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: 1295926
Sex: F
Age: 31
State: TX

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Itching and redness to the face, arms, back and legs

Other Meds: none

Current Illness: none

ID: 1295927
Sex: M
Age: 17
State:

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient experiences syncopal episode within 10 minutes of dose. He was discharged after 30 minutes of steady recovery and was released after having returned to his baseline.

Other Meds: None

Current Illness:

ID: 1295928
Sex: F
Age: 47
State: KY

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Woke up sick at stomach @ 4:00 AM. Went to kitchen to get something to eat to sooth it. Felt faint. Tried to make it to couch but passed out and fell before I could get there. Bruised chest in fall. Blood pressure bottomed out. Stayed low throughout ER stay.

Other Meds: Vraylar Trintellix Baclofen Alprazolam Synthroid Tylenol

Current Illness: None

ID: 1295929
Sex: F
Age: 56
State: WI

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

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

Lab Data:

Allergies: erythromycin sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 0.3ml of dose given initially and error discovered in need for additional 0.2ml and 0.2ml dose Moderna same lot administered

Other Meds:

Current Illness:

ID: 1295930
Sex: F
Age: 47
State: MN

Vax Date: 01/08/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: COVID positive >14 days post vaccine series.

Other Meds:

Current Illness:

ID: 1295931
Sex: M
Age: 22
State: TX

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/07/2021
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: 2nd Pfizer COVID-19 vaccine administered on April 29th around 8:15 am, around 10 pm that day patient developed abdominal cramping and nausea with vomiting. The vomiting continued through Monday May 3rd. Patient reports stools were a loose for a few days but are formed now. Nausea has resolved but patient continues to have per-umbilical abdominal cramping with decreased appetite. Patient doesn't think he's lost any weight. No body aches, no fever.

Other Meds: None

Current Illness: None

Date Died: 04/19/2021

ID: 1295932
Sex: F
Age: 66
State: WA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 05/07/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Aspirating severe

Other Meds: Clozaril

Current Illness: None known

ID: 1295933
Sex: F
Age: 27
State: CA

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Dizziness, nausea, feeling "hot". Observed 15-20 min. Stable and released.

Other Meds:

Current Illness:

ID: 1295934
Sex: F
Age: 50
State: FL

Vax Date: 04/30/2021
Onset Date: 05/02/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: Codine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Soreness on the right underarm and on the side of the right breast of the arm that that vaccine was administered. Soreness last 5 days and the soreness subsided on 5/7/2021. Twitching in the right eye for 5 days. The twitching started on Sunday. Two days after the vaccine. The twitching stopped on 5/7/2021.

Other Meds: Metformin Wellbutrin Advil

Current Illness: None

ID: 1295935
Sex: F
Age: 41
State: TX

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 05/07/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Edema and tingling of upper and lower lips

Other Meds: SPIRONOLACTONE

Current Illness: None

ID: 1295936
Sex: M
Age: 55
State: WI

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

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

Lab Data:

Allergies: none

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

Symptoms: 0.3ml of dose given initially and error discovered in need for additional 0.2ml and 0.2ml dose Moderna same lot administered

Other Meds:

Current Illness:

ID: 1295937
Sex: M
Age: 31
State: FL

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
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: acetaminophen

Symptom List: Rash, Urticaria

Symptoms: Rash at injection site, as well as fever

Other Meds: At the time of reaction, applied topical cortizon-10 and took oral ibuprofen tablets

Current Illness: n/a

ID: 1295938
Sex: F
Age: 47
State: NH

Vax Date: 04/26/2021
Onset Date: 04/28/2021
Rec V Date: 05/07/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Pain in my left shoulder joint.

Other Meds: levothyroxine trazodone

Current Illness: none

ID: 1295939
Sex: F
Age: 41
State: IN

Vax Date: 05/04/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: Oyster mushrooms, Zithromax, synthetic opiates e.g. Codeine

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

Symptoms: Extremely swollen lymph nodes in left armpit, pain in left fingers, low-grade fever

Other Meds: IBgard peppermint supplement for IBS, prescribed Allegra for allergies

Current Illness:

ID: 1295940
Sex: M
Age: 45
State:

Vax Date: 02/05/2021
Onset Date: 04/01/2021
Rec V Date: 05/07/2021
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:

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

Symptoms: Myopericarditis with fatigue, myalgias, joint pains, and dispnea on exertion since his second COVID 19 shot. Pt also found to have a DVT.

Other Meds:

Current Illness:

ID: 1295941
Sex: F
Age: 23
State: OH

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

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

Symptoms: Swollen, hot red injection site. Fever of 102 next day. Went to ER. Diagnosed with COVID-19.

Other Meds: Omperazole, norvasc, desvenlavaxine, vistril, birth control, ibueprofin, tyelenol

Current Illness: asthma, reynauds, high blood pressure, herniated disc L4 L5

ID: 1295942
Sex: M
Age: 57
State: IL

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 05/07/2021
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: 2 days after 2nd shot, I couldn't walk or use my right leg. Days later, soreness spread to my arms, neck and hands

Other Meds: Sertraline HCL 200mg 1xday Amlodipine Besylate 10mg 1xday Atorvastatin 20mg 1xday Metoprolol er succinate 200mg 1xday Valacyclovir HCL 500mg 1xday Losartan HCTZ 100/12.5mg 1xday

Current Illness: None

ID: 1295943
Sex: F
Age: 35
State: FL

Vax Date: 04/09/2021
Onset Date: 04/16/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Delayed hypersensitivity reaction- arm rash in area of vaccination that appeared a week after administration and took a few days to go away

Other Meds: norethindrone/ethinyl estradiol birth control

Current Illness: none

ID: 1295944
Sex: F
Age: 53
State: IL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: swelling of mouth, tongue and gums (resolved in 5 days) ; "pins and needles throughout body including face" (resolved in 5 days); swelling in lymph nodes (greater swelling on vaccination side), resolved in 9 days. Reported to Dr. to confirm no known interaction with Trulicity.

Other Meds: Trulicity, Metformin

Current Illness: None

ID: 1295945
Sex: F
Age: 62
State:

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/07/2021
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: Patient returned to clinic 1 1/2 hours after her dose, reporting discomfort in chest, itching, and tongue swelling

Other Meds:

Current Illness:

ID: 1295947
Sex: F
Age: 33
State: TX

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 05/07/2021
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

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

Symptoms: Both legs - muscle fatigue, weakness, twitching. Pain in muscles and shin bones. Lower back pain. Continuing now 2+ weeks after vaccination.

Other Meds: Xanax (as needed and not taken surrounding vaccine), multivitamin , b12, vitamin D

Current Illness: None

ID: 1295948
Sex: M
Age: 33
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/07/2021
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: Unevaluable event

Symptoms: Patient received vaccine in a drive up clinic and was waiting in his car during the 15 minute observation time. 10 minutes after the vaccine, he became lightheaded and alerted for medical attention. When we arrived at his car he was having tonic clonic seizure like activity which lasted about 20 seconds. Patient was reclined in his car seat, VS taken and stable. Oriented x4 but described feeling light headed, tingling in left arm and lips, and diaphoresis. EMS arrived and assumed care. Extended observation showed improving vital signs, and resolution of described symptoms. Patient was released from EMS care and was transported to the ER by a friend for further eval.

Other Meds:

Current Illness:

ID: 1295949
Sex: F
Age: 32
State: PA

Vax Date: 01/13/2021
Onset Date: 01/17/2021
Rec V Date: 05/07/2021
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: NKA

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

Symptoms: Pregnant -- EDD 5/28/21 Cough Shortness of Breath Difficulty breathing Headache Congestion or running nose Nausea or vomiting

Other Meds: busPIRone (BUSPAR) 15 mg tablet multivitamin with minerals tablet

Current Illness:

ID: 1295950
Sex: F
Age: 51
State: TX

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Client experience burning sensation to the arm. B/P: 130/90 Oxy: 100 Temp: 96.4 HR: 76

Other Meds:

Current Illness:

ID: 1295951
Sex: M
Age: 28
State: OR

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Last weekend on Sunday morning (April 25th), I received my second shot of Pfizer vaccine at 9am. My body started to show some side effects on the evening of Sunday. I felt super cold around 10 pm and at the same time, I had a fever, too. I went to bed early that night (around 10:30 pm) and since I was super cold, I had 3-4 blankets on me when I was on my bed. Suddenly, at 1 am, I woke up due to a very strange noise in my head (a very low-volume noise of knocking on the door every 10 seconds!! I think it was only something in my mind). Since I couldn't sleep because of that low artificial noise, I decided to go to the bathroom at around 1:10 am (My bode was also in lots of pain at that time). When I started to walk, I realized that something is wrong with my body. When I peed and stood up to get back to my bed, I noticed that I'm losing control! Therefore, I hit the bathroom door to wake up my girlfriend, and then I fainted! (I can't remember anything for about 30 seconds here). My girlfriend told me that when I fainted, one of my eyeballs was upward and the other was downward (like zombies!!). She started to freak out and called her mom, but once they started talking, I woke up. My body was soaking wet when I woke up and I was in lots of pain. I asked her to help me to lay down on the ground. After 10 minutes, that my sweats were gone, I started feeling cold and asked her to give me a blanket. I couldn't sleep for about 2-3 hours after I fainted, but I was feeling better (I was much better than the time before fainting). On Monday afternoon, I called the health center and told them my side effects. They strongly recommended visiting ER ASAP since the symptoms that I described were severe side effects of Pfizer. Therefore, I went to ER on Monday (April 26th) to see what?s the issue. Hopefully, after spending 3-4 hours there, and passing some tests, the results did not show anything wrong with my body, but just the side effects of the vaccine.

Other Meds: NA

Current Illness: NA

ID: 1295952
Sex: M
Age: 35
State: IN

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: No

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

Symptoms: Extreme muscle soreness in my entire body, headache, loss of appetite, 103 fever lasted approx 18 hours

Other Meds: Adderal

Current Illness: No

ID: 1295953
Sex: F
Age: 53
State: MA

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pain in armpit and upper back side of arm. Sore when touched. Swelling of lymph nodes in armpit. Soreness, swelling, and pain decreasing over time but still present today, May 7th.

Other Meds: Hydrochlorothiazide, Vitamin D, Vitamin E, milk thistle pills

Current Illness: none

ID: 1295954
Sex: F
Age: 51
State: MA

Vax Date: 04/25/2021
Onset Date: 04/29/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: zoloft

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: severe vertigo, nausea, vomiting required ER visit vertigo still existing one week later

Other Meds: trazodone, ropinerole, abilify, pregabalin

Current Illness: none

ID: 1295955
Sex: F
Age: 30
State: NC

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: Sulpha based meds

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

Symptoms: Red, itchy, sore, swelling at site

Other Meds: No

Current Illness: No

ID: 1295956
Sex: F
Age: 30
State: IN

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: Severe stiffness and pain in shoulder around injection site. Persisted for 36 hours before lessening in intensity for an additional 12 hours after which the area returned to normal.

Other Meds: Have a Mirena IUD

Current Illness: N/A

ID: 1295957
Sex: F
Age: 51
State: CA

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: sulpha, penicillin, Keflex; Erythromycin; egg whites; sensitivities to dairy

Symptom List: Injection site pain

Symptoms: The next morning, I woke up with sore arm - not quite as sore as before (first vaccine). I was hydrating all the time - more than usual. I was foggy. That weekend, I started having hot flashes. Not a measurable fever - hot and red face. I didn't have them the week before and I hadn't had them for months before. My family, who had gotten vaccinated the same day - were getting fevers and I had hot flashes. They were legit! I had no energy. I had to lay low and not do nothing for those two days. I did go to work the next week - but I wasn't thinking my best. My energy was low and I was foggy.

Other Meds: Armour Thyroid; Gemfibrozil; Vitamins - C and D, Milk Thistle, Zinc, NAC, glutathione

Current Illness: no

ID: 1295958
Sex: M
Age: 34
State: MI

Vax Date: 04/27/2021
Onset Date: 05/04/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Pain, inflammation, redness, presenting one week after shot. Being seen by urgent care to rule out infection. Likely late local reaction treated with OTC pain relief.

Other Meds: Allegra. multivitamin

Current Illness: No

ID: 1295959
Sex: M
Age: 22
State:

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
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: not reported (unknown)

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

Symptoms: 5 minutes after injection patient exhibited diaphoresis, nausea, vomiting, chills. Routine patient care and water was given.

Other Meds: not reported (unknown)

Current Illness: not reported (unknown)

ID: 1295960
Sex: F
Age: 23
State: OH

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
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: Sulfa

Symptom List: Tremor

Symptoms: swollen, red, warm injection site same day, around 8pm. fever next day of 100.5, lasting all day.

Other Meds: Omperazole, norvasc, desvenlavaxine, vistril, birth control, ibueprofin, tyelenol

Current Illness: asthma, reynauds, high blood pressure, herniated disc L4 L5

ID: 1295961
Sex: F
Age: 55
State: IN

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Zophran

Symptom List: Erythema, Pruritus

Symptoms: Fever 102, extreme dizziness, nausea, vomiting, horrible ringing in ears, site of injection very hot and very swollen.

Other Meds: Wellbutrin, seroquel, topomax, Gabapentin, sertraline

Current Illness:

ID: 1295962
Sex: F
Age: 49
State: OR

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 05/07/2021
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: Amoxicillian, grasses/pollens/flowers, fragrances, colognes, perfumes, cleaning products

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

Symptoms: Day 1 - fatigue and headache. Day 2 - SEVERE muscle and joint pain, muscle stiffness, migraine, nausea, dizziness. Day 3 - SEVERE muscle and joint pain, muscle stiffness, migraine, nausea, dizziness, fever, sweating, chills. Day 4 - Moderate muscle and joint pain, muscle stiffness, nausea, migraine, dizziness, sweating, chills. Day 5 Minimal muscle and joint pain, muscle stiffness, nausea, migraine, dizziness. Day 5 I went to the urgent care because of continued nausea, migraine, and dizziness was preventing me from going to work for 3 days. Before going to the urgent care,I tried taking ibuprofen, naproxen, and acetaminophin and nothing helped the pain. My normal prescription migraine medication didn't help the migraine.

Other Meds: Sertraline 100 mg, olmesartan-hydrochlorothiazide 20-12.5 MG Tabs, buPROPion XL 150 MG Tb24

Current Illness: None

ID: 1295964
Sex: M
Age: 54
State: CA

Vax Date: 03/19/2021
Onset Date: 03/21/2021
Rec V Date: 05/07/2021
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:

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

Symptoms: Started developing Chest pain and eventual heart attack.

Other Meds:

Current Illness:

ID: 1295965
Sex: F
Age: 79
State: WA

Vax Date: 02/08/2021
Onset Date: 03/06/2021
Rec V Date: 05/07/2021
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: Demerol - rash

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient developed a DVT (deep vein thrombosus) in left leg which was diagnosed on 3/6/21.

Other Meds: Zyrtec 10 mg qD Benadryl 25 mg q4 PRN Naproxen 220 mg 1-2 BID PRN Lactase 4500 mg daily PRN Turmeric 500 mg qD Multivitamin 1 daily Calcium 600 mg daily

Current Illness: None

ID: 1295966
Sex: M
Age: 70
State:

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 05/07/2021
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:

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

Symptoms: Presented to hospital with chest pain and was diagnosed with STEMI. Treated with 2 drug-eluting stents and did well. Had a prior history of CAD.

Other Meds:

Current Illness:

ID: 1295967
Sex: M
Age: 42
State: CA

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: Syncope. Fell and hit head, woke up within 30 sec - 1 min. Abrasion to elbow and left forehead. EMT applied antiseptic ointment/bandage. Observed an additional 15-20min. Water, crackers given. Stable and released.

Other Meds:

Current Illness:

ID: 1295968
Sex: F
Age: 27
State: MI

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Pain in extremity

Symptoms: Fever and chills, extreme body aches all over body, numbness in arm of injection, nausea, headache, fatigue

Other Meds: Birth Control (Tri-Sprintec)

Current Illness: No

ID: 1295969
Sex: F
Age: 45
State: PA

Vax Date: 01/13/2021
Onset Date: 01/22/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: AcetaminophenOther (document details in comments) CocoaOther (document details in comments) CodeineOther (document details in comments) Green PepperOther (document details in comments) PenicillinsOther (document details in comments) Phenobarb-hyoscy-atropine-scopOther (document details in comments) Shellfish Containing ProductsOther (document details in comments) StrawberryOther (document details in comments) Sulfa (Sulfonamide Antibiotics)Other (document details in comments)

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

Symptoms: Fever or Chills Cough Fatigue Headache Congestion or running nose Nausea or vomiting

Other Meds: DAILY MULTI-VITAMIN ORAL diclofenac sodium (VOLTAREN) 1 % gel(Expired) dicyclomine (BENTYL) 20 mg tablet docusate sodium (COLACE) 100 mg capsule FERROUS SULFATE ORAL ibuprofen (MOTRIN) 200 mg tablet Lactobacillus acidophilus 100 million cel

Current Illness:

ID: 1295970
Sex: F
Age: 48
State: MD

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: C/O Nausea/Dizziness/Sweating. Vital signs: B/P 149/98 Pulse:83 Sats: 98% Room air; seen by in house EMT's Discharged home at 13:25 p.m. Recorded by (Name), RN

Other Meds:

Current Illness:

ID: 1295971
Sex: M
Age: 73
State: AZ

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 05/07/2021
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: accupril

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

Symptoms: Patient had pain once vaccine was given and has continued since 04/12/21 and hurts when lifting left arm (described like a bad toothache). Has taken Tylenol, Ibuprofen, and has iced but not alleviated pain.

Other Meds: crestor valsartan

Current Illness: none

ID: 1295972
Sex: M
Age: 35
State: IL

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/07/2021
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: Extream fatigue/inability to stay awake, nausea/throwing up even trinng to drink water, fever 104+ then dropping to 95 degrees an back up, extreme hot and cold flashes(sweating while having goose bumps), migraines an knub feeling doing anything about past out, above lasted 36 hours, afterwards still extreme fatigue even walking up stairs loose energy/breath like im going to pass out, numb feeling, loss of appetite etc which has continued to today.

Other Meds: Meloxicam 15mg, bupropion hcl sr 100mg, montelukast sodium 10mg, buprenorphine/nalox 8-2mg sl film, multi vitamin. Benadryl

Current Illness: Allergies

ID: 1295973
Sex: F
Age: 71
State: KY

Vax Date: 01/24/2021
Onset Date: 04/28/2021
Rec V Date: 05/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Altered mental state

Other Meds:

Current Illness:

ID: 1295974
Sex: F
Age: 63
State: NC

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

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

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Severe

Other Meds:

Current Illness:

ID: 1295975
Sex: F
Age: 17
State: VA

Vax Date: 04/25/2021
Onset Date: 04/26/2021
Rec V Date: 05/07/2021
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: penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: The day after vaccine patient developed fever, myalgias, sore throat. Fever persisted 4-5 days. She developed rash on 4/30. Labs done showed low platelets (64k), low WBC with neutropenia. Fever resolved by 4/30 and rash resolved by 5/1/21. Platelets and WBC are recovering.

Other Meds:

Current Illness:

ID: 1295976
Sex: M
Age: 45
State: CO

Vax Date: 04/22/2021
Onset Date: 04/29/2021
Rec V Date: 05/07/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: Transverse myelitis in the thoracic cord. Symptom onset 1 week after 2nd vaccine dose. Sensory change in the left leg and increased reflexes/clonus

Other Meds: synthroid

Current Illness: none

ID: 1295977
Sex: F
Age: 62
State: WI

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/07/2021
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: Denied

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

Symptoms: On 4/30/21 the patient contacted JCHD to report symptoms experienced after receiving the second dose of Moderna 4/22. She reported on 4/23 she experienced a fever of 102.1, resting HR 120. Very weak. Saturday into Sunday (4/24-4/25) she developed blisters on her nose into her nose and her lips. Feels it may be cold sores. She is a MS patient and did speak with her physician about getting the vaccine.

Other Meds: Unknown

Current Illness: Denied

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm