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: 1314429
Sex: F
Age: 49
State: TX

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

Lab Data:

Allergies: no

Symptom List: Dysphagia, Epiglottitis

Symptoms: Given too early. First dose was administered on 4/26/2021

Other Meds: abilify, vitamin b-12, ferrous sulfate, ibuprofen, lisinopril 5mg, prazosin, topiramate, Cymbalta, singular, diclofenac patch, Prilosec, lidocaine ointment, cordran ointment, Norco

Current Illness: elevated cholesterol

ID: 1314430
Sex: F
Age: 58
State: NM

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: Sulfa, Molybdynum, Vitamin E, anything with cortisone, steroids

Symptom List: Anxiety, Dyspnoea

Symptoms: I experienced the following day, I started getting very bad chest tightening and felt like spasms. I was not sure if I was having a heart attack, like a gripping pain in my chest, lasted for 1-2 hours. In the meantime, I did go to the ER because I thought I was having a heart attack. EKG and x-ray of the chest was performed, lab work was also performed. My BP went way up as well and I felt very nervous. I also saw a cardiologist for the chest tightening sensation. I think that the J&J vaccine I received was related to my symptoms. I can say today I sometime experience chest tightness but very lightly and at this time I have no symptoms. I do not have my lot# at this time to provide.

Other Meds: None reported

Current Illness: None reported

ID: 1314431
Sex: M
Age: 20
State: OH

Vax Date: 05/12/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Vomiting, sick to stomach, headache, and soreness

Other Meds: None

Current Illness: None

ID: 1314432
Sex: F
Age: 14
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Dizziness, weakness in legs, claimed loss of vision by patient. Events occurred ~15 minutes after receiving injection. Patient transferred to emergency department for evaluation

Other Meds:

Current Illness:

ID: 1314433
Sex: F
Age: 46
State: AL

Vax Date: 04/29/2021
Onset Date: 04/29/2021
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: Sensitive to sulfa drugs.

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

Symptoms: 4/29, 8:10 p.m.- Right arm hurts, upper arm is numb (not like my spinal cord damage, but like when your arm is squeezed tight by a blood pressure cuff). The numbness has spread around my back along my shoulder blade. 4/29, 9:40 p.m.- Numbness has spread down my arm and into my little finger. 4/29, 10:06 p.m.- Numbness/pain spread over the upper right side of my body running from spine to sternum, feels numb, but also like I?m on fire. Muscles hurt like someone took a baseball bat to that arm. 4/30, 5:30 a.m.- The burning and numbness spread across my spine and into my left shoulder blade. I started running a fever. 4/30, 12:46 p.m.-I?m still in pain, but the numbness pulled back some so that it?s only going from spine down my right arm, no left side involvement, but I now can?t feel my ring finger or little finger and it bothers me to use them.

Other Meds: Synthroid, Gabapentin, Ibuprofen, multi-vitamin, B vitamins, Vitamin D, Calcium, Glucosamine.

Current Illness:

ID: 1314434
Sex: F
Age: 58
State: CA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: no

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

Symptoms: 06:00pm I started feeling sick and I fell asleep. I slept through the night. I felt feverish. I had nightmares that night and I never have nightmares in my sleep - I was talking to the dead - it was crazy - I had never experienced this before. I didn't have any pain in the arm. The fever was gone. I felt okay. No diarrhea. I felt more tired though for about a week about and had some brain fogginess. As time went on, I noticed I was starting to get pains in my lower in my back / sharp pains in kidney area - I went to the hospital to check my kidneys. I went to ER -to check kidneys. It finally went away (the pain). Had a follow up doctor visit.

Other Meds: Thyroid medication - Euthyrox; Topamax; Zyrtec; Prilosec - generic version: OMEPRAZOLE; Potassium pill; Vit D2 - once a week - 50,000 mg; Spironolactone; Furosemide; Ambrisengan; Tadalafil

Current Illness: no acute illnesses - what I was experiencing with the vaccine dose 1, though.

ID: 1314435
Sex: M
Age: 28
State: KS

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

Lab Data:

Allergies: various minor food allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient said after about 15 minutes that his throat was swelling mildly. We asked him to wait an extra 15 minutes in which he said it was resolving. I offered him some Benadryl, but he did not want one. He said he has had it happen before but not as bad with food allergies. Not sure what is causing his food allergies.

Other Meds: not sure

Current Illness: not sure

ID: 1314436
Sex: M
Age: 75
State: RI

Vax Date: 03/11/2021
Onset Date: 04/19/2021
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: NKDA, NKA

Symptom List: Pharyngeal swelling

Symptoms: 3/11/2021-- received dose of Pfizer vaccine. Soon after vaccination, had B/L anterior rib pain that he could not otherwise explain. No trauma, dyspnea, dizziness, fever, headache, N/V, falls, personal or family history of blood clots or autoimmune disease, recent smoking (quit 38 yrs ago), prolonged immobility or travel, history of bleeding, red/hot joints, known cancer, or cough/hemoptysis (and patient has outpatient medical follow-up including preventive measures like screening colonoscopy). 4/19/2021-- B/L rib pain got worse with new scant hemoptysis. Went to Urgent Care and diagnosed with "pneumonia"-- prescribed azithromycin, Augmentin; of which he took 2 doses the next two days. Due to persistent symptoms, he presented to the ER 4/21/2021 and was found to have B/L segmental and subsegmental PE's without R heart strain. He had a mild troponin elevation in the setting of known vascular disease. He was not hypoxemic or hemodynamically unstable. No residual DVT noted on imaging. He was transitioned to Eliquis on was discharged home after 1 day (4/22/2021) with outpatient follow-up with outpatient physicians (plus hematology referral) for pending hypercoaguable workup. His medications were adjusted accordingly (e.g. ASA dose decreased given his new DOAC use).

Other Meds: ASA 325mg, famotidine 40mg PO daily, vit. D, vit. B12, metoprolol tartrate 25mg PO BID, metformin 850mg PO daily, losartan 12.5mg PO daily, tamsulosin 0.4mg PO daily, SloMag

Current Illness: N/A

ID: 1314437
Sex: F
Age: 23
State: IL

Vax Date: 05/11/2021
Onset Date: 05/11/2021
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: Morphine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Numbness to injection site, radiating to right side of face and ear

Other Meds: Melatonin, Zoloft

Current Illness: none

ID: 1314438
Sex: F
Age: 57
State:

Vax Date: 04/19/2021
Onset Date: 04/19/2021
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: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: dizzy, nauseous, the first 24 hrs. then fever for about 12 hrs. injection site pain for several days as well as fatigue and headache

Other Meds: none

Current Illness: none

ID: 1314439
Sex: M
Age: 16
State: PA

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: SYR
Vax Site: LA

Lab Data:

Allergies: NA

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

Symptoms: Started with sore arm and headache, progressed to high fever (101). Next day had sores on mouth, which spread all over lips and started sore throat. Fever did not go away without medication. Medication would alleviate it but it continued for 6 days, reaching 102.4. Pediatrician tested for strep and for COVID, both were negative. Sore throat persisted after fevers subsided. Had to finally be prescribed magic mouthwash. Doctor said sores on lips were herpes so prescribed viral medications. My son never has a sore throat and has never had a herpes sore until after the shot.

Other Meds: NA

Current Illness: NA

ID: 1314440
Sex: F
Age: 79
State:

Vax Date: 02/18/2021
Onset Date: 03/21/2021
Rec V Date: 05/13/2021
Hospital: Y

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

Other Meds:

Current Illness:

ID: 1314441
Sex: F
Age: 83
State: MO

Vax Date: 05/13/2021
Onset Date:
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: ADHESIVES, EMYCIN, PCN

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

Symptoms: VACCINE WAS THAWED ON 4/30/21 WHEN RECEIVED, AFTER RECEIVING, VACCINE WAS PLACED IN FREEZER AND FROZEN. TAKEN OUT OF FREEZER AND PLACED IN FRIG ON 5/12 TO THAW. VACCINE WAS GIVEN TO PT ON 5/13. WHEN OPENING 2ND VIAL OF VACCINE, SAW THE EXPIRATION DATE OF 5/10/21 ON VIAL, (SPOKE WITH HOSP WHO DISPENSED VACCINE TO US AND FOUND OUT VIAL EXPIRED ON 5/10/21 DUE TO THAWING)

Other Meds: ATORVASTATIN, ASA, BUMETADINE, CALCIUM, FARXIGA, CYMBALTA, NEXIUM, GLIPIZIDE, METOPROLOL, K+, SITAGLIPTIN, HYDOXYZINE

Current Illness: NONE

ID: 1314442
Sex: F
Age: 88
State: GA

Vax Date: 05/01/2021
Onset Date: 05/11/2021
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: NKA

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

Symptoms: Patient daughter in-law stated that patient started having Facial swelling that started on 05/11/2021 on one side and later in the day patient had facial swelling to her entire face. Patient was seen by her PCP and prescribed Cephalexin 250mg TID time 7 days, steroid injection, and follow-up with PCP on 05/12/2021 with complaint of sore throat and facial pain. Prescribed Prednisone injection and Valacyclovir. Reporter asked if patient was diagnosed with Shingles and daughter in-law stated that the doctor mentioned that diagnoses but was not sure that it was Shingles.

Other Meds: ASA 81mg, Vit D, B-12 injection, Zyrtec, Felodipine. Pantopraz

Current Illness:

ID: 1314443
Sex: F
Age: 16
State: MN

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: 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: Patient was 16yo received her vaccination before the indicated age. Per CDC recommendations, the second dose in the series was given. No other adverse events occurred.

Other Meds:

Current Illness:

ID: 1314444
Sex: F
Age: 25
State: WA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
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: Penicillin, Sudafed, grapes

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

Symptoms: Metal taste I mouth when eating or drinking, runny nose and congestion, shortness of breathe, severe fatigue, muscle and joint aches, swollen lymph nodes on armpit near site

Other Meds: Daily vitamins, elderberry immune booster, sprinted birth control

Current Illness: None

ID: 1314445
Sex: F
Age: 38
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
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: none

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

Symptoms: Patient complained of nausea and dizziness. EMT was called. Vital signs BP 128/64 HR 76 O2 sat 97% and respirations 16. Patient given water. Patient refused need to accompany EMT to hospital. Patient states she is feeling ok.

Other Meds: none

Current Illness: none

ID: 1314446
Sex: F
Age: 56
State: NY

Vax Date: 05/11/2021
Onset Date: 05/11/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Moderna Covid 19 Vaccine EUA. Shooting pains in arms, legs, wrists, and feet. Extreme fatigue, chills, lethargy. Symptoms began about 10 hours after injection and lasted throughout the night and the entire next day until I took two Alleve and went to sleep.

Other Meds: Vitamin C, Vitamin B12, Magnesium, Vitamin D3, Fish Oil

Current Illness: None

ID: 1314447
Sex: M
Age: 80
State: TX

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: n/a

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: general malaise achy joints and muscles also tested positive for COVID-19 on 03-10-2021

Other Meds: n/a

Current Illness: n/a

ID: 1314448
Sex: F
Age: 30
State: CA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
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:

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

Symptoms: Pt felt dizzy after vaccine was brought to med bay. Vitals stable (BP 103/60; HR 70; RR 17). Pt states she feels better. Observed for 25 min, no signs of distress & pt released

Other Meds:

Current Illness:

ID: 1314449
Sex: M
Age: 38
State: CO

Vax Date: 05/08/2021
Onset Date: 05/09/2021
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: IBPROFIN AND ASPRIN

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

Symptoms: (First 72 hours after 2nd shot) Severe Chills, and then over heating. Temperature as high as 103.5 Severe fatigue and brain fog Severe Low Back Pain (48 hours after 2nd shot) Puking and Diahrea (After 72 hours) Fatigue Can't regulate body temp in regards to feeling very hot and sweating Rash on forehead on left side from eye brow to hair line Insomnia Low Back Pain Stomach Issues

Other Meds: None

Current Illness: NONE

ID: 1314450
Sex: M
Age: 23
State: CA

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/13/2021
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: No Known Drug Allergies

Symptom List: Unevaluable event

Symptoms: Acute NSTEMI versus myopericarditis versus COVID-19 side effect. Patient requires telemetry monitoring due to high risk for electrolyte imbalance, sudden death from myocardial injury Follow-up cardiology recommendations for discharge planning, recommends to monitor for 24 hours while troponins are trending down. Follow-up respiratory panel possible viral infection as a source of NSTEMI. Replace magnesium.

Other Meds: None

Current Illness: No Chronic Problems Documented

ID: 1314451
Sex: M
Age: 37
State: MA

Vax Date: 04/21/2021
Onset Date: 04/22/2021
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: Penecillin, Eggs

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

Symptoms: Severe soreness at site of injection, vertigo, nausea, fever, chills, lethargy.

Other Meds: None.

Current Illness: None

ID: 1314452
Sex: F
Age: 66
State: ND

Vax Date: 03/11/2021
Onset Date: 04/09/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Patient presented to ED on 4/9/21. Patient presented to ED and was subsequently hospitalized on 4/12/21. These are within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1314454
Sex: M
Age: 78
State: MI

Vax Date: 05/07/2021
Onset Date: 05/10/2021
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: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: dvt ER despense blood thiner Left arm swelled to twice its size from shoulder to tinger tips.

Other Meds: Plavix--liptor- carvilol--spironolact-wellbutrin-lasix 75mg 80mg 6.5 mg 25 mg 300 mg 40 mg

Current Illness: none

ID: 1314455
Sex: F
Age: 62
State: CA

Vax Date: 03/12/2021
Onset Date: 04/09/2021
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:

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

Symptoms: Bloom clot in left arm

Other Meds:

Current Illness:

ID: 1314456
Sex: M
Age: 55
State: NH

Vax Date: 05/06/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: pt developed right upper leg DVT 2 days after receiving second covid vaccine, first administered on 4/7

Other Meds: lidocaine poatch, zolpidem, tramadol, losartan, omeprazole, amlodipine, celecoxib (now stopped), thyroid medicine, aspirin, testosterone pellets, fish oil, B12, DIM hormone balancer, vitamin D

Current Illness: no acute illness

ID: 1314457
Sex: M
Age: 49
State: CA

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt experienced dizziness during vaccination. Has hx of DM2 & high cholesterol but unsure of medications. BP 169/85; HR 80; RR 16. Given Benadryl, released from site. Pt's significant other drove pt home. Pt stablet to release from site per MD

Other Meds:

Current Illness:

ID: 1314458
Sex: F
Age: 56
State: CA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
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: Lamisil oral medication - causes rash and itching

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

Symptoms: Approx. 24 hrs after 2nd Pfizer Covid-19 vaccine, I experience a fever, nausea, no appetite, severe headache, fatigue, and tinnitus w/itching in right ear. 24 hours later the fever and nausea were gone, headache and tinnitus lingered. 24 hours later just fatigued and tinnitus and itching in right ear. Now almost 5 weeks post 2nd Covid vaccine, tinnitus and itching in right ear still persists.

Other Meds: multi vitamin, D3, Align, Vit. C

Current Illness:

ID: 1314459
Sex: F
Age: 16
State: NC

Vax Date: 05/03/2021
Onset Date: 05/08/2021
Rec V Date: 05/13/2021
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: Nothing

Symptom List: Nausea

Symptoms: Patient started swelling in the left hands on Saturday May 08th and inflammation in the bowel during Monday morning May 10th. She was not able to eat and had nausea. Patient stayed at Hospital until May 13th and got many exams as endoscopy and colonoscopy and did not find any reason for such inflammation. Also, blood exams were ok. The swelling in the hands combined with inflammation on the bowel sound suspect of reaction of Pfizer vaccine as there is no event close to this date to create abnormal effects of swelling and inflammation.

Other Meds: Nothing

Current Illness:

ID: 1314460
Sex: F
Age: 27
State: IN

Vax Date: 05/07/2021
Onset Date: 05/08/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: 100.8 degree fever, shivering followed by hot flash and sweating, dizziness, nausea, chest pain. Following day had all over body pain and fatigue.

Other Meds: Sertraline Chloraphen-12

Current Illness: None

Date Died: 03/05/2021

ID: 1314461
Sex: M
Age: 76
State: TN

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: Aspirin, Nsaids

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

Symptoms: Passed away in his sleep 28 hours after vaccine. No illness prior.

Other Meds: Amlodipine, Metoprolol ER, Atorvastatin, Warfarin

Current Illness: None

ID: 1314462
Sex: F
Age: 29
State: IN

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

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

Symptoms: Deep redness color, raised, hot, not painful. About the size of two thumbs.

Other Meds:

Current Illness: Fever, nausea, chills, diarrhea

ID: 1314463
Sex: M
Age: 64
State: MA

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

Lab Data:

Allergies: no

Symptom List: Tremor

Symptoms: He had a seizure at 1:15 pm on Saturday. Body shaking; foaming at the mouth; bit his tongue; gurgling sounds.

Other Meds: metroprolol, amlodipine, pantoprazole, vitamind. These he took at 8:00am atorvastatin,warfarin,metoprolol, These he takes at 8:00pm

Current Illness: Had a stroke in November 2020

ID: 1314464
Sex: F
Age: 55
State: OH

Vax Date: 05/01/2021
Onset Date: 05/01/2021
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: Contrast , seasonal allergies

Symptom List: Erythema, Pruritus

Symptoms: Severe headache which was immediate. chills & fever for 3 days, tremors lasted an hour or two day of vaccine, body aches a day, brain fog example trouble concentrating, forgetfulness hard to focus still have but is improving. I called my Doctor and was prescribed a Migraine medication which seems to helping greatly. Missed two days of work due to fever and headache.

Other Meds: Tylenol, One A Day women's vitamins

Current Illness: None

ID: 1314465
Sex: F
Age: 56
State: CO

Vax Date: 04/28/2021
Onset Date: 05/13/2021
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: Celiac, Latex

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

Symptoms: May 6 2021-midnight- Approx 8 days after vacc, severe back pain and leg weakness, legs weak and shaky to the point of not being able to get out of bed due to pain and weakness. Took Tylenol and later IB, with no real relief until day 3. resolving at day 6- May 11- 2021-developed fever, chills, skin sensitivity. Fever on 5-11-21 to 101.9 lasted for 2 days- severe headache, weakness, legs still weak and shaky, to the point of going up and down stairs is still very difficult. Day 16- 5-13-2021 some sx resolving, back pain and legs still shaky/weak. fever gone, headache still comes and goes. Missed a week of work as a store mananger

Other Meds: Co-Q-10, Turmeric, multi, Magnesium.

Current Illness: none

ID: 1314466
Sex: M
Age: 58
State: GA

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

Lab Data:

Allergies:

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

Symptoms: NO ADVERSE REACTION. PATIENT WANTED TO RECEIVE JANSEN VACCINE INSTEAD OF MODERNA. WAS INSTRUCTED BY DISCTRICT MANAGER TO REPORT TO THIS SITE

Other Meds:

Current Illness:

ID: 1314467
Sex: M
Age: 53
State: IN

Vax Date: 05/10/2021
Onset Date: 05/11/2021
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

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 16 hours after dose (10:15am Tuesday) I was dizzy and felt 'off balance'. This lasted for approximately 2 hours. I also endured muscle aches and mild fatigue. 30 hours after dose (10:00pm Tuesday) I began getting the 'chills'. This continued most of the night. I woke up at 6am Wednesday morning and my t-shirt was extremely wet with perspiration. The rest of Wednesday and Thursday I have had mild muscle aches and mild fatigue.

Other Meds: multi-vitamin, magnesium, levothyroxin

Current Illness: none

ID: 1314468
Sex: F
Age: 62
State: VA

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

Lab Data:

Allergies: Environmental Pet dander

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

Symptoms: Breathing difficulty within 2 hours required increased inhaler usage. More tightness overnight requiring dr visit. Nebulizer Rx/ chest X-ray/ antibiotics/ new inhaler

Other Meds: Albuteral

Current Illness: NA

ID: 1314469
Sex: F
Age: 24
State: PA

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Patient complained of feeling disoriented and sick to her stomach. Pain worsens if patient moves around. Patient has received water from vaccinator. Patient recovered and was released at 2:45 pm. At 2:26pm, the heart rate was at 79 bpm and the blood pressure was at 143/85. The oxygen saturation and respirations were normal. At 2:36pm, the heart rate was at 72 bpm and the blood pressure was at 135/84. The oxygen saturation and respirations were normal. At 2:43pm, patient had normal respirations and oxygen saturation. Heart rate was at 77 bpm and blood pressure was at 126/72.

Other Meds: Aristada

Current Illness: Schizophrenia

ID: 1314470
Sex: F
Age: 59
State: FL

Vax Date: 04/14/2021
Onset Date: 05/05/2021
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: Penicilin

Symptom List: Pain in extremity

Symptoms: I had the first shot did ok had a headache and tired. 2nd short not so well had to go to walk in and Doctors, walk-in (2) Had prescription and then Went to family Doctor and Perscriptions and Breathing treatment this is just, I had full details and was to long and had to start over, need more details to give me more time before it starts over or asks me.

Other Meds: tylonol

Current Illness: Ear Ache earlier

ID: 1314471
Sex: F
Age: 26
State: AZ

Vax Date: 04/15/2021
Onset Date: 04/16/2021
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: Yes

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

Symptoms: Worsened dizziness (up to 3 days after each shot,) Muscle pain (3-5 days after each shot,) Worsening of weakness (persisting still,) All over body itching - especially of the face (1-3 days after each shot,) Hives of the face (day of each shot,) Severe- but temporary- burning / nerve pain in the feet (few hours the night after first shot only,) Worsening of exhaustion (persisting still,) Signs of hormonal imbalance (persisting still- lab testing to follow,) Cold sweats / chills (1-3 weeks after each shot,) Nausea (persisting still {pt never had nausea before, and this has been the worst / most pervasive side effect},) Brain fog (1-3 weeks after each shot) Pain at injection site (1-3 days after each shot,) Vivid nightmares (1-3 nights after each shot,) Swollen lymph nodes (persisting still,) Sore throat (1-3 days after each shot.)

Other Meds: Pregabalin, baclofen, Propranolol, midodrine, medroxyprogesterone, Nexplanon, famotidine, Allegra, celebrex

Current Illness:

ID: 1314472
Sex: F
Age: 25
State: UT

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

Lab Data:

Allergies: almonds

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

Symptoms: Raised, swollen, hard, bruised at injection site. Treated with diphenhydramine 25mg and cold compress. Patient remained at pharmacy for observation for 20 minutes. No other reactions occured and patient felt fine and left pharmacy after 20 minutes

Other Meds: levothyroxine, birth control

Current Illness: none

ID: 1314473
Sex: F
Age: 65
State: IL

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

Lab Data:

Allergies: Penicillin and Tylenol 3

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

Symptoms: Patient received the Pfizer vaccine on 4/21/2021 - Pfizer EW0169. The patient was then administered a Moderna vaccine rather than the Pfizer for their second dose.

Other Meds: OTC Asprin 81MG Atovastatin Calcium 80 MG Cetseizine HCI 10MG Cyanocobalamin 1000mcg Injectable Monthly Fluticasone Propionate 50mcg/ nasal spray Doxycycline Monohydrate 100MG Gabapentin 100MG Norco 10-325MG Levothyroxine 75MG Metopro

Current Illness: N/A

ID: 1314474
Sex: M
Age: 35
State: TX

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: I have had tinnitus since the day after the vaccine. It is constant 24-7 at roughly a 5-7 volume. I have not found anything that makes it go away. I went to an ENT who essentially told me there was nothing he could do.

Other Meds: None

Current Illness: None

Date Died: 02/28/2021

ID: 1314475
Sex: F
Age: 95
State: PR

Vax Date: 02/03/2021
Onset Date:
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: Unknown.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Unknown

Other Meds: Carvedilol, losartan 12.5mg, nitroglycerine, Atrovent, indur.

Current Illness: Unknown.

ID: 1314476
Sex: F
Age: 67
State: WY

Vax Date: 04/01/2021
Onset Date: 04/03/2021
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: Keflex

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

Symptoms: extreme pain lower back, sciatic, right leg with 48 hours after injection, continues today extreme pain in base of toes on both feet, continues today stiffness and pain in neck, continues today I also experienced most of the same symptoms I had in November when I had Covid: severe aching throughout body, low grade fever, on fourth day after injection, extreme fatigue (couldn't keep my eyes open but couldn't sleep either. These symptoms regressed in about a week.

Other Meds: Celebrex, Simvastatin, Metformin, Victoza, Omeprazol, Losartan, Lexapro, Tizanidine, Levothyroxine, Tylenol 3, Calcium Liquid, Multi Vitamin, Echinacea, Flaxseed Oil, Magnesium, Allegra, Vitamin D3, Vitamin E, CBD Oil

Current Illness: None

ID: 1314477
Sex: F
Age: 54
State: TX

Vax Date: 04/28/2021
Onset Date: 05/07/2021
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: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: The patient reported normal pain the day after her 2nd dose on 4/29, the same kind of pain as from her first dose. The pain continued then went away. Pain symptoms returned severely on 5/7 at 2:00pm. She reported severe left upper shoulder pain, back pain and chest pain. She began taking three (3) tablets of Ibuprofen 200mg over-the-counter for pain every 6 hours. Upon speaking to the patient on 5/13 at 11:00am, the pain is still present with slight improvement. She continues taking Ibuprofen scheduled every 6 hours for the current pain. The patient stated she had COVID in early January and was hospitalized for 2 days because her oxygen was low and she received medications which were continued at home.

Other Meds: Lantus insulin, Metformin, Acarbose, Enalapril, Aspirin 81mg, Vitamin D2 50,000, a statin for cholesterol, and on a few medications which she stated were for circulation and pain

Current Illness: None

ID: 1314478
Sex: F
Age: 39
State: KY

Vax Date: 04/02/2021
Onset Date: 05/11/2021
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:

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

Symptoms: tested positive for covid-19 5/13/21

Other Meds:

Current Illness:

ID: 1314479
Sex: M
Age: 41
State: IL

Vax Date: 04/14/2021
Onset Date: 05/03/2021
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: None

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

Symptoms: Eye irritation which progressed to severe swelling, such that patient could not fully open his eyes. The swelling occurred on the eyelid and below the eye to about the jawline. Went to urgent care on 5/4 and was prescribed steroid. Swelling persisted until roughly 5/10 before returning to normal. At the same time, patient broke out ink a series of rashes on his arms, legs, ears, and torso. The rash continues to evolve, spread to new locations, and change appearance.

Other Meds: Daily multi-vitamin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm