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: 1314273
Sex: F
Age: 34
State: AL

Vax Date: 04/08/2021
Onset Date: 04/15/2021
Rec V Date: 05/13/2021
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: Aspirin Allergy Latex Allergy

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient received the vaccine Thursday 4/8/21 and on the Friday went to Hospital in complaining of not being able to breathe. A chest x-ray was done to rule out a PE. None was found. The following day the patient was called back and found to have a blood clot in her left calf muscle. She was treated and is now ok. I do not know specific test and dates. Hospital was the treatment facility. Patient did not know the name of the Doctor who treated her. We only found out about this adverse effect when we called her to schedule her 2nd dose.

Other Meds: Unknown

Current Illness: Unknown

ID: 1314274
Sex: F
Age: 51
State: MA

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Shingles

Other Meds: Vitamin D

Current Illness:

ID: 1314275
Sex: F
Age: 16
State:

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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:

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

Symptoms: Patient received second dose of Pfizer vaccine. Vaccine expiration time 0930 on 5/12/2021. Patient received vaccine on 5/12/2021 at 0943. MD made aware. No harm to patient or adverse reactions.

Other Meds:

Current Illness:

ID: 1314276
Sex: F
Age: 69
State: NH

Vax Date: 05/08/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Late in the evening on May 12, my mother started having pain on her right side. She also could not take a deep breath without having a stabbing-like pain. The pain level was severe and kept her awake all night. On May 13, she went to the urgent care department at the medical center. An xray of her chest cavity was taken. It showed fluid in her right lung, but the results were inconclusive because of her limited able to take a deep breath. Extensive blood work was also performed. The urgent care doctor suspected that she has a blood clot in her lung, and she was sent to the hospital for further testing. She is still in the ER of the Medical Center. They are still doing tests and have not officially confirmed that she has a blood clot yet.

Other Meds: Thyroid drug (Lev-something), Vitamin D

Current Illness: None

ID: 1314277
Sex: F
Age: 51
State: NY

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Latex Tylenol

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

Symptoms: Ten minutes after getting the second dose of the vaccine I was sitting waiting. I felt like I couldn't get enough air. Suddenly I felt like someone was standing on my chest. I felt like I needed to go outside and get air. The doctor came over and I was taken to the ER. I did not take Benadryl because I had to drive home. I felt like I was slipping in and out of consciousness. I was observed but not very often but I was not given anything else. I was discharged after three hours and I managed to get myself home. The day after the vaccine I had a low grade fever, severe body aches and lack of appetite. It lasted for thirty six hours. I had bad pain in my arm for five days. My arm was also swelled up for a week which started a week after the shot. It was swollen up like I had cellulitis.

Other Meds:

Current Illness:

ID: 1314278
Sex: F
Age: 53
State: SD

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 05/13/2021
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: NKDA

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

Symptoms: Pt stated that post vaccination she developed a large rash, described as "blotches", to her entire face, that were quarter size. The rash began the same night post vaccination and lasted the entire night and into the next morning. Pt did not take any medication and the rash went away on it's own. Patient did not report this until presenting for her second dose.

Other Meds: Venlafaxine, Insulin Aspart, Lisinopril

Current Illness: None noted

ID: 1314279
Sex: F
Age: 38
State: KY

Vax Date: 04/07/2021
Onset Date: 04/12/2021
Rec V Date: 05/13/2021
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: Penicillin and Codiene

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: About a week after being vaccinated I started experiencing bad headaches, chest pains and pains in my leg. I went to the emergency department at Hospital to get checked out. They took blood and I had a high d dimer test result. They did an Ultrasound of both legs, and a CT with contrast of the lungs and a CT of the head. No blood clots were evident at the time. Over the next couple of weeks my left leg has continued to swell and hold fluid. On 5-11-2021 I had another ultrasound of the left leg again to rule out a possible blood clot. Again they did not find anything. After reviewing blood work from a coag profile all results were elevated but not worrisome per the dr. I continie to have more swelling in the left lower extremity, muscle aches and pains in that leg along with more busted blood vessels. I have experienced pains in places that I have never had before. Example a sharp pain started around my left pelvic area and shot up to the left shoulder and then burned for several minutes.

Other Meds: Suboxone, Prilosec

Current Illness: None

ID: 1314280
Sex: F
Age: 68
State: MN

Vax Date: 04/06/2021
Onset Date: 04/18/2021
Rec V Date: 05/13/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Patient presented to the ED and was subsequently hospitalized for COVID-19 within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1314281
Sex: F
Age: 43
State: CA

Vax Date: 03/19/2021
Onset Date: 04/15/2021
Rec V Date: 05/13/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient developed mild symptoms on 4/15/2021 but was not diagnosed with COVID-19 until she was tested as part of response testing during an outbreak of COVID-19 in a homeless shelter, where she was PCR positive on 4/29/2021

Other Meds:

Current Illness:

ID: 1314282
Sex: F
Age: 19
State: CA

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 05/13/2021
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: Amoxycillin, Pollen, dogs, cats, mice, grass, nuts

Symptom List: Diarrhoea, Nasal congestion

Symptoms: About 10 minutes after my throat and mouth was extremely dry. I went to the EMT and noticed my heart rate was beating fast. They told me to go to ER and I was having a bizarre reaction and also had an anxiety attack, which took a little while for my heart to go down. I was extremely nauseas the following one week and a half. I am no longer having these symptoms today.

Other Meds: Albuterol inhaler, avascone daily inhaler

Current Illness: asthma and an infection

ID: 1314283
Sex: M
Age: 15
State: MD

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Pt had spent 10 mins in the observation hall when he w.. as reported to be feeling light-headed and his vision, blurry. Mother reported that he had nothing for breakfast b/4 the vaccination appointment. V/S taken was bp 98/57, rr 14, Hr 80, O2 96% RA, T. 95 degrees. When writer offered some drinks and snack, the Pt accepted the offer. 2 small packs of apple juice and 2small packs of crackers were consumed by the Pt. A recheck of the v/s showed the following readings. bp 98/64 , Hr 69, O2 99% RA .Pt and mother stayed for about 15 extra mins before the Pt verbalized feeling okay and ready to leave. He left in the company 0f mom unassisted

Other Meds: None

Current Illness: none

ID: 1314284
Sex: F
Age: 19
State:

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/13/2021
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: shellfish

Symptom List: Rash, Urticaria

Symptoms: Patient experienced shortness of breath shortly after dose One day post dose - patient experienced vertigo

Other Meds: hydroxyurea, vitamin D, ursodiol

Current Illness:

ID: 1314285
Sex: F
Age: 59
State: FL

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Penecillin, Tetrocyclene, Mangos, Fish,

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

Symptoms: 12 hours after injection, came down with flu like symptoms, major head congestion, fever, body aches, headache, severe fatigue, lasted about 36 hours. 24 hours after injection, severe pain in left side of neck radiating down to the injection site in my left arm. At first felt like a stiff neck, but then progressed to severe radiating pain starting at neck and radiating down to injection site and then spreading to shoulder area. Took Tylenol every 4 hours. Pain would subside, and then suddenly come back with in 3.5 to 4.0 hours. Gradually worsened to the point that I almost went to the hospital. Took hot showers and put heating pad on shoulder. Pain level about 8. Pain lasted about 18 hours. Woke up and pain was suddenly gone, but pain in my arm at injection site because severe. Had no pain until that happened. Did not seek medical assistance at any time. Pain in my left arm at injection site lasted 3 days. Stomach issues occured appoximately 72 hours after injection and lasted about 4 days. Did not feel better and complete until 8 days had passed.

Other Meds: Procardia 60mg, Synthroid 150 mg, Vitamin D, Valsartin 160 mg, Celexa 40 mg

Current Illness:

ID: 1314286
Sex: F
Age: 80
State: MD

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 05/13/2021
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: Developed tinnitis, ringing in ears which is constant

Other Meds: Omeprosole Lisinapril Sertraline Matzim Lorazepam Rouvustatin Vitamins

Current Illness: None

ID: 1314287
Sex: F
Age: 66
State: CO

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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: Fatigue, fever, nausea, headache and muscle pain throughout the whole body.

Other Meds: None

Current Illness: None

ID: 1314288
Sex: F
Age: 51
State: PA

Vax Date: 04/21/2021
Onset Date: 05/05/2021
Rec V Date: 05/13/2021
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: pollen, bee strings, citrus

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

Symptoms: On 5/5/2021 pt says the left side of her body became very sore from her shoulder to her elbow. On 5/10/21 she developed an x-shaped rash around her left arm pit and left breast. The lymph nodes are swollen under the left armpit. On 5/11/21 pt went to Dr. and was diagnosed w/ Shingles and prescribed Valtrex. She was told to take Ibuprofen for the pain.

Other Meds:

Current Illness:

ID: 1314289
Sex: F
Age: 29
State: CO

Vax Date: 04/06/2021
Onset Date: 04/27/2021
Rec V Date: 05/13/2021
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: NKDA

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

Symptoms: nonocclusive dural venous sinus thrombosis

Other Meds: acetazolamide Junel OCP

Current Illness: idiopathic intracranial HTN

ID: 1314290
Sex: F
Age: 34
State: CA

Vax Date: 03/04/2021
Onset Date: 03/26/2021
Rec V Date: 05/13/2021
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: I have had pretty intense arm pain since my second shot which was now almost 2 months ago. The pain is still as prominent as ever. I did not get sick after the second shot, only normal arm pain but it has continued up until now. Whenever I move my arm at all, the pain is on my left arm around the injection site.

Other Meds:

Current Illness:

ID: 1314291
Sex: F
Age: 45
State: FL

Vax Date: 05/08/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Swelling to bilateral upper eyelids, rash to forehead with mild itching

Other Meds: None

Current Illness: None

ID: 1314292
Sex: F
Age: 34
State: CA

Vax Date: 05/09/2021
Onset Date: 05/09/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Minimal intolerance to pork and shrimp.

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

Symptoms: First it started with the arm pain, then a headache, internal fever, chills and a lot of pain throughout the body, mainly the pain in my back and my lower back. Through the area of ??the kidneys and the pelvis. The intense pain lasted about midnight, I took a pill of TYLENOL for pain and to be able to sleep, which helped me a bit but the next day the body and back pain persisted ... what hurt the most was my lower back and I could not bear to lie down in any way so I remained semi-lying or sitting in bed because when I lay down my back bothered me. I took natural teas to help me and I took water and electrolytes to feel better. gradually by the end of the second day my pain symptoms were decreasing. The dizziness in the head remained very persistent on the 2nd day. On the third day I felt a relief from my muscle pain but the discomfort or dizziness of the head was still there, it was not as strong as the last days, but when moving my head from side to side or sitting or standing up it was like a vertigo or a unstable that I felt was there. By the 4th day I felt better almost no symptoms just like body sweat ... like hot flashes.

Other Meds: None at this time

Current Illness: Just high cholesterol

ID: 1314293
Sex: M
Age: 58
State: WA

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 05/13/2021
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: Generalized twitching without alteration in consciousness. Initial onset within 1 hour of receiving vaccine. At that time twitching involved upper and lower body. Since that time has gradually improved, now only involving upper body, right arm and left chest.

Other Meds: amlodipine 10mg, atorvastatin 10mg, ferrous gluconate 324mg, flonase nasal spray, gabapentin 300mg BID, glipizide 10mg, loratidine 10mg, losartan 100mg, metformin 1000mg BID, spironolactone 25mg

Current Illness: none

ID: 1314294
Sex: F
Age: 57
State: IN

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: SHELLFISH, PEANUTS, ERYTHROMYCIN

Symptom List: Unevaluable event

Symptoms: MILD LEFT ARM SORENESS STARTED DAY AFTER VACCINATION AND PERSISTS 6 WEEKS LATER. NOTICES IF PUTS ARM ABOVE HEAD. POINT TENDERNESS AT DELTOID INJECTION SITE.

Other Meds:

Current Illness:

ID: 1314295
Sex: F
Age: 77
State: TX

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Headache, lethargy, nausea, fever for first three days then rash covering all extremeties and abdomena nd chest

Other Meds: chlortrimeton

Current Illness: none

ID: 1314296
Sex: F
Age: 35
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 05/13/2021
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: Allegorical to topamax

Symptom List: Injection site pain, Pain

Symptoms: that same day I was feeling dizzy and my whole right side of my body went numb and as well the believe it was a stroke and they said I had a stroke as well

Other Meds: Keppra 500mg,lamectal 200mg,tegratol 200mg

Current Illness: Face went numb and hospitalized

ID: 1314297
Sex: F
Age: 46
State: NY

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Sulfa allergy.

Symptom List: Injection site pain, Menorrhagia

Symptoms: patient experienced redness and inflammation at the site of infection, and expanded from the shoulder all the way down to the elbow. her PCP prescribed her Augmentin 875MG. but symptoms did not improve.

Other Meds: N/A

Current Illness: N/A

ID: 1314298
Sex: F
Age: 18
State: WA

Vax Date: 05/10/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
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: NKA

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

Symptoms: PATIENT'S MOM CALLED IN ON 05/13/2021 REPORTING THAT PT. STARTED TO HAVE CHEST PAINS THIS MORNING. SHE WAS EXPERIENCING THE USUAL MUSCLE PAIN AND FATIQUE YESTERDAY FROM THE VACCINE.

Other Meds: ELINEST, ALBUTEROL

Current Illness: NONE

ID: 1314299
Sex: M
Age: 32
State: NY

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Febrile seizure

Other Meds:

Current Illness:

ID: 1314300
Sex: F
Age: 39
State: IL

Vax Date: 04/07/2021
Onset Date: 04/20/2021
Rec V Date: 05/13/2021
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: Mild Shingles symptoms, left side of face/neck. Oral sores on left lower gums. Treated with anti-viral meds.

Other Meds:

Current Illness:

ID: 1314301
Sex: M
Age: 40
State: TX

Vax Date: 02/01/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt was considered fully vaccinated but, tested positive for COVID during routine testing for a procedure. He is asymptomatic.

Other Meds:

Current Illness:

ID: 1314302
Sex: F
Age: 53
State: NV

Vax Date: 04/14/2021
Onset Date: 04/16/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Have had food allergies and anaphylaxis in the past, but they went away in 2007. After my 1st Moderna Shot on 3/18/2021 at 11am, I had a delayed reaction 24 hours later. I began having anaphylaxis to everything I ate for the next 3.5 days. Even had difficulty swallowing water. This ended on 3/22/2021.

Symptom List: Nausea

Symptoms: 1st Shot on 3/18/2021 - delayed adverse reaction, 24 hours later developed anaphylaxis to everything I ate for 3/5 days. Difficulty swallowing water. This ended on 3/22/2021. 2nd Shot on 4/14/21 - for two days normal expected reactions, joint pain, sore arm, chills, etc. This went away and I went to work on 4/16/21. Then at 2 pm on 4/16/21, my arm swelled to twice its size and I developed a rash at the injection site. That is when the adverse reaction began with relentless itching from head to toe, non-stop, 24/7. It has been a month now, and am still experiencing these symptoms. I am unable to work. I have been going to an allergy specialist every week and receiving Dupixent shots and taking Gabapentin every 4 hours around the clock. on 5/11/21 the itching seemed to be going away and I was getting better, but today 5/13/21 it has returned with a vengeance. I am again itching from head to toe like fire ants all over my body. It never stops.

Other Meds: Benazepril 40mg Metoprolol ER 25mg Fluticasone Propionate/Salmeterol Diskus 250/50 Claratin Flonase

Current Illness: No illnesses at the time of vaccination or one month prior.

ID: 1314303
Sex: F
Age: 59
State: FL

Vax Date: 04/16/2021
Onset Date: 04/25/2021
Rec V Date: 05/13/2021
Hospital: Y

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

Lab Data:

Allergies: Tetracycline

Symptom List: Injection site pain

Symptoms: 10 days after the shot I developed severe abdominal pain. I was admitted to the Medical Center on 4/25/2021. I was diagnosed with a small bowel obstruction with no previous history or abdominal surgery. On 5/1/2021 I underwent surgery. My small bowel was found to have twisted. The surgeon noted an enlarged lymph node on the bowel that may have been due to an inflammatory reaction and it may have pulled the bowel down and caused the twist. My White Blood Cell Count also rose during this ordeal and I was treated with IV antibiotics. The only thing I can relate this inflammatory reaction to is the CoVid 19 vaccine.

Other Meds: Armour Thyroid 1.5 grains daily, Sprionolactone 100mg daily, Progesterone 200 mg daily, Vitamine D 5,000 IU daily, DIM one tab daily, Iodine 12.5 mg daily . Hormone replacement therapy pellets 4 times a year

Current Illness: none

ID: 1314304
Sex: F
Age: 19
State: CO

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: First symptoms were fever of 103.5 at midnight on the 28th. I called the RA on call in my university department and they called PD - to come and make sure I was okay. For 36 hours, I felt terrible - couldn't do anything. About 1 1/2 to 2 weeks later, I started getting really severe back pain that made it hard for me to do things - even sitting in a chair caused so much pain or walking or standing for long periods of time made me light headed because it was intense pain. There was one instance, when I nearly passed out from the pain but I didn't as I called for help for someone to catch me. It kind of moves around - the pain - sometimes it's a along my spine and sometimes it's low below my shoulder blades. I'm still having this pain. It's not on the same pain scale as it was a couple of weeks ago. It's more manageable right now. I do stretches and some medications and there are a couple of patches - Salontas - that my dad uses that he recommended I try to use for backaches. I am calling my doctor today to make an appointment.

Other Meds: no

Current Illness: no

ID: 1314305
Sex: F
Age: 36
State: WA

Vax Date: 05/07/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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: Fish (like tuna and salmon -- reaction is throat swells and skin hives).

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

Symptoms: Left armpit lymph node is swollen and painful. This is not the regular muscle pain around the injection site. I was reading others have had similar reactions (under the armpit is swollen and likely due to the lymph node thinking it's infected - or is infected?). I was recommend to fill out this form.

Other Meds: None

Current Illness: None

ID: 1314306
Sex: F
Age: 16
State: MI

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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: The patient felt tired and describes her eyes going dark, then passed out a few minutes after vaccination. She was vaccinated and then left the immunization room to sit down for a 15 minute waiting period. When she went to sit down, she collapsed on the floor. Her mother assisted her into a chair. She continued to be incoherent and have her eyes rolling back into her head for a few minutes. We used a cool cloth on her forehead and the back of her neck. The parents requested that we call 911. EMS arrived shortly and evaluated her. Heart rate, blood pressure, pulse ox, blood sugar and chest sounds were all within normal range. The patient stated that her arm felt heavy and "funny". She then stated that her tongue felt funny. EMS evaluated her tongue and said it looked normal. To err on the side of caution, she was taken to the hospital to determine whether or not she was having a delayed onset anaphylactic reaction. This patient has no history of seizures.

Other Meds:

Current Illness:

ID: 1314307
Sex: M
Age: 48
State: NH

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/13/2021
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: Patient said he had a seizure at home in his sleep. He said he wetted his pants and his wife told him he had a seizure. He sought medical attention after and his doctor changed his seizure medications. He is now asked by his doctor not to drive for 2 months

Other Meds:

Current Illness:

Date Died: 04/18/2021

ID: 1314308
Sex: M
Age: 92
State: PR

Vax Date: 03/02/2021
Onset Date: 04/16/2021
Rec V Date: 05/13/2021
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: Unknown.

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

Symptoms: Fever and respiratory problems.

Other Meds: Antibiotics and Levotiroxina 150 mg.

Current Illness: Unknown.

ID: 1314309
Sex: F
Age: 53
State: CA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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: Neomycin, morphine

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

Symptoms: Chills, nausea. low-grade fever, tiredness, body aches, headache, injection site pain

Other Meds: Ibuprofen

Current Illness: None

ID: 1314310
Sex: M
Age: 70
State: AL

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/13/2021
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: Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: rhinorrhea-Severe, Systemic: Nausea-Severe, Systemic: Shakiness-Medium, Systemic: Vomiting-Severe, Systemic: Weakness-Severe, Additional Details: also taste changes

Other Meds:

Current Illness:

ID: 1314311
Sex: F
Age: 55
State: NJ

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 05/13/2021
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: vancomycin, pennicillians

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

Symptoms: Extreme burning pain throughout my spine within 2 hours after vaccine, then bottom of feet and hands were also extremely painful , still having issues with that since vaccine on and off and then today 5/13/2021 I went in the sun for only 5 minutes and my shoulders are Burning and developed a rash on both shoulders within minutes however I had clothes covering the shoulders and you cant even touch the shoulders as they were burning hot ( but just the shoulders ) .. This has never EVER happened to me in my life.. My body has been so off since this vaccine I am miserable.

Other Meds: prilosec, plaqunil, symbacort, claritin

Current Illness: Rheumatoid Arthritis , asthma

ID: 1314312
Sex: F
Age: 48
State: ID

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/13/2021
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: Swelling through out body but prominent on the right side. swelling in lymph nodes in right arm pit, and on neck and shoulder area. swelling in my face sinuses, ear, legs , breast area right side severe pain, and under right arm, neck severe pain, right arm severe pain down to tip of fingers, severe pain in left arm, hand, fingers, pain is nerve pain, then i have so much swelling it is cutting off circulation to hands, arms, whole right side of body and upper body on left side. head aches, exhaustion. I am a phone customer service representative and can not do my job right now because it hurts too much to type. I am on short term disability until the symptoms go away or get better. I am being treated with steroids, and tramadol for pain

Other Meds: synthroid, omeprazole, simvistatin, lamotragine, citalapram, singular, trazadone, estradiol

Current Illness: none

ID: 1314313
Sex: M
Age: 47
State: IL

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 05/13/2021
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: Onset of dry cough, moderate chest congestion, afternoon fatigue, and mild sore throat 1 day after receiving 2nd dose of Pfizer COVID-19 vaccination on 01-May (8 days now).

Other Meds: None

Current Illness: None

ID: 1314314
Sex: U
Age: 53
State:

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: kna

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

Symptoms: Fever. hot flashes and diarraha

Other Meds: n/a

Current Illness: n/a

ID: 1314315
Sex: F
Age: 49
State: GA

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 05/13/2021
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: None to food or medications outdoor allergies - trees, grass, pollen indoor allergies - dust, mites moderate to severe - cats minor to moderate - dogs, rabbits, hamsters, horses

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

Symptoms: When i lift my arm, I get a quick shooting pain. I lower my arm and raise it again. The second time, the pain is less and I can lift it. I thought it was normal soreness at first, but it hasn't gone away. I got the 2nd shot a month later and now my right arm does the same thing, although not as bad. Also, my shins just below my knees have started to hurt when I first stand up. Just lasts a few minutes, then goes away. I don't know if it is related, but wanted to mention it incase this has happened with other people.

Other Meds: Amlodipine Besylate Sertraline Singulair Cetirizine HydroChlorothiazide Magnesium Potassium D3 Patanase (as needed - not daily) Pataday (as needed - not daily)

Current Illness:

ID: 1314316
Sex: F
Age: 57
State: IN

Vax Date: 05/11/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: None stated.

Other Meds: None

Current Illness: No

ID: 1314317
Sex: F
Age: 55
State: IN

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
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: during administration the syringe came loose from the barrel, where and unknown amount of vaccine was injected into patient. some went into patients arm and some ran out

Other Meds:

Current Illness:

ID: 1314318
Sex: M
Age: 28
State: VT

Vax Date: 04/25/2021
Onset Date: 05/07/2021
Rec V Date: 05/13/2021
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 had single episode of loss of consciousness - episode preceded by nausea and lightheadedness Paramedics came to home, no vitals done, patient not transferred to hospital Patient continues to have lightheadedness No personal or family history of stroke, diabetes, hypotension, seizures, migraines

Other Meds: None

Current Illness: None

ID: 1314319
Sex: F
Age: 30
State: MA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Severe, Systemic: Shakiness-Severe, Additional Details: Pt has history of fainting to needles in the past; post injection in the observation area, pt felt lightheaded. We gave her an ice pack at which point she loss consciousness and shortly after started, what appeared to be, seizing.(RN) I carefully moved her to the floor as she continued to shake. 911 was called. Shaking/seizing lasted roughly a minute (pt was still unconsious); she regained consiousness and waiting on floor until EMT arrived.

Other Meds:

Current Illness:

ID: 1314320
Sex: M
Age: 22
State: IN

Vax Date: 04/26/2021
Onset Date: 05/03/2021
Rec V Date: 05/13/2021
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: Seven days after received Dose 1 of Pfizer Covid-19 vaccine, right arm was swollen and uncomfortable, the next day was purple. He want to urgent care center who thought he had "Covid arm" and was put on prednisone. Arm worsened, so he went to ER in middle of night on 5/4/21. He was given shot of Lovenox and sent home to return in am for ultrasound. Ultrasound next morning showed right subclavian vein DVT. He was put on Eliquis and told to follow up with hematologist. He is working on getting appointment with a hematologist before flying home, where he will do further work up with hematologist there.

Other Meds: None

Current Illness: None

ID: 1314321
Sex: M
Age: 34
State:

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: ibuprofin

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

Symptoms: Severe expected symptom (9h-48h after injection): - swelling of arm - headache - chills/body aches - 102-104 degree fever (treated with Tylenol -- only medicine taken) Unexpected symptoms - vomiting, diarrhea (6h-18h after shot) - swollen lymph nodes in armpit of injected arm (12h-72h after shot) - dizziness/disorientation (6h-36h after shot)

Other Meds: 0

Current Illness: 0

ID: 1314322
Sex: F
Age: 24
State: CT

Vax Date: 03/16/2021
Onset Date: 03/18/2021
Rec V Date: 05/13/2021
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: N/A

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

Symptoms: Got the shot on March 16, and came down with a fever and aches by 9pm. Overnight I got a 103 fever and had a 99.9 fever for the next day. On March 18, I noticed what I thought looked like razor bumps from shaving but they really hurt. I had not been sexually active and was confused what they would be. Went to the gyno and she thought they were in grown hairs from shaving and sweating from my fever. Then over the weekend I experienced more red spots on my crotch and severe pain that kept me up at night and made me want to cry. I called the emergency line for the gynocologist and she prescribed something for a bacterial infection as well as for type 1 herpes. I then went in the following thursday and was seen again for the bumps. The bumps felt exactly like described in other cases i recently read about - shingles. I was in pain for 2-3 weeks and would use zinc and witch hazel and advil to try to get through the pain. It did eventually feel better and go away.

Other Meds: Tylenol

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm