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: 1288873
Sex: F
Age: 44
State: MA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Site: Redness at Injection Site-Mild, Systemic: Allergic: Rash Generalized-Medium, Systemic: Red sunburn like reaction-Medium, Systemic: Flushed / Sweating-Medium, Additional Details: pt immediately started getting hot, skin from neck down turned red, like a sunburn. pt given benadryl, didn't seem to help. pt stated getting worse. RN gave epinephrine out of an abundance of caution. gave ibuprofen, and pt declined ice packs. Patient redness slowly resolved, but felt jittery post epipen. pt redness was nearly cleared and she felt better as she went to leave ~110pm

Other Meds:

Current Illness:

ID: 1288874
Sex: F
Age: 55
State: MA

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 05/05/2021
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: Flagyl medication Bee stings

Symptom List: Anxiety, Dyspnoea

Symptoms: I got first shot on Friday April 9. On Monday the 12th, I got small rash on lower left arm, NOT at the injection site, but below it. By Tuesday the rash spread all over my body and got much worse. I was having short episodes of breathlessness and feeling a bit dizzy, and on the 15th I went to ER because the rash was getting worse and was creeping towards my face. The rash was red, kind of looked like a million mosquito bites, caused some swelling, and very itchy in the first few days. I was very uncomfortable and unable to sleep well. I tried Benadryl before I went to ER but it made me overly tired. At the ER the doctor diagnosed me with allergic reaction to the shot. He prescribed a course of Prednisone to calm the rash. I had a very active rash for OVER two weeks between April 12 to the week of April 26, and there is still remnants of the rash today, which I hope do not reactivate at any time. I could figure out the timeframe of most active rash better by looking at my notes and doctors but that is a general summary.

Other Meds: None

Current Illness: None

ID: 1288875
Sex: F
Age: 33
State: NY

Vax Date: 03/11/2021
Onset Date: 03/19/2021
Rec V Date: 05/05/2021
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: Pantoprazole: anaphylaxis Lactose intolerance Latex: Hives Silicone: hives, itching

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

Symptoms: Found to be COVID-19 positive, altered mental status and symptomatic with O2 requirement. Treated with one 200mg dose of remdesivir and dexamethasone 6mg IV daily x 5 days. Oxygen delivered via nasal cannula and SO2 remained over 90% (and mostly over 95%) the entire admission. Acute encephalopathy and Seizure, possible, post-dialysis versus dialysis disequilibrium syndrome occurred during this admission and was the reason for time spent in the ICU (~24 hours).

Other Meds: acetaminophen (TYLENOL) 500 MG tablet Aflibercept (EYLEA) 2 MG/0.05ML SOLN by Intravitreal route cefadroxil (DURICEF) 500 MG capsule colestipol (COLESTID) 1 g tablet darbepoetin Alfa (ARANESP) 40 MCG/ML SOLN ferric gluconate (FE

Current Illness: Presents to ED with chest pain and confusion

ID: 1288876
Sex: M
Age: 17
State: CA

Vax Date: 04/03/2020
Onset Date: 04/03/2020
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypotension-Medium, Systemic: Weakness-Medium

Other Meds:

Current Illness:

ID: 1288877
Sex: F
Age: 34
State: WV

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/05/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Severe headache starting that day lasting 3 days. Severe upper back/lower neck pain as well as shoulder blade. I can barley even move my head without pain.

Other Meds: Exedrine Migraine

Current Illness: N/A

ID: 1288878
Sex: M
Age: 27
State: MI

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: Swollen lymph node in left armpit, golf ball sized, tender to the touch

Other Meds: Zyrtec

Current Illness:

ID: 1288879
Sex: F
Age: 49
State: IL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 05/05/2021
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 and bees.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Extreme dizziness. 1st 3 days falling down and banging into things. I am still having a lot of dizziness and needing to grab into things 22 days later. I do vertigo exercises that aren?t really helping. I take dramamine 3 times a day and it does ease dizziness. I just want to know how long air will have to take this and when it will get better? I?m told this is a normal side effect but for how long? It is very bad at end of day and when I?m tired. The room spins horribly. I throw up from dizziness as well.

Other Meds: Potassium Citrate 720mg , Bupropion HCL 75mg, Synthroid 0.05mg, Alive multi-vitamin, Alive Calcium and D3, D3, B12, Zinc, Iron, Melatonin 6mg, Biotin drops, Vitamin C, daily member marks allergy pill.

Current Illness: None

ID: 1288880
Sex: F
Age: 18
State: NY

Vax Date: 04/03/2020
Onset Date: 04/03/2020
Rec V Date: 05/05/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Weakness-Mild

Other Meds:

Current Illness:

ID: 1288881
Sex: M
Age: 28
State: OK

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium

Other Meds:

Current Illness:

ID: 1288882
Sex: F
Age: 26
State: IN

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/05/2021
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: Peanuts, soybeans, sulfa drugs

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Day 1: exhaustion Day 2: sore body, fevers (high of 102.4), exhaustion, chills, hot red ?rash? on arm (under injection shot) Day 3: mild fevers (high of 99.7), sore body Day 4: hives (treated with Benadryl)

Other Meds: Allegra, sprintec birth control.

Current Illness:

ID: 1288883
Sex: F
Age: 43
State: IL

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

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

Symptoms: May 3 - exhausting, sweats/chills while sleeping; May 4 - exhaustion, full body ache (similar to body ache from flu), headache, and again sweats/chills while sleeping at night

Other Meds: Sertraline, Amitriptyline, Synthroid

Current Illness: None

ID: 1288884
Sex: F
Age: 25
State: OK

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypotension-Mild

Other Meds:

Current Illness:

ID: 1288885
Sex: F
Age: 50
State: MI

Vax Date: 04/23/2021
Onset Date: 05/02/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: biaxin, bactrim, soma, bees, spider bites

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

Symptoms: 8 days after receive injection I developed a large lump under the skin in the upper left arm. On day 9, I developed a 3 inch diameter red and hot ring around injection site.

Other Meds: none

Current Illness: Bronchititus

ID: 1288886
Sex: M
Age: 37
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Systemic: Seizure-Mild, Systemic: Shakiness-Medium, Additional Details: About 5 minutes after the shot, the patient lost conciousness, fell face forward on the ground. Face appeared grey, was unresponsive, but was making grunting sounds. His body appeared to be shaking lightly, possible seizure, was not responsive. Oral benadryl was not possible at this point. Turned patient on back/side in order to adminster the epipen. Patient quickly became alert and responded. No injection site reaction. Paramedics arrived shortly to check vitals and transfer him

Other Meds:

Current Illness:

ID: 1288887
Sex: M
Age: 22
State: CA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Systemic: Fainting / Unresponsive-Severe, Additional Details: patient fell as he passed out called 911 paramedics checked out patient

Other Meds:

Current Illness:

ID: 1288888
Sex: M
Age: 50
State: TN

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

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

Lab Data:

Allergies: None

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

Symptoms: Extreme chills in hands and toes, body aches, arthralgia (joint pain), muscle aches (mostly larger muscles, quadriceps), some vision loss (lights are dim), nausea, gall bladder pain

Other Meds: Fish Oil, Glucosamine, Fiber pills

Current Illness: None

ID: 1288889
Sex: F
Age: 21
State: ID

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Severe, Additional Details: light headed started to fall sweating called 911 paramedics took to hospital as blood pressure too long could not leave her

Other Meds:

Current Illness:

ID: 1288890
Sex: M
Age: 25
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Additional Details: Pt fainted about 2 minutes after getting their COVID vaccine. We had him sit with his feet up. We checked blood pressure about 5 minutes after and found he was hypotensive (109/71). Called the ambulance was was released by them.

Other Meds:

Current Illness:

ID: 1288891
Sex: M
Age: 43
State: IN

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: Starting 16 hours after injection and lasting until about 36 hours after, I experienced a fever of 100.7? gradually reduce to normal over time, chills, aching joints, and headache.

Other Meds: Psyllium, doxycycline, One A Day Men?s

Current Illness:

ID: 1288892
Sex: M
Age: 25
State: MN

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

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

Lab Data:

Allergies:

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

Symptoms: Had vertigo for the first time in my life approximately 4 weeks after Johnson and Johnson vaccine.

Other Meds: Lexapro

Current Illness:

ID: 1288893
Sex: M
Age: 22
State: VA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hyperventilation-Severe, Systemic: Nausea-Medium, Systemic: Shakiness-Medium, Systemic: Tachycardia-Medium

Other Meds:

Current Illness:

ID: 1288894
Sex: F
Age: 73
State: PA

Vax Date: 04/10/2021
Onset Date: 04/12/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: Sulfamethoxazole-trimethoprim

Symptom List: Unevaluable event

Symptoms: Fever, sinus drainage, bad taste in mouth

Other Meds: calcium carbonate-vitamin D3 600 mg(1,500mg) -200 unit per tablet famotidine (PEPCID) 20 mg tablet fluocinonide (LIDEX) 0.05 % cream levothyroxine (SYNTHROID) 25 mcg tablet metFORMIN XR (GLUCOPHAGE-XR) 500 mg 24 hr tablet mv-min-folic acid-

Current Illness: GERD without esophagitis

ID: 1288895
Sex: F
Age: 45
State: TX

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 05/05/2021
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: penicillin

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

Symptoms: injection site swelling, redness and soreness lasting several weeks

Other Meds: n/a

Current Illness: n/a

ID: 1288896
Sex: M
Age: 29
State: CA

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

Symptom List: Injection site pain, Pain

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Additional Details: PATIENT FAINTED AFTER RECEIVING VACCINE AND INJURED THEIR CHIN, PATIENT WAS SITTING DOWN AND WAS ABLE TO FEEL BETTER AFTER GIVEN WATER AND REST ON BENCH

Other Meds:

Current Illness:

ID: 1288897
Sex: F
Age: 33
State: IN

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

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

Lab Data:

Allergies: Sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: severe body aches (lasting approx. 30 hours) headache (treatable with Tylenol) Soreness at injection site

Other Meds: norethindrone (birth control), pre-natal vitamins

Current Illness: N/A

ID: 1288898
Sex: F
Age: 63
State: MA

Vax Date: 05/02/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: Sore left arm, swollen and red around injection site, slight fever, muscle aches, nausea, dizziness

Other Meds: None

Current Illness: None

ID: 1288899
Sex: M
Age: 56
State: VA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/05/2021
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: Systemic: Flushed / Sweating-Severe

Other Meds:

Current Illness:

ID: 1288900
Sex: F
Age: 35
State: CA

Vax Date: 04/19/2021
Onset Date: 04/29/2021
Rec V Date: 05/05/2021
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: I developed a rash / redness on my neck (right side) that became really painful after 10 days of getting the vaccine. I?ve never had that happen to me before and then my throat started to hurt as well. I developed sore throat that has not gone away with phlegm and sneezing. I usually don?t get bad flu symptoms because I work at a health clinic and I have pretty good immune system. These ?flu-like? symptoms are different. My body usually experiences sore throat for about 2 days then it goes away on its own. This is not the case anymore.

Other Meds: Alive women?s multi vitamins, Olly prebiotic probiotic gummies, Nature Made Vitamin D3.

Current Illness: None

ID: 1288901
Sex: F
Age: 48
State: GA

Vax Date: 04/20/2021
Onset Date: 04/24/2021
Rec V Date: 05/05/2021
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: Penicillin Sulfa Drug Erythromycin

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

Symptoms: Five days after second vaccine I had to have an emergency appendectomy. No prior issues with appendix. Pain started at 12:00PM on Saturday 4/24 and appendix was removed Sunday 4/25 at 8:30AM.

Other Meds: Wellbutrin XL

Current Illness:

ID: 1288902
Sex: F
Age: 51
State: FL

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

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

Lab Data:

Allergies: Some intolerance to high histamine foods

Symptom List: Nausea

Symptoms: Lethargy around 7pm. Night sweats and hot then cold sensation all night and ever since 2nd shot. I also did not get my period, which was due 3days after the 2nd dose. I?ve had hot flashes and cold/hot sensations every day and night since the shot. I had not, ever, experienced hot flashes prior to the 2nd shot. It feels as if the 2nd shot brought on instant menopause.

Other Meds: Levothyroxine .125 mcg

Current Illness: Hypothyroidism

ID: 1288903
Sex: F
Age: 40
State: NY

Vax Date: 04/11/2021
Onset Date: 04/13/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies only

Symptom List: Injection site pain

Symptoms: Developed bumpy itchy rash on both wrists, right wrist/arm worse than left. Some areas appeared like heat rash bumps and others as hives. Spread over several days up towards elbow. Seemed to start to go away a few days before Second Dose.

Other Meds: None

Current Illness: None

ID: 1288904
Sex: F
Age: 62
State: OH

Vax Date: 02/25/2021
Onset Date: 04/15/2021
Rec V Date: 05/05/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Tinnitus. Rare moments of reprieve from it.

Other Meds: HCTZ, lisinopril

Current Illness: None

ID: 1288905
Sex: M
Age: 20
State: NY

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1288906
Sex: F
Age: 42
State: IL

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: Doxycycline, morphine, silver nitrate, latex, adhesive tape

Symptom List: Tremor

Symptoms: After the first shot/vaccine on 4/12/21 I only experienced pain in my right arm for 2 days. After the second shot/vaccine I had pain in my right arm. The night of the vaccine I woke up at 11:30 pm with a fever of 100.7? and muscle aches, joint pain, chills, headache and nausea. I took 2 advil and went back to bed. Then woke up at 2:30 am with all the above symptoms worse than before and a fever is 102.3?. At this point I was feeling very unwell. I took tylenol and had a full glass of Gatorade and headed back to bed. I slept very little that night. 5/4/21 I was extremely tired, still had muscle aches, arm pain and joint pain and a 100.8? fever all day. I got up at 5:30 am. Why back to bed at 8 am slept until 12 pm ate lunch. Went back to bed at 1:30 and slept until 5 pm. Got up had dinner and then went back to sleep at 9:30. Today 5/5/21 I have felt better so far. No Symptoms today.

Other Meds: Valcyclovir, ativan, lexapro, topamax, amoxicillin, levothyroxine, magnesium citrate, vitamin c and advil.

Current Illness: UTI

ID: 1288907
Sex: F
Age: 47
State: OH

Vax Date: 04/28/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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 and Sulfa

Symptom List: Erythema, Pruritus

Symptoms: Day after receiving 2nd shot, I felt a lot a pain around my right-side neck, shoulder, chest and back. Pain was to the point I could not lift my right arm. On the morning on 5/4/21, I woke up to a red rash and blisters in the same area that was affected with pain. In the evening of 5/4/21, I was diagnosed with shingles.

Other Meds: None

Current Illness: None

ID: 1288908
Sex: F
Age: 21
State: VA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Nausea-Medium

Other Meds:

Current Illness:

ID: 1288909
Sex: F
Age: 40
State: NY

Vax Date: 05/02/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Seasonal allergies, no allergies to products

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

Symptoms: Lump in left underarm, swollen and tender

Other Meds: No

Current Illness: None

ID: 1288910
Sex: F
Age: 70
State: WI

Vax Date: 03/17/2021
Onset Date: 04/26/2021
Rec V Date: 05/05/2021
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: Severe rash on back of neck, face

Other Meds: Humira, Levothyroxine, Lithium, Methotrexate, Preservision, Fish Oil, Vitamin D, Tumeric, Folic Acid

Current Illness: None

ID: 1288911
Sex: F
Age: 34
State: MD

Vax Date: 04/13/2021
Onset Date: 04/21/2021
Rec V Date: 05/05/2021
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: Touch allergy to latex

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

Symptoms: Period lasting over 14 days (still on going). Multiple pads filled in a 2 hour window. A piece of uterine lining came out of body, approximately 2 inches long and an inch across.

Other Meds: Birthcontrol- levonirgeatrel and ethical estradiol tablets

Current Illness: None

ID: 1288912
Sex: M
Age: 19
State: CA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Systemic: Dizziness / Lightheadness-Medium

Other Meds:

Current Illness:

ID: 1288913
Sex: M
Age: 60
State: MD

Vax Date: 04/06/2021
Onset Date: 04/13/2021
Rec V Date: 05/05/2021
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: Red marks and severe itching mostly on the palms of my hands. Fades at times. Wakes me up in the middle of night and Im scratching

Other Meds: Losartan 25mg / Myrbetriq 50mg/Prilosec OTC

Current Illness: NONE

ID: 1288914
Sex: M
Age: 28
State: GA

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 05/05/2021
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: Systemic: Throat felt itchy, but he never had any swelling.-Medium, Systemic: Shakiness-Mild, Additional Details: Pt waited 15 minutes, left. Then felt throat tingling and tightness on his drive home. Came back to the pharmacy, drank some water, we opted to give him loratadine instead of benadryl since he had a 2+ hour back home. He stayed in the pharmacy for another hour and was able to drink water and eat a snack with no issues and wanted to continue on his trek home. He called us when he arrived home and was feeling fine.

Other Meds:

Current Illness:

ID: 1288915
Sex: M
Age: 75
State: PA

Vax Date: 04/10/2021
Onset Date: 04/19/2021
Rec V Date: 05/05/2021
Hospital: Y

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

Lab Data:

Allergies: No Known Allergies

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

Symptoms: " feels rough" + DM + drinking fluids + 100.1 + ibuprofen + DOE (not new) Pulse ox: 90-95%; during triage: 90-93%

Other Meds: aspirin 81 mg tablet atorvastatin (LIPITOR) 80 mg tablet carvediloL (COREG) 25 mg tablet glimepiride (AMARYL) 2 mg tablet lisinopriL (ZESTRIL) 10 mg tablet mirtazapine (REMERON) 30 mg tablet MULTIVITAMIN ORAL pantoprazole (PROTONIX) 40 mg D

Current Illness: None

ID: 1288916
Sex: M
Age: 48
State: PR

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

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

Symptoms: My husband received the second shot of Moderna vaccine. After 4 hours he started a heavy headache that have no better nor with Tylenol . He took 2 tablets at 12:30 and 2 more at 8:00. At 5:30 am he went to the bath with a big headache and start to bleed by nose and mouth. The again at 5:45 am it happen again but in less amount. After that the headache gone but a strong sleepiness started. Actually he feel dizzy and a strong pain in the arm but have no headache. He never have problems of any bleeding before. In the first dosis have no any adverse reaction , just a strong arm pain during two days.

Other Meds: Tylenol

Current Illness: No

ID: 1288917
Sex: F
Age: 47
State: WV

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 05/05/2021
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:

Symptom List: Vomiting

Symptoms: Chills, temperature of 101.9, headache, tiredness

Other Meds:

Current Illness:

ID: 1288918
Sex: F
Age: 55
State: FL

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/05/2021
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: food: rice and onion. environmental: cats and dogs.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient returned to site immediately after leaving. She complained of facial tingling along with her tongue. Patient was assessed and found to not have any obvious cardiac or respiratory distress. Patient was advised to take Benadryl when she returned home.

Other Meds: Benadryl (prn), Collagen

Current Illness: no

ID: 1288919
Sex: M
Age: 26
State: KY

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Shakiness-Mild, Systemic: Vomiting-Medium, Additional Details: patient fell in the ground a few min after he received vaccine and he started sweating. pt felt better after he vomited and refused to go to the hospital

Other Meds:

Current Illness:

ID: 1288920
Sex: M
Age: 58
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Mild tinnitus developed within one hour and has persisted for two weeks now.

Other Meds: None.

Current Illness: None.

ID: 1288921
Sex: M
Age: 22
State: OH

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Additional Details: Patient asked for water, I told him to put his head down in between his knees and asked my tech to get him water. Patient fainted and fell out of the chair onto the floor. Unresponsive for about 15 seconds, felt pulse. Blood pressure was 120/75, pulse 55. Had him lay with feet propped on chair until he was feeling normal and then had him sit, drink water, and stay 30 minutes. Said he felt fine after, called to check in on him tonight at closing and he said feeling fine.

Other Meds:

Current Illness:

ID: 1288922
Sex: M
Age: 67
State: TN

Vax Date: 03/24/2021
Onset Date: 04/04/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Ran a temperature and rash to the upper torso for 12 hours

Other Meds: Daily multi vitamin , asprin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm