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: 1303854
Sex: F
Age: 34
State: MI

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

Lab Data:

Allergies: Ceclor Tempura Peanuts Ragweed Molds Dust Maple Trees

Symptom List: Dysphagia, Epiglottitis

Symptoms: Grand Mal Tonic-Clonic seizure 3:30 p.m.

Other Meds: 250 mg Zonegran daily 25 mg Onfi daily 500 mg Magnesium daily 500 mg vitaman C daily 2 Flintstone gummies daily 2 Align with cranberry gummies daily 1 Occuvite capsule daily 800 mg Folic Acid daily 2 Calcium + D3 gummies daily

Current Illness: Epilepsy (Lennox-Gastaut Syndrome)

ID: 1303856
Sex: F
Age: 52
State: WI

Vax Date: 04/14/2021
Onset Date: 04/29/2021
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: possible penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: 4 year - Post Menopause cramping, bloating, and spotting. Have not had a period since 5/2017. 'Spotting' 4/29-5/1. Minor cramping off and on 4/29-present. Bloating 4/29 (possibly prior) - present

Other Meds: multi-vitamin

Current Illness: none

ID: 1303857
Sex: F
Age: 23
State: CA

Vax Date: 05/10/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/a

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

Symptoms: patient received vaccination and after 15 minutes self reported tingling and numbness in her left arm. she felt hot to the touch and experienced mild anxiety. patient waited an additional hour and 45 minutes before being picked up. she was stable when she left and stated she would go to urgent care.

Other Meds: n/a

Current Illness: n/a

ID: 1303858
Sex: M
Age: 77
State:

Vax Date: 02/20/2021
Onset Date: 03/31/2021
Rec V Date: 05/10/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I63.81 - Other cerebral infarction due to occlusion or stenosis of small artery R29.810 - Facial weakness I63.81 - Left sided lacunar stroke

Other Meds:

Current Illness:

ID: 1303859
Sex: F
Age: 37
State: FL

Vax Date: 04/15/2021
Onset Date: 04/17/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient has tingling,numbness, in Left thumb, index, and middle fingers. Feels as if fingertips are asleep. She has not sought treatment.

Other Meds:

Current Illness:

ID: 1303861
Sex: F
Age: 31
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Administered 0.5 mL of vaccine instead of 0.3 mL

Other Meds:

Current Illness:

ID: 1303862
Sex: F
Age: 29
State: UT

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Erythema multiforme (minor). 1 week after injection patient developed classic painful papular targetoid lesions on the palms, soles, distal extremities with no recent episode of herpes labialis. Patient was otherwise well and rash is self-resolving after ~2 weeks

Other Meds: Clonazepam, venlafaxine, pantoprazole

Current Illness:

ID: 1303863
Sex: M
Age: 77
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: unknown

Symptom List: Pharyngeal swelling

Symptoms: Pfizer covid vial diluted. Drawn out and administered 3 doses from dilluted vial. Upon drawing up 4th dose, there was not enough solution.

Other Meds: unknown

Current Illness:

ID: 1303864
Sex: F
Age: 78
State:

Vax Date: 04/10/2021
Onset Date: 04/27/2021
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: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I26.99 - Pulmonary embolism on right I26.99 - Other pulmonary embolism without acute cor pulmonale

Other Meds:

Current Illness:

ID: 1303865
Sex: F
Age: 41
State: FL

Vax Date: 04/26/2021
Onset Date: 04/26/2021
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: Allergic to milk and cilantro

Symptom List: Diarrhoea, Nasal congestion

Symptoms: No reaction to shot#1. Started to feel ill 6 hours after shot #2, developed a fever up to 101.6, had bad chills, headache for hours and then finally took tylenol. Fever/chills lasted about 48 hours. Fever came down and then my menstrual cycle started, it came 1 week early. My cycle is always regular, have never been early in 25+years. Have now had period for the last 12 days, cramps, headache.

Other Meds: HCTZ for high blood pressure, daily One A Day Women's gummy vitamin, daily vitamin D3

Current Illness: None

ID: 1303866
Sex: F
Age: 15
State: OR

Vax Date: 04/25/2021
Onset Date: 04/25/2021
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:

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

Symptoms: pfizer given to 15yo, unauthorized age

Other Meds:

Current Illness:

ID: 1303867
Sex: F
Age: 40
State: ID

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Vaccine vial remained in freezer one day longer than reccommended per manufacturer. Should have been pulled from freezer and refrigerated before 3pm Thursday 5/6/2021 but was not; Administered Friday 05/07/2021 after removal from freezer that morning. "USE BY DATE" on "FREEZER" sticker on original container was noticed Friday afternoon after injection had been admistered.

Other Meds:

Current Illness:

ID: 1303868
Sex: M
Age: 49
State: CA

Vax Date: 04/10/2021
Onset Date: 05/01/2021
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: Tinnitus comes on goes. Sometimes is very low sometimes is unbearable with a headache.

Other Meds: None

Current Illness: None

ID: 1303869
Sex: M
Age: 38
State: IL

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: 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: Patient's injection site was red and itchy, gave 1.5 tablets of diphenhydramine 25mg, patient was monitored for an extra 15 minutes and felt fine so went home

Other Meds: none

Current Illness: none

ID: 1303870
Sex: F
Age: 84
State:

Vax Date: 02/27/2021
Onset Date: 04/15/2021
Rec V Date: 05/10/2021
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: N17.9 - Acute kidney failure, unspecified R65.10 - Systemic inflammatory response syndrome (sirs) of non-infectious origin without acute organ dysfunction

Other Meds:

Current Illness:

ID: 1303872
Sex: F
Age: 58
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Administered 0.5 mL of vaccine instead of 0.3 mL

Other Meds:

Current Illness:

ID: 1303874
Sex: F
Age: 43
State: CA

Vax Date: 05/10/2021
Onset Date: 05/10/2021
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: NKA

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

Symptoms: administered vaccine and patient reported slight shortness of breath and heaviness in her chest. after 20 minutes of observation, patient stated she felt better and patient was stable before leaving...Benadryl 25 mg given po

Other Meds: NO MEDICATION TAKEN AT THIS TIME

Current Illness: N/A

ID: 1303875
Sex: M
Age: 16
State: NM

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Vaccine administered to a 16 year old but the minimum age is 18 years old.

Other Meds:

Current Illness:

ID: 1303876
Sex: F
Age: 39
State: IL

Vax Date: 03/01/2021
Onset Date: 04/01/2021
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: Eggs, milk

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I have a very heavy period. It stops for a week then starts again with a very heavy period for 2 weeks with huge clots. This has been going on for 2 months now

Other Meds: Elderberry, Xanax, lexapro

Current Illness: None

ID: 1303877
Sex: F
Age: 32
State: IA

Vax Date: 05/07/2021
Onset Date: 05/09/2021
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: cats

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

Symptoms: red spots on left or right leg, painful

Other Meds: yes

Current Illness:

ID: 1303878
Sex: F
Age: 52
State: FL

Vax Date: 05/07/2021
Onset Date: 05/07/2021
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 reported

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

Symptoms: patient reports feeling symptoms of headache and fever on may 7th and may 8th after getting her 2nd covid-19 vaccine. may 9th she reports feeling better. On May 10th, she reported vertigo.

Other Meds:

Current Illness:

ID: 1303879
Sex: F
Age: 56
State: CO

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

Lab Data:

Allergies: Macrobid, Penicillin and Augmentin

Symptom List: Unevaluable event

Symptoms: pt had a lot of dizziness about 20 minutes after dose. she vomited and complained of tingling in face(chin, lips) and inside mouth. We administered benadryl 25mg by mouth. Then she thought that the throat was closing and she did have audible wheezing and pt's daughter noticed swelling in lips. Pt blood pressure was elevated and heart rate was high. We administered one dose of the epi-pen and then paramedics arrived and they were headed to hospital.

Other Meds: don't know

Current Illness: She was recently diagnosed with Premature ventricular contractions

ID: 1303880
Sex: M
Age: 59
State: TX

Vax Date: 04/19/2021
Onset Date: 04/19/2021
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: ibuprofen

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

Symptoms: soreness of left shoulder for 2 days, head ache on day 3

Other Meds: fluticasone

Current Illness: none

ID: 1303881
Sex: M
Age: 68
State:

Vax Date: 03/24/2021
Onset Date: 04/04/2021
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: I61.9 - ICH (intracerebral hemorrhage) (CMS/HCC)

Other Meds:

Current Illness:

ID: 1303882
Sex: F
Age: 49
State: CA

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

Lab Data:

Allergies: Erythromyacin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, body aches, fever, chills, nausea, treated with Tylenol 1000 every 6 hours had to back up with ibuprofen 400 in between the Tylenol doses for the second day to keep down fever and make it between doses. Otherwise I was hurting and fever would rise. Also took Zophram for nausea.

Other Meds: Mesalamine, Famotadine, Gabapentin, albuterol, wixellaHub, Vitamin c, Zinc, essential oils,

Current Illness: Gallbladder surgery on March 10, 2021

ID: 1303883
Sex: F
Age: 33
State: FL

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

Lab Data:

Allergies: None

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

Symptoms: On the day of the vaccine (5/7) I just felt tired and pain on my arm. The next day (5/8) I had a pounding headache that wouldn't go away. Pain in all my joints. Pain in my lower back. Neck pain. Low fever. Exhaustion. Felt extremely cold. Pain in the shot area. I took an Aleve and rested all day, symptoms were better but didn't completely go away. 5/9 Strong lower back pain. Headache (mild) . Felt angry and exhausted all day as if I had PMS, but it can't be PMS since I had period the week prior to the vaccine. 5/10 developed a big red bump with hives on the vaccine area and also pain. Been having headaches on and off all day. Little blurriness of vision, feeling a little bit dizzy. Strong lower back pain. Took aleve and put voltaren on back. Feeling a little bit of heart palpitations every now and then. Will take benadryl to see if it helps with the bump/hives.

Other Meds: Synthroid 150mcg

Current Illness: None

ID: 1303884
Sex: F
Age: 72
State: IL

Vax Date: 05/10/2021
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: LA

Lab Data:

Allergies: unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pfizer covid vial diluted. Drawn out and administered 3 doses from dilluted vial. Upon drawing up 4th dose, there was not enough solution.

Other Meds: unknown

Current Illness: unknown

ID: 1303885
Sex: F
Age: 39
State: ID

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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Vaccine vial remained in freezer one day longer than reccommended per manufacturer. Should have been pulled from freezer and refrigerated before 3pm Thursday 5/6/2021 but was not; Administered Friday 05/07/2021 after removal from freezer that morning. "USE BY DATE" on "FREEZER" sticker on original container was noticed Friday afternoon after injection had been admistered.

Other Meds:

Current Illness:

ID: 1303886
Sex: F
Age: 0
State: PA

Vax Date: 05/10/2021
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: Vancomycin Penacillin Terramycin Laytex Clarithromycin Levoxyl When not Pfizer or King

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

Symptoms: After the second shot the area around the shot hurt and had a lump. After about 4 days it went away. No other reactions. About a week later it flared up again and was very painful. It lasted about 3 days. I called my family doctor in April because this still continued. Dr. said to take Advil and use an ice pack on it when it flares up. I have been using the ice packs and Tylenol. Advil upsets my stomach to much. To this date, May 10,2021 these flare ups still continue. The pain is at the injection site, in the muscle and is very painful. The pain will last anywhere from five minutes to 15 minutes. Dr. said there is no way to tell how long this will go on. The flare up will last around three or four days, go away for two or three days and then start up again.

Other Meds: Levoxyl 100MCG/88MCG Alternate Vit. C Multivitamin/Mineral Biotin 1000 Mcg Glucosamin 2000 Mg Condroitin 1200 Mg Calcium 1000 Mg Xidra Eye Drops

Current Illness: No

ID: 1303887
Sex: F
Age: 29
State: NM

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: AFTER 5 MINS PT GOT VERY SWEATY AND THEN NAUSEOUS AND NOT FEELING WELL ALSO DIZZY AND WEAK. THEN PT GOT SUPER COLD AND CHILLS AND PT WAS STILL SWEATING PARAMEDICS CAME AND CHECKED HER OUT AND AFTER ABOUT 30 MINS PT STARTING FEELING BETTER

Other Meds:

Current Illness:

ID: 1303888
Sex: F
Age: 46
State: NE

Vax Date: 05/04/2021
Onset Date: 05/04/2021
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: None

Symptom List: Injection site pain

Symptoms: Soreness at injection site, mild nausea and low grade fever. Onset 6 hours post-injection. Duration: 24 hours from onset

Other Meds: Centrum women's multi-vitamin, Calcium with Vitamin D and Zyrtec

Current Illness: None

ID: 1303889
Sex: F
Age: 58
State: CA

Vax Date: 04/07/2021
Onset Date: 04/29/2021
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: epinephrine

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

Symptoms: I took the vaccine to travel. I moved on 4/29/21. The first night at a hotel, I had severe leg cramps: the left leg was toes to hip spasms lasting over 2 hrs. The right leg a bit less severe (toes to knee, also + 2 hrs). I did not receive food on the +5 hr flight and was dehydrated. I stretched etc as normal, with no results. At 2am, I went to the salt water pool and went between the pool and hot tub for about an hour. The next day I saw a huge bruise on the back of my right leg, above the knee. This repeated for 4 more nights, although less severe. Each morning I woke with another bruise: right leg above the knee = 3 bruises (purpuras), (con't below)

Other Meds: AFTER the vaccine, approx 1 wk, 2 wks, and on the day of trav

Current Illness: none

ID: 1303890
Sex: M
Age: 30
State: IN

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

Lab Data:

Allergies: Penicillin, Banana

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

Symptoms: Swelling, irritation, redness and warmth above and inside both knees.

Other Meds: Oxcarbazepine, Amlodipine, Daily multivitamin.

Current Illness: None

ID: 1303891
Sex: F
Age: 49
State: AL

Vax Date: 05/04/2021
Onset Date: 05/07/2021
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:

Symptom List: Tremor

Symptoms: Patient has a rash covering both arms and her feet are swollen.

Other Meds:

Current Illness:

ID: 1303892
Sex: F
Age: 97
State:

Vax Date: 01/30/2021
Onset Date: 02/08/2021
Rec V Date: 05/10/2021
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:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: I63.9 - Cerebral infarction, unspecified

Other Meds:

Current Illness:

ID: 1303893
Sex: F
Age: 47
State: GA

Vax Date: 04/02/2021
Onset Date: 04/24/2021
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: None

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

Symptoms: On Saturday, March 27, I felt a "tingling" in my scalp and in my left eyebrow. The tingling increased and intensified in the next several days, and by Tuesday evening (March 30), I had a rash down my face from my hairline to just between my eyebrows. It tingled and felt the tingling changed to a burning/tingling/electric feeling. By Wednesday morning, the burning had started becoming stronger, when I went to Urgent Care at 7:30 before school to see a doctor. The physician's assistant at Urgent Care looked at my face and heard my symptoms and diagnosed me with shingles. She prescribed Tylenol with codeine and Valtrex (Sorry - I don't know the dosage. I had to take it for 7 days, and I finished it so I threw away the pill bottle). The Tylenol with codeine did NOTHING for the pain. It steadily got worse through the week (Wed-Sat) and the rash became blisters. By Friday afternoon, even though I was on the Valtrex, the shingles had spread and pretty much covered the scalp on the left side of my head and went down my left forehead into my eyelid area. I saw my ophthalmologist, and he checked my eye and determined it was NOT affecting my ocular nerve and prescribed erythromycin ointment (3.5 gm) to apply to the rash twice daily. On Saturday, the nerve pain was incredible, and I called Urgent Care to see if there was something else I could try. When I spoke to a doctor on the phone he prescribed Gabapentin (300 mg, three times daily). This is what I have been using ever since. The shingles blisters have gone away and the skin that's left is very red/tender. I continue to use the erythromycin ointment twice daily and gabapentin. I still have pain in my left eye and where the shingles are currently subsiding.

Other Meds: 20 mg Citalopram (daily), 0.025 mg Levothyroxine (daily), 2400 mg flaxseed oil (daily)

Current Illness: None

ID: 1303895
Sex: F
Age: 59
State: VT

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Blurry vision for couple days

Other Meds: None but do smoke cigarettes

Current Illness: None but prediabetic

ID: 1303896
Sex: M
Age: 16
State: NM

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Moderna vaccine administered to a 16 year old but the minimum age is 18 years old.

Other Meds:

Current Illness:

ID: 1303898
Sex: F
Age: 43
State: IN

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: No known allergies

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

Symptoms: I went to bed at 9:00 pm on May 7th feeling ok. Then at about 1:00 am I woke up and felt like I was buzzing, I ached all over and I was wide awake and could not sleep for about 3 hours. I took some IBProfin and went to bed. I slept until 8:30 in the morning. At that time the buzzing had stopped and but I still felt achy all over. I was also tired. I felt like that all the rest of the day on May 8th. That night I went to bed around 9:00 pm and slept in until 7:00 am. This whole time my left arm where vaccine was given was sore when I lifted my arm. On May 9th I felt fine.

Other Meds: No

Current Illness: No

ID: 1303899
Sex: M
Age: 61
State: ID

Vax Date: 05/07/2021
Onset Date: 05/07/2021
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: Vaccine vial remained in freezer one day longer than reccommended per manufacturer. Should have been pulled from freezer and refrigerated before 3pm Thursday 5/6/2021 but was not; Administered Friday 05/07/2021 after removal from freezer that morning. "USE BY DATE" on "FREEZER" sticker on original container was noticed Friday afternoon after injection had been admistered.

Other Meds:

Current Illness:

ID: 1303901
Sex: F
Age: 38
State: FL

Vax Date: 05/04/2021
Onset Date: 05/05/2021
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: Pain in extremity

Symptoms: Rash on right knee, enlarged lymph nodes on neck, racing heartbeat, muscle aches, head ache Symptoms lasted one day then reappeared May 10, 2021

Other Meds: OTC Iron, fish oil, multi vitamin

Current Illness: None

ID: 1303902
Sex: F
Age: 30
State: WA

Vax Date: 04/05/2021
Onset Date: 04/12/2021
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: Patient reported that a week after receiving the vaccine she had pressure in the head, dizziness and nausea, then it went away. It came back today, but with extra shakiness and she almost fell over, "feels like a sinus infection but my nose is clear".

Other Meds:

Current Illness:

ID: 1303903
Sex: F
Age: 45
State:

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient complains of dizziness upon standing, denies any additional symptoms. PowerAid drink given to patient . Patient states feeling better after drinking but requested for her blood pressure to be checked to make sure everything is ok. Paramedic checks first BP it was 166/97 After several minutes the recheck BP came down to 144/56 . Patient states feeling a lot better , patient husband takes her home.

Other Meds:

Current Illness:

ID: 1303904
Sex: F
Age: 29
State: TX

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

Lab Data:

Allergies: N/A

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

Symptoms: Swollen lips, discomfort around swelling. Swelling lasted ~3 hrs. After swelling resolved, general itchiness all over body.

Other Meds: Zyrtec , tizanidine

Current Illness: N/A

ID: 1303905
Sex: F
Age: 33
State: NY

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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:

Symptom List: Vomiting

Symptoms: Given wrong manufacturer- 1st dose was Moderna on 1/4/21

Other Meds:

Current Illness:

ID: 1303906
Sex: F
Age: 19
State: NV

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

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient states she received the first dose of the Pfizer COVID vaccine on 5-5. Patient states she has the feeling of her throat closing on 5-5, but then resolved into a sore throat which has affected her eating. Patient woke yesterday with urticaria allover causing itching and a burning sensation. Patient has been taking Benadryl and using hydrocortisone cream with little relief of itching, but no relief of the urticaria. Patient denies changes in lotions, soaps or detergents. Patient has not eaten anything new. Patient states the only thing different recently was being put on Bactrim and Keflex for an abscess on 4-30. Patient stopped taking the antibiotics yesterday when she saw the rash. Patient received the vaccine at pharmacy.

Other Meds: Bactrim DS Keflex Aviane

Current Illness: Was being treated for a cutaneous abscess.

ID: 1303907
Sex: F
Age: 45
State: IA

Vax Date: 02/16/2021
Onset Date: 03/01/2021
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: RA

Lab Data:

Allergies: PCN Ilosone/Erythromyacin

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

Symptoms: Started with increased heart rate, fatigue and shortness of breath. Didn?t go to Dr until April 23, 2021 & April 26, 2021, syncope, multiple large bilateral pulmonary Emboli & DVT & right heart strain

Other Meds: Pantoprazole 40 qd Lasix 40qam Bactriam DS qHS Flexeril 20 bid Naproxen 500 usually qHS & prn Vyvanse 60 qAM Bupropion xl 300 qAM Escitalopram 20mg qAM Clonazepam 1mg bid Flonase prn Miralax 3X/week Probiotic Women?s Daily vitamin HAir sk

Current Illness: N/A

ID: 1303908
Sex: F
Age: 62
State: AL

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Freezing (Freezing) during the night, then woke up with all the same feeling & symptoms of Covid

Other Meds: Vitamins

Current Illness: None

ID: 1303909
Sex: M
Age: 41
State: ID

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Vaccine vial remained in freezer one day longer than reccommended per manufacturer. Should have been pulled from freezer and refrigerated before 3pm Thursday 5/6/2021 but was not; Administered Friday 05/07/2021 after removal from freezer that morning. "USE BY DATE" on "FREEZER" sticker on original container was noticed Friday afternoon after injection had been admistered.

Other Meds:

Current Illness:

ID: 1303910
Sex: M
Age: 20
State: MN

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Patient fainted

Other Meds: Duloxetine Trazodone

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm