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: 1317077
Sex: F
Age: 16
State: LA

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 05/14/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Temperature excursion with vaccine administered

Other Meds:

Current Illness:

ID: 1317078
Sex: F
Age: 17
State: MN

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/14/2021
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: NKDA

Symptom List: Anxiety, Dyspnoea

Symptoms: fever and headache since second pfizer COVID vaccine that was given on 5/1/2021, noted at urgent care appt on 5/10/2021

Other Meds: unknown

Current Illness: unknown

ID: 1317079
Sex: F
Age: 24
State: MI

Vax Date: 03/16/2021
Onset Date: 05/08/2021
Rec V Date: 05/14/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: fever

Other Meds:

Current Illness: Folliculitis

ID: 1317080
Sex: F
Age: 67
State: TX

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

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: NONE

Other Meds:

Current Illness:

ID: 1317081
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 02/03/2021
Rec V Date: 05/14/2021
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: On 1/12/2021 patient received dose one of Pfizer COVID vaccine, complained of prickling of upper extremities, and mid back, no breathing difficulties, 50mg IM diphenhydramine administered, symptoms resolved. Patient was advised by her PCP to take oral diphenhydramine prior to her second dose which pt. reports she did (50mg PO Benadryl) on 2/3/21 at 230PM in advance of dose 2 appt. On 2/3/2021 3:10 PM Pfizer COVID vaccine dose 2 was administered. At 3:50, pt reported the same prickling sensation as previous vaccine dose, moved from respite area to exam room, Health officer was consulted, decision was made to give IM Benadryl. When NP returned to exam room, patient's symptoms had progressed to feeling itchy and hot, which then quickly progressed to c/o tingling lips and roof of mouth. facial erythema and eyelid edema were noted, at 3:59PM epipen 0.3mg dose administered, EMS activated, vital signs monitored and stable, paramedics arrived at 4:07 and assumed care, Pt was alert and oriented and speaking throughout, pt was transported to ED at 4:15PM.

Other Meds:

Current Illness:

ID: 1317082
Sex: F
Age: 72
State: MD

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/14/2021
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: Fever/chills/fatigue/muscle & joint pain 2 days later developed itchy red rash at injection site

Other Meds:

Current Illness:

ID: 1317083
Sex: M
Age: 76
State: GA

Vax Date: 02/27/2021
Onset Date: 04/29/2021
Rec V Date: 05/14/2021
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: Pyrexia, White blood cell count decreased

Symptoms: PUI has pneumonia in both lungs, a pace maker, multiple myeloma cancer. Congestive heart failure, on oxygen, has dementia, has PTSD. He's pre-diabetic.

Other Meds:

Current Illness:

ID: 1317084
Sex: M
Age: 16
State: ME

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

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

Lab Data:

Allergies: NKA

Symptom List: Pharyngeal swelling

Symptoms: A 16 year old got the Moderna Vaccinatin

Other Meds: Unknown

Current Illness: none

ID: 1317085
Sex: F
Age: 17
State: NY

Vax Date: 04/05/2021
Onset Date: 05/03/2021
Rec V Date: 05/14/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Administration Error: Issued the Moderna vaccine at 17 years old.

Other Meds: No

Current Illness: No

ID: 1317086
Sex: M
Age: 48
State: IN

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/14/2021
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 known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fatigue, from around 6:03 pm on the 12th. I am continuing to have affects on 05/13/2021 at 12:39 pm.

Other Meds: None

Current Illness: None

ID: 1317087
Sex: F
Age: 42
State: CO

Vax Date: 05/06/2021
Onset Date: 05/09/2021
Rec V Date: 05/14/2021
Hospital: Y

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: Hospitalized for severe vertigo, nausea and disrupted eye sight. Dizziness and tinnitus continuing past hospital stabilization.

Other Meds: Multi- vitamin

Current Illness: MA

ID: 1317088
Sex: M
Age: 39
State: VA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 05/14/2021
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: Carafate, and certain tea leaves.

Symptom List: Rash, Urticaria

Symptoms: After the 15 minute wait, I started to feel funny and was walking around the pharmacy parking lot for another 15 minutes. After that, I decided to go home and on the way home my neck started to get tight, not stiff, tight. I could still breathe but it was hard to take in a deep breath. I turned around and headed to the Hospital. I stayed in the hospital parking lot for about 30 minutes and the symptoms improved as well as my breathing improved but still felt tight in my neck. I went home started driving with plenty of water and was monitoring my breathing., and put on my machine for at least an hour.

Other Meds: N/A

Current Illness: Splenomegaly

ID: 1317089
Sex: F
Age: 61
State:

Vax Date: 02/26/2021
Onset Date: 05/10/2021
Rec V Date: 05/14/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Date of symptom onset: 05/10/21 New cough, New sore throat, New headache

Other Meds:

Current Illness:

ID: 1317090
Sex: F
Age: 70
State: WI

Vax Date: 01/26/2021
Onset Date: 02/15/2021
Rec V Date: 05/14/2021
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: latex, codine

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

Symptoms: 2 1/2 weeks after EACH shot I experienced a lapse in short term memory that lasted approximately 30-45 minutes similar to transient global amnesia

Other Meds: Losartan, levothyroxine ,pravastatin,triam/hctz

Current Illness: None

ID: 1317091
Sex: M
Age: 64
State: TX

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/14/2021
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: NKA

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

Symptoms: RECEIVED 4 SERIES OF MODERNA

Other Meds: NOT REPORTED

Current Illness: NOT REPORTED

ID: 1317092
Sex: M
Age: 51
State: IL

Vax Date: 05/04/2021
Onset Date: 05/07/2021
Rec V Date: 05/14/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Shortly after getting the second dose, my legs started cramping the 3rd day after and then I came down with shingles. It started at my lower back and traveled down my left leg to the bottom of my left foot.

Other Meds: None

Current Illness: None

ID: 1317093
Sex: F
Age: 31
State: CA

Vax Date: 05/07/2021
Onset Date: 05/09/2021
Rec V Date: 05/14/2021
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: Client informed RN that after 1st Moderna Vaccine on 04/09/21 she experienced bumps in her mouth and on her chin. Client went to PMD at Kaiser 24 hours later who diagnosed her with fever blisters. Client states " There was no fluid in the bumps." Client experienced one small raised area to the lower lip 32 minutes after the 2nd Moderna COVID vaccine on 05/07/2021, no distress noted. Client advised to follow up with PMD doctor and use emergency medical services as needed. Client verbalized an understanding

Other Meds: 500 mg Iron daily

Current Illness: None

ID: 1317094
Sex: F
Age: 18
State:

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
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: Chills, Headache, Fatigue

Other Meds:

Current Illness:

ID: 1317095
Sex: F
Age: 76
State: NC

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: seasonal pollen allergy, allergy to dust

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills (no fever) within 24 hours of the Janssen vaccination, lethargic, no appetite. Very dizzy and lightheaded on day 5 and day 6 after the Janssen vaccination with continued lethargy and loss of appetite for approximately 3 weeks. Heavy nosebleed in left side of nostril with large blood clots for 1.5 hours approximately 3 weeks after the Janssen vaccination

Other Meds: Glaucoma prescription, multi-vitamin,

Current Illness:

ID: 1317096
Sex: F
Age: 48
State:

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: Patient was administered invalid 2nd dose of Pfizer vaccine (vaccine was stored 5 days beyond recommended freezing time). Pfizer was contacted and recommended that the patient receive a booster in the opposite arm. Patient can receive booster immediately and will be contacted to schedule booster dose.

Other Meds: none

Current Illness: none reported

ID: 1317097
Sex: F
Age: 33
State: GA

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 05/14/2021
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: Nickle and latex

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

Symptoms: The day after I got my 2nd covid vaccine, I lost my sense of taste and smell. I did have covid in January and lost my sense of taste and smell, but got it back once I tested negative. But since the vaccine, I have not gotten my smell or taste back.

Other Meds:

Current Illness:

ID: 1317098
Sex: F
Age: 37
State:

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/14/2021
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: Unevaluable event

Symptoms: AS PT WAS WALKING BACK TO CARE, FELT A SUDDEN WAVE OF NAUSEA, VSS, SX RESOLVED, REFUSED TRANSPORT, AMA SIGNED.

Other Meds:

Current Illness:

ID: 1317099
Sex: F
Age: 49
State: CA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/14/2021
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 allergies

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

Symptoms: After vaccine was administered , pt. reported facial numbness, headache, nauseas, Pt. was assessed by pcp and vital signs were taken every 15 minutes, Pt. was sent home with ER precautions An appointment was given for next day for reassessment

Other Meds: no

Current Illness: no

ID: 1317100
Sex: F
Age: 62
State: NY

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: sulfur and gluten

Symptom List: Injection site pain, Pain

Symptoms: One day after vaccine 2nd shot - lightheartedness, slight dizziness, headache, head felt heavy and buzzing in ears (tinnitus). The tinnitus has continued and has not stopped along with heaviness on head. This is affecting my daily activities. Headache around three times. After one week after vaccine shot, abdomen area is very bloated and is still continuing. Also on May 5th, my right ear has sharp pains and that alerted me to see the ENT. This is continuing on and off.

Other Meds: No

Current Illness: none

ID: 1317101
Sex: M
Age: 28
State: IN

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: Intense soreness and aches, fever, tiredness, lack of appetite, chills, sensitivity to light

Other Meds: Tylenol

Current Illness: N/A

ID: 1317102
Sex: F
Age: 56
State: OR

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
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: Stomach cramps from 4 a.m. - 10:30 p.m. on 5/13. The cramps worsened after eating each meal, and reminded me of having endometreosis cramping in my 40's. Also woke up with a large canker sore on the right side of my lower lip on the morning of 5/13. I typically get a canker sore when I'm very stressed, and I had been feeling fine prior to the receiving the shot, so this reaction surprised me. I did not seek medical attention for either issue, and both problems were gone when I woke up on 5/14.

Other Meds: Atorvastatin (10 mg); CoQ10 (300 mg); Biotin (1000 mg)

Current Illness: None

ID: 1317103
Sex: M
Age: 44
State: CA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Dizziness BP: 116/68 Pulse 68 No Any Pain P.T.O. #18 Advised patient to drink more water 2. Patient wait in observation area for extra 15 mins. 3. Revocered from dizziness and stated he feels ok now and went home.

Other Meds:

Current Illness:

ID: 1317104
Sex: F
Age: 63
State: MI

Vax Date: 03/25/2021
Onset Date: 04/21/2021
Rec V Date: 05/14/2021
Hospital: Y

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

Lab Data:

Allergies: amitriptyline, demerol

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt w/hx of COPD/current smoker presented to ED w/2 week episode of dizziness, syncopy, poor appetite, chills, N/V/D with no SOB or fevers. Pt stated that she may have had COVID infxn months ago prior to receiving Moderna vaccines on 2/25 & 3/25. CXR impression consistent w/known COVID-19 infection upon workup and subsequent positive COVID test (5/8). Admitted on 5/5 for additional management of acute hypoxic respiratory failure d/t bilat PNA. Pt received dexamethasone, convalescent plasma, and tocizumab and is still in hospital requiring 9L of O2.

Other Meds: Suboxone, fluoxetine, anoro ellipta, melatonin, albuterol

Current Illness: COPD, smoker

ID: 1317105
Sex: M
Age: 57
State: MD

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/14/2021
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: Aches, chills and fever of 102

Other Meds:

Current Illness:

ID: 1317106
Sex: F
Age: 42
State: NJ

Vax Date: 04/21/2021
Onset Date: 05/01/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: Possibly seafood

Symptom List: Nausea

Symptoms: 10 days after second shot got a week long fever of 102, that only went down 7 days later. Muscle aches and fatigue and fever. However after the fever went down on May 7 or 8, constant muscle pain in both legs, both arms, and both hands. Hands are now arthritic with nerve pain, which is new. Hips very painful and stiff.

Other Meds: Vitamin c, iron, d, zinc, b complex

Current Illness: None

ID: 1317107
Sex: M
Age: 39
State: IL

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 05/14/2021
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: I have had headaches every day since I received the vaccination that last most of the day. There is a constant pressure in my head that moves around all areas, from the back base of the head, to the sides, temples, forehead/sinus regions. It is from waking until sleeping. Not incredibly intense, but constant. I have difficulty sleeping through the night and have not slept well since, either. I have also experience blurred vision. I have also experience bruising on various parts of my body including my arm, abdomen, and toe nails. My quality of life has suffered tremendously and I wish I hadn't gotten the vaccine.

Other Meds: Insulin Atorvistatin

Current Illness:

ID: 1317108
Sex: F
Age: 34
State: PA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
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 Clindamycin Ciprofloxcin

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

Symptoms: 10 hours after: body aches 11 hours after: nausea 12 hours after: chills, fever 101-102 Woke up twice in next 10 hours, dehydrated, had to urinate, chills gone, fever 100.8 24 hours after: still dehydrated, fever 99.8, symptoms otherwise resolved

Other Meds: Montelukast 10 MG Bupropion 150 MG Omeprazole 10 MG Levocetirizine 5 MG Cranberry Supplement Vitamin D3 2000 IU

Current Illness: None

ID: 1317109
Sex: F
Age: 31
State: NC

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/14/2021
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: NKA

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

Symptoms: Immediately after receiving vaccine, patient felt numbness and stiffness that radiated down right arm. Patient stated this was also felt in right leg and foot. Minimal right handed grip strength was also reported. This lasted for around 24 hours per patient. Fatigue was noticed immediately and lasted for 2 days. Lastly, patient reported headache immediately that lasted for three days. Patient was given juice and crackers. Vital signs taken. HR 81, BP 136/84. Patient took Tylenol from personal medications. Patient refused transport and EMS evaluation. Patient was called by provider in afternoon and stated she was resting with no new/worsening symptoms.

Other Meds: None

Current Illness: Recent wisdom tooth extraction. No other conditions or illnesses.

ID: 1317110
Sex: F
Age: 29
State: UT

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

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

Lab Data:

Allergies: Penicillin and shellfish

Symptom List: Tremor

Symptoms: Shortness of breath/asthma attack. Heart racing and costochondritis

Other Meds: Prenatal Vitamins; Albuterol Inhaler

Current Illness: N/A

ID: 1317111
Sex: F
Age: 30
State: IN

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/14/2021
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: No

Symptom List: Erythema, Pruritus

Symptoms: Tiredness started 7 hrs after injection, then woke up at 330am with chills,.nausea, fever, muscle cramps, headache, and pain, swelling, and redness at the injection site all throughout the next day. Day 2, no fever or chills, some vomiting, very fatigued and arm reaction seems more inflamed.

Other Meds: Gummy multivitamin, gummy probiotic, allertec

Current Illness: No

ID: 1317112
Sex: F
Age: 51
State:

Vax Date: 02/12/2021
Onset Date: 05/08/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Date of symptom onset: 05/08/21 New cough, New sore throat

Other Meds:

Current Illness:

ID: 1317113
Sex: F
Age: 50
State: CO

Vax Date: 05/07/2021
Onset Date: 05/14/2021
Rec V Date: 05/14/2021
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: Amoxicillin Sulpha

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

Symptoms: Swelling, itching, round rash of about 3 inches diameter and redness in the injection site

Other Meds: Rosuvastatin Calcium 5mg (3 times a week)

Current Illness: N/A

ID: 1317114
Sex: F
Age: 51
State: NY

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/14/2021
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: Sulfa drugs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Woke up in the middle of the night unable to breathe, administered daughter?s asthma inhaler (expired), could not catch my breath if laying down, tried side, back, prone. Found relief when standing- was able to breathe enough not to feel like I was dying, although still shallow. Sat upright for 3+ hours until breathing normalized.

Other Meds: Lexapro (generic) 10mg, Finacea (topical), multi- vitamin, probiotic, Vit D 1000mg, Fish Oil

Current Illness: N/A

ID: 1317115
Sex: F
Age: 26
State: MI

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

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

Lab Data:

Allergies: none

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

Symptoms: Patient received first dose of pfizer vaccine, after about 5 minutes she came to the consult window saying she felt dizzy and asked if she could sit down. We asked her to sit down and grabbed her a water and asked what she was feeling. She stated at that time she had a history of fainting with vaccines, but did not state that on her questionnaire or before getting the vaccine. I could tell patient was about to lose consciousness, and she fainted. She gained consciousness after a minute and we gave her a banana, chocolate and some water as she stated she had not had anything to eat today. I began to check her vitals, her BP was 108/76. EMS was called and patient was evaluated by them and never returned.

Other Meds: unknown

Current Illness: none known

ID: 1317116
Sex: M
Age: 17
State: TX

Vax Date: 01/19/2021
Onset Date: 05/07/2021
Rec V Date: 05/14/2021
Hospital: Y

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: allergic to contrast; opti ray

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

Symptoms: Patient was recently admitted to the hospital with heart failure due to rejection. The medication that has been administer to him has caused too many side effects and negative reactions. I was told to report it.

Other Meds: tacrolimus, calcitroil, calcitrate, magnesium oxide, prednisone, lisinopril, metformin, insulin, insulin long-lasting, famotidine

Current Illness: gallbladder removal, obstruction of the bile duct, allergic reaction, hives big circles

ID: 1317117
Sex: F
Age: 23
State: TX

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Sulfa

Symptom List: Pain in extremity

Symptoms: High fever to 103 with myalgias followed by abdominal cramping and persistent nausea and diarrhea through today 5/14/2021.

Other Meds: None known

Current Illness: None

ID: 1317118
Sex: F
Age: 72
State: WA

Vax Date: 01/21/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: Allergic to mushrooms, molds, dust

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

Symptoms: Similar side effects to those after first shot: headache, mm aches, neck spasm, extremely tired, chills Rest, fluids and Tylenol

Other Meds: Dorzolomide/Timolol eye drops, Losartan, Amlodipine Besylate, B-12 2000, Vitamin D emulsion, Phosphatidylserine, Tylenol (prn), Vitamin C (prn),

Current Illness: None

ID: 1317119
Sex: F
Age: 71
State: NJ

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/14/2021
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: Amoxicillin, hydrocodone, Tetricyclen , vancomycin, clarthromycin

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

Symptoms: The morning after 2nd does left lymph gland under jaw line started to swell. Kept swelling, tried Tylenol and warm compresses. By Saturday morning 5/8 drove myself into the ER Was admitted with severe pain, swelling, high white count, difficulty swallowing and opening mouth with neck restrictions. Treated with numerous IV antibiotics, c scan first day and another on Friday Discovered abscess and removed some puss to further test. Still in hospital, swelling remaining the same Waiting for test results

Other Meds: Wellbutrin, arimidex, mirtazapine, lorazepam, fish oil, folic acid, magnesium. Vit C, calcium, bilberry, turmeric, lutein, zeaxanthin, vit D, vit b complex, CoQ10,

Current Illness: None

ID: 1317120
Sex: F
Age: 31
State: TX

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/14/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Subj stated today was day 21 in her Pfizer treatment from 1st dose. After the injection was given it was discovered today was day 14 from 1st dose. Subj stated no adverse effects from the shot, and stated she was feeling fine. I contacted health services who stated to complete this report and advise subj to seek further medical assistance if any issues occur. Subj left clinic with no issues. Vaccine was given at 11:06 today.

Other Meds:

Current Illness:

ID: 1317121
Sex: F
Age: 49
State: TX

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/14/2021
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: nka

Symptom List: Vomiting

Symptoms: Patient was administered invalid 2nd dose of Pfizer vaccine (vaccine was stored 5 days beyond recommended freezing time). Pfizer was contacted and recommended that the patient receive a booster in the opposite arm. Patient can receive booster immediately and will be contacted to schedule booster dose.

Other Meds: none

Current Illness: none reported

ID: 1317122
Sex: M
Age: 59
State: MD

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/14/2021
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: About 13 hours after the shot, at about 12:45 am of 5.5.21,, I had severe shaking while getting ready for bed. This happened while standing up. The shaking was so bad that I could not use my phone to search the side effects. The shaking started to subside after I laid down. Other symptoms after this event: unable to fall asleep for about 4 hours; feeling warm at times, with some minor chills; thirsty during this 4 hour period.

Other Meds: None

Current Illness: None

ID: 1317123
Sex: F
Age: 19
State: CT

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 05/14/2021
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: Spotting and irregular long lasting periods

Other Meds: Vyvanse 20 mg, birth control

Current Illness:

ID: 1317124
Sex: M
Age: 34
State: CA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
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: FRUIT, VEGETABLES, NUTS, WHEAT - PT STATED ASTHMA AND ALLERGY TO WHEAT/GLUTEN, NUTS, SOY, FRUIT/VEGGIES BACK ON 4/22/21

Symptom List: Injection site swelling, Limb discomfort

Symptoms: PATIENT HAD A SEVERE REACTION TO FIRST COVID-19 VACCINE, PT WAS TAKEN BY ABULANCE TO ER. HE STATED THAT HE TALKED TO HIS PHYSICIAN AND THAT IS WAS LIKELY NERVES/ANXIETY, HE WAS GIVEN XANAX OR ATIVAN AND TOLD TO TAKE PRIOR TO VACCINE #2. WE WERE PREPARED AS WE ARE THE SAME STAFF THAT WAS HERE WHEN HE HAD HIS FIRST REACTION. AFTER VACCINE 2 HE SEEMED OK BUT THE RPH STAYED WITH HIM INCASE OF REACTION. HE GOT PALE, SWEATY, SEEMED OK. HE THEN WENT UNCONSCIOUS, 911 WAS CALLED, HE SEEMED TO CONVULSE, AND BIT HIS CHEEK. FIRST RESPONDERS CHECKED HIM OUT, HE REFUSED TO GO TO THE ER VIA AMBULANCE. PATIENTS WIFE SAID SHE WOULD DRIVE HIM TO URGRNT CARE. 5/14/21

Other Meds: NONE GIVEN

Current Illness: PATIENT HAD A SEVERE REACTION TO FIRST COVID-19 VACCINE, PT WAS TAKEN BY ABULANCE TO ER. HE STATED THAT HE TALKED TO HIS PHYSICIAN AND THAT IS WAS LIKELY NERVES/ANXIETY, HE WAS GIVEN XANAX OR ATIVAN AND TOLD TO TAKE VACCINE #2.

ID: 1317126
Sex: M
Age: 53
State: MS

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Experiencing intermittent left arm buzzing and tingling feeling from injection site to mid-palm area. Occurs everyday.

Other Meds: None

Current Illness: None

ID: 1317127
Sex: F
Age: 42
State: PA

Vax Date: 04/29/2021
Onset Date: 05/06/2021
Rec V Date: 05/14/2021
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: One week after vaccine administration, tachycardia, heart palpitations, and fluttering/pounding feeling in chest occurred intermittently for several minutes at a time throughout the day, even at rest. These symptoms were distinct from heart palpitations felt in the past, which lasted only seconds. Symptoms peaked about 8-9 days after vaccination. During the 10-14 days after vaccination, symptoms slowly subsided until they occurred only during exercise or other events that would normally elevate heart rate. 15 days after vaccination, symptoms stopped and no fluttering was felt in chest even with exercise. The episodes caused hesitance about getting the second dose of the vaccine.

Other Meds: None.

Current Illness: None.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm