazodone, Prilosec, Calcium, Zinc, Magnesium, Zetia, Metoprol, Wellbutrin

Current Illness:

ID: 1280573
Sex: M
Age: 16
State: WA

Vax Date: 04/30/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: A volunteer inadvertently administered vaccine to a 16yo (ineligible for Moderna)

Other Meds:

Current Illness:

ID: 1280574
Sex: F
Age: 20
State: MN

Vax Date: 04/29/2021
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: Unevaluable event

Symptoms: Headache lasting 36 hours. Heavy menstrual cycle on the day after receiving the vaccine. I had to change my tampon every 2 hours.

Other Meds: Nexplanon Implant in left arm.

Current Illness: None

ID: 1280575
Sex: F
Age: 59
State:

Vax Date: 04/16/2021
Onset Date: 04/18/2021
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: abducens nerve palsy right and fever

Other Meds:

Current Illness:

ID: 1280576
Sex: F
Age: 57
State: NC

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

Lab Data:

Allergies: morphine, ketorolac, meperidine, latex

Symptom List: Injection site pain, Pain

Symptoms: Anaphylaxis. Patient experienced shortness of breath, tingling in hands and arms, cold chills, and feeling faint.

Other Meds: Duloxetine 30mg, celecoxib 100mg, dicyclomine 20mg, Nucynta 50mg, sertraline 50mg,

Current Illness:

ID: 1280577
Sex: F
Age: 44
State:

Vax Date: 04/24/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Augmentin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Red, itchy, welt appeared a week post vaccination at the injection site. The welt is hot to touch and the spot is hard and painful.

Other Meds: Ambien Vitamin D Potassium Magnesium Daily vitamin

Current Illness: Non-COVID virus three weeks prior to vaccination

ID: 1280578
Sex: F
Age: 29
State: IA

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

Lab Data:

Allergies: None

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

Symptoms: Premature rupture of membranes at 34w3d gestation. Treatment= antibiotics, betamethasone injection, labor induction

Other Meds: Prenatal Vitamin

Current Illness: None

ID: 1280579
Sex: M
Age: 17
State: WA

Vax Date: 04/30/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Volunteer administered this vaccine to a 17-year-old (although per document review, this patient had received first dose of Moderna at a different site on 3/26/2021)

Other Meds:

Current Illness:

ID: 1280580
Sex: F
Age: 81
State: FL

Vax Date: 02/23/2021
Onset Date: 03/05/2021
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: Penicillin, some pollen

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Tinnitus began within a week of first Pfizer injection. Seemed a bit better, comes and gets a bit better, never leaves after 2nd injection, both ears affected...

Other Meds: None

Current Illness: None

ID: 1280581
Sex: F
Age: 74
State: MA

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: RA

Lab Data:

Allergies: None

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

Symptoms: 12 hours after the shot, the symptoms appeared. Fever; chills; headache; muscle cramps. Fever broke after about 12 hours. Healing began. Never had medical care.

Other Meds: Flexeral Amyitriplyne Imitrex Clonapin Oxycodone Metformin Statin Proton-Pump inhibitors

Current Illness: None

ID: 1280582
Sex: F
Age: 51
State: OH

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

Lab Data:

Allergies: Codeine

Symptom List: Nausea

Symptoms: Horrible headache, stuttering, loss of speech within 12 hours of shot, pain and weakness down left side, fever, chills, arm swollen and red and hot to touch, extreme fatigue, shaking.. Loss of taste and smell. O2 levels dropped to 80s. Symptoms still have not fully resolved, but speech has returned and O2 levels returned to normal. Still have horrible headache and arm is still swollen, red and hot to touch. Still have a fever.

Other Meds: Vitamin D3, Lisinopril, Metformin

Current Illness:

ID: 1280583
Sex: M
Age: 30
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Injection site pain

Symptoms: Approximately 15 minutes after administering the first dose of the Moderna vaccine, patient started to feel fatigued and was sweating profusely. Checked patient's temperature and it was decreasing. Patient appeared to be disoriented and was going to pass out. Patient was seated the entire time and did not move. Ambulance came and checked patient's vitals and took him to the hospital.

Other Meds: n/a

Current Illness: n/a

ID: 1280584
Sex: F
Age: 25
State: AZ

Vax Date: 04/28/2021
Onset Date: 04/29/2021
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: Pencillin, Latex

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

Symptoms: So there was no symptoms that day but 1;00am the next day I had chills and then the next morning I had a 101.5 fever I then took Tylenol every four hours my fever broke during the night I then was able to go one with other activities. I also had some aches.

Other Meds: Lexapro

Current Illness:

ID: 1280585
Sex: M
Age: 17
State: WA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Volunteer inadvertently administered this vaccine to a 17yo (not eligible for Moderna).

Other Meds:

Current Illness:

ID: 1280586
Sex: F
Age: 29
State: TX

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

Symptom List: Tremor

Symptoms: COVID-19 Vaccine EUA; On April 22 around 6pm, I felt dizzy when I was eating. So, I stopped eating and got rest and that made me feel better. April 23 to April 28, the dizziness comes and goes during the day each day. Mostly, it comes when I eat, and I feel like my head are heavy sometimes. I seen a doctor about the dizziness on April 26 and he ordered a blood test for me, and the result came back normal. I felt better on April 30, less dizzy.

Other Meds: Women's daily multivitamin gummies

Current Illness:

ID: 1280587
Sex: M
Age: 17
State: WA

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Volunteer inadvertently administered this vaccine to a 17yo (ineligible for Moderna).

Other Meds:

Current Illness:

ID: 1280588
Sex: M
Age: 17
State: WA

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

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

Symptoms: A volunteer inadvertently administered this vaccine to a 17yo (ineligible for Moderna).

Other Meds:

Current Illness:

ID: 1280589
Sex: F
Age: 61
State: NY

Vax Date: 04/07/2021
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: None.

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

Symptoms: On the night of Saturday May 1 I fainted in the street (injuring my face and breaking a front tooth) and was transported to ER.

Other Meds: None.

Current Illness: None.

ID: 1280590
Sex: F
Age: 39
State: OK

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Red rash, circular in shape, very painful, hot to the touch, itchy, fever, flu like symptoms. Red and swollen at injection site, covering about 3-4 inches around.

Other Meds: Fluoxetine, buproprion

Current Illness: None

ID: 1280591
Sex: F
Age: 79
State: ID

Vax Date: 02/03/2021
Onset Date: 02/01/2021
Rec V Date: 05/02/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: statins

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

Symptoms: Experiencing progressive weakness and numbness in arms and hands. Legs feel heavy. Hands become stiff and freeze in position, occasionally cramping. I've described the arm and leg sensations as "dead arm" and Heavy legs. Also have a feeling in them that I can't describe. I started paying attention to this in early March. Now it is frequent?several times a day lasting for 15 to 20 minutes.

Other Meds: Albuterol, symbicort

Current Illness:

ID: 1280592
Sex: F
Age: 60
State: TX

Vax Date: 02/27/2021
Onset Date: 02/28/2021
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: wheat

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

Symptoms: First symtom occurred after shot while driving home: I can only explain it as as 'rush' in my head; some kind of dizziness I've never had. 1:30 am on 2/28/21: Chills and fatigue. The next day and since then I have had: extreme fatigue, malice, headache, extreme joint pain, dizziness. I still have it today on 5/2/21. I cannot search for a job, I feel debilitated.

Other Meds: Cymbalta, amitriptyline, clonazapame, estrogen, progesterone, gamapintine

Current Illness: Fibromyalgia

ID: 1280593
Sex: F
Age: 68
State: WA

Vax Date: 02/27/2021
Onset Date: 02/28/2021
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: none

Symptom List: Pain in extremity

Symptoms: [ second Shot on 2/27/2021] on 2/28/2021 woke up early morning with severe headache. By evening I started feeling seve muscle pains and fatigue and chills.. ALso had sevre nausea and vomiting although I didnt eat anything due to nauses and tiredness. On 3/1/2022 right ear started chirping and clicking with post nasal drip- took Allegra_D 12 hr for couple of days. EAr ringing was maddening non stop like an alrm with 2 pitches - slightly low followed by high pitch throught out night and day for almost 10 days. Was devastating depressing . Went to ENT who did not see anything wrong, Audiologist just confirmed [what I already knew and had for 2 years}-hearing loss. and tinnitus.

Other Meds: none

Current Illness: General headaches- tension and migraines

ID: 1280594
Sex: M
Age: 30
State: GA

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: none listed

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

Symptoms: Patient was anxious before vaccination, I spoke with patient to calm him then adminstered vaccine. During the 15 minute waiting period, the patient passed out and fell face forward onto the floor. We administered ice packs, monitored blood pressure (which remained normal) and called 911. Emergency personnell took over care an monitored blood glucose (98) and bp. Patient was monitored in an abulance and then allowed to leave on his own will.

Other Meds: none listed

Current Illness: none listed

ID: 1280595
Sex: F
Age:
State: TX

Vax Date:
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Covid arm

Other Meds:

Current Illness:

ID: 1280596
Sex: F
Age: 72
State: CA

Vax Date: 02/19/2021
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: Sulfa, hay fever

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

Symptoms: Woke up with numbness and tingling on left side of top of head, forehead, left eyebrow, left eye, L nostril and L upper lip and L upper teeth which has remained for since March 24, 2021 onset. Seeing Neurologist on May 17, 2021

Other Meds: metoprolol, Zyrtec, vitamin D, AREDS

Current Illness: none

ID: 1280597
Sex: F
Age: 29
State: TX

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

Lab Data:

Allergies: No

Symptom List: Vomiting

Symptoms: Lymph node swelling in the armpit and neck area (right side)

Other Meds: Apri birth control

Current Illness: No

ID: 1280598
Sex: F
Age: 46
State: CA

Vax Date: 12/19/2020
Onset Date: 12/26/2020
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: sulfa medications

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 5 days after first dose, tips of toes on both feet and one finger on right hand started to develop petechiae. Red/purple raised blisters formed. Painful, cold to touch. Contacted a provider for video visit. Told this was " covid-toes" due to exposure or reaction to vaccine. Advised to use antibiotic ointment and wrap feet for warmth. Employer contacted at this time and told of symptoms. I was sent home, and swabbed nasally for testing. Covid -19 test was negative at this time. Returned to work. Condition worsened significantly after second dose of vaccine. Tips of toes turned blue, cold to touch and numbness started. blisters worsened. Painful to walk at this time. Had another video visit. Told this could be an auto immune disorder that was dormant triggered by vaccine, or reaction. Advised to elevate feet, wrap and wear socks continually for warmth. Go to ER is numbness continued. ER visit in my town at this time was very long and advised to go only if needed. Condition stayed the same for whole month of jan. Blisters healed beginning of feb. However red scars/left. Then tips of toes tuned blue. feet went numb for hours at at time. I kept a diary and pics of all events

Other Meds: none

Current Illness: none

ID: 1280599
Sex: F
Age: 66
State: NY

Vax Date: 03/08/2021
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: ASA, NSAIDs

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

Symptoms: Deep venous thrombosis

Other Meds:

Current Illness:

ID: 1280600
Sex: F
Age: 17
State: NJ

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Error: Patient Too Young for Vaccine Administered

Other Meds:

Current Illness:

ID: 1280601
Sex: M
Age: 34
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None known

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

Symptoms: Fatigue, muscle soreness, headache, injection site soreness. No treatment. Symptoms significantly better with 48 hours.

Other Meds: None

Current Illness: None

ID: 1280602
Sex: M
Age: 54
State: FL

Vax Date: 04/05/2021
Onset Date: 04/08/2021
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: None

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

Symptoms: Began developing rash on both arms with severe itching. Initially appeared as typical hives/Swollen skin. Now has progressed to entire body. Looks somewhat like chicken pox. Has crusty top in mornings and leaks fluid when scratched. Provider gave me topical cream but no positive results.

Other Meds: Morphine Sulfate Lyrica Lamotragine Omeprazole Risperidone Methylphenidate

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm