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: 1290223
Sex: F
Age: 70
State:

Vax Date: 04/03/2021
Onset Date: 04/20/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Arm sore at injection site. No tenderness, no redness - just slightly sore to the touch

Other Meds: simvasatin tresemren (sp) prilosec

Current Illness: none

ID: 1290224
Sex: M
Age: 61
State: PA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NO KNOWN ALLERGIES

Symptom List: Anxiety, Dyspnoea

Symptoms: SYRINGE DEFECTIVE, LEAKED OUT OF SYRINGE INSTEAD OF GOING THROUGH NEEDLE

Other Meds: METOPROLOL 100 MG ONCE DAILY HYZAAR 100-25 MG ONCE DAILY

Current Illness:

ID: 1290225
Sex: F
Age: 16
State: MI

Vax Date: 04/06/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: No adverse event to report, just an error. Vaccine administered to unauthorized age group.

Other Meds:

Current Illness:

ID: 1290226
Sex: M
Age: 27
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: nkda

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pt complained of nausea and acid reflux about 5 minutes after receiving the first dose of Pfizer covid vaccine. Nausea resolved after about 15 minutes and pt then complained of headache, sensitivity to light, lightheadedness and sore throat. Denied chest pain, SOB, difficulty breathing, swelling of face, tongue or throat, itchiness rash or hives. Pt maintained O2 98% or above while in clinic.

Other Meds: None

Current Illness:

ID: 1290227
Sex: M
Age: 18
State:

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

Lab Data:

Allergies:

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

Symptoms: caller received second pfizer vaccine yesterday. today has headache, tired, low grade fever, chest pain above nipple on one side. has not received medical attention for chest pain.

Other Meds:

Current Illness:

ID: 1290229
Sex: F
Age: 30
State: CO

Vax Date: 04/05/2021
Onset Date: 04/09/2021
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: Sulfa, pineapple

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

Symptoms: Made me get a second period. I never get two periods in a row. I also have been bleeding and have not stopped since this has occurred.

Other Meds: Lansoprazole, alavert

Current Illness: None

ID: 1290230
Sex: F
Age: 57
State:

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Exacerbation of autoimmune disorder. Increase in neuropathy.

Other Meds:

Current Illness: Hashimoto?s disease

ID: 1290231
Sex: M
Age: 59
State: CA

Vax Date: 04/07/2021
Onset Date: 04/01/2021
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: NKDA

Symptom List: Pharyngeal swelling

Symptoms: When coming for his 2nd dose, patient reported suffering short term memory loss around the time of receiving his 1st dose. When asked specifically when his memory loss started; he could not identify. He stated it may have started 5 weeks ago, or 4 weeks ago but could not say for certain that his memory loss manifested before or after his 1st Moderna dose. He reported his memory loss to his PCP, who still recommended he come for his 2nd dose.

Other Meds: unknown

Current Illness: non reported

ID: 1290232
Sex: F
Age: 53
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Administered 0.5 mL of vaccine, not 0.3 mL

Other Meds:

Current Illness:

ID: 1290233
Sex: M
Age: 37
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: temperature of 102 and a fever

Other Meds:

Current Illness:

ID: 1290234
Sex: M
Age: 51
State:

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

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

Symptoms: Patient developed a "massive headache" soon after he received his vaccine. He stated his right side felt weak and numb. His blood pressure at the vaccine clinic was noted to be severely elevated (patient was on blood pressure medication in the past but was taken off of it a while ago). Patient drove himself to the ER and stroke alert was called. Patient needed nicardipine drip and labetalol pushes to bring down blood pressure, and once it was controlled patient was given alteplase.

Other Meds: Ibuprofen 800mg every 8 hours as needed for pain.

Current Illness:

ID: 1290235
Sex: M
Age: 21
State: IL

Vax Date: 04/23/2021
Onset Date: 04/26/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: 21 year old previously healthy male had 2nd dose of COVID vaccine on 4/23. He had fever and chills over the next two days that resolved spontaneously. On 4/26, he began having palpitations with onset of substernal chest pain described as a piece of metal on top of his chest. He also had nausea and vomiting. After 1 hour, he took one ibuprofen which resolved symptoms. On 4/27, he again had chest pain but immediately took ibuprofen which resolved symptoms. He saw his PCP on 4/28 and had abnormal EKG with ST and T wave abnormalities, elevated troponin of 10, and he was sent to the ED for further evaluation. He was given 324mg aspirin and admitted for observation. He did not have any additional symptoms, and echo was normal. Troponins down trended to 2 by 4/29, and he was discharged on a 5 day course of indomethacin with follow up with his PCP, no cardiology follow up required.

Other Meds: No prescription medications, daily multi-vitamin, 1 cup of coffee each morning

Current Illness: None

ID: 1290236
Sex: F
Age: 18
State: IN

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: NKDA

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

Symptoms: Approximately two minutes after vaccine injection, pt started to feel dizzy, saw spots, felt like she was going to pass out. Someone got a wheelchair and we took her back to observation/treatment area. Patient was very drowsy, felt nauseous, hands were tingling, and was cold and clammy. We asked her to text her Mom, who was sitting out in the parking lot, to have her come inside. Pt reported passing out with HPV vaccine and on blood draws. We moved patient to pt bed and took vitals (listed below). Patient was able to recover without any medication administration under close observation. After about 20 mins in obs/treatment area, she was feeling better and we moved her to the observation room with her Mom. We had leftover vaccine syringes, so Mom received her first dose of vaccine. They waited together until Mom's 15 mn obs time was over. Patient and someone left the clinic feeling fine and under their own power around 1845.

Other Meds: Iron supplement

Current Illness: anemia - taking iron supplement

ID: 1290237
Sex: F
Age: 43
State: OK

Vax Date: 04/30/2021
Onset Date: 05/03/2021
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: Penicillin and cilantro

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

Symptoms: Arm close to the injection site is a red rash and itchy.

Other Meds: Smart Vitamins for Women (Multivitamin)

Current Illness: No illness but end of menstrual cycle-in case that is relevant

ID: 1290238
Sex: F
Age: 69
State: NY

Vax Date: 04/01/2021
Onset Date: 04/04/2021
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: None known.

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

Symptoms: Tingling in arms, hand, and fingers (mostly hand and fingers), numbness (like "asleep), some body pain. No treatment. Just feel it needs to be reported. Ongoing since I got the vaccine.

Other Meds: Took none that day. Citalopram, Omeprazole, Synthroid, Crestor. Vitamin c with zinc, calcium, vitamin D.

Current Illness: None

ID: 1290239
Sex: F
Age: 25
State: VA

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

Lab Data:

Allergies: n/a

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

Symptoms: Patient was not feeling well after receiving Pfizer Covid-19 Vaccine. Patient was pale and complaining dizziness and nausea. after a few minutes, these symptoms are gone.

Other Meds: n/a

Current Illness:

ID: 1290240
Sex: F
Age: 78
State: CA

Vax Date: 02/19/2021
Onset Date: 04/10/2021
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: zithromax

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

Symptoms: right bell's palsy. severe

Other Meds: estriol

Current Illness: HLD cervical spondylosis dermatitis thyroid nodule

ID: 1290241
Sex: F
Age: 62
State: TX

Vax Date: 04/26/2021
Onset Date: 04/30/2021
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: Penicillin, laytex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Shingles 4 weeks after second dose Covid vaccination

Other Meds: Cymbalta Wellbutrin

Current Illness: None

ID: 1290242
Sex: F
Age: 42
State: KS

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: Swollen cheeks, throat, metallic taste, pain in old scar tissue (surgery at L5-S1) within twenty/thirty minutes of injection Fever/headache/chills/sweating for four nights Hair shedding started 4-14-2021 and continues still

Other Meds: Tirosint

Current Illness:

ID: 1290243
Sex: F
Age: 48
State: MO

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: 1545 Pt reported feeling sharp pain when breathing in. 1600 Pt reported tingling bilateral arms and back of neck. 1615 Pt reported sharp pain upon breathing had resolved. Tingling sensation beginning to go away.

Other Meds:

Current Illness:

ID: 1290244
Sex: F
Age: 48
State: OH

Vax Date: 05/03/2021
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: Patient experienced runny nose, cough, congestion, arm and breast pain. Patient reported back pain. Patient has been taking extra strength tylenol. Patient has not done a rapid test for COVID.

Other Meds:

Current Illness:

ID: 1290245
Sex: F
Age: 35
State: NY

Vax Date: 04/03/2021
Onset Date: 04/11/2021
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: Allergic to many fruits (apples, pears, berries).

Symptom List: Unevaluable event

Symptoms: Rash near injection site. The redness was like the outlines of an oval, but the oval wasn't filled in.

Other Meds: None

Current Illness: None

ID: 1290246
Sex: F
Age: 60
State: WI

Vax Date: 01/07/2021
Onset Date: 01/08/2021
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, morphine, hydrocodone

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

Symptoms: 1/7/2021 vaccination 1/8/2021 bruise/pain R lower leg, hard warm to touch. Painful and sore. Progressively got worse; red, bluer. 1/10 or 1/11 ER . Ultra sound on leg. 10cm clot. Put me on aspirin, warm compresses. Had to increase aspirin up to 2x day. It eventually cleared. Referred to surgeon. Found some other veins their inspecting further. *have not had any more clots

Other Meds: maxzide, locartan, levothyroxine, crill oil, biotin, vit C, zinc, gabapetin

Current Illness: n/a

ID: 1290247
Sex: F
Age: 44
State: VT

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

Lab Data:

Allergies: Beano, Afrin, NSAIDs, Nuts, Bees, Hydromorphone, Lithium, Ultram, Ceclor, Sulfa, Percocet, Flexeril, Benzocaine, Isopropyl alcohol, polytrim, ultracet, Trazodone, Amitriptyline, Phenergen, Dyphylline, Lactose, Fluticasone, Omeprazole, Levofloxacin

Symptom List: Injection site pain, Pain

Symptoms: Within a minute of vaccination the patient ran to the bathroom vomiting. She came back into the pharmacy waiting area and complained of a rash on her chest and arms and difficulty breathing. We contacted EMS and administered her own Epinephrine 0.3mg/0.3mL pen. The patient said within a few minutes that she was having an easier time breathing and was feeling slightly better. EMS arrived and continued monitoring her and brought her to the local hospital for further observation and treatment.

Other Meds: Alprazolam 2mg - three times daily PRN Diphenhydramine 25mg - PRN Albuterol 90mcg - PRN Linzess 145mcg - 2 capsules daily PRN Cimetidine 200mg - 2 tablets twice a day Epinephrine 0.3mg - PRN

Current Illness: NA

ID: 1290248
Sex: F
Age: 53
State: MD

Vax Date: 04/08/2021
Onset Date: 04/09/2021
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: Regalin, Percocet, darvacet, codeine, morphine dilaudid

Symptom List: Injection site pain, Menorrhagia

Symptoms: 1 day after blurry vision felt like pass out. 8 days later lymph nodes by collarbone extremely swollen and painful. 3 weeks later severe right abdominal pain right side. 2 ct scans and transvagional sonogram and numerous blood tests and Er visits twice in one week, regular dr 3 visits in one week gynecologist and gastroenterologist each in one week.

Other Meds: Blurred vision felt faint

Current Illness:

ID: 1290249
Sex: M
Age: 62
State: MN

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 05/05/2021
Hospital: Y

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

Lab Data:

Allergies: none

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

Symptoms: fever, dizziness, lethargy, diplopia, and shakiness in arms. acute encephalitis. Intravenous immunoglobulins started 5/2-5/6. slow cognitive improvement. slow improvement in gait. Transferred to inpatient rehab.

Other Meds: aspirin (Aspirin Low Dose) 81 mg enteric coated tablet Take 81 mg by mouth at bedtime. ? atorvastatin (LIPITOR) 20 mg tablet Take 20 mg by mouth at bedtime. ? cholecalciferol, Vitamin D3, 2,000 unit tablet Take 4,000 units by mouth at bedt

Current Illness: none

ID: 1290250
Sex: M
Age: 79
State: PA

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: LA

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I have a sore left arm in area of where the shot was taken. Arm accidentally bumped which made the soreness apparent on 5/4. On 5/5 still very sore. I cannot raise my arm past shoulder height.

Other Meds: hydrochlorothiazide, atorvastatin, levothyroxine, lisinopril, metoprolol, tamsulosin, aspirin, insulin

Current Illness: major illnesses includes: type 2 diabetes

ID: 1290251
Sex: F
Age: 20
State: IN

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sore muscles, achey bones, fever, headache, nausea. Lasted until the end of day when I fell asleep. Medicine did not help.

Other Meds:

Current Illness:

ID: 1290252
Sex: F
Age: 30
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Administered 0.5 mL of vaccine, not 0.3 mL

Other Meds:

Current Illness:

ID: 1290253
Sex: F
Age: 36
State: AL

Vax Date: 04/15/2021
Onset Date: 04/21/2021
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: gluten/soy

Symptom List: Nausea

Symptoms: Over a period of two weeks has experienced alternate swelling of different body parts. Usually occurring after accidentally rolling over and sleeping on the arm which received the shot (recipient is a side sleeper). First lower lip swelled on one side (the left side), then left ankle, then vulva area/clitoris, then left arm around the inside of elbow, then back of right leg around the inside of knee, then back of left leg around the inside of knee, then back of left arm again around the inside of elbow, then under left breast, then around the basal joints of both hands/base of thumb and space between thumb and forefinger (left hand more generalized hand swelling, right hand more between the thumb and index finger), then on left side at point of bending over at the waist (top of thigh), then under lower left buttock cheek, then under lower right buttock cheek. slight swelling on both wrists also.

Other Meds:

Current Illness: none

ID: 1290254
Sex: M
Age: 37
State: TX

Vax Date: 04/12/2021
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: None

Symptom List: Injection site pain

Symptoms: Since vaccine have severe headaches, sensitivity to light, feeling lethargic, balance is off, headaches keep me up at night. I've seen my primary doctor, neurology, ophthalmology, and had an MRI,and an iv. I don't have insurance, and I've haven't been to work or been able to drive. Doctor wants me to go to ER

Other Meds: Trintellix

Current Illness: None

ID: 1290255
Sex: F
Age: 43
State: CO

Vax Date: 05/02/2021
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: slight allergy to eggs which is why I got the Pfizer

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

Symptoms: Right at injection I felt a mix of shooting and burning. I thought all shots must be this way so I went into the waiting area for 15 minutes per instruction. I had no respiratory symptoms but realized that my arm, shoulder, left upper back, a little bit of the chest area in front near the shoulder, down my arm and into my fingers (mostly pinky ring and part of thumb) were either completely numb or pins and needles. My arm was getting heavy and tired and after 10 minutes many of the areas were completely numb. I told the nurse at the 10 minute mark and she checked for any respiratory distress which I had none. She told a few others and they decided it was probably just swelling around a nerve or something. They gave me ice and told me to give it a few days and pay attention if it goes up my neck or face. By the time I got home it felt like the left side of my face had pins and needles and a light numbness. Later that night my left ear was numb and my teeth started hurting and my lips felt like a dentist had done a numbing shot or something. This is day three and some parts are still numb and some have returned to pins and needles. Some places feel like they are...covered in cling wrap when people try to touch me. Today I have a ringing sound in my ears. I knew there was a chance for some side effects with these shots, but this seem really not ordinary. I reached out to a rep at the VAERS and he suggested I try to report to you all. I do not have health insurance so I am unable to get this checked out without accruing major bills. Has anything like this happened to other people? What do they do to fix it? Will it go away? Please advise.

Other Meds: n/a

Current Illness: n/a

ID: 1290256
Sex: M
Age: 70
State: WA

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

Lab Data:

Allergies: zofran

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

Symptoms: Four minutes after his vaccination, patient reported feeling "hot", and sweating profusely. Some shortness of breath, and mild chest pain. Patient was responsive, and able to answer questions. By 2:50 PM, pt reported feeling "better" but still "groggy".

Other Meds: Sildenafil, aspirin 81mg

Current Illness: unknown

Date Died:

ID: 1290257
Sex: M
Age: 59
State: WI

Vax Date: 04/16/2021
Onset Date: 04/18/2021
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: Unknown

Symptom List: Tremor

Symptoms: Pt. called his daughter on Sunday April 18 and told her was not feeling well and said it was from the effects of the (one shot) COVID-19 vaccine. You would have to contact her directly for more information. He was found dead in his room by the manager around 5 pm on April 22nd. Manager told me his body was cold to the touch so she thought he may have passed the previus day on April 21st. Daughter todl me earlier today that a doctor is running some tests to try to determine the cause of death. You would need to contact her for the doctors name. My own inpression is that the emphysema was not severe enough to have d=caused his death as he could walk up to half a mile.

Other Meds: Unknown

Current Illness: Emphysema

ID: 1290258
Sex: F
Age: 45
State: GA

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

Lab Data:

Allergies: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: The injection site developed a blister that caused the first layer of skin surrounding the site to burst. Site is also red.

Other Meds: N/A

Current Illness: N/A

ID: 1290259
Sex: M
Age: 33
State: OR

Vax Date: 04/30/2021
Onset Date: 04/30/2021
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: Patient stated he had dose one 4-weeks prior, however he was only 3 weeks and as a result got the vaccine one week early.

Other Meds:

Current Illness:

ID: 1290260
Sex: F
Age: 52
State: CA

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

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

Lab Data:

Allergies: unknown

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

Symptoms: Continued to monitor patient & she left by ambulance to hospital. - BP did lower to 156/98

Other Meds: 3 min. after receiving Maderna Vaccine, patient stated she felt like she couldn't breath & her eyes rolled back, almost seem she started to shake similar to a seizure lasted approx. 1 min. Vital Signs 2:05- O2 sat 96%, Heart rate 107 BP- 1

Current Illness: Unknown

ID: 1290261
Sex: M
Age: 78
State: IN

Vax Date: 04/21/2021
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: unknown

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: This is an error report. Patient received Moderna COVID-19 vaccine on 4/21/21 at. Administration is not available in the state EMR for COVID-19 vaccine, Zotec. Patient arrived at manufacturing company today and informed screeners that he was there to receive his first dose. He was administered Pfizer COVID-19 vaccine.

Other Meds: unknown

Current Illness: unknown

ID: 1290262
Sex: M
Age: 33
State: PA

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

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

Lab Data:

Allergies: Unknown

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

Symptoms: My entire world has unraveled since getting this shot. Been to 4 ERs for systemic inflammation and neurological symptoms. Written off a psycho and about to be committed, but was brilliant. I believe I was given an undiluted dose of Pfizer without diluent, and became psychotic, and furthermore I believe my parents, who also got it, have had their judgement affected as well. They have been a lot less urgent with concern for their welfare of me since the shot. All they do is sleep all the time, wouldn't take me to the ER even when I was having trouble reading and staggering around. I understand I have no credibility here, but please look into this matter seriously, and not just the ravings of a crazy person.

Other Meds: Risperdal, Latuda, Toprol, Valium

Current Illness: None

ID: 1290263
Sex: F
Age: 27
State: FL

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: running a temperature/fever, aches and pains, and headache

Other Meds:

Current Illness:

ID: 1290264
Sex: M
Age: 33
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Patient has a history of chronic panic attack . Present with signs and symptoms of anxiety. Patient reports feeling lightheadedness and dizziness after vaccine. Vitals all in normal limits . After being asses patient reports feeling better. Patient walk out of facility back to prior function

Other Meds:

Current Illness:

ID: 1290265
Sex: F
Age: 70
State: MN

Vax Date: 03/30/2021
Onset Date: 04/05/2021
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: Viocase - in powder form- medication for cystic fibrosis

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

Symptoms: Vasovagal response at home, followed by going to ER - high blood pressure, lightheadedness. There for 3.5 hours. B/P 173/92 on discharge. CScan, ECG 12 lead, and troponin, mg, phosphorus, hemogram, plus, diff, basic metabolic panel.

Other Meds: Daily vitamin, sometimes extra vit c,

Current Illness: None

ID: 1290266
Sex: M
Age: 33
State: MD

Vax Date: 04/08/2021
Onset Date: 04/20/2021
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: none

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

Symptoms: 4/8 got vaccine. Then on 4/20 patient developed myalgias in back, legs, and jaw and headaches, tingling in hands, normal strength. Then on 4/25 developed Bells palsy treated with prednisone and valcyclovir for possible meningitis (no LP). Full body pain particularly in LE persisted even though Bells palsy resolved. He then developed confusion and intrusive thoughts, as well as urinary retention. He was direct admitted to our hospital. Neuro exam was notable for diffuse myalgias and 1+ patellar reflexes bilaterally. Patient was treated with gabapentin for neuropathic pain control, urinary hesitancy improved, no strength deficits. Lumbar MRI showed cauda equina enhancement consistent with ascending infectious or inflammatory process like GBM.

Other Meds: none

Current Illness: none

ID: 1290267
Sex: M
Age: 68
State: NM

Vax Date: 03/10/2021
Onset Date: 03/18/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Had blood drawn for physical 8 days (March 8, 2021) after initial vaccination. Results indicated that platelet count could not be made because of "clumping platelets." Did a follow-up blood test on March 29 as recommended by family physician, and had same results. Have never previously experienced that condition. I am blood type A positive.

Other Meds: None

Current Illness: None

ID: 1290268
Sex: M
Age: 48
State: AZ

Vax Date: 12/29/2020
Onset Date: 12/29/2020
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: penicillin, sulfa, erythromycin

Symptom List: Vomiting

Symptoms: Extreme pain during vaccination. Worsening pain and would wake me when I rolled on to my arm for 4 days. Evolved into joint pain that would not resolve with medication. Developed a loss of range of motion and pain that mimicked a rotator cuff tear. This worsened over months. Doctor prescribed meds and PT. After PT I suffered a partial tear of the biceps tendon. MRI pending. Shoulder pain improved after the tear.

Other Meds: n/a

Current Illness: n/a

ID: 1290269
Sex: F
Age: 42
State:

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: penicillin, crustaceans

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 2 hours post-injection, I experienced an episode of nearly fainting (all over body heat, sweat, hearing and vision lessening). I made sure my feet were planted and put my head down between my knees. After 10-15 minutes, I started to return to normal. I never fully fainted. I was sitting at home on the couch.

Other Meds: women's multivitamin, vitamin c, vitamin d3, cranberry, melatonin

Current Illness:

ID: 1290270
Sex: F
Age: 68
State: CA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: Vomited diarrhea diarrhea lasted 2 1/2 months after five probiotics. The only one that worked was the medical grade probiotic. My food was coming out chewed food and I would have eight or nine incidences a day with no prior history of colon problems

Other Meds: Synthroid forteo

Current Illness: None

ID: 1290271
Sex: F
Age: 30
State: CO

Vax Date: 04/20/2021
Onset Date: 04/21/2021
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: minocycline, chlorhexadine, montelukast, ruconest, peanuts, tree nuts, dairy, gluten, sesame

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme flu like symptoms, fatigue, headaches, whole body joint pain, chest pain, and sore throat for 3 days post shot. Mild symptoms for following week followed by another week of severe joint pain, fatigue, headache, flu-like symptoms, sore throat, dizziness and inability to get out of bed due to illness. 2 weeks later, still dealing with these symptoms and they don't seem to be resolving.

Other Meds:

Current Illness:

ID: 1290272
Sex: F
Age: 47
State: CA

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

Lab Data:

Allergies: penicillin; sulpha; gloves - latex

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

Symptoms: I didn't feel anything in the beginning, when I came up that night, I found brown spots on underwear - I thought it was my period because I usually have period around that time. But then my period lasted two weeks every day (non stop) - too long (usually 3-5 days). I emailed my primary care doctor. April 15th - period became heavier; it lasted 3 or 4 days like and then it became less. I saw OB/GYN - she said it is almost stopped so she said my exam was normal. I still had my period two more days but then it stopped. In total, It lasted 2 1/2 weeks, it has never been that long before.

Other Meds: Pomegranate Zakuro EX - from Japan - extracts

Current Illness: no

ID: 1290273
Sex: M
Age: 35
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: body aches

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm