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: 1282080
Sex: F
Age: 51
State: MN

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
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: Compazine, Sulfa, Cypro

Symptom List: Dysphagia, Epiglottitis

Symptoms: I fainted 5 different times through out the day starting in morning and last spell was 9 pm at night.

Other Meds: Vitamin D, Nortrel 1/35 - Birth Control

Current Illness: I have Multiple Sclerosis. I stopped taking My current MS medication- Kesimpta-Doctor instructed me to stop month prior to Covid Vaccine and restart 2 weeks after last shot.

ID: 1282081
Sex: F
Age: 43
State: MD

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

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

Lab Data:

Allergies: none

Symptom List: Anxiety, Dyspnoea

Symptoms: itching, dizziness and facial swelling sensation. Given PO benadryl. Advise going to ER given persistent itching and feeling her lips and face were swollen and numbness. Normal exam. Patient refused 911 or driving to eR, wants to go home and observe herself for a while

Other Meds: none

Current Illness: none

ID: 1282082
Sex: M
Age: 40
State: GA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/03/2021
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: Aprrox 5 minutes after getting the vaccine started to feel dizzy and light headed. I passed out for a couple minutes. Approx 10 minutes later I felt fine. Don't know if it was a reaction to the vaccine or the fact that I don't like shots all that well, but I was told to report it. This has happened before when I have gotten a shot but it doesn't always happen. I would say its 50/50

Other Meds: None

Current Illness: None

ID: 1282083
Sex: M
Age: 29
State:

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
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: Dizziness. Recommended to give next vaccine in supine position. Stable, released from vaccination site.

Other Meds:

Current Illness:

ID: 1282084
Sex: F
Age: 50
State: KS

Vax Date: 03/13/2021
Onset Date: 04/23/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: Adhesive tape, Codeine Sensitive

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

Symptoms: Increased difficulty breathing, wheezing on inhale, high pitched crowing sounds on inhale and exhale, shortness of breath, fatigue, constant cough, drainage down back of throat, pulse O2 Sat variations, inability to sleep due to wheezing, cough

Other Meds: Fluoxitine, Metformin, Adderall, Levothyroxine, Premarin, Estradiol, Alprazolam, Promethazine, Albuterol Inhaler, Ibuprofen, Pepto Bismol, OTC Allergy Meds, Multivitamin, Fiber Gummies, Butabitol, BREZTRI Inhaler Prednisone

Current Illness: Migraines, Seasonal Allergies

ID: 1282085
Sex: F
Age: 56
State: MD

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/03/2021
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: erythromycin, lopid, augmentin

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

Symptoms: swollen and painful joints in hands and feet

Other Meds: Benicar, singulair, Nexium, lialda, Effexor, vit c, fish oil, calcium plus D

Current Illness: n/a

ID: 1282086
Sex: F
Age: 65
State: NY

Vax Date: 03/27/2021
Onset Date: 04/07/2021
Rec V Date: 05/03/2021
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: Significant amount of Hair falling out

Other Meds: Atavorstatin levothyrixin Metoprolol tartrate

Current Illness: None

ID: 1282088
Sex: F
Age: 45
State: MD

Vax Date: 01/12/2021
Onset Date: 03/22/2021
Rec V Date: 05/03/2021
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: Pharyngeal swelling

Symptoms: Fatigue, New loss of taste or smell, Congestion or runny nose and Nausea or vomiting

Other Meds: NONE

Current Illness: NONE

ID: 1282089
Sex: M
Age: 27
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/03/2021
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: Approximately eight hours after injection, sweeping to severe fatigue began to onset along with severe headache and moderate to severe chills, along with other "flu-like" symptoms, including symptoms of fever but no recorded fever. Lasted through the night and hindered sleep without the help of OTC sleep medication. After 8 hours of overnight sleep, woke up next day feeling better, but still had a terrible headache and a great deal of fatigue. Considered visiting a walk-in clinic or the ER at least four times throughout this timeframe. Symptoms lessened with time with a bad headache and lingering fatigue being the most consistent 24 to 36 hours after the initial injection time. Now May 3 at 1:00pm, several days after, most symptoms have subsided except for some lingering fatigue which still is present.

Other Meds:

Current Illness:

ID: 1282090
Sex: F
Age: 35
State:

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient complained of dizziness, lightheadedness and nausea within 5 mins of receiving her COVID vaccine. Patient states symptoms resolved within 10-15 minutes. Patient lowered herself to ground, flat with legs propped on chair. Patient was transported via stretcher to ACCC after about 15 minutes of being in observation area. Patient states itching all over her body started within 24 hours after her injection Per ACCC report, patient became hypotensive, diaphoretic and shaky.

Other Meds:

Current Illness:

ID: 1282091
Sex: F
Age: 59
State: FL

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

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

Lab Data:

Allergies: Codeine, kiwi

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

Symptoms: Fainted, sweating, lightheaded, dizzy, tingling all over, felt like bugs were crawling under her skin

Other Meds: Levothyroxine

Current Illness: No

ID: 1282092
Sex: F
Age: 59
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/03/2021
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: After the vaccine everything I ate or drank had a strong metallic taste, this lasted for 8 full days.

Other Meds: Multi vitamin

Current Illness: None

ID: 1282093
Sex: M
Age: 27
State: MO

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: trazadone

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

Symptoms: as per my PCP, tendinitis in left upper arm due to the vaccine. Currently undergoing anti-inflammatory naproxen for two weeks and will see how it is after.

Other Meds: levocetirizine, one a day vitamin

Current Illness:

ID: 1282094
Sex: F
Age: 73
State: ND

Vax Date: 02/10/2021
Onset Date: 02/16/2021
Rec V Date: 05/03/2021
Hospital: Y

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: Patient was hospitalized on 2/16/21 after receiving their first COVID vaccination. They also presented to the ED and subsequently were hospitalized on both 3/12/21 and 3/27/21.

Other Meds:

Current Illness:

ID: 1282095
Sex: F
Age: 60
State: CA

Vax Date: 04/23/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
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 known

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

Symptoms: Entire left side of body (shoulder, arm, leg) is in extreme pain, and unable to walk.

Other Meds: None

Current Illness: None

ID: 1282096
Sex: F
Age: 47
State: OK

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

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

Symptoms: Severe pain at injection site, huge knot and redness still today on day 3. Tired, nausea, stomach ache, severe headache, muscle aches. Generally feeling unwell and low grade fever.

Other Meds: Ibuprofen

Current Illness: None

ID: 1282097
Sex: F
Age: 45
State: CA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
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: first shot = very sore arm without redness, moderate headache, mild fatigue no other symptoms second shot friday at 3pm, that night I developed a severe headache, muscle aches, joint aches, too painful to sleep, started dry heaving at 6am saturday morning, major fatigue, slept from 7am until 5 pm saturday, woke nauseated, still muscle and joint aches, fever 100 degrees F on ibuprofen and nyquil, went back to sleep at 9pm saturday, woke 7am sunday, felt much better - no more joint aches, muscle aches greatly diminished, nausea gone, but major headache/throbbing still there, and began experiencing vertigo as soon as I woke. I have only experienced vertigo once before (years ago). Vertigo impacted ability to walk and function normally. Did not cause nausea though. Vertigo lessened over the day, nearly gone by late afternoon Sunday. Headache still present, continued to take ibuprofen/nyquil, woke Monday morning with severe headache and some confusion, only very slight vertigo. Confusion is new. Trying to work from home, having difficulty with comprehension. Just had to listen to a voicemail five times to understand information provided. This is very atypical for me. I feel kind of strange, checked my smartwatch, and my resting heartate went up the day I was vaccinated to higher than it's been since I had a smartwatch (several years ago), still up/increasing, so al though I didn't realize it, I was also experiencing increasing heartrate. It is still increasing. I have gone from 68 on Friday to 70 on Saturday to 72 on Sunday to 74 bpm today. I've never been this high. The increased heart rate, confusion, and dizziness is why I'm deciding to report - headache I am sure happens to everyone.

Other Meds: sertraline, benadryl, ibuprofen

Current Illness: none

ID: 1282098
Sex: F
Age: 37
State: MI

Vax Date: 01/27/2021
Onset Date: 04/25/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies: Iodine Latex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient is a 37-year-old female presents emergency department due to exertional hypoxia in the setting of COVID positive. The patient does look comfortable stable vital signs. With talking she does begin to desaturate to the 80s, but continues to look comfortable

Other Meds: Zofran Phentermine

Current Illness: None

ID: 1282099
Sex: F
Age: 48
State: KS

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

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

Lab Data:

Allergies: Sulfa allergy

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: At 3am I woke up with significant pain in the nodes under my arm pit. Pain at injection site. Stiff neck and pressure in my head. Later that day the stiffness in neck and pressure in head went away. Swelling continued in nodes of arm and got worse. 24-48 hours I iced nodes several times during the day and starting taking Tylenol. Fatigue and nausea set in by 48 hours. 72 hours from injection the swelling decreased slightly under arm, but moved to right clavicle and neck.

Other Meds: None

Current Illness: None

ID: 1282100
Sex: F
Age: 40
State: MA

Vax Date: 04/25/2021
Onset Date: 04/26/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: coconut

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

Symptoms: Vaginal spotting was seen the day after the vaccine was administered and has not stopped yet. This spotting is otherwise unexplainable as it is not within my cycle time, nor am I premenopausal as per bloodwork done in the beginning of the year for my wellness checkup. There has also been no sexual activity to explain the vaginal spotting seen after the vaccine was given.

Other Meds: Iron supplements 27mg

Current Illness: None

ID: 1282101
Sex: F
Age: 38
State: CA

Vax Date: 04/22/2021
Onset Date: 05/02/2021
Rec V Date: 05/03/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: I had a flare up of Herpes on my lip. Prior to that I did not have any flare ups in the prior 3-5 years.

Other Meds: Tazorac

Current Illness: None

ID: 1282102
Sex: M
Age: 47
State: NV

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
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: None

Symptom List: Unevaluable event

Symptoms: Leg cramp alerted me to deep vein thrombosis (DVT) and pulmonary embolism (PE) . I had the second dose of Moderna Monday afternoon. First cramp Tuesday evening. Mild infrequent leg pain Wednesday. Intense morning cramp on Thursday, hospitalized Thursday night with confirmed DVT w/P?. Discharged Sunday afternoon. Was fully hidrates at the time, no recent travel by car or plane. No extended period of inactivity such as bed rest or sitting. No evidence I?d internal trauma or injury. No recent surgery. No sign of any form of cancer. Vaccine listed as suspected cause of the DVT

Other Meds: Atorvastatin. Zyrtec.

Current Illness: None

ID: 1282103
Sex: F
Age: 46
State: CA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/03/2021
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: Congestion, fever, common cold, severe neck pain, swelling and pain in index finger, headache

Other Meds:

Current Illness: Seasonal allergies

ID: 1282104
Sex: M
Age: 42
State: CA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
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: Anectine

Symptom List: Injection site pain, Pain

Symptoms: Pt c/o of tingling in tips of fingers, pins/needles.

Other Meds: Zofran

Current Illness:

ID: 1282105
Sex: F
Age: 53
State: AZ

Vax Date: 03/22/2021
Onset Date: 04/23/2021
Rec V Date: 05/03/2021
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: CVA with thrombosis on 4/23/21

Other Meds:

Current Illness:

ID: 1282106
Sex: M
Age: 31
State: CO

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient received his second dose of the MODERNA vaccine on Thursday, 4/29. He started experiencing flu-like symptoms with fever on 4/30. He stated that he felt fine on 5/1 and went out and had two mojitos. Awoke at ~3 am on 5/2 with subxiphoid/epigstric pain, associated with L elbow pain. His father had an MI in his 30's. Patient is also going through a divorce. Treated in ED with lovenox, Pepcid, morphine, and nitro. Transferred for further management of NSTEMI.

Other Meds: Albuterol INH prn

Current Illness:

ID: 1282107
Sex: F
Age: 51
State: MO

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/03/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt was being administered a vaccination, but the needle retracted during the administration causing the patient to receive only a partial dose. The pt was given another injection to ensure full administration of the full amount.

Other Meds: None

Current Illness: COPD

ID: 1282108
Sex: F
Age: 23
State: IN

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

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient was very very anxious to receive the IMZ. Pharmacist calmed the patient down and administered the IMZ. Patient went over to wait 15 minutes in the post IMZ waiting area . Patient started to become very anxious again while waiting and vomited. Pharmacist came out & assisted and calmed the patient down. Provided water to patient and after patient calmed down & feeling OK patient left with her father. Patient was feeling fine when left with her father.

Other Meds: None

Current Illness: None

ID: 1282109
Sex: F
Age: 25
State: IN

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
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: Antibiotics, acetaminophen

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

Symptoms: By the end of the night I was shivering, with a 102+ degree fever that has responded to ibuprofen and had gotten slightly better within the last couple of days but I still have a 101+ degree fever when not using ibuprofen (when waking up in the morning) it had only been 2 days but it is still very uncomfortable and the degree of fever at first was very scary

Other Meds: None

Current Illness: 1 week prior. Unknown fever, cough, sneezing. (not covid 19, tested twice, negative both times)

ID: 1282110
Sex: F
Age: 52
State: OH

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 05/03/2021
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: Nausea

Symptoms: Patient was given 2nd dose of series too early; administered 23 days after 1st dose.

Other Meds:

Current Illness:

ID: 1282111
Sex: F
Age: 29
State: FL

Vax Date: 04/08/2021
Onset Date: 04/15/2021
Rec V Date: 05/03/2021
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: Injection site pain

Symptoms: I was on mensuration during time and have been bleeding and clotting ever since. Bleeding is still happening. I have very regular periods. So this is very new to me .

Other Meds: Zoloft

Current Illness:

ID: 1282112
Sex: F
Age: 43
State: FL

Vax Date: 04/23/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: Pennicillin

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

Symptoms: On day 1 and day 2 (4/23-4/24) experienced headache and mild fatique. On day 5, (4/27) started noticing involuntary twitching in legs, feet, arms, abdomen, shoulders, and back. This has been occuring daily since the onset.

Other Meds: Vitamin D3, Jubila

Current Illness: N/A

ID: 1282113
Sex: F
Age: 67
State: WA

Vax Date: 03/15/2021
Onset Date: 04/02/2021
Rec V Date: 05/03/2021
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: none

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

Symptoms: Patient got second COVID vaccine on 4/1/21 Lot ER8737. On 4/2/21 she present to ED with R hip pain and was noted to have left lower extremity edema, ultrasound showed near occlusive DVT of L tibial vein. Time course of symptom onset unclear. Started on eliquis and continues to be monitored.

Other Meds: cyclobenzaprine, atorvastatin, levothyroxine, ibuprofen

Current Illness: none

ID: 1282114
Sex: M
Age: 49
State: IN

Vax Date: 04/09/2021
Onset Date: 04/28/2021
Rec V Date: 05/03/2021
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: Tremor

Symptoms: Rash appeared on feet, ankles, lower and upper legs. Dark red itchy blisters, then dark red painful spots. Appears to be vasculitis.

Other Meds: None

Current Illness: None

ID: 1282115
Sex: M
Age: 39
State: IL

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 05/03/2021
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: High-pitched ringing in both ears. More prevalent in right. Both ears 'popping' constantly.

Other Meds: Fish Oil Omega-3 1,600mg Magnesium Oxide 400mg Vitamin D-3 5,000 IU

Current Illness: Mild head cold. No temperature.

ID: 1282116
Sex: F
Age: 40
State:

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
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: Tingling in right hand. Stable, released from vaccination site.

Other Meds:

Current Illness:

ID: 1282117
Sex: F
Age: 51
State: IN

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
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: Penicillin, sulfa, cocoa, pet dander, grass, dust, wool, goldenrod, tomato, cottonseed oil,

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

Symptoms: Rash, swelling of arm and armpit, pain when lifting arm(4/30/2021-5/3/2021), fever(5/1/2021), severe fatigue(5/1/2021-5/3/2021). Unable to return to work on 5/3/2021 (rural mail carrier). Took OTC medicine and sleep. Slowly improving. Scheduled to return to work on 5/6/2021.

Other Meds: Nasacort, Allegra D, turneric. B complex, multivitamin, calcium, zinc, UC -II plus, stool softener, omega 3-6-9, milk thistle, Expert remedies Glucose Discovey, Burn Evolved AM and PM, young living Inner defense, prostate health , detox

Current Illness: None

ID: 1282118
Sex: F
Age: 36
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 05/03/2021
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: Allergy to Gluten (celiac disease)

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: About 3 hours after receiving the first dose of the Pfizer covid-19 vaccine, I began feeling a pain on the left side of my chest, near my heart. It lasted for about an hour. I treated it by taking amlodipine which usually helps me with angina pain. The same pain occurred two other times within a week of the first dose.

Other Meds: Vitamin D3, Vitamin A, Zinc, probiotic

Current Illness: N/A

ID: 1282119
Sex: M
Age: 81
State: PA

Vax Date: 04/16/2021
Onset Date: 04/23/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies: Vitamin A

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

Symptoms: 4/25/21 - COVID-19 infection: Pneumonia due to COVID-19 virus Reason for admission?patient completed course of remdesivir, plasma therapy. He was treated with IV dexamethasone?changed to oral medicine at the time of discharge. Patient was requiring 2 to 3 L of oxygen via nasal cannula?we will continue and expect improvement down the road. 4/30/21 - readmitted COVID-19 virus infection

Other Meds: acetaminophen (TYLENOL) 500 mg tablet allopurinol (ZYLOPRIM) 300 mg tablet amLODIPine (NORVASC) 5 mg tablet aspirin 81 mg tablet carvedilol (COREG) 12.5 mg tablet cholecalciferol, vitamin D3, 1,000 unit capsule dexAMETHasone (DECADRON) 6 mg

Current Illness: Date Unknown Diabetes mellitus, type 2 (CMS/HCC) Date Unknown Hypertension

ID: 1282121
Sex: M
Age: 39
State: NY

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 05/03/2021
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: None aware of

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

Symptoms: Left arm burning. And cramping in elbow tingling in fingers for over a month. Went to healthcare facility to check if should still get 2nd shot they told me I would need to see a neurologist. I got the 2nd shot 3 weeks after first shot and now issue spread into my neck muscles and leg cramps. Seems to be worse when it rains. Told me take anti-inflammatory but no help. My doctor gave me muscle relaxers neither has helped try ice and heat. Arm still burns. Took xrays. But I couldn?t get appointment with neurology til mid May.

Other Meds: Metoprolol succ

Current Illness:

ID: 1282122
Sex: F
Age: 29
State: KS

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: N/a

Symptom List: Pain in extremity

Symptoms: Abnormal Vaginal spotting outside of mensural window. Currently on day 3 of consistent light spotting

Other Meds: Women?s multi vitamin

Current Illness: Shingles

ID: 1282123
Sex: F
Age: 29
State: OH

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient was given 2nd dose of series too early; administered 14 days after 1st dose.

Other Meds:

Current Illness:

ID: 1282124
Sex: F
Age: 46
State: FL

Vax Date: 03/16/2021
Onset Date: 03/20/2021
Rec V Date: 05/03/2021
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: Aspirin, NSIDs

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

Symptoms: I missed my period expected on 3/20/21, got my period on April 6, 2021 and I am still bleeding to this day. I have not stopped bleeding since April 6, 2021. I have never had problems with my period before.

Other Meds: Methimazole 10mg, once a day, atenolol 25 mg once a day. Magnesium, Potassium, Vitamin D, B-12

Current Illness:

ID: 1282125
Sex: M
Age: 69
State: NY

Vax Date: 02/16/2021
Onset Date: 02/25/2021
Rec V Date: 05/03/2021
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: sufasalizine. cyclosporine

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

Symptoms: DVT left thigh severe muscle pain left side and back

Other Meds: valsartan, jardiance, simvastatin, pantoprozole, glubiride, humyra, sodium citrate/citric acid

Current Illness: diabetes, sarcoidosis. stage 3 kidney disease

ID: 1282126
Sex: F
Age: 17
State: PA

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/03/2021
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: N/A

Symptom List: Vomiting

Symptoms: Sudden sweatiness, nausea and tunnel vision. Very brief LOC. Immediately better when placed supine. More scarred than anything else. No fall or injury. BP/pulse/O2 saturation all Normal Initial 126/89, 69, 100%. No orthostasis. Classic vasovagal reaction. Resolved.

Other Meds: Alderill / Syngular / Loritan / Clonidine

Current Illness: N/A

ID: 1282128
Sex: M
Age: 17
State: NJ

Vax Date: 04/29/2021
Onset Date: 05/02/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Myopericarditis secondary to Pfizer vaccine

Other Meds:

Current Illness:

ID: 1282129
Sex: F
Age: 42
State: OH

Vax Date: 04/18/2021
Onset Date: 04/20/2021
Rec V Date: 05/03/2021
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: Omnicef

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

Symptoms: On April 20, 2021, two days after I received my second dose of Pfizer, I felt that my lymph nodes in my left armpit were swollen. I received the dose in my left arm. This symptom was observed in the morning and other than that, I had no other symptoms. Later, around seven in the evening, I noticed that my throat felt very sore and my chest began to hurt. My temperature was in the mid- 99's and I felt tired. The following day, my symptoms increased and my head began to ache, my lower back ached, my chest felt heavy, and my sinuses felt full and pressurized. My temp went above 100 and I then scheduled for a rapid covid screen. I tested positive and my symptoms lasted through Friday, April 30, 2021. My chest held a lot of congestion and this took several days to break up.

Other Meds: Daily Multivitamin

Current Illness: None

ID: 1282130
Sex: M
Age: 60
State: FL

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
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: No

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Day 2 following the vaccine, patient began to experience flu-like symptoms (fatigue, head ache, body ache). Followed by a syncope episode, did not follow up with any emergency care. Did not contact primary care or go to the hospital, or take any medication to treat symptoms. Mentioned having eye soreness, eyes feeling fatigued which is not usual for the patient and coincide with timing of adverse effects.

Other Meds: Lisinopril 20mg (only one dose once a day)

Current Illness: No

ID: 1282131
Sex: F
Age: 72
State: OH

Vax Date: 04/27/2021
Onset Date: 05/03/2021
Rec V Date: 05/03/2021
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: "COVID arm" red and irritated started 6 days after injection

Other Meds:

Current Illness:

ID: 1282132
Sex: F
Age: 31
State: MA

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
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: No

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

Symptoms: Fatigue, lack of energy, depression

Other Meds: Birth Control oral, fish oil supplement

Current Illness: TDAP on 4/1/21

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm