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: 1291958
Sex: F
Age: 18
State: VA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/06/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: About 10-15 hours after injection - Came down with headache, fever, body aches, fatigue, and night sweats. Recovered fully 24 hours after injection. May 5th, 2021 ~7:30 am (4 days post-vaccination) I stood up from a seated position and then collapsed moments later and had, what my brother described as, a seizure which was followed by confusion, nausea, and fatigue.

Other Meds: 60mg Duloxetine

Current Illness: HSP

ID: 1291960
Sex: M
Age: 39
State: FL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 05/06/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Chills, nausea, diarrhea, dizziness, fatigue, brain fog, blurry vision, poor depth perception and headaches.

Other Meds: chlorthalidone, Cephalexin

Current Illness: Infected cyst

ID: 1291961
Sex: M
Age: 54
State: IN

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fever 101, Chills, sweats starting about 11:30PM, lasting until 7:00am, Tylenol.

Other Meds: Vitamin D, Vitamn B, Vitamin C,

Current Illness: None

ID: 1291962
Sex: F
Age: 72
State: PA

Vax Date: 04/12/2021
Onset Date: 05/17/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approximately three days after receiving the Covid 19 vaccination the patient and her husband (separate VAERS report submitted) started experiencing the following symptoms: tiredness, loss of appetite, nausea and some vomiting. On the fifth day the patient and her husband experienced extreme diarrhea. They went to the doctor when the diarrhea occurred. The doctor prescribed antibiotics.

Other Meds: Calcitriol 0.5 MCG (ROCALTROL) 1 capsule daily Levothyroxine 125 MCG (SYNTHROID) 1 tablet daily Losartan - hydrochlorothiazide 100 - 25 MG (HYZAAR) 0.5 tablet daily Melatonin 10 MG tablet @bedtime Omeprazole 40 MG DR (PRILOSEC) 1 c

Current Illness:

ID: 1291963
Sex: M
Age: 21
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Systemic: Visual Changes/Disturbances-Severe, Additional Details: Got shot 2:09pm pt had vision loss, sweating, low bp after recieving shot. 1st bp: 120/50 pulse 51 at 2:23pm, 2nd bp: 97/56 pulse 52 at 2:34pm, 3rd bp:97/47 pulse 54 at 2:48pm. advised pt to not drivr had friend leave with him at 2:50pm

Other Meds:

Current Illness:

ID: 1291964
Sex: F
Age: 60
State: GA

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: None

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

Symptoms: Severe flu-like symptoms. Chills, fever, headach, body aches. Arm is red from vaccine site to almost elbow. Very sore arm.

Other Meds: None

Current Illness: None

ID: 1291965
Sex: F
Age: 32
State: MA

Vax Date: 01/20/2021
Onset Date: 02/10/2021
Rec V Date: 05/06/2021
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: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: First menstrual cycle after first dose, two days late and lasted 3 days, very light First menstrual cycle after second dose, seventeen days late and lasted 5 days, moderate Second menstrual cycle after second dose, ten days early lasted 5 days, very light (Typically it is very regular. Same time of the month, every month for sixteen years, lasts 4 days)

Other Meds: Wellbutrin Sr 150mg Tab Prilosec 20mg Cap Ventolin Hfa Aer

Current Illness: n/a

ID: 1291966
Sex: M
Age: 60
State: NY

Vax Date: 04/24/2021
Onset Date: 04/29/2021
Rec V Date: 05/06/2021
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: Pharyngeal swelling

Symptoms: Right axillary Lymphadenitis on same side

Other Meds: None

Current Illness: Right neck strain

ID: 1291967
Sex: F
Age: 50
State: OH

Vax Date: 04/21/2021
Onset Date: 04/29/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: Feraheme

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 2nd shot administered 4/21 and a couple of days later (4/23-4/24) I experienced headache, nausea, chills and feeling hot (but no fever) fatigue and vomiting. I could not eat much (basically soup). The vomiting went went away but the other symptoms lasted 2 days, then I was okay. A week later (4/29-4/30) I experienced severe traveling pain. It was an immediate onset of pain that started ~2:00PM with a headache, then it radiated to the back of my neck, then back of both of my shoulders, then my back, while pain extended from my shoulders down my arms (primarily my left arm) down to my fingertips, then down both my legs to my feet and toes. It was very severe pain and it was so sudden and intense. I took 15mg Meloxicam for the pain (1 every 2 hours, then about every 4 hours) for the rest of the day and throughout the evening. I experienced chills and I was very hot but my temperature was only 98.1. The pain gradually went away and I have not experienced that level of pain since. I could only think that this was a side affect of the vaccine. I reported it to my Primary Care Physician this morning during our scheduled visit and she encouraged me to report this to site. She acknowledges that it may not be related to the Moderna vaccine, but that it was important that it be reported in case other people experience the same thing and it will allow trending analysis to occur.

Other Meds: Metformin Lantus Lisinopril Atorvastatin Gabapentin

Current Illness: None

ID: 1291968
Sex: M
Age: 54
State: IA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 05/06/2021
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: ORIGINAL ON FILE AT FACILITY

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PREPARATION AND ADMINISTRATION ERROR. PATIENT RECEIVED 180 MCG OF PFIZER COVID 19 VACCINE IMx1.

Other Meds: ORIGINAL ON FILE AT FACILITY

Current Illness: ORIGINAL ON FILE AT FACILITY

ID: 1291969
Sex: F
Age: 39
State: PA

Vax Date: 01/02/2021
Onset Date: 01/13/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: Sulfamethoxazole-trimethoprimHives / Urticaria Camphor OilRash

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

Symptoms: Fever or Chills Cough Fatigue Sore throat Congestion or running nose

Other Meds: none

Current Illness:

ID: 1291970
Sex: M
Age: 47
State: MI

Vax Date: 01/11/2021
Onset Date: 04/21/2021
Rec V Date: 05/06/2021
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 known

Symptom List: Rash, Urticaria

Symptoms: Patient received 2 doses of COVID-19 vaccine. On 4/21/21 developed body aches, headache, cough, and nasal congestion. Tested positive for COVID.

Other Meds: cyanocobalamin, ergocalciferol, losartan, rosuvastin,

Current Illness: none

ID: 1291971
Sex: F
Age: 60
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pain at Injection Site-Medium, Redness at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypotension-Severe, Systemic: Nausea-Mild, Systemic: Visual Changes/Disturbances-Severe, Additional Details: recieved shot at 3:10pm, patient reported severe arm pain, nausea, blurred vision. 1st bp: 96/66 pulse 64 at 3:34pm, 2nd bp:102/68 pulse 62 at 3:50pm, 3rd bp 122/76 pulse 68 at 4:04pm. advised pt not to drive and left pharmacy around 4:10pm, observed patient for over 30mins due to use of epipen for cipr allergy in past

Other Meds:

Current Illness:

ID: 1291972
Sex: F
Age: 40
State: SC

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/06/2021
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: Beginning on day 2 and continuing (today is one week): Periodic "hot flashes" lasting over 30 minutes. Profuse sweating during those times. Occurs 3-4 times a day, morning and evening especially. No fever at that time, temperature was 98.3.

Other Meds: Prozac

Current Illness: None

ID: 1291973
Sex: F
Age: 36
State: MD

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 05/06/2021
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: Advil gel tablets, shellfish

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

Symptoms: After receiving the first dose of the Pfizer vaccine (Apr 13 at 11:15AM), I experienced chest aches and pains, difficulty taking a deep breath, heart palpitations severe fatigue, massive headache, and pain in the injection site. The fatigue and headache subsided after a day, the pain at the injection site subsided after three days, and the chest pains began to subside by day 6. Even after day 6, I continued to have radiating pains in my chest, but the difficulty taking a deep breath subsided. For my second dose (May 04 at 11:15), I experienced severe fatigue, massive headache, and stabbing pains in my chest. These chest pains, I notice at times, caused elevated heart palpitations again, the headache is ongoing two days after the second dose and the chest pains radiate down my arm at times.

Other Meds: Birth Control (Blisovi FE)

Current Illness: N/A

ID: 1291974
Sex: F
Age: 34
State:

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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: Red welt at injection site. Firm, warm, and painful to the touch. Welt is approximately 2 inches in diameter.

Other Meds: Synthroid, Zoloft, Wellbutrin

Current Illness: None

ID: 1291975
Sex: F
Age: 35
State: IN

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Could not move left arm at all started at 3 am on 05/5/21. Proceeded to have hot and cold flashes all day. On 5/6/21 around 5 am I got up to drink water and couldn?t see was super dizzy and fainted. My blood pressure was in the 90s as per my blood pressure machine. By time I got up at 8 am my blood pressure was 112/72.

Other Meds: None

Current Illness: None

ID: 1291976
Sex: F
Age: 87
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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: Chills-Mild, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Systemic: Nausea-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Systemic: Visual Changes/Disturbances-Severe, Systemic: Vomiting-Mild, Systemic: Weakness-Severe, Additional Details: shot 4:23pm, pt complained of seeing stars, being nausous, weak, was going in and out of concsiousness for 30 -45 seconds. Had patient elevate legs a while seated and took bp at 4:30pm was115/36 pulse 52. pt tried to vomit but nothing came up.Took 2nd bp at 4:44pm 137/91 pulse 75. Moved patient inside pharmacy had her lay down flat with legs elevated for 8 minutes. complained of tingliness in both arms up to elbows. 3rd bp at 4:50pm was 127/80 pulse 65, 4th bp 125/82 pulse 77, left at 5pm

Other Meds:

Current Illness:

ID: 1291977
Sex: F
Age: 55
State: IN

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Body/muscle aches and headache

Other Meds: Viibryd, Losartin

Current Illness: None

ID: 1291978
Sex: F
Age: 58
State: CT

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: On April 9th, 2021 I received my second Moderna Vaccine. I started feeling sick early morning of April 10th, 2021. Have been sick since then. Migraine headaches, fever, chills, stiff neck, painful ear aches, body aches, exhaustion, severe night sweats, etc.

Other Meds: Meloxicam 7.5 MG Vyvanse 30 MG Vitamin D 2000MCG

Current Illness: None

ID: 1291979
Sex: F
Age: 41
State: NC

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/06/2021
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: Site: Itching at Injection Site-Mild, Systemic: approximately 0.5cm bulla located at injection site, no sign of infection-Mild

Other Meds:

Current Illness:

ID: 1291980
Sex: F
Age: 45
State: PA

Vax Date: 01/02/2021
Onset Date: 01/24/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin Erythromycin BaseOther (document details in comments) LatexRash SulfamethoxazoleOther (document details in comments) Sulfamethoxazole-trimethoprimOther (document details in comments) TrimethoprimOther (document details in comments)

Symptom List: Unevaluable event

Symptoms: Congestion or running nose

Other Meds: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler clindamycin (CLEOCIN T) 1 % lotion levonorgestreL (MIRENA) 52 mg IUD valACYclovir (VALTREX) 1 gram tablet Clinic-Administered Medications levonorgestreL (MIRENA) IUD 52 mg

Current Illness:

ID: 1291981
Sex: F
Age: 19
State: NH

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: PATIENT IMMEDIATELY FELT DIZZY AND PASSED OUT A FEW SECONDS LATER. THE VACCINATOR WAS NOT ABLE TO CATCH HER FALL AND SHE FELL OUT OF THE CHAIR AND HIT HER FOREHEAD. PT WAS IN AND OUT OF CONSCIOUNESS Q5 MIN, UNRESPONSIVE TO PAINFUL STIMULI, AND MUCOUS MEMBRANES WERE BLUE FOR 30 SECONDS BEFORE JERKING AWAKE AND COLOR RETURNED TO NORMAL. SHE DENIES NECK PAIN, HEADACHE, AND SPINE INTACT. SHE REPORTED DIZZINESS, BLURRED VISION, AND RINGING IN THE EARS FOR Q15 MINUTES UNTIL RESIDED. PT PRESENTED WITH DIAPHORESIS UNTIL HER REPORTED SYMPTOMS RESIDED. VITALS, CLEAR LUNG SOUNDS, AND GLUCOMETER WERE DONE. MEDICS GAVE ORAL GLUCOSE. VITALS MONITORED UNTIL STABLE. PATIENT STAYED WITH FIRE Q1H AND SIGNED AMA WITH FIRE TO GO HOME. SCHOOL SECURITY WALKED HER HOME.

Other Meds: NONE

Current Illness: NONE

ID: 1291982
Sex: M
Age: 32
State: CA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: Chest Tightness / Heaviness / Pain-Medium, Systemic: Chills-Medium, Systemic: Tingling of Lips and Tongue-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium

Other Meds:

Current Illness:

ID: 1291983
Sex: F
Age: 36
State: IN

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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: Injection site pain, Menorrhagia

Symptoms: Aches and chills 12 hours after Aches and Fever 16 hours after Aches until 36 hours after

Other Meds: Claritin

Current Illness: None

ID: 1291984
Sex: F
Age: 40
State: TX

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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:

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

Symptoms: Nausea, exhaustion

Other Meds:

Current Illness:

ID: 1291985
Sex: F
Age: 52
State: PA

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/06/2021
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: Sulfa meds

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I have always had "silent" acid reflux but the day of my shot and still today, 3 full days later, my reflux has been out of control. It is much worse than normal. This is the abnormal side effect I am reporting. I tried to Google it and see if others had this same issue. Very little is mentioned. Just minor heartburn. I also had all of the other typical side effects for the second vaccine. My arm is very sore, swollen, itchy, hot, red. I had 2 days of fatigue, tiredness, extreme body aches, joint pain, headache, nausea, diarrhea.

Other Meds: Cetirizine, Levothyroxine, multivitamin, fish oil pill, ashwagandha supplement

Current Illness: none

ID: 1291986
Sex: F
Age: 33
State:

Vax Date: 02/18/2021
Onset Date: 03/21/2021
Rec V Date: 05/06/2021
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: Significant dizziness/off balance, shaky when upright, blurry vision with fast head movements or looking up/down and laterally; headaches base of skull into pressure behind eyes. Muscle spasms neck/back. Increased s/s of ? autoimmune; suspect autoimmune related flair. Multiple ED visits, PCP visits, specialist visits across the course of 2 months; time off of work >5 weeks d/t s/s. Not completely resolved at time of this submission.

Other Meds: None

Current Illness:

ID: 1291987
Sex: F
Age: 36
State: IN

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: Allergy to sulfa drugs, white fish

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

Symptoms: Sore throat, headache, muscle aches, joint aches, chills, fatigue, nausea. Lasted 18 hours. Treated with otc ibuprofen and rest.

Other Meds: Plaquenil 200mg daily Mirena IUD

Current Illness: No.

ID: 1291988
Sex: F
Age: 28
State: AZ

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: pt reported feeling faint 2 minutes after vaccination, pt became dizzy, lightheaded, and fainted. pt did not fall or injur themselves, technician observer and pharmacist were in view of the patient during the event. we layed the patient down on the floor and put her feet up and checked her blood pressure (100/70, low per pt hx). pt recovered after 3-4 minutes, but layed on the floor for an additional 15. pt then sat in a chair and fully recovered and sat for 15 minutes. no injuries reported

Other Meds:

Current Illness:

ID: 1291989
Sex: F
Age: 42
State: OH

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: bactrim, tegretol

Symptom List: Injection site pain

Symptoms: Pt stated she received vaccine at 1:30pm on 05/05/2021 and waited for 30 minute post vaccine as instructed with no reaction. When she was driving on her way to pick up her child from school, her throat began itching. Call received at 2:44pm on 05/05/2021, pt stated she was having itchy throat and scratchy voice. RN instructed pt to promptly seek medical care. After picking child up from school, pt went to local fire department and was transported to ER for further treatment. Pt stated at ER, she was given steroids, benedryl, and toradol and had improvement in symptoms. Pt was discharged from ER with Epi-Pen and benedryl.

Other Meds:

Current Illness:

ID: 1291990
Sex: M
Age: 74
State: PA

Vax Date: 04/12/2021
Onset Date: 04/17/2021
Rec V Date: 05/06/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient and his wife received a Covid19 vaccine on 04/12/2021 Approximately three days after receiving the vaccination they started experiencing the following symptoms: tiredness, loss of appetite, nausea and some vomiting. On 04/17/2021 extreme diarrhea developed and they went to their primary care doctor. The doctor prescribed antibiotics. As of 04/26/2021 the symptoms were still occurring but less severe.

Other Meds: Finasteride 5MG TAB 1per day Rosuvastatin 5mg tab USP 1per day Metformin 500mg tab 1tablet twice daily. Low dose aspirin 81mg 1tablet per day.

Current Illness: N/A

ID: 1291991
Sex: M
Age: 35
State: PA

Vax Date: 01/04/2021
Onset Date: 01/18/2021
Rec V Date: 05/06/2021
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: NKA

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

Symptoms: SORE THROAT

Other Meds: busPIRone (BUSPAR) 5 mg tablet

Current Illness:

ID: 1291992
Sex: F
Age: 59
State: MN

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: Tremor

Symptoms: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Hypertension-Medium, Systemic: Shakiness-Medium, Systemic: Tachycardia-Medium, Additional Details: Patient experienced throat tightness and dry mouth. Benadryl administered, then Epipen 0.3mg. Blood pressure was high, paramedics came to check her out. BP went back to normal and patient was sent home

Other Meds:

Current Illness:

ID: 1291993
Sex: M
Age: 33
State: KY

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Fever persisting 36 hours with a peak temperature of 102.6 degrees, body aches and fatigue

Other Meds: Zyrtec

Current Illness:

ID: 1291994
Sex: F
Age: 77
State: WI

Vax Date: 02/19/2021
Onset Date: 03/15/2021
Rec V Date: 05/06/2021
Hospital: Y

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 presented to the ED on 3/15/21 and was subsequently hospitalized with NSTEMI. She also presented to the ED on 4/14/21 with chest heaviness.

Other Meds:

Current Illness:

ID: 1291995
Sex: F
Age: 32
State: TX

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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

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

Symptoms: Muscle ache, light headache, chills.

Other Meds: None

Current Illness: None

ID: 1291996
Sex: M
Age: 45
State:

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 05/06/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Tinnitus almost constantly since shot

Other Meds: Vitamin D, multivitamin

Current Illness:

ID: 1291997
Sex: F
Age: 33
State: FL

Vax Date: 04/26/2021
Onset Date: 04/28/2021
Rec V Date: 05/06/2021
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: None

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

Symptoms: Migraine, muscle spasms, heart palpitations, arm soreness. All set in swiftly within a 30 minute period, two and a half days after the vaccine was administered.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1291998
Sex: F
Age: 62
State: MI

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/06/2021
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: N/A

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

Symptoms: I have had frequent sharp stabbing pain in my left upper arm where the shot was administered and in my left thigh, along with extreme pain from shoulder to shoulder and in my neck, along with constant ach/pain in all sites. These symptoms lasted for 9-10 days. Then the sharp stabbing pain in left arm & leg subsided, but the other ach/pain continued. Currently, a month later, I still have occasional sharp pain in my left arm along with the constant ach/pain in my left arm where the shot was administered.

Other Meds: Synthroid, Metaprolol

Current Illness: N/A

ID: 1291999
Sex: F
Age: 53
State: AR

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 05/06/2021
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: Received the first dose on 1/15/2021 approx 10:15 am. I noticed I had ringing in my ears that started later that evening. The ringing is constant and has never gone away since the first vaccine. I received the second dose on 2/5/2021 and the ringing just continued on. It is now May 6th and I still have the constant ringing in my ears.

Other Meds: Daily multi vitamin

Current Illness: None

ID: 1292000
Sex: M
Age: 33
State: IN

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: Pain at injection site, fever, chills, body aches, headache, fatigue Treatment: NSAIDs for 24 hours, fluids

Other Meds:

Current Illness:

ID: 1292001
Sex: F
Age: 24
State: IN

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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: Body aches, headache, loss of taste and smell for about 5 hours, fatigue but unable to sleep, hot and cold flashes

Other Meds:

Current Illness:

ID: 1292002
Sex: F
Age: 42
State: IN

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: Cymbalta, witch hazel, adhesive, thimerisol

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

Symptoms: Left arm pain and immobility, fatigue, headache, neck and shoulder pain, nauseated

Other Meds: Lexapro, Lyrica, Prilosec, Flexeril

Current Illness:

ID: 1292003
Sex: M
Age: 55
State: FL

Vax Date: 01/14/2021
Onset Date: 01/18/2021
Rec V Date: 05/06/2021
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: nkda

Symptom List: Vomiting

Symptoms: anosmia

Other Meds: asa 81, multivitamin, emergen-c

Current Illness: none

ID: 1292004
Sex: F
Age: 27
State: GA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: No

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pain in the left arm, fatigue, weakness, headache

Other Meds: No

Current Illness: No

ID: 1292005
Sex: F
Age: 71
State: MO

Vax Date: 05/04/2020
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: Patient received first dose of COVID-19 vaccination on 03/06/2021 which was Moderna vaccination. Patient did not recall receiving previous dose of COVID-19 vaccination and signed up to receive dose of Pfizer COVID-19 Vaccination. Patient did receive a dose of Pfizer Vaccination on 05/04/20201 after previous dose of Moderna Vaccination

Other Meds: Patient originally received a dose of COVID-19 Vaccination of Moderna on 03/06/2021. Patient received another dose of Pfizer vaccination on 05/04/2021. Patient did not recall vaccination upon initial assessment.

Current Illness: N/A

ID: 1292006
Sex: M
Age: 39
State:

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/06/2021
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: Rigors, Fever, Convulsions.

Other Meds: None

Current Illness: None

ID: 1292007
Sex: F
Age: 44
State: FL

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/06/2021
Hospital:

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

Lab Data:

Allergies: Latex

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

Symptoms: Pt. stated, "My arm feels heavy. It happened as soon as I got vaccinated." At 10:32am pt. stated, "It's getting better." At 10'6 pt. stated, "I feel ok, I can go home now. The heaviness is gone." Pt went home at 10:49am.

Other Meds: None

Current Illness:

ID: 1292008
Sex: F
Age: 46
State: NY

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/06/2021
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: Sulfa

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

Symptoms: Nausea and diarrhea within 2 hours of shot - resolved Headache and stiff neck within 2 hours of shot - persists Fever reaching 102.9 - 5/5 4am Fever persists 99-100 with advil / tylenol

Other Meds: Premarin 0.9mg

Current Illness: No

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm