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: 1303288
Sex: M
Age: 73
State: IN

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 05/10/2021
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: I'm tired. Sleepy. Arms, legs, joints are sore - continuously. I can't sleep at night. Was concerned about a heart attack or even a stroke.

Other Meds: Generic Lipitor 20 MG. 20 MG Ibuprofen. 81 MG (baby) aspirin

Current Illness: None

ID: 1303289
Sex: F
Age: 36
State: ID

Vax Date: 04/26/2021
Onset Date: 05/03/2021
Rec V Date: 05/10/2021
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: None that I know of

Symptom List: Anxiety, Dyspnoea

Symptoms: Developed shingles in right shoulder blade area one week after the vaccine listed above.

Other Meds: None

Current Illness: None

ID: 1303290
Sex: M
Age: 84
State:

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/10/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Worsening lower extremity weakness.

Other Meds:

Current Illness:

ID: 1303291
Sex: F
Age: 94
State: TX

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 05/10/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 1/14 MODERNA 4/28 PFIZER, NO RXN.

Other Meds: NONE REPORTED

Current Illness: NONE REPORTED

ID: 1303292
Sex: F
Age: 51
State: MO

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/10/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever; chills; muscle aches; swelling of lymph nodes under arm; headache.

Other Meds: Vitamins: D3, Airborne, Melatonin and Daily Women's supplement Birth Control

Current Illness: None

ID: 1303293
Sex: F
Age: 32
State: CA

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

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

Symptoms: The night of the vaccine I had muscle aches and I started gagging. The muscle aches were better in a few days. I went to the Emergency room the night of the shot. I was diagnosed with a bladder infection. The urge to gag was constant. I was given some nausea medicine in the ER and it helped a little I became dehydrated after a week. I had no appetite and had the gag reflex problems for three weeks. I was diagnosed with a kidney stone about three weeks after vaccination. My anxiety was also bad during that time. I have been feeling better, less anxious and eating more for the last two weeks.

Other Meds: Paroxetine

Current Illness:

ID: 1303294
Sex: F
Age: 73
State: OH

Vax Date: 03/01/2021
Onset Date: 04/22/2021
Rec V Date: 05/10/2021
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 developed Covid Feet on both feet, burning, itching, painful measle like rash. Treated with Cortisone cream. As of today 5-10-21 symptoms have mostly resolved.

Other Meds:

Current Illness:

ID: 1303295
Sex: F
Age: 55
State: MI

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/10/2021
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: 20 minutes after receiving 2nd Pfizer dose, my mouth had the strongest metallic taste to it - it has been 4 days, and I am still experiencing the "mouthful of nickles" taste. I also had severe, severe, diarrhea the first day only - was gone by day after 2nd dose. With my first injection on April 15th, I felt tired, but the strangest reaction was the constriction of my pupils - they became tiny little pin holes, which I have never seen before - that lasted 2 days, then disappeared

Other Meds: predisone, zinc, lisinipril, vitamins

Current Illness:

ID: 1303296
Sex: F
Age: 51
State: TX

Vax Date: 04/26/2021
Onset Date: 05/06/2021
Rec V Date: 05/10/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: FATIGUE STARTED ON 5/6/21

Other Meds: unknown

Current Illness: unknown

ID: 1303297
Sex: F
Age: 56
State: VT

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/10/2021
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: codine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: on 5/6/2021 at 7:30AM my nose began bleeding from left nostal. Went to ED. Nose was cauterized. I was released & later in the day I was slightly feverish & tired. On 5/9/2021 at approx 7:30 AM, left nostril began bleeding again. I was vomiting blood & blood was coming out of my tear ducts. I went to Hospital ED. They cauterized my nose using silver nitrate stick and inserted "rhino Rocket"5.5cc with 3cc of air. Was prescribed Keflex500mg pills 4x/day - 5 days 5/10/2021 Nose is oozing, feel slightly feaverish & achey

Other Meds: over the counter multi vitamin

Current Illness: n/a

ID: 1303298
Sex: F
Age: 54
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/10/2021
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: Adverse event: Itchy rash at waistline, shoulder (not side of injection), and between thighs consisting of small hard bumps over a widespread area. New bumps continue to appear on chest and arm but only one or two so far. The bumps sting when they appear and then turn itchy. Time: April 30, 2021 to present (May 10, 2021) -- new bumps still appearing.

Other Meds: Lisinopril; Vitamin C; Vitamin D; Ocuvite

Current Illness: None

ID: 1303299
Sex: F
Age: 33
State: PA

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 05/10/2021
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: N/A

Symptom List: Rash, Urticaria

Symptoms: 1st day- pain in area where injected 2nd day- pain in area where injected, muscle pain throughout the top half/left side of my body, headache; chills and hot flashes 3rd day- less pain but now experiencing nausea and still have headaches; chills and hot flashes

Other Meds: Vitamins and Plaquenil

Current Illness: Common cold prior

ID: 1303300
Sex: F
Age: 82
State: TX

Vax Date: 04/22/2021
Onset Date: 05/26/2021
Rec V Date: 05/10/2021
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: pruritis, erytherma, and swelling to the left upper arm

Other Meds: calcium + vit D, flonase, levocertrizine, montelukast, macrobid, olopatadine, tamoxifen, vitamin c, vitamin d3,

Current Illness: none

ID: 1303301
Sex: F
Age: 57
State: NJ

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 05/10/2021
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: Had body aches and tiredness after 12 hours. Left underarm sore. Soreness spread across upper chest and breast bone. winded but not sure of breath or hard to breath. Sensation across chest persists but is not worse, still winded on & off.

Other Meds: Pantoprazole, Zoloft, restasis

Current Illness: None

ID: 1303302
Sex: F
Age: 29
State: IL

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/10/2021
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: nkda

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

Symptoms: Patient presented to pharmacy on 5/10/21 and reported not feeling well since first dose of covid-19 vaccine received on 5/3/21. Side effects began 5/4/21 and included nausea, vomiting, fatigue, fever, and dizziness. Recommended patient to continue otc analgesics, hydration, and contact PCP for further follow up.

Other Meds: n/a

Current Illness: n/a

ID: 1303303
Sex: M
Age: 19
State: VA

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/10/2021
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: Coconut oil, sesame seeds, tree nuts, peanuts

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

Symptoms: Patient presented with chest pain approximately 15 hours after the 2nd Moderna COVID-19 vaccine. Workup was significant for an elevated troponin, sed rate, CRP, and D-dimer. Cardiac MRI revealed myocarditis. Cardiac CT was negative for coronary disease. Treated with colchicine, metoprolol, and ibuprofen.

Other Meds:

Current Illness:

ID: 1303304
Sex: F
Age: 35
State:

Vax Date: 01/19/2021
Onset Date: 01/22/2021
Rec V Date: 05/10/2021
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:

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

Symptoms: 3 days after moderna vaccine, burning sensation on lower back and both thighs, developed highs on entire back and both thighs above the knee, swollen lymph nodes under left arm. Spoke with a doctor who recommended benadryl and claritine. Symptoms went away a few days but from time to time feels a itching sensation strong enough to prevent her from completing her work task. Associate states she will be speaking to an allergist.

Other Meds:

Current Illness:

ID: 1303305
Sex: F
Age: 42
State: CA

Vax Date: 04/20/2021
Onset Date: 05/09/2021
Rec V Date: 05/10/2021
Hospital:

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

Lab Data:

Allergies: Paper tape adhesive

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Dizziness/vertigo; nausea, sweats, abdominal/uterine cramping, rash on chest and neck

Other Meds: Vitamin D

Current Illness: N/A

ID: 1303306
Sex: M
Age: 63
State: IL

Vax Date: 03/15/2021
Onset Date: 03/22/2021
Rec V Date: 05/10/2021
Hospital:

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

Lab Data:

Allergies: Non

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Ringing Ears all day long (Tinnitus?) Occurred after 3 days to a week. Affecting quality of sleep. Worse at around Bed time. Also noticeable fatigue. Running at about 80-90% of my previous normal.

Other Meds: Non

Current Illness: Non

ID: 1303307
Sex: M
Age: 41
State: CA

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/10/2021
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: Fatigue, body aches, fever, headache

Other Meds:

Current Illness:

ID: 1303308
Sex: F
Age: 22
State: CO

Vax Date: 05/01/2021
Onset Date: 05/08/2021
Rec V Date: 05/10/2021
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: Rash and redness in arm at injection site in circular pattern with onset 8 days after vaccination, pruritic, tender, and warm to the touch, consistent with "Moderna arm".

Other Meds: Nexplanon implant

Current Illness: None

ID: 1303309
Sex: F
Age: 48
State: OR

Vax Date: 04/19/2021
Onset Date: 04/26/2021
Rec V Date: 05/10/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Unevaluable event

Symptoms: Acute left-sided sensorineural hearing loss occurred 7 days after vaccine. ENT visit, no improvement with prednisone. Planned follow up 5/11/21 with possible steroid injection.

Other Meds: ferrous sulfate

Current Illness: NA

ID: 1303310
Sex: M
Age: 20
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/10/2021
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:

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

Symptoms: Administered 0.5 mL of vaccine instead of 0.3 mL

Other Meds:

Current Illness:

ID: 1303311
Sex: F
Age: 71
State:

Vax Date: 02/27/2021
Onset Date: 03/03/2021
Rec V Date: 05/10/2021
Hospital: Y

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: This 71 year old female received the Covid shot on 2/27 /21 and went to the ED on 3/3 /21 and was admitted on 3/4/21 with the following diagnoses listed below. R56.9 - Unspecified convulsions

Other Meds:

Current Illness:

ID: 1303312
Sex: M
Age: 48
State: MI

Vax Date: 03/22/2021
Onset Date: 03/24/2021
Rec V Date: 05/10/2021
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: left side of body very tingling and numb

Other Meds: none

Current Illness: none

ID: 1303313
Sex: M
Age: 20
State: IL

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/10/2021
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: None

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

Symptoms: Patient during his observation period @1010 reported symptoms of HA, lightheaded, joint pain, and shortness of breath following Pfizer vaccine administration. Patient was provided 25mg Benadryl @1018 and legs elevated for possible allergic and syncopal symptoms respectively. After no immediate clinical improvement, patient was transferred to ED via EMS . Patient did not require any interventions in ED and was diagnosed with Anxious reaction to vaccine. Patient released to home.

Other Meds: None

Current Illness: None

ID: 1303314
Sex: F
Age: 60
State: VA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/10/2021
Hospital: Y

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: no

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient described intractable vomiting, dehydration, blood sugar over 800. Patient went to hospital and was admitted to ICU for approximately 4 days. Patient has been discharged from the hospital.

Other Meds:

Current Illness:

ID: 1303315
Sex: F
Age: 54
State: CA

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 05/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever, body aches, headache

Other Meds:

Current Illness:

ID: 1303316
Sex: F
Age: 35
State: OH

Vax Date: 02/26/2021
Onset Date: 05/10/2021
Rec V Date: 05/10/2021
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: Zithromax

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

Symptoms: Vaccine 1: 1/29/21. Vaccine 2: 2/26/21. Found out I was pregnant: 3/25/21. Miscarriage: 5/10/21. First OBGYN appointment baby was smaller than expected and had to get vaginal ultrasound. Baby was measuring at 6 weeks with no heartbeat. 10 days later repeated ultrasound and baby had not grown and still no heart beat. Baby never developed longer than 6 weeks. Adverse event: miscarriage.

Other Meds: Omeprazole Pre Natal vitamin Vitamin D Heather?s tummy tamers Cranberry Valcycolvir

Current Illness: None

ID: 1303317
Sex: M
Age: 52
State: TX

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

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Patient called us today to say that he had to go ER on 5/7/21 due to rash all over and tingling in his throat. He said he started shortly after the vaccine on 5/5/21 but thought it was his allergies. He noticed later that night that he was developing a rash all over his body. He went to ER on 5/7/21 and they treated him for allergic reaction due to the vaccine. They gave him Benadryl and Steroid for 2 days.

Other Meds: None

Current Illness: None

ID: 1303318
Sex: F
Age: 52
State: GA

Vax Date: 04/30/2021
Onset Date: 05/07/2021
Rec V Date: 05/10/2021
Hospital:

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

Lab Data:

Allergies: Adhesive Allergy (ie surgical tape, band-aides)

Symptom List: Injection site pain

Symptoms: COVID arm - warm, itchy, raised, large welt over the area of the injection. Resolved within 3 days. Did not require treatment other than ice. UCTD flare - ongoing. Seemed to aggravate all of my UCTD symptoms (i.e. joint pain, all over pain, fatigue, costochondritis).

Other Meds: Apres Tabs (Birth Control)

Current Illness: UCTD Interstitial Cystitis

ID: 1303319
Sex: M
Age: 77
State: AZ

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 05/10/2021
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: Patient Experienced Temperature between 99.9 - 100 deg. cel., he complained of body aches, tiredness, and being sweaty. Symptoms lasted for 11 hours.

Other Meds:

Current Illness:

ID: 1303320
Sex: F
Age: 17
State: NE

Vax Date: 03/12/2021
Onset Date: 04/09/2021
Rec V Date: 05/10/2021
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: None

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

Symptoms: No symptoms was administered outside the EUA for Moderna. Notified State of Nebraska VFC program who notified CDC. Was advised by CDC to Finish the Series. 1st Dose 3/12/2021 2nd Dose 5/10/2021

Other Meds: None

Current Illness: None

ID: 1303321
Sex: F
Age: 70
State: NC

Vax Date: 02/15/2021
Onset Date: 03/15/2021
Rec V Date: 05/10/2021
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: penicillin, erythromycin

Symptom List: Tremor

Symptoms: developed fevers and chills for 3 days after the 2nd shot. Since then has been experiencing severe fatigue, myalgias, muscle weakness, and chills for nearly 2 months. Labs show elevated sed rate and equivicoal Lyme test. ANA, RF, CMP, CPK all normal. Working diagnosis right now is atypical PMR/TA vs. Lyme vs. immune response to vaccine.

Other Meds: b complex, synthroid, vitamin d

Current Illness: none

ID: 1303322
Sex: M
Age: 40
State:

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/10/2021
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: Pt notified staff outside of patient's of dizziness. EMTs notified and on scene. No LOC, A&Ox4. Transported to medical bay w/ wheelchair. VSS. Pt had resolution of symptoms, felt "normal" and D/C'd to home, self.

Other Meds:

Current Illness:

ID: 1303323
Sex: F
Age: 16
State: PA

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

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Patient was given Moderna vaccine. Not eligible due to age 16. No signs/symptoms at time of vaccine or as reported by mother next day (5/6/21) during follow up call.

Other Meds:

Current Illness:

ID: 1303324
Sex: F
Age: 59
State: WI

Vax Date: 04/12/2021
Onset Date: 05/09/2021
Rec V Date: 05/10/2021
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: Hydrocodone Nausea and Vomiting; Codeine Nausea and Vomiting

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

Symptoms: Asymptomatic testing for pre-surgical work-up.

Other Meds: Unknown

Current Illness: Unknown

ID: 1303325
Sex: F
Age: 53
State: CA

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

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

Lab Data:

Allergies: amLODIPine clindamycin felodipine lisinopril

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 53 year old female with hypertension and recent COVID-19 vaccine (Moderna, 1st dose on 4/5/21), sent for abnormal labs to the ED and new onset dizziness. As for the dizziness, the patient describes it as: of 2-3 week duration, onset 4 days following COVID-19 vaccine (Moderna, 1st dose on 4/5/21), progressive, intermittent, reproducible with activity, some improvement at rest, of variable pain intensity; associated with taste change, dry mouth, malaise, nausea, and poor appetite. Of note, urgent care reported BUN 54 and Creatinine 2.89. On arrival to the ED, the patient's CT of head was notable for: No evidence of acute intracranial pathology

Other Meds: None

Current Illness: unknown

ID: 1303326
Sex: M
Age: 33
State: KS

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/10/2021
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: Chills, 102.3 Fever, Nausea, Waves of Vertigo

Other Meds: None

Current Illness: None

Date Died: 03/23/2021

ID: 1303327
Sex: M
Age: 67
State: GA

Vax Date: 01/04/2021
Onset Date: 03/13/2021
Rec V Date: 05/10/2021
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: Hospitalization and Death

Other Meds:

Current Illness:

ID: 1303328
Sex: F
Age: 42
State: IL

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 05/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Patient states she woke up on 05/08 with a fever along with being sweaty and achy all over. As of report date (05/10/21), Patient states she still has a fever and is sweaty, but is no longer experiencing achiness except for localized immunization reaction.

Other Meds:

Current Illness:

ID: 1303329
Sex: M
Age: 36
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/10/2021
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: Administered 0.5 mL of vaccine instead of 0.3 mL

Other Meds:

Current Illness:

ID: 1303330
Sex: M
Age: 53
State:

Vax Date: 04/08/2021
Onset Date: 04/01/2021
Rec V Date: 05/10/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: sister-in-law states dx: Guillain-Barre requiring hospitalization

Other Meds:

Current Illness:

ID: 1303331
Sex: M
Age: 27
State: VA

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 05/10/2021
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: Gluten

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

Symptoms: Tried all the time and can?t hold an appetite manly bread

Other Meds:

Current Illness:

ID: 1303332
Sex: F
Age: 54
State: IL

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/10/2021
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: Penicillan

Symptom List: Vomiting

Symptoms: Within 23 to 24 hrs of 1st shot, felt faint and legs wobbly. Lied down on kitchen floor with legs raised for about 5 to 7 minutes. Then within an hour had chills and a fever of 100.1, took Tylenol, then had hot spells. Went to bed about 830pm. Next morning felt fine except for soreness in left underarm, lymph node area in addition to slight pain in injection site. 4 days later underarm less pain but still slight pain at injection.

Other Meds: Losartan, simvistatin, multiple vitamin, probiotic

Current Illness: Cold

ID: 1303333
Sex: F
Age: 35
State: WA

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 05/10/2021
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: Dihydroergotamine, Metoprolol, Tramadol, Buspirone, Latex, Penicillins, Venlafaxine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Left eyelid ptosis, left facial sensory deficit, possible left sided vision changes started morning of 5/7/2021. . Remote 2mm cerebellar stroke found on imaging.

Other Meds: Lisinopril, Mirena, Ibuprofen, Melatonin, Restoril, Imitrex, Robaxin, Tenormin, Aspirin, Ciloxin, Gabapentin, Maxidex, Ciprodex

Current Illness: Left side otitis media with effusion, maxillary sinusitis

ID: 1303334
Sex: F
Age: 45
State: SC

Vax Date: 05/07/2021
Onset Date: 05/09/2021
Rec V Date: 05/10/2021
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: Food allergies

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

Symptoms: Left leg numb swollen from thigh down to my feet and aching the whole leg however mostly in my knee.

Other Meds:

Current Illness: None

ID: 1303335
Sex: F
Age: 26
State: VA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/10/2021
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: Arm pain right after and continuing for the next 24 hours. A headache that developed around 10pm and lasted until about 8AM. Extremely lethargic. Slept from 1AM until 4:30PM the following day.

Other Meds: None

Current Illness: None

ID: 1303336
Sex: F
Age: 86
State:

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 05/10/2021
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:

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

Symptoms: This 86 year old female received the Covid shot on 3/10/21 and went to the ED and admitted on 3/12/21 with the following diagnoses listed below. J18.9 - Pneumonia, unspecified organism D69.6 - Thrombocytopenia, unspecified Altered Mental Status

Other Meds:

Current Illness:

ID: 1303337
Sex: F
Age: 48
State: MI

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 05/10/2021
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: none

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

Symptoms: swollen legs and feet that doesn't go away

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm