VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1344299
Sex: F
Age: 18
State: CO

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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 known

Symptom List: Dysphagia, Epiglottitis

Symptoms: Client came into clinic to receive the second dose of Covid vaccine. The dose was administered a week too early.

Other Meds: none known

Current Illness: none known

ID: 1344300
Sex: F
Age: 58
State: WA

Vax Date: 04/24/2021
Onset Date: 05/10/2021
Rec V Date: 05/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Full blood allergy panel and the test range was really broad

Allergies: No

Symptom List: Anxiety, Dyspnoea

Symptoms: I work remotely and ate hazel nuts but I never had food allergies, but 10 minutes I started having strange pain in upper back, my face felt flush and it was scarlet red, I got severe vertigo, and was disoriented. I took Benadryl and layed down, I took my BP and my systolic was down to 90. The doctor said it was an allergic reaction and it was serious enough that I thought I was having a heart attack. It all happened really rapidly. I went to see the allergist and was tested and it came back with nothing.

Other Meds: Estrogen and Progesterone low dose daily, Generic Prozac ,

Current Illness: No

ID: 1344301
Sex: M
Age: 15
State: UT

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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: No known allergies

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

Symptoms: Pt dad thinks pt has vasovagal syncope. Pt passed out immediately after getting vaccinated and vomited when regained consciousness. Pt turned white in the face and fell forward in chair when he fainted and after vomiting pt continued to go in and out of consciousness. Took about 10-15 minutes of placing feet on another chair and raising hands over head but pt color returned and he felt much better.

Other Meds: unknown

Current Illness: None

ID: 1344302
Sex: F
Age: 12
State: NY

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: None.

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Chills, headaches, nauseous, only for that date.

Other Meds: None

Current Illness: None

ID: 1344303
Sex: F
Age: 30
State: WA

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: I did not get any medical tests done. I was planning on going to the ER the next day if my heart kept racing. Thankfully, it was more normal when I woke up the next day. I do have fitbit data which tracks my heart rate to show the unusual spike.

Allergies: Skin allergy to nickel, cipro causes rapid heart beat.

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

Symptoms: The day after my second Moderna vaccine, my heart raced all day. It felt like it was skipping which made me occasionally cough. My resting heart rate is normally 74 bpm. That day, despite resting on the couch all day, my heart rate was in the fat burn zone for 11 hours and 39 minutes. My heart rate was over 100 bpm for most of the day. My heart rate got up to 128 bpm.

Other Meds: Errin - daily birth control pill. Spironolactone - daily pill for acne.

Current Illness: N/A

ID: 1344304
Sex: M
Age: 16
State: CA

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 05/24/2021
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: N/A

Allergies: NO KNOWN ALLERGIES

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

Symptoms: ONE MINUTE AFTER ADMINISTERING PAITENT HIS FIRST DOSE OF PFIZER COVID-19 VACCINE, THE PATIENT FELL TO THE FLOOR. PATIENT REPORTS , " HE FELL ASLEEP", BUT CLAIMED HE WAS OKAY. THE PATIENT WAS ESCORTED TO THE WAITING AREA AND INSTRUCTED TO WAIT FOR 15-30 MINUTES FOR OBSERVATION. SOON AFTER SITTING IN THE WAITING AREA,THE PHARMACIST WHO ADMINISTERED THE VACCINE REPORTS THE PATIENT PASSED OUT FOR THE SECOND TIME. PER PHARMACIST REPORT, THE PATIENT WAS UNRESPONSIVE AND SEEMED NOT TO BE BREATHING. EPINEPHRINE 0.3MG DOSE WAS GIVEN INTRAMUSCULARLY AND EMERGENCY WAS CALLED AT 11:56AM. THE PATIENT REVIVED AND REPORTED HE "FELT FINE". EMERGENCY HEALTHCARE AND AMBULANCE ARRIVED AT 12:06PM AND TOOK OVER CARE OF THE PATIENT.

Other Meds: UNKNOWN

Current Illness: UKNOWN

ID: 1344305
Sex: M
Age: 0
State:

Vax Date: 09/17/1961
Onset Date: 05/15/2021
Rec V Date: 05/24/2021
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: Patient received 0.5cc of air first- vaccinating nurse did not notice she did not withdraw vaccine from vial. She did realize of the error after injection and withdrew proper dosage of Moderna vaccine 0.5cc and administered it in left arm again. Nurse was re-educated.

Other Meds:

Current Illness:

ID: 1344306
Sex: F
Age: 33
State:

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

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

Lab Data:

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: Menstrual cycle was late - period was delayed by 28 days and had a period with more PMS symptoms than normal

Other Meds: N/A

Current Illness: N/A

ID: 1344307
Sex: M
Age: 15
State: CA

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

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

Lab Data: none.

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderna vaccine is only for patients older than 18 years of age. Patient was 15 years at the time of first dose. Per parent there was no adverse or allergic reaction from vaccine.

Other Meds: none

Current Illness: none

ID: 1344308
Sex: F
Age: 19
State: MI

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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: Patient had a delayed reaction she was in the parking lot after 30-40 minutes from receiving the moderna shot and she started having hives, threw up, and had massive headache. She had epi-pen injected into her leg and ems was called and came to pick her up after about 20 minutes from epi-pen injection.

Other Meds:

Current Illness:

ID: 1344309
Sex: M
Age: 35
State: CA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: N/A

Allergies: None noted on intake form

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

Symptoms: (Note: patient has reported incident to VAERS as well) Patient called to cancel second dose due to severe adverse reaction to first dose. Patient notified and is under the care of his primary physician, who has referred him to neurologist specialist. Pt reported severe pain at injection site (left deltoid) approximately one hour following shot. Approximately 4 to 5 hours after vaccination pt was observed by friend to have fainted, he appeared to be asleep and snoring for 3 minutes. Pt reported to have lost feeling in arm (shoulder down to fingers) for a period of time, which slowly has resolved. Currently he still has numbness in his fingers of left hand and has the sensation of pins and needles.

Other Meds: N/A

Current Illness: N/A

ID: 1344310
Sex: F
Age: 29
State: CA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: 4/24/2021 - 07:00 PM Urgent care - 2025 So Cal Ave - Blood work and EKG - everything was normal

Allergies: no

Symptom List: Rash, Urticaria

Symptoms: In first 24 hours, at 03:00 am, I woke up feeling chills and with headache and I got dizzy and feeling weak and tired. My muscles hurt and a body felt very fatigued. Also, a little bit nauseous. I think my fever got to 100 degrees. By noon, I broke my fever. By three pm I was fine again. The following days, I had soreness at injection site. I had a couple of headaches. There was one episode where two weeks later, I did get a panic attack and went to urgent care. I went because it lasted longer than normal. This panic attack lasted for 30 minutes that is why I went to Urgent Care. Usually my panic attacks last for 3 minutes - but I also had personal things going on that could have caused it. No treatment, they just said to relax.

Other Meds: Rainbow Women's Multi- Vitamin; Vit D supplement

Current Illness: no

ID: 1344311
Sex: M
Age: 27
State: IN

Vax Date: 05/19/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: N/A. Have yet to get checked out by medical professionals after the event.

Allergies: N/A

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

Symptoms: Woke up at 3:00 AM Friday 5/24 having chest pain near my heart and issues breathing. I sat up on the corner of my bed feeling dizzy. Every time I would take anything more than a light breath, I would get a tight pain on the left side of my chest, which specifically felt like I had blockage in my heart. As I sat on the corner of my bed I tried to control my breathing and started to rub the area as I was taking breaths. The sharp pain in my chest while taking normal / deep breaths lasted for a few minutes and I feared I was having a heart attack. After going away initially that night, I felt the sensation in a less intense fashion again later on Friday night and once more got a slight tight feeling in my chest while breathing on Saturday. During the initial episode on Friday night, I also got a deafened noise in my ears as if they had to pop as if I was gaining altitude in a plane or something. I got up off my bed to go to the bathroom and sat to urinate in case I was going to faint. The deafened noise went away after about a minute or so and turned into a static / fizzy noise for another minute or two while I was in the bathroom. (The static fizz sounds got louder as I put my chin to my chest for some reason.) I was also sweating profusely throughout this entire process.

Other Meds: Lexapro 20mg.

Current Illness: N/A

ID: 1344312
Sex: M
Age: 14
State: OH

Vax Date: 05/19/2021
Onset Date: 05/23/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data: Troponins were ordered and trended. Day 5 post vaccine value was 1951. Day 6 post vaccine value was 1928 and repeated later that day to be 995. Patient had EKG that displayed sinus bradycardia. Patient had echocardiogram that was within normal limits.

Allergies: Environmental allergies

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

Symptoms: Patient developed maculopapular uticarial rash day of vaccine that started on his lower extremities and progressed over a few days to include part of his trunk and his proximal upper extremities. Parents gave benadryl at home. It began to self resolve 5 days after vaccine, with complete resolution on day 6 after vaccine. Additionally, on day 5 following vaccine, the patient had one, isolated, episode of chest pain and SOB that lasted 2-3 minutes. Patient believed he was having a panic attack. Patient's mother took BP during event which was 190/95. Patient subsequently brought to ED where all his vitals were diffusely within normal limits including BP. No persistent chest pain and physical exam unremarkable. Troponin was obtained in ED and found to be elevated at 1951. Patient was admitted, troponins were trended, and patient remained in stable condition without further adverse events, and was subsequently discharge home with diagnosis of suspected myocarditis.

Other Meds: Multivitamin

Current Illness:

ID: 1344313
Sex: M
Age: 28
State: MD

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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

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

Symptoms: Patient fainted due to carry over fear of the needle. He stated before the shot that he did not like needles. After the shot I took him to the waiting area to wait for 15 minutes. After about 3 minutes, he lost consciousness and fell off of his chair. After about a minute he came to and slowly got to his knees and came to and was able to sit back down in the chair.

Other Meds: unknown, not our patient

Current Illness: unknown

ID: 1344314
Sex: F
Age: 58
State: OR

Vax Date: 04/29/2021
Onset Date: 05/03/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: I received the vaccine in my right arm and sometime in the week following a small rash developed on that arm on the radial side of the elbow crease. The rash has grown to be about the size of a quarter, itches and oozes after itching. Ha persisted to present which is more than 3 weeks post vaccine. I believe the reaction was a re-activation of prior inflammatory reactions.

Other Meds: Vitamin C 1,000 mg/day Vitamin D3 5,000 IU/day Digestive Enzymes

Current Illness: None

ID: 1344315
Sex: M
Age: 39
State: IL

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: COVID test-negative 5/11/21

Allergies: NONE

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

Symptoms: 103 temp, sweats, chills, slept 72 hours, no taste, no appetite and black stools for 6 days.

Other Meds: NONE

Current Illness: NONE

ID: 1344316
Sex: F
Age: 13
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: sulfa antibiotic

Symptom List: Ear pain, Hypoaesthesia

Symptoms: About 3 min after getting vaccinated, patient fainted Reason for visit in ER: Near Syncope Diagnosis: Syncope and collapse

Other Meds: none

Current Illness: none

ID: 1344317
Sex: F
Age: 72
State:

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 05/24/2021
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: FATIGUE, HEADACHE, BODY ACHES

Other Meds: Gabapentin Pramapexole Fish oil Vit D Cal/mg

Current Illness: None

ID: 1344318
Sex: F
Age: 53
State: FL

Vax Date: 02/21/2021
Onset Date: 05/09/2021
Rec V Date: 05/24/2021
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: Bell?s Palsy- right side of face paralyzed with severe ear pain and loss of taste. Doctor prescribed Prednisone 10 mg and Valacyclovir 1g

Other Meds: Hormone replacement therapy

Current Illness: None

ID: 1344319
Sex: F
Age: 16
State: PA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
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: Lyme titer, pending

Allergies: none

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

Symptoms: Bell's Palsy, mild

Other Meds: none

Current Illness: no

ID: 1344320
Sex: F
Age: 35
State: TX

Vax Date: 05/04/2021
Onset Date: 05/12/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: Sulfa allergy

Symptom List: Unevaluable event

Symptoms: 1.) Mild headache and moderate body aches with low grade fever beginning day of vaccination, dissipating on day 2. 2.) Arm soreness and minor rash at injection site appeared 8 days after vaccine administration, lasted approximately 2 days. 3.) First post-vaccine menstruation was 12 days early and noticably heavier than usual with increased cramping and body aches.

Other Meds: Ibuprofen, magnesium supplement

Current Illness: N/A

ID: 1344321
Sex: F
Age: 58
State: OR

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/24/2021
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: None

Allergies: sulfa, neomycin

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

Symptoms: Chills through the night from 10:30 PM-6:30 AM, then nausea and vomiting from 6:30 AM-8:00AM. Passed out for about 30 seconds around 7:00 AM. Slept for a few hours after 8:00 AM, and woke up feeling much better. That was almost a week ago, and I'm fine now.

Other Meds: fish oil, vitamin D, vitamin B, lysine

Current Illness: none

ID: 1344322
Sex: M
Age: 51
State: NY

Vax Date: 05/11/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None.

Symptom List: Injection site pain, Pain

Symptoms: After about a week my arm started to itch where the injection was made. Today, 13 days after the vaccine I developed a large itchy, hot, rash.

Other Meds: None.

Current Illness: None.

ID: 1344323
Sex: F
Age: 14
State: CA

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Dose given outside age eligibility at time of administration.

Other Meds:

Current Illness:

ID: 1344324
Sex: F
Age: 51
State: PA

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: none

Allergies: Ibuprofen , peanuts .

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

Symptoms: First couple days I had a very sore arm , pinpoint pains in the right side of my head , very vivid dreams . 2 weeks later I got a rash and mild pain at injection site . 3 weeks later I got swelled up ankles .

Other Meds: One a day multivitamin .

Current Illness: none

ID: 1344325
Sex: M
Age: 31
State: NC

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/24/2021
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: ECG 12 lead - May 19th - Doctor said everything looked normal

Allergies: Sulfa

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had chills on May 19th that started around 3 am and then I had fever ranging from 99F to 100F that I checked around 11 am. After taking a nap, around 2 pm my heart rate increased to 130 bpm and didn't come down for an hour. So I went to emergency room. Heart rate ranged from 110 bpm - 130 bpm for 5-6 hours. Then it reduced down close to 100. No medication was given

Other Meds:

Current Illness: Loose stools 2 weeks prior, no medication was taken

ID: 1344326
Sex: M
Age: 59
State: NY

Vax Date: 02/27/2021
Onset Date: 03/02/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: Doctor examined me on February 17. On February 24th I was also diagnosed with pleurisy, however the shoulder symptoms noted above still persist to this day.

Allergies: Contrast dye, tetracycline

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Beginning shortly after the expected soreness from the vaccine, I experienced a weakness, instability and pain in the shoulder of the vaccinated arm. This displayed as a feeling that the arm was dislocating with movement and when carrying any weight, even minor.

Other Meds: Omeprazole, Irbesartan, Crestor, Famotidine, Vitamins C, D & B-12, Fish oil, Lutein, Melatonin, low-dose aspirin, Ducosate Sodium, Nicotinamide, Heliocare

Current Illness: None

ID: 1344327
Sex: F
Age: 17
State: AZ

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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: Milk, blueberries

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

Symptoms: Immediately light headed, sweaty, cold ALL over, vomit

Other Meds: Adderal, Lexapro, birth control

Current Illness:

ID: 1344328
Sex: F
Age: 26
State: AK

Vax Date: 04/06/2021
Onset Date: 04/15/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: Covid test

Allergies: Penicillin

Symptom List: Nausea

Symptoms: At the time of vaccine, I was 21 or 22 weeks. I was diagnosed with covid this past weekend. I have congestion and sneezing and no fever. EDD: 08-11-2021

Other Meds: None reported

Current Illness: None reported

ID: 1344329
Sex: M
Age: 74
State: OR

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: None

Allergies: Erythromycin

Symptom List: Injection site pain

Symptoms: The day following the vaccination, noted new onset dizziness and that continues. This is not triggered by position change but does worsen with change in head position. The severity varies. He fell once and he has had to change his activity level on two days. The other days have been milder but annoying. He is in the middle of a building project and is unable to climb ladders.

Other Meds: Flomax; Metformin; Testosterone; Wellbutrin; Atorvastatin; Vitamins?C,D3, B12,B complex

Current Illness: None

ID: 1344330
Sex: F
Age: 72
State: MT

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: PT WENT TO HOSPITAL FOR TACHCARDIA THE DAY AFTER RECEIVING VACCINATION.

Other Meds:

Current Illness:

ID: 1344331
Sex: M
Age: 32
State: VA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Patient received vaccination and immediately slumped over in chair and fell on the floor. Patient did not hit head, but did lose consciousness for about 10-15 seconds. Patient also vomited after this fall. Patient subsequently reported a needle phobia, but thought it was only an issue for blood draws, not vaccinations. He did not verbalize his needle phobia to the vaccinating staff until after he was vaccinated.

Other Meds:

Current Illness:

ID: 1344332
Sex: M
Age: 17
State: CA

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/24/2021
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: Patient was not 18 years old at time of vaccination

Other Meds:

Current Illness:

ID: 1344333
Sex: M
Age: 65
State: OH

Vax Date: 03/15/2021
Onset Date: 03/29/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data: halter monitor for 30 days

Allergies: no

Symptom List: Erythema, Pruritus

Symptoms: AFIB

Other Meds: lisinopril

Current Illness: none

ID: 1344334
Sex: M
Age: 19
State: FL

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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: Unknown- was administered by EMT

Allergies: nkda

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

Symptoms: Patient received the vaccine and fainted within 5 minutes after receiving the vaccine. He fell and hit his head and had a nose bleed. He was put in the Trendelenburg position and recovered immediately. The EMT was called and provided care to the patient. Checked on patient and patient said he was able to walk home on his own.

Other Meds: Not Known

Current Illness: not known

ID: 1344335
Sex: M
Age: 59
State: WA

Vax Date: 05/22/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data: ECG on 5/24 consistent with pericarditis, neg troponin, elevated CRP

Allergies: NKDA

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

Symptoms: Patient received first dose of vaccine on 4/18/2021, and second dose on 5/22/2021. Now presents with pericarditis on 5/24/2021. I know there has been some potential association of pericarditis with vaccination

Other Meds: ASA, flexeril, doxycycline, triamcinalone ointment

Current Illness: None

ID: 1344336
Sex: F
Age: 24
State: VA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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: Client was nervous prior to vaccination. Once the vaccine was administered, patient quickly became light-headed and nauseous. She was taken to a cot via wheelchair to lay down. No loss of consciousness was reported.

Other Meds:

Current Illness:

ID: 1344337
Sex: F
Age: 18
State: WA

Vax Date: 05/20/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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: Troponin: 5/23 0900 1.17 5/23 1230 4.66 5/23 2200 3.49 5/24 0600 2.65 Chest x-ray: normal, no sign of pneumothorax

Allergies: None

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

Symptoms: Patient presented to the emergency room with acute chest pain in the sternal area and a troponin of 1.1. EKG showed early repolarization, not concerning for ACS. Her pain was classic for pericarditis in that it was worse when leaning back, nonexertional, and not accompanied by diaphoresis or nausea. She was treated for presumed pericarditis with ibuprofen and colchicine. Her troponin peaked at 4.6 and then downtrended. Her chest pain resolved. She was discharged with presumed pericarditis.

Other Meds: Amphetamine- dextroamphetamine ER 25mg qam Fluoxetine 40mg qpm Levonorgestrel-ethinyl estradiol 0.15-0.03 mg qpm

Current Illness: None

ID: 1344338
Sex: M
Age: 50
State: IN

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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: None

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

Symptoms: Body aches, a little light headedness, sleepy. Began 3 hours after injection

Other Meds: Zoloft and Truvada

Current Illness: None

ID: 1344339
Sex: M
Age: 18
State: NY

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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: Patient had facial pressure and some throat tightness. His VS were normal and he was transported to the ER.

Other Meds: Accutane Omeprazole

Current Illness: None

ID: 1344340
Sex: F
Age: 28
State: CT

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: Augmentin

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

Symptoms: Big red splotch on arm right below injection site. It takes up about 1/3 of my upper arm. At first it was slight itching, and then before I went into work that evening for 3, my arm was sore and I looked and the large red splotch had appeared. It was bright red, painful and hot to the touch. At this point it didn't itch. Today, it's still red but not as red, and there is minimal pain, but extreme itching. Today at my gynecologist she informed me this is what I'd being called "covid arm".

Other Meds: Incassia birth control and lexapro

Current Illness: None

ID: 1344341
Sex: F
Age: 18
State: VA

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

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

Lab Data: n/a

Allergies: n/a

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

Symptoms: Patient received the vaccine and shortly after became light headed and dizzy. We told her to remain seated and got her a water. She then vomited into the trashcan. She stayed in the pharmacy waiting area with her brother until 6 pm when she said she felt fine and left with him.

Other Meds: n/a

Current Illness: n/a

ID: 1344342
Sex: F
Age: 72
State: TX

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/24/2021
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 ? Sulfa ? Codeine

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

Symptoms: Tremors (could not walk, lost sight in both eyes, Extremely high BP (220/110), Could not breathe (put on ventilator in ICU), Found blood in brain) Fluid built up in lungs. All over 4 1/2 days starting on 05/08/2021

Other Meds: LEVEMIR FlexTOUCH, ZOCOR, BRILINTA, glipiZIDE, LASIX, Simvastatin, Lisinopril

Current Illness: congestive heart disease, diabetes (type 1)

ID: 1344343
Sex: M
Age: 90
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: CT - all negative

Allergies: No known food, environmental or drug allergies

Symptom List: Vomiting

Symptoms: Patient presented to ER on 5/22/21 complaining of left eye swelling and vision being blurred. Physician diagnosed as a corneal abrasion and left periorbital cellulitis. Patient came back to the ER on 5/24/21 complaining of left side of face drooping. Patient stated he noticed this the day prior. Patient was having difficulty closing his left eye. Today 5/24 he is drooping on the left side of his face and difficulty drinking water without running out of his mouth. No chest pain. According to physician, exam was most consistent with Bell's palsy but given patient's HTN, age and bounce back status, a CT was done. Everything was negative. Physician treated patient for Bell's Palsy with Valtrex and prednisone. This all happened within two weeks of receiving the 2nd dose of the Moderna Vaccine.

Other Meds: Erythromycin 5 mg/1/gm Ophthalmic Ointment, Augmentin 500MC-125 MV Oral tablet, Furosemide 40 MG Oral tablet, Potassium Chloride 10 MEQ Oral Tablet, Extended Release, Tamsulosin HC1 0.4 mg oral capsule

Current Illness: On 4/13/21 patient complained of knee pain. Received a cortisone shot.

ID: 1344344
Sex: M
Age: 16
State: PR

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 05/24/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Lump or soft nodule on the right back of the head, a little above the nape and slightly red.

Other Meds:

Current Illness:

ID: 1344345
Sex: F
Age: 60
State: CT

Vax Date: 03/26/2021
Onset Date: 04/01/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: ringing in left ear

Other Meds: One-A-Day daily vitamin Viactiv (calcium & vit. D) Atorvastatin

Current Illness: No

ID: 1344346
Sex: F
Age: 67
State: AZ

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/24/2021
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: none

Allergies: penicillin drugs, chili peppers, cats

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 4 hours after the vaccine, a dull headache; restless sleep/insomnia throughout the night. 24 hours after the vaccine two rashes appeared (upper back behind left shoulder; and on the underside of left breast); they are suspected as herpes zoster. Rx is 800mg acylovire 5x/day for 7 days with advil or tylenol for pain, caladryl for itching and ice. Pain is localized and severe. No fever.

Other Meds: Vitamins C, B complex, B12 sublingual, E, D/K, Fish oil, lysine, milk thistle, CoQ10, lutein topical estrogen: E2 (.25)/E3(2.0) 100 mg progesterone

Current Illness: none

ID: 1344347
Sex: M
Age: 37
State: VA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Severe chest pain. Worse than the usual chest pain I have every once in awhile. Made a doctor's appointment. They couldn't figure out what was causing it. It finally subsided after 4 days.

Other Meds: Gabapentin 100 mg 2 times a day Diltiazem 240 mg 1 time a day

Current Illness: None

ID: 1344348
Sex: F
Age: 49
State:

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/24/2021
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: history of allergic to multiple medicines (PCN, Latex, sulfa, gentamycin) with anaphylactic reactions (rash, shortness of breath, swelling of throat)

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

Symptoms: "Rash at injection site, neck, face, upper trunk within first 5-10 minute(s) while in observation area after vaccine was given on 5/01/21. No note indicating that a rescue med was used. Patient reports via translation, history of allergic to multiple medicines (PCN, Latex, sulfa, gentamycin) with anaphylactic reactions (rash, shortness of breath, swelling of throat) Advise to get J&J vaccine 28 days after 1st dose Pfizer vaccine (ie, 5/29/21) Patient doesn't want to get J&J vaccine, information was provided, patient will consider later. Pt returned for second dose on 5/22 and was turned away due to allergy.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am