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: 1289809
Sex: M
Age: 50
State: MD

Vax Date: 04/14/2021
Onset Date: 05/05/2021
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: Patient came in on 5/5/21 to receive 2nd dose of vaccine. Her CDC card states that she received Pfizer, but she thought it was Moderna on 4/14/21. She received a dose of Moderna. I have recommended she reach out to her PCP to determine if she should receive another dose of Pfizer.

Other Meds:

Current Illness:

ID: 1289810
Sex: F
Age: 21
State: PA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
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: Cefdinir

Symptom List: Anxiety, Dyspnoea

Symptoms: Cough Shortness of Breath

Other Meds: busPIRone (BUSPAR) 30 mg tablet DULoxetine (CYMBALTA) 60 mg capsule etonogestrel (NEXPLANON) 68 mg implant(Expired) hydrOXYzine HCL (ATARAX) 25 mg tablet lamoTRIgine (LaMICtaL) 150 mg tablet norethindrone-e.estradioL-iron (JUNEL FE 1/20, 28

Current Illness:

ID: 1289811
Sex: M
Age: 24
State: PA

Vax Date: 04/30/2021
Onset Date: 05/04/2021
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: Cisapride, animal dander, pollen

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

Symptoms: Patient presented to the ED on 5/4/21 with chest pain. Patient received initial dose of of COVID vaccine on 4/2/21 and stated he received his second dose on 4/30/21.

Other Meds: Albuterol, Xanax, Symbicort, Wellbutrin

Current Illness: None

ID: 1289812
Sex: F
Age: 29
State: FL

Vax Date: 05/04/2021
Onset Date: 05/05/2021
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: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I have severe menstrual cramps and my period started today. But I have a Mirena IUD, and I haven't had my period in several years. I'm not sure if I should go to the doctor over it. The cramps are worse than I remember them being years ago.

Other Meds: 20 mg Lexapro daily, 300 mg bupropion daily, 1mg prazosin nightly

Current Illness: none

ID: 1289813
Sex: F
Age: 54
State:

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: see note

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

Symptoms: The client received the COVID vaccine (Pfizer dose 1, lot # EW0167, expiration date 5/6/2021) at 1430. At 1500, she reported a "pinching" sensation in her left chest, which didn't get worse or better upon inspiration or expiration. The pinching sensation was intermittent and didn't radiate. RN and EMT responded at this time. She denied any shortness of breath or changes in vision, and had no visible flushing, diaphoresis, or swelling. The client was sitting in her chair in the observation area, in no apparent distress. At 1505, the client's vital signs were as follows: blood pressure 144/100, heart rate 82, respiratory rate 12, and O2 96%. Lung sounds were clear to auscultation bilaterally. The client stated her blood pressure is "usually high" but wasn't sure of her exact baseline. The client stated that she hadn't eaten or drank anything yet that day. She was offered water at that time, which she accepted. The client stated she has a history of fibromyalgia, migraines, and obesity, and she takes duloxetine, gabapentin, and vitamins. She has allergies to keflex and ben-gay. The client was alert and oriented. She denied any need to lie down and stated her symptoms were improving. At 1510, the client's vital signs were as follows: blood pressure 140/98, heart rate 78, respiratory rate 12, and O2 98%. She was offered benadryl, which she declined. The client stated that her symptoms had resolved at that time and she wanted to go home. Client advised of recommended 30 minute wait time and educated regarding emergency management, AMR activation, v-safe, and primary care follow up. The client stood up without any dizziness and ambulated to her car with a steady gait, where she was driven home by her husband.

Other Meds: see note

Current Illness: see note

ID: 1289814
Sex: M
Age: 86
State: NY

Vax Date: 04/30/2021
Onset Date: 05/01/2021
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: u/k

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

Symptoms: Patient had a fever of 100.1 that resolved.

Other Meds: u/k

Current Illness: u/k

ID: 1289815
Sex: F
Age: 48
State: MI

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: codeine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: SIRVA - extreme joint and muscular pain in shoulder following injection continuing over 6 weeks post-injection. Limited mobility in the joint and arm.

Other Meds: none

Current Illness: none

ID: 1289816
Sex: M
Age: 19
State: MI

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: not known

Symptom List: Pharyngeal swelling

Symptoms: The patient was crying at time of shot administration, came out to waiting area, after about 10-15 minutes, we were asked to come help by his mom. He had passed out, we checked his pulse it was present., patient was very tense with head laid back. after about 30 seconds patient woke up and was agitated and was jerking his arms about . mom tried to calm him down. He was very pale , was sweating, and said he felt he had to throw up. We called 911 and has management staff come to area. He stated his arm was numb that he received shot in and was very emotional. We moved him to a more private area and got him a cold cloth and waited for ambulance to arrive. He refused to go in ambulance and mom was gonna take him to er in her vehicle.

Other Meds: not known

Current Illness: mom stated no health conditions

ID: 1289817
Sex: F
Age: 75
State: PA

Vax Date: 04/09/2021
Onset Date: 04/16/2021
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: Levaquin [Levofloxacin]Shortness of breath / Dyspnea, Diarrhea, Insomnia TriazolamConfusion / Delirium Latex Erythromycin BaseDiarrhea LisinoprilCoughing

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: runny nose chest tightness sinus pressure body aches steroids Mucinex Tylenol

Other Meds: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler aspirin 81 mg tablet atenoloL-chlorthalidone (TENORETIC) 50-25 mg per tablet budesonide-formoteroL (SYMBICORT) 80-4.5 mcg/actuation inhaler calcium citrate-vitamin D3 250 mg calcium- 200

Current Illness: Hypertension

ID: 1289818
Sex: M
Age: 16
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Zertec

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Within 3 minutes of receiving the vaccine, Subject experienced syncope, had ringing in the ears, loss of vision, was pale, diaphoretic, and hyperventilation. BP 102/49 and 96/58. Staff responded, provided supportive care. Subject regained consciousness. Reported on 5/5/2021 made a full recovery. It is noted he reports he worked out that morning, had not eaten or had water that day. Did not seek medical attention.

Other Meds: None

Current Illness: No

ID: 1289819
Sex: M
Age: 54
State: SC

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

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

Lab Data:

Allergies: Rituximab

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

Symptoms: 24 Hours after 2nd vaccination came down with fever of 103, shaking chills, and weakness all over. Slept 6 hours and symptoms subsided. 2 days after started having severe numbness in hands and feet. a few days later started having weakness in arms and legs, progressed over next week to the point I was unable to walk. Began steroid infusions on Mon 26 Apr. Admitted to hospital Wed 28 May for assessment and treatment. Released home on 30 Apr and returned 1 May for outpatient steroid.

Other Meds: Zestoretic, Metformin, Zyrtec, Prevacid, Privigen, Prednisone

Current Illness: High Blood Pressure, Diabetes type2, hereditary hemochromatosis, CIDP

ID: 1289820
Sex: M
Age: 38
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: Patient received 1st dose Moderna on 4/13/21 , received Pfizer on 5/4/21 for second dose. I discovered Moderna was given at 1st dose when billing 3rd party for 2nd dose. Patient thought he had gotten Pfizer for the first dose. I informed patient about 10 minutes after his 2nd dose - he didn't report any adverse events at this time. We will follow up with patient.

Other Meds: none

Current Illness: none

ID: 1289821
Sex: F
Age: 29
State: RI

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

Lab Data:

Allergies: Demerol

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

Symptoms: I got sick to my stomach almost instantaneously, I lost my taste for 3 days, I had fever and body aches for 3 days, my period became completely extreme I had blood clots which is not ordinary for me and it lasted an extra 4 days, my ears were pluged as well as not being able to move my arm for 3 days really at all, my throat was also sore and I had glands swell up

Other Meds: Vyvanse, clonidine, clonazepam, motrin, tylenol

Current Illness: Allergies/cold

ID: 1289822
Sex: F
Age: 30
State: AZ

Vax Date: 04/26/2021
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: None

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

Symptoms: Redness, swelling, itchy rash at injection site started a week after shot

Other Meds: Birth control

Current Illness: None

ID: 1289823
Sex: M
Age: 24
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: Sweating and Dizziness. Hx of vertigo (last episode 48 hrs ago). Apple juice (120mls), water, crackers given at 1735 (pt unable to recall last meal). At 1745, pt feeling better. Stable and released.

Other Meds:

Current Illness:

ID: 1289824
Sex: F
Age: 28
State: WA

Vax Date: 04/27/2021
Onset Date: 05/05/2021
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: NA

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

Symptoms: I received my vaccine on 4/27/21. On 5/5/21, I woke up with a rash/hives on my left arm on the injection site. My arm feels sore and a bit numb.

Other Meds: Buspirone, Adderall, Benadryl, Fish Oil, Vitamin b-12, Vitamin D3, Biotin, Calcium, Mangesium.

Current Illness: No

ID: 1289825
Sex: M
Age: 26
State: CA

Vax Date: 04/16/2021
Onset Date: 04/22/2021
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: No

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

Symptoms: Swollen lymph node on left shoulder

Other Meds: No

Current Illness: No

ID: 1289826
Sex: F
Age: 61
State:

Vax Date: 05/03/2021
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: Patient had second Moderna on 5/3/21, and next day was feeling achy, tired, headache. Today she stated she woke up with a sore arm at injection site that is also swollen and about 3" round.

Other Meds:

Current Illness:

ID: 1289827
Sex: F
Age: 28
State: ID

Vax Date: 04/21/2021
Onset Date: 05/04/2021
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: No

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Dizziness and vertigo

Other Meds: Pre-natal vitamins

Current Illness: No

ID: 1289828
Sex: F
Age: 52
State: OR

Vax Date: 04/01/2021
Onset Date: 04/30/2021
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: penicillin, sulfur, arithromyocin, pain meds

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

Symptoms: I got my 2nd vaccine on 4/30/21 at 10:45 AM. By 6:00 PM I was dizzy and lightheaded. I am now on day 5 and still am experiencing these symptoms. I have been drinking plenty of liquids and eating fine.

Other Meds: setraline 200 mg, buspirone 10 mg, lamotrogine 200 mg, spironolactone, 100 mg, levothyroxoxine .025 mg lipotriad dry eye omega 3 1400 mg, digestive enzymes w/probiotics, iron 325 mg, multi vitamin, B-12, fenugreek

Current Illness: none

ID: 1289829
Sex: M
Age: 71
State: PA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: None Known

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

Symptoms: Patient reported increased shortness of breath on exertion since receiving COVID vaccine on 3/9/21.

Other Meds: Amlodipine, Atorvastatin, Fish oil, Levitra, Loratadine, Vitamin D3-Vitamin C

Current Illness: None

ID: 1289830
Sex: F
Age: 31
State: OH

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: sulfa drugs (anaphylaxis)

Symptom List: Unevaluable event

Symptoms: patient reported that she had an anaphylactic reaction to sulfa drugs, advised to stay at pharmacy for a 30 minute wait post injection, patient called at 2pm stating that she had been having a severe headache, drowsiness, and weakness making it difficult to walk. Advised patient to call 911 and/or seek emergency medical care if they continued to feel this way.

Other Meds:

Current Illness:

ID: 1289831
Sex: M
Age: 43
State: PA

Vax Date: 12/31/2020
Onset Date: 01/03/2021
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: PenicillinHives / Urticaria

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

Symptoms: cough

Other Meds: aspirin 81 mg tablet atorvastatin (LIPITOR) 80 mg tablet escitalopram (LEXAPRO) 20 mg tablet lisinopriL (ZESTRIL) 2.5 mg tablet LORazepam (ATIVAN) 0.5 mg tablet metoprolol tartrate (LOPRESSOR) 25 mg tablet nitroglycerin (NITROSTAT) 0.4 mg S

Current Illness:

ID: 1289832
Sex: M
Age: 54
State: OH

Vax Date: 03/14/2021
Onset Date: 03/14/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: 4 hours after injection - started experiencing pervasive Tinnitus (ringing in the ears). It has not stopped since that time. I have seen my family doctor - and also had an initial visit with an ENT specialist. Current advice is to limit caffeine - and wait and see if it subsides.

Other Meds: Vitamin D3 Vitamin C Zinc Supplement Men's Multi-Vitamin (One a day Men's VitaCraves)

Current Illness: None

ID: 1289833
Sex: F
Age: 55
State: MT

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Face Swollen, Headache, Body aches, Muscles Spams, Arm Swollen

Other Meds:

Current Illness:

ID: 1289834
Sex: F
Age: 53
State: IL

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

Lab Data:

Allergies: Amoxicillan Sulfa

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

Symptoms: Within 3 hours of receiving 2nd dose a very swollen red welt began to appear at the site of injection. The welt itched, as well as burned, and continued to spread in length and width to the point where it reached my elbow. As of 5/5/21 the welt remains.

Other Meds: Atorvastatin (Lipitor) Claritin Co-Enzyme Q-10 Ergocalciferol (Vitamin D) Fenofibrate Fosamax Furosemide (Lasix) Magnesium Oxide Metroprolol Succinate ER Montelukast (Singulair)

Current Illness: N/A

ID: 1289835
Sex: F
Age: 24
State: WY

Vax Date: 04/16/2021
Onset Date: 05/01/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: My period came on much stronger after the vaccine, with the most significant change being in my cramps. I normally get cramps during the first couple days of my cycle, but never bad enough that it affects my life. After my first menstrual cycle after my first dose, my cramps were strong enough to wake me up in the middle of the night. My second cycle, which follows my second dose, had the same effect. I was woken up this morning with significant cramp pain and had to take medication to be able to get to work. It isn't a super serious side effect, but I'd definitely be interested in learning more about why that happened. I can't say for certain whether my flow was impacted or not.

Other Meds: None

Current Illness: None

ID: 1289836
Sex: F
Age: 42
State: FL

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: 42 y/o female with past medical history of HTN, Asthma and Hypercholesterolemia who presents with Dizziness pot vaccination. Patient states that this is her 1st vaccination in the two-dose series. Patient denies previous reaction to vaccinations in the past. Patient states that she received the vaccination to her left arm. NP and Paramedics at patient side. Patient given a bottle of water and vitals assessed. Patient initial BP 180/116, 84HR, 99% RA. Patient states that she took her BP medication this am. Patient monitored for a period and BP was taken manually, 140/90 Left arm, much improved. Patient discharged home with resolution of dizziness and elevated BP.

Other Meds: Metoprolol Aspirin

Current Illness:

ID: 1289837
Sex: M
Age: 44
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
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: none

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

Symptoms: Consistently, Weak/exhausted/no appetite/constipated since 1 hour from shot on 4/27. Fever/Headache coming and going mostly in the 5 days following shot, better in the last few days. Headaches severe 3-4 days after shot.

Other Meds: none

Current Illness: none

ID: 1289838
Sex: F
Age: 26
State: RI

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: none

Symptom List: Nausea

Symptoms: After receiving vaccination, patient sat down in waiting area to be observed for 15 minutes. She stated on consent form that she has not had any reactions to vaccines previously or any allergies. While in the waiting area, the patient collapsed and slid down onto the floor. She did not hit her head on the way down. I attended to her immediately and had the pharmacy technician call 911. The patient came back to right away. She felt lightheaded and clamy but was not having any difficulty breathing. I had her lie down and gave her water. She began to feel better fairly quickly. After her reaction the patient stated that she has anxiety and has experienced a reaction like this previously to vaccinations in the past. I recommended that if she receives her second dose she does so in a more controlled setting such as the state run clinics with emergency medical care on sight. The rescue arrived and the patient was taken into the ambulence to have her vitals checked. She walked out of the store okay with no issue and was not taken to the hospital.

Other Meds: n/a

Current Illness: none

ID: 1289839
Sex: M
Age: 57
State: NY

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: u/k

Symptom List: Injection site pain

Symptoms: Fever of 99.9 on 5/3, 99.6 on 5/4, and 100 on 5/5. Patient started on IVF, Zosyn & Vancomycin ABT's IC for Pnuemonia, Nebulizer treatment for COPD, VS every 4 hours x 48 hours.

Other Meds: u/k

Current Illness: u/k

ID: 1289840
Sex: F
Age: 55
State:

Vax Date: 04/29/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Elevated liver enzymes: before vaccination 4/15/ test ALS 28, ALT 31. After vaccination test 5/3 ALS 208 ALT 165 the others: nausea, let's arm pain ,headache , fatuque

Other Meds:

Current Illness:

ID: 1289841
Sex: F
Age: 16
State: IA

Vax Date: 05/05/2021
Onset Date:
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: no

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

Symptoms: Immediately after second dose, patient reported feeling tingly, light headed and "off". She had had this same reaction in the past with her 1st dose and was prepared that it may happen again. Her mom and dad were both with her. She laid down for awhile and was monitored directly in immunization room for 30 minutes. She reported feeling better, back to normal before leaving with direction supervision of her parents. They report that she often has these reactions to shots or medical procedures. This is the same reaction she had to the first shot.

Other Meds: unknown

Current Illness: unknown

ID: 1289842
Sex: F
Age: 42
State: IN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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: Ceclore, Entex La, Zithromax, Zoloft, all sulfa drugs

Symptom List: Tremor

Symptoms: Rash on face and both arms and a numb upper lip all within 30 minutes of receiving vaccination.No treatment. Very easily bruised within the weeks that followed vaccination.

Other Meds: Vitamin D

Current Illness:

ID: 1289843
Sex: M
Age: 54
State: GA

Vax Date: 03/24/2021
Onset Date: 03/25/2021
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

Symptom List: Erythema, Pruritus

Symptoms: High fever (103 for 3.5 days), sensitive to light, tiredness Same symptoms of FMF disorder

Other Meds: colchicine, Crestor, Repatha

Current Illness:

ID: 1289844
Sex: M
Age: 57
State: PA

Vax Date: 12/31/2020
Onset Date: 01/05/2021
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: NKA

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

Symptoms: FEVER, Fatigue, Muscle or body aches, Headaches and Congestion or runny nose

Other Meds: aspirin 81 mg tablet cyclobenzaprine (FLEXERIL) 10 mg tablet psyllium husk (METAMUCIL) 0.4 gram capsule

Current Illness:

ID: 1289845
Sex: F
Age: 17
State: PA

Vax Date: 04/09/2021
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: No Known Allergies

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

Symptoms: Fatigue

Other Meds: None

Current Illness: None

ID: 1289846
Sex: M
Age: 64
State: GA

Vax Date: 04/29/2021
Onset Date: 05/02/2021
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: Sinuses

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Lip & facial swelling left side

Other Meds: Bp Lisinopril * Amlodipine* Atorvastatin Bronchial inhaler

Current Illness: None

ID: 1289847
Sex: F
Age: 17
State: MT

Vax Date: 04/30/2021
Onset Date: 05/02/2021
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:

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

Symptoms: Fever, Headache, Body aches, Fatigue

Other Meds:

Current Illness:

ID: 1289848
Sex: F
Age: 41
State: PR

Vax Date: 04/20/2021
Onset Date: 04/28/2021
Rec V Date: 05/05/2021
Hospital: Y

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: Morphine

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

Symptoms: 41 yo female chronic smoker with PMHx of Migraine currently in no treatment came in to de ER with severe bilateral muscular leg pain. Patient was found with severe CPK elevation ( baseline 47,400) elevated AST (baseline 515) elevated ALT (baseline 141) . Patient denies use of statin or medications, viral hepatitis titer negative and no known other cause of CPK elevation. Naranjo adverse drug reaction probability scale reported as 5 which may be consider as a probable vaccine reaction.

Other Meds: Patient does not uses medications nor supplements

Current Illness: Patient was healthy before vaccination

ID: 1289849
Sex: F
Age: 37
State: GA

Vax Date: 03/17/2021
Onset Date: 04/01/2021
Rec V Date: 05/05/2021
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: vankomycin

Symptom List: Pain in extremity

Symptoms: After getting my first Pfizer shot on 3/17, menstruation was delayed by a few days. It was lighter than normal but lasted a typical 5 days. I was off my period for 5 days, then it started again and continued for 4 weeks. Period was light but more than spotting. It ended and now am late for a regular cycle. In the two weeks after my first dose of the vaccine, I had several dizzy spells (felt like vertigo with a pounding pressure in my chest) but no other symptoms. I got the second vaccine in early April. In mid-April, I started wearing a heart monitor due to the chest pressure and dizziness. I had several episodes of bradycardia and heart pauses (for up to 7 seconds). This may have started prior to the first vaccine, but was worse in mid-to-late April. I received a pacemaker April 30.

Other Meds: asmanex inhaler, singulair, propranolol, Zoloft, probiotics, multi-vitamin, fiber capsules

Current Illness: anxiety, asthma/allergies, irritable bowel

ID: 1289850
Sex: M
Age: 64
State: PA

Vax Date: 04/24/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Occasional food allergy Minor cats, dust mites and mold

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

Symptoms: Feeling of overheating upon mild exertion. No fever to report. Symptoms have continued for over 10 days after second covid vaccine.

Other Meds: metformin ER 500 MG 24 hr tablet metoprolol SUCCINATE ER 25 MG tablet memantine 10 MG tablet donepezil 5 MG tablet montelukast 10 MG tablet simvastatin 20 MG tablet OXAPROZIN 600 MG PO TABS esomeprazole 40 MG DR capsule triamterene-HCTZ 37.

Current Illness: None

ID: 1289851
Sex: M
Age: 37
State:

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

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

Symptoms: headache lasting 1 day

Other Meds:

Current Illness:

ID: 1289852
Sex: M
Age: 21
State: TX

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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:

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

Symptoms: Pt fainted and fell from chair hitting the floor. Vital signs were taken and were elevated. Pt was assessed, and pt became alert immidetly after ending up on the floor. He did not complain of pain anywhere, vital signs started to trend towards within normal limits. No medication was given. pt left indepently with normal walking gait and partner waiting outside. Pt was educated on when to seek urgant care.

Other Meds:

Current Illness:

ID: 1289853
Sex: F
Age: 25
State: NY

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

Symptom List: Vomiting

Symptoms: Sever body aches and fever complicated by shortness of breath episode. SOB started at 2:00 AM almost 12 hours after the vaccine administration and lasted 20-30 min. Fever and body aches started at 10:00 PM 05.04.21 and continued through 05.05.21

Other Meds: None

Current Illness: None

ID: 1289854
Sex: F
Age: 45
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Client stated a rush of dizziness overcome her as well as feeling hot.

Other Meds: none

Current Illness: none

ID: 1289855
Sex: M
Age:
State: NC

Vax Date: 05/01/2021
Onset Date: 05/05/2021
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: N/A

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

Symptoms: Arm swollen, pain in arm, cold chills back pain arm pain right toes hurt fatigue could not sleep tired dehydrated sleepy shoulder pain bruising at injection site. Waiting for side affects to subsidize before seeking medical attention

Other Meds: Tummeric,Allegra-d,probiotics ,Amolodfine blood pressure medication

Current Illness: N/A

ID: 1289856
Sex: F
Age: 76
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Dizziness and sleepy. At 1314: BP 174/88, HR 50, O2 95%. Observed 15 minutes and pt drank water. At 1338: BP 155/77, HR 54, O2 96%. Pt stated feeling better and had steady stable gait. Advised to seek ED if sx worsen. Stable and released.

Other Meds:

Current Illness:

ID: 1289857
Sex: F
Age: 25
State: NY

Vax Date: 04/01/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Mild soreness and itching around vaccine site. Two or three days later I saw a small elongated bubble formed about an inch below the injection site, which is where it was itching. A few days later it popped and some sort of clear liquid came out. My assumption is that it was some sort of blister or other immune system response. If needed I can provide a photo of the bubble.

Other Meds: None

Current Illness: None

ID: 1289858
Sex: F
Age: 37
State: NC

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Prednisone, Medrol

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

Symptoms: The day after receiving the second Pfizer vaccine dose, I had a 99.5 degree fever, severe muscle aches, weakness, increased appetite, irritability, and overall just felt horrible. These symptoms lasted 48 hours. On the third day after receiving the vaccine, I had a moderate headache that lasted 24 hours.

Other Meds: Tylenol, Claritin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm