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: 1285461
Sex: F
Age: 32
State:

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/04/2021
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: heaviness on arm / tingling - resolved

Other Meds:

Current Illness:

ID: 1285462
Sex: M
Age: 37
State: CO

Vax Date: 05/02/2021
Onset Date: 05/03/2021
Rec V Date: 05/04/2021
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: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: High fever, headache, extreme shivers, sweats, shortness of breath, clammy skin.

Other Meds: N/A

Current Illness: N/A

ID: 1285463
Sex: F
Age: 28
State: NY

Vax Date: 01/21/2021
Onset Date: 04/25/2021
Rec V Date: 05/04/2021
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: Celiac disease- wheat

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

Symptoms: Pulmonary embolism L lung, unknown origin.

Other Meds: Paxil-20mg, Apri (birth control), daily vitamin.

Current Illness: N/A

ID: 1285464
Sex: M
Age: 49
State: MN

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

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

Lab Data:

Allergies: Clomipramine, Paxil

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Tinnitus and diminished hearing in the left ear only 5 minutes post injection. Pain at injection site lasting 1 week. Anxiety prior to receiving vaccine and post lasting 1 hour. Fatigue, body aches starting 5 hours post injection. Chills starting 12 hours post injection and lasting 2 hours. Headache lasting 24-36 hours. Elevated temp at 98.4, normally 97.4

Other Meds: Vitamin D, Escitalopram, Simvastatin, Lisinopril/HCTZ, L-Methylfolate

Current Illness: Elevated blood pressure, Elevated cholesterol

ID: 1285465
Sex: F
Age: 70
State: OH

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

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

Lab Data:

Allergies: Sulfa drugs. Aleve.

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

Symptoms: On May 2, 2021 (8 days after injection) upper right arm near injection site began itching and developed into redness with swelling. No pain. Today redness has increased and swelling remains. I researched symptoms on the internet and it does not appear serious, but am reporting nonetheless. Have not sought treatment, basically because I do not have a primary doctor.

Other Meds: Timolol eyedrops for glaucoma. Terbinafine Hcl 250 mg. Vitamin D3 2000 IU. Calcium 650 mg wZinc Copper, Manganese, Sodium twice daily. Hair-Skin-Nails vitamin supplement-includes 2500 mcg Biotin, once daily.

Current Illness: None.

ID: 1285466
Sex: F
Age: 47
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/04/2021
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: I experienced extreme exhaustion intermittently for 10 days after the vaccine. I also had some cold-chilling during that time.

Other Meds: multi vitamen

Current Illness:

ID: 1285467
Sex: F
Age: 62
State: TN

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/04/2021
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: lightheaded then came the headache and nausea. The next afternoon I had achiness all over, low grade fever (99.2), headache and nausea. It lasted until about 5pm on the 2nd of May.

Other Meds: Cymbalta 60mg once daily Naltrexone once daily Metoprolol 25mg twice daily Vitamin D daily Melatonin 15mg daily Allegra daily Pepsid daily Tylenol exrtra strength 2 every 4 hours

Current Illness: none

ID: 1285468
Sex: F
Age: 26
State:

Vax Date: 05/02/2021
Onset Date: 05/03/2021
Rec V Date: 05/04/2021
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: Chills, fever, muscle aches, migraine, drowsiness, dizziness.

Other Meds:

Current Illness:

ID: 1285469
Sex: M
Age: 61
State: GA

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

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: extreme fatigue leading to frequent sleep day and night for 2 full days, lethargic, joint pains, chills, metallic taste, mild cough, no fever - some improvement with paracetamol 500mg QID. Metallic taste remains to date (5/4/21), though improved. I am a physician, if not i would have panicked and gone to the ER.

Other Meds: Atrovastatin 10 mg daily

Current Illness: None

ID: 1285470
Sex: F
Age: 82
State: GA

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Acute onset of severe vertigo requiring emergency department visit. Further workup by primary physician and neuro-otologist has not determined the cause. Patient has difficulty standing due to the vertigo. Symptoms have not abated despite treatment with Antivert. Vestibular therapy has been ordered.

Other Meds: Unknown

Current Illness:

ID: 1285471
Sex: M
Age: 43
State: MA

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: VACCINE-RELATED LYMPHADENOPATHY, symptoms started within hours at mid-throat, right side only. This began to radiate pain outwards and upwards over the course of few days. By the fourth day, the pain and swelling had spread to entire jawline and neck, right side. Visit to ER confirmed periodontal abscesses, in total 3. After one week of antibiotic, symptoms returned with greater pain, spreading back to entire right neck and jawline into right ear. As of this writing, it has been 19 days since the second Moderna shot and the lymph nodes in the entirety of my right side hurt.

Other Meds: ESCITALOPRAM OXALATE 20MG TAB 1PD, PROPRANOLOL HCL 20MG TAB 2PD, IBUPROFEN 200MG TAB 8PD

Current Illness: NONE

ID: 1285472
Sex: F
Age: 36
State: NC

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 05/04/2021
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: no

Symptom List: Rash, Urticaria

Symptoms: The night of my vaccine I got sharp intense rib pain in my left rib. The pain was made worse by deep breathing. Uncomfortable friction then developed in that same rib cage. After a few weeks of not getting better, I went to the doctor, who then also heard the pleural friction rub. The doctor ordered X-rays and I am awaiting my results.

Other Meds: Multi Vitamin, Vitamin C and Zinc

Current Illness: no

ID: 1285473
Sex: F
Age: 43
State: OH

Vax Date: 04/01/2021
Onset Date: 04/03/2021
Rec V Date: 05/04/2021
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: On date that patient received vaccine arm was sore for about an hour, felt fine the following day, Friday and continued to feel fine until the following evening, Saturday evening. Patient began to feel nauseous, fatigued, vomiting, couldn't keep anything down, headache. This continued thru Sunday, ate a small amount of dinner but vomited. Called PCP on following Monday 4/5/2021. Symptoms improving but still nauseated and can't eat anything. Headache persists.

Other Meds:

Current Illness:

ID: 1285474
Sex: F
Age: 43
State: CT

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 05/04/2021
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: None

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

Symptoms: Facial swelling, redness, burning/pain started 24 hours after injection and has not resolved itself 9 days later. Other common reactions (nausea, joint pain, chills, fatigue) started at the same time, and have since mostly resolved itself except I'm still experiencing fatigue and tiredness.

Other Meds: Magnesium, Vitamin D/K3, Vitamin B12

Current Illness: None

ID: 1285475
Sex: M
Age: 95
State: AZ

Vax Date: 04/21/2021
Onset Date: 04/28/2021
Rec V Date: 05/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Blood clots, organs shut down, death.

Other Meds:

Current Illness:

ID: 1285476
Sex: F
Age: 28
State: MS

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 05/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: FELT LIKE SHE HAD BEEN HIT BY A TON OF BRICKS, LETHARGY

Other Meds:

Current Illness:

ID: 1285477
Sex: F
Age: 16
State: CA

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

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: 16 YO HAD 1ST DOSE OF MODERNA 3/17/21, RETURNED FOR 2ND DOSE. MED CONSULTATION DONE REGARDING OFF LABEL USE. MOTHER SIGNED CONSENT. PT GOT 2ND DOSE MODERNA.

Other Meds:

Current Illness:

ID: 1285478
Sex: F
Age: 20
State: MD

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

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

Lab Data:

Allergies: Eggs, flu vaccine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient experienced tingling in tongue and fingers; EMS evaluated for low oxygen.

Other Meds:

Current Illness:

ID: 1285479
Sex: M
Age: 56
State:

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/04/2021
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: States that he feels like BP is elevated, VS obtained (BP 142/75, HR 88, RR 97%) - felt better

Other Meds:

Current Illness:

ID: 1285480
Sex: M
Age: 63
State: WA

Vax Date: 04/13/2021
Onset Date: 04/15/2021
Rec V Date: 05/04/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: After getting the first dose of the Pfizer vaccine, I just experienced arm soreness for the first 24 hours, but then I noticed my tinnitus which I had slightly for many years had become louder and constant. Right now I'd say it is a 3/10. My concern is that if I get the second dose that it will become even louder. My second dose was supposed to be today, but unless the tinnitus diminishes I do not want to risk a second shot for a 10-15% efficacy increase for Covid

Other Meds: Multi-vitamin, aged garlic extract, vitamin D, Vitamin C, Fish Oil, Magnesium, Co-Q10, 81 mg aspirin

Current Illness:

ID: 1285481
Sex: M
Age: 48
State: CO

Vax Date: 04/17/2021
Onset Date: 04/19/2021
Rec V Date: 05/04/2021
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: Received shot on 4/17 Saturday afternoon at 1 pm and on Monday morning 4/19 at ~9 am I started to get ringing in my ears. Has not stopped. Went to doctor and he has me start taking prednisone, still taking the steroids for the next 5-6 days.

Other Meds:

Current Illness:

ID: 1285482
Sex: F
Age: 39
State: FL

Vax Date: 04/25/2021
Onset Date: 05/04/2021
Rec V Date: 05/04/2021
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: I woke up this morning (5/4/21) with a very swollen, sore and achy left arm with a large red rash on swollen area. The swelling is at the vaccine site. I also have had a headache since waking up. My left arm feels weak all the way down to my hand. I felt heart palpitations this morning which is very unusual, not sure if that?s related.

Other Meds: None

Current Illness: None

ID: 1285483
Sex: F
Age: 27
State:

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/04/2021
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: Dizziness - resolved.

Other Meds:

Current Illness:

ID: 1285484
Sex: F
Age: 89
State: MI

Vax Date: 02/16/2021
Onset Date: 04/18/2021
Rec V Date: 05/04/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: heparin, codeine, effexor, penicillins

Symptom List: Injection site pain, Pain

Symptoms: Pt w/hx of dementia brought to ED w/fevers and low oxygen saturation and worsening SOB and lethargic. CXR showed chronic appearing interstitial prominence and left basilar opacity. Pt was found to be positive of COVID-19 infection. Had received both Moderna vaccines (1/19/21 & 2/16/21). Pt admitted for additional management for acute hypoxemic respiratory failure, COVID-19 pneumonia and treated with dexamethasone, combivent nebs, remdesivir, and azithromycin/ceftriaxone empirically for secondary bacterial pneumonia. Pt ultimately was discharged 3 days later to an assisted living facility where she resides oxygenating well and more alert.

Other Meds: amlodipine, gabapentin, lisinopril, metoprolol, mirtazapine, pantoprazole, atorvastatin, iron, budesonide, ascorbic acid

Current Illness: Blood loss anemia, HTN, thrombocytopenia

ID: 1285485
Sex: F
Age: 47
State: TN

Vax Date: 03/12/2021
Onset Date: 03/19/2021
Rec V Date: 05/04/2021
Hospital:

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

Lab Data:

Allergies: Paregoric, Guiatuss

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient was at home cleaning and experience a sudden onset of shortness of breath. She felt her lungs close and she could not take a breath for about a minute. Then when she was able to breathe, she heart a whistling sound. Her daughter called 911. By the time they got to the ER, she felt perfectly fine and the ER was full so she asked to leave. Her bp was high in the ambulance 156/89, O2 sat 99% on room air. BMP, CBC, troponin and CXR in ER all normal. She remained symptomatic so a CT scan of chest was done and negative for PE on 04/05/21

Other Meds: Citalopram 20mg daily, Actigall 300mg daily, Allegra 180mg daily as needed, Esomeprazole 20mg daily, flonase 2 sprays each nostril daily, Metamucil 1 scoop daily, Terbinafine 250mg daily, Vitamin D3 2000IU daily

Current Illness: None

ID: 1285486
Sex: F
Age: 65
State: NJ

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/04/2021
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: erythromycin

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

Symptoms: On 4/7/221 pt had fatigue after taking the vax. On 4/8/2021 she had pain in the left thigh. The pain felt like it was from the inside out. On 4/9/2021 she still had pain in the left leg but it was starting to get better at this point. She no longer has this symptom.

Other Meds: Wellbutrin 150mg, Allegra

Current Illness: Covid in December 2020

ID: 1285487
Sex: F
Age: 62
State: MN

Vax Date: 02/17/2021
Onset Date: 02/22/2021
Rec V Date: 05/04/2021
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: Oxy, contrast dye, mushrooms, nuts

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Burning mouth began 5 days post-vaccine (2) along with numbness/tingling in lower limbs that is not yet resolved.

Other Meds: Estriadol patch (.0375 mg); supplements: calcium, vitamin c, probiotic, zinc

Current Illness: None

ID: 1285488
Sex: F
Age: 51
State: FL

Vax Date: 04/10/2021
Onset Date: 04/14/2021
Rec V Date: 05/04/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe burning, tingling, chest and back pain, intense pressure started on 04/14/21. Visited the family doctor on 04/15/21 and visited ER on 4/16/21 to rule out a heart attack. Shingles rash appeared on 4/18/21 and pain persistent and unrelenting. Extreme pain, only prescribed Advil or any OTC from HCP.

Other Meds: Omeprazole, Clonazepam, hydroxyzine (as needed for allergies).

Current Illness: n/a

ID: 1285489
Sex: F
Age: 53
State:

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

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

Lab Data:

Allergies:

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

Symptoms: headahce; BP 141/77; P=74; O2=98%

Other Meds:

Current Illness:

ID: 1285490
Sex: F
Age: 19
State: MD

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/04/2021
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 experienced vasovagal reaction and fainted at vaccination table but was caught by RN. EMS evaluated patient; patient vomited; EMS administered cold compress to back of patient's neck. EMS took vitals and monitored her for 30+ minutes and she was able to leave. Patient said she has had this reaction before for bloodwork.

Other Meds:

Current Illness:

ID: 1285491
Sex: F
Age: 23
State: MI

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 05/04/2021
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: Patient developed right foot tingling and posterior right lower leg achiness and fatigue of the leg the day after receiving COVID-19 vaccine (1st dose). No known injury or trauma. She did some sciatica exercises, had minimal improvement. Reports symptoms worsening after 2nd COVID vaccine on 2/25/21. Feels like she has to move the leg all the time, almost like a constant restless leg syndrome.

Other Meds:

Current Illness:

ID: 1285492
Sex: M
Age: 47
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: C/O SYNCOPE, SEIZURE ACTIVITY X 20 SECS, NAUSEA, NO HX PRIOR ALLERGIES, PROVIDED WATER AND SNACK, SX RESOLVED, NO TRANSPORT.

Other Meds:

Current Illness:

ID: 1285493
Sex: F
Age: 68
State: VA

Vax Date: 03/07/2021
Onset Date: 04/01/2021
Rec V Date: 05/04/2021
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: Procardia

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

Symptoms: (1) Approximately one month after vaccine, swelling in the muscle behind my left leg. I went to my Primary Care doctor, he examined my leg and immediately sent me to hospital ER because he was concerned that it might be a blood clot. They performed an ultrasound, but the results were negative and showed no signs of any blood clots. (2) Approximately three weeks after vaccine, I developed stiffness on the left side of my body in my arm, thigh and hip area. The stiffness was intense, uncomfortable and bothersome enough for me to take Tylenol for the pain the next 5 days and it lasted for about a week.

Other Meds: Amlodopine, Atenolol, Aspirin (low dosage)

Current Illness: N/A

ID: 1285494
Sex: F
Age: 44
State: IL

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 05/04/2021
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: AMOXICILLIN

Symptom List: Tremor

Symptoms: pt states that one hour post vaccination she developed numbness of the left side of her face and that this lasted until 4-29-2021 when she took benadryl 1 tab 25 mg which seemed to help

Other Meds:

Current Illness: NONE

ID: 1285495
Sex: F
Age: 46
State: KS

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 05/04/2021
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: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: I've had a migraine, almost consistently, for almost a month. No medicine is helping it.

Other Meds: Multivitamin, calcium + D, omeprazole, Claritin

Current Illness: None

ID: 1285496
Sex: F
Age: 35
State: NY

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 05/04/2021
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: NKA

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

Symptoms: On April 9th received 1st dose of vaccine, approx. 12 hours later experienced bright red spotting, called MD and was seen and fetal heart tone was present on April 12th. Received 2nd dose of vaccine on May 1st and and approx. 12 hours later started to have bright red vaginal bleeding which then turned into spotting. On May 3rd at 1130pm started to have bright red bleeding and water broke. Came to the emergency room for evaluation where I was told I had lost the baby, no fetal heart tone present. I am experiencing a miscarriage @ 15 weeks gestation and 6 days today on May 4th 2021.

Other Meds: prenatal vitamin synthroid 62.5 mcg

Current Illness: n/a

ID: 1285497
Sex: M
Age: 41
State: IL

Vax Date: 04/12/2021
Onset Date: 04/23/2021
Rec V Date: 05/04/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Night sweats, fever, cough, chills, swollen lymph nodes, mass located on lymph node

Other Meds: Arm our Thyroid, levothyroxine, Testosterone cypionate, anastrazole, Pregablin

Current Illness: Non

ID: 1285499
Sex: F
Age: 56
State: ME

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 05/04/2021
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: Codeine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Swollen lymph nodes in right armpit right after vaccine received and this lasted for 2 to 3 weeks. One week later noted eczema type rash from right armpit to right elbow that is still present. No history of eczema.

Other Meds:

Current Illness:

ID: 1285500
Sex: F
Age: 73
State: IN

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/04/2021
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: PATIENT STATED SHE IS ALLERGIC TO MANY THINGS INCLUDING VICODIN, VANCOMYCIN, HORNET STINGS, CHOLESTEROL SHOTS AND BP MEDS. PATIENT DIDN'T HAVE THE LIST WITH HER AT THE TIME OF THE VACCINATION VISIT.

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

Symptoms: ON THE DAY OF THE VACCINE PERIOD - she had a reaction the first dose - itchy face - after one day. she talked with her hcp and was told to take steroids afterwards. discussed risks and benefits, she would like to go ahead and get the 2nd dose. advised to let RN on appointment day know. EMTS SUGGEST TAKING BENEDRYL ABOUT 15-30 MINUTES AFTER THE DOSE. SHE IS ALLERGIC TO MANY THINGS SO UNSURE IF THE REACTION WAS TO THE VACCINE. WAITED FOR 30 MINUTES FOR THE FIRST DOSE, WILL DO THE SAM EFFORT THIS ONE AS WELL. PARAMEDICS STAYED WITH PATIENT FOR OBSERVATION PERIOD. ON 5/2/21 - RN CONTACTED PATIENT TO SEE HOW SHE WAS DOING. PATIENT STATED SHE HAD REDNESS ON THE LEFT CHEEK THAT STARTED RIGHT UNDER HER EYE AND ENDED AT HER CHIN. SHE STATED SHE WOKE UP THAT DAY WITH DRY EYE AS WELL. SHE ALSO NOTED TO THE RN SHE HAD HAD CATARACT SURGERY WITHIN THE LAST 4 WEEKS. RN STATED THAT SHE SHOLD FOLLOW UP WITH HER HCP BUT PATIENT STATED SHE DIDN;T HTINK SHE NEEDED TO SINCE "IT WASN;T THAT SERIOUS".

Other Meds: PATIENT STATED SHE IS A LIST F MEDICATION BUT DID NOT BRING THEM AT THE TIME OF THE VACCINATION VISIT.

Current Illness: NONE THAT RN KNOWS OF, ALTHOUGH PATIENT STATED HER ANKLE HAD BEEN BOTHERING HER.

ID: 1285501
Sex: F
Age: 56
State: WI

Vax Date: 04/24/2021
Onset Date: 04/26/2021
Rec V Date: 05/04/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 2 days after the vaccine, 04/26/2021 I had severe itching all over my body. There were rashes, redness and flushing on my face. I took antihistamines such as Benadryl, Flonase and Claritin. The itching and rashes would only subside for a bit then come back. On day 7, 05/03/2021 doctor gave me Methylprednisolone 6-day pack. There was some improvement today at Day 2. I really don't want to be on steroids but I haven't slept for a week now. I do not think I will get that booster shot. I am telling my friends and relatives not to get Moderna.

Other Meds:

Current Illness:

ID: 1285502
Sex: M
Age: 58
State: FL

Vax Date: 04/25/2021
Onset Date: 04/27/2021
Rec V Date: 05/04/2021
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: Pain in extremity

Symptoms: Eyes are almost swollen shut , rash red raised fluids, bags under eyes puffy, weeping corner of each eye progressively worse. He has tried Benadryl 50 mg and hydrocortisone cream not working did not help. Informed if symptoms worsening and Benadryl not helping recommend hcf. She said going to Orlando Healthy Free Standing ER on . 4/30-F/U call made; Went to ER in Orlando and diagnosed with shingles. Started on antiviral, prednisone, and eye gtts. Will be seeing ophthalmologist today.

Other Meds: HCTZ; Lisinopril

Current Illness:

ID: 1285503
Sex: F
Age: 58
State: MD

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 05/04/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Levaquin.

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

Symptoms: She got her vaccine, had no reaction, put ice on her arm and tried to stay moving it and was thirsty and drank a lot of water. She took her shower and went to bed as usual. The next morning early she felt so bad when she tried to stand up and she could not. She felt so bad and shaking that she was having seizures. Her whole body aches, her arm hurt, her head felt like she had gotten shot in the head. She went to bed for 4 hours, went to the bathroom and had severe tremors/violently shaking. She used the bathroom and slept for another 10 hours. By about 6:00 PM that night she could sip some water but not a lot as was afraid of throwing up. The 2nd day was bad as well, not as bad. She started drinking around 12:00 and tried to hold that down and by about 5:00 PM she was bale to eat. She had a temp of 101.7 and 101.9. She did take Ibuprofen and when she tried to eat, she felt sick again like she was back to the first day and her temp came immediately back. It's been a week and she still feels like crap, and was trying to go to the grocery store and had to leave as she had no energy. She does have a rash on her right arm around the injection site. She has improved some, able to eat 1/2 of what she used to, still feels sick after she eats, her temp is low grade and exhausts out quickly and does not feel well and not back to herself. She did drive today but was afraid to do so due to the feeling she is still having.

Other Meds: None.

Current Illness: None.

ID: 1285504
Sex: F
Age: 44
State: MN

Vax Date: 04/06/2021
Onset Date: 04/12/2021
Rec V Date: 05/04/2021
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: Ceclor and Amoxicillian (hives)

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

Symptoms: A week after the vaccination I developed a mild case of shingles -- deep pain along upper back/between shoulder blades, along right shoulder, along right rib. It eventually ran up right side of neck. A few days later blister-like welts appeared along right shoulder/upper back and later right side neck. A lot of pain and burning along right shoulder and neck followed and continued for 3 weeks. Chills and headache also followed for 3-4 weeks. Slowly the blisters opened and crusted over.

Other Meds: Multi-vitamins, Allegra, Imitrex as needed, Topiramate 75mg for migraine

Current Illness: Chronic migraine and seasonal allergies

ID: 1285505
Sex: F
Age: 45
State: NJ

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 05/04/2021
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: My menstrual flow was interrupted and still has not come. I have taken many tests and I am not pregnant according to them.

Other Meds: Labetalol, Hydrochlorithiazide, Pre Conception Prenatals, Vitamin D3, CoQ10, DHEA, Magnesium, Zinc and Selenium

Current Illness: None

ID: 1285506
Sex: F
Age: 61
State: SD

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 05/04/2021
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: Sensitive to morphine as it causes confusion. As of 12-30 DNP and pulmonologist states severe reaction to covid vaccine

Symptom List: Vomiting

Symptoms: Became acutely ill early morning of 12-30. I was then seen in ER by DNP with diagnosis of covid pneumonia, UTI, high CRP and shortness of breath.

Other Meds: Synthyroid 125mcg qd

Current Illness: Did have covid 11-13 with no shortness of breath concerns with it. I was more aching and had n/v with it.

ID: 1285507
Sex: F
Age: 70
State: OH

Vax Date: 12/20/2020
Onset Date: 02/12/2021
Rec V Date: 05/04/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: This individual called and stated she received this first Pfizer vaccine at the facility where she worked. About two months after receiving this vaccine she noticed tingling in her left hand, feels like it fell asleep. She received her second Pfizer vaccine in her right arm on 1/12/21, same lot number and again in about two months stated she starting having tingling in her right hand as well. She also has swollen lymph nodes in right arm pit. Currently both hands feel tingly and occasional feel like they have fallen asleep. Denies any other lingering side effects. States at the time of vaccination she had a tender arm(s) after injection and then nothing until the tingling showed about two months after each injection.

Other Meds:

Current Illness:

ID: 1285509
Sex: F
Age: 62
State: CA

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/04/2021
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: ADENOSINE CONTRAST DYE REGADENSON COMPAZINE PHENERGAN

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

Symptoms: 5/3/21 Pt felt itchy 15 min into obs period. Skin increased blotchiness on face and neck with increasing itchiness reported. No resp distress noted. Assisted to gurney for observation. Telephone order for 25 mg po Benadryl obtained. 1235 benadryl given with little relief after 20 min. BP 146/85 HR 60's-70's, awake, alert with no c/o throat swelling. But increasing discomfort due to hives. Team Alert called. Transported to ED via gurney by ED

Other Meds: CLONAZEPAM HYOSCYAMINE GLIPIZIDE TINZANIDINE XYZAL BUDESONIDE ROPINIROLE SINGULAR

Current Illness: CROHNS ASTHMA MAJOR DEPRESSIVE DISORDER

Date Died: 04/19/2021

ID: 1285510
Sex: M
Age: 60
State: NY

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 05/04/2021
Hospital: Y

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: 60 yo male with BMI 30 and vodka x 2-3 bottles per day. In hospital 4/9-14 for obstructive uropathy of undetermined origin. In hospital on 4/12 and got J & J there. 4/13 with no prior history developed a DVT. D/C'd on 4/14 on Eliquis. Found unresponsive 4/19. At autopsy, found pulmonary thromboemboli

Other Meds:

Current Illness: obstructive uropathy of undetermined origin

ID: 1285511
Sex: F
Age: 53
State: IN

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 05/04/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: 4/14/21 7:15pm arm started to hurt 4/15/21 6:10 am vomitting diahirra headache servere arm pain

Other Meds: multi vitamin vitamin C & E zinc loratadine

Current Illness: none

ID: 1285512
Sex: F
Age: 36
State: TX

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 05/04/2021
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: Fever fluctuating between 100 and 103 lasting 3 day now; does not go away after taking acetaminophen or ibuprofen. Strange pains come and go in different parts of the body (arms, legs, back, chest)

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm