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: 1321365
Sex: M
Age: 22
State: OR

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: Pt passed out in chair about a minute or so after administration of vaccine. He brought along his girlfriend who was in the consultation room with him. Prior to administration, pt informed me that he was afraid of needles. After administration, we discussed the type of needle that was used (vanish point syringe) and the mechanism of how it works. He seemd anxious so I advised that it was ok for them to sit in the room for a few minutes instead of getting up to wait in the lobby, I left the door open for them. I walked back into the pharmacy and his girlfriend alerted me that he had passed out. He regained conscious within a few seconds. I advised he sit with his head between his legs, as he mentioned feeling light headed, feeling hot and sweaty. he threw up a little into the trash. pt sat in room for at least 30 minutes until he felt better. was given a few cups of water while sitting. did not leave until he felt comfortable and no longer light headed. pt mentioned that his last vaccine was about 2 years ago and the same response occured then.

Other Meds:

Current Illness:

ID: 1321366
Sex: M
Age: 23
State: IL

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: amoxicillin or PCN per pt

Symptom List: Anxiety, Dyspnoea

Symptoms: Approximately 10 minutes after receiving the second dose Pfizer vaccine, pt collapsed. Pt was able to regain consciousness within a few seconds without external factors/help/medication. Pt was orientated to location/name/age upon regained consciousness. EMT was called. Upon checking his blood pressure, EMT was concerned about hypotension and transported pt to hospital. Pt stated that he feel hot and his hands were shaking. Per pt, this reaction did not happened with the first vaccine but happened a few years ago with another vaccine.

Other Meds: none reported per pt

Current Illness: Unknown

ID: 1321367
Sex: F
Age: 24
State: IN

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
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: No

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

Symptoms: Large welt at injection site that is very tender and swollen, like half a golf ball size. Slightly sore throat, wheezing and muscle soreness and fatigue.

Other Meds: Wellbutrin, Lexapro, yaz

Current Illness: None

ID: 1321368
Sex: F
Age: 17
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: Patient got vaccinated at 4:03 p.m. At 4:10 p.m., patient had involuntary muscle movements and lost consciousness. Per parent, patient has history of panic attacks presenting like same symptoms observed., vital signs taken: BP 154/89 and 120/77, PR: 138; blood glucose: 124, EKG: sinus tachycardia; oxygen given at 4:26 p.m. and discontinued at 4:37p.m.; patient transported to hospital at 4:45 p.m.

Other Meds:

Current Illness:

ID: 1321369
Sex: M
Age: 37
State: GA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient said he felt a warm feeling

Other Meds:

Current Illness:

ID: 1321370
Sex: M
Age: 62
State: MI

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: penicillin-per consent form

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

Symptoms: severe syncope, pt was pale and sweaty and 'felt funny'...administered epipen and pt stated he felt better then lost consciousness again and thready pulse...called 911, EMT came, gave oxygen and started infusion, took him to hospital. Pt discharged after several hrs

Other Meds: n/a

Current Illness: n/a

ID: 1321371
Sex: F
Age: 24
State: MD

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 05/15/2021
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: Not that I know of

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Bulge developed on clavicle (left) , continues to swell larger and cause pain to the left arm/shoulder/neck region. This is after BOTH shots.

Other Meds: N/A

Current Illness: N/A

ID: 1321372
Sex: F
Age: 29
State:

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Fever, chills, body aches and fatigue starting 7 hours after the shot, and lasting for 24 hours

Other Meds:

Current Illness:

ID: 1321373
Sex: M
Age: 45
State: NJ

Vax Date: 05/10/2021
Onset Date: 05/13/2021
Rec V Date: 05/15/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Diagnosed with Myocarditis. Severe chest pain began at 2:30am. Went to hospital ER at 4am. Was given an ekg and blood test which showed a potential heart attack and was treated with Nitroglycerin at 4:30 am. Was given a cardiac catheterization at 6am that showed no heart attack and no arterial obstructions but showed one wall of the heart was not functioning properly. Heart issue was confirmed later in the day by an echocardiogram study. Was admitted to the hospital. Had an additional attack of chest pains at approximately 2:30pm the next day which was treated with 3 tablets of Nitroglycerin. Blood tests showed markers for inflammation.

Other Meds: None

Current Illness: None

ID: 1321374
Sex: M
Age: 62
State: PA

Vax Date: 04/25/2021
Onset Date: 04/26/2021
Rec V Date: 05/15/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: He has been having diarrhea for the past 2 weeks ever since he received a second Covid vaccination he has been increasingly weak and could barely make it into the pulmonary function lab. At the pulmonary function lab, he was found to have new onset atrial fibrillation and worsening hypoxemia from baseline. Taken to ED from the lab on 5/12, found to have right middle lobe and right lower lobe consolidation and ground glass changes. Admitted. Conditioned worsened, respiratory acidosis and shock, started on biped and pressors. Taken to ICU. Found to have RV failure. Today he was intubated.

Other Meds: albuterol, trelegy, lassie, gabapentin, Ativan, oxycodone, aldactone, lisinopril

Current Illness:

ID: 1321375
Sex: F
Age: 57
State: CA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Chocolate, Caffeine.

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

Symptoms: Rapid Heartbeats 5 minutes after 1st dose high blood pressure. High Blood Pressure after 2nd dose and still having it,

Other Meds: Synthroid 75mg one hour prior to vaccination

Current Illness: None

ID: 1321376
Sex: M
Age: 16
State: OR

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
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: UNKNOWN

Symptom List: Rash, Urticaria

Symptoms: reports "throat feels a little tight " and "hard to swallowing". Brought to observation area. Vss ( baseline HTN per his report). reports seasonal allergies. Oropharynx red upon inspection and drainage noted at back of throat. Able to drink fluids with difficulty. Reports immediate improvement of symptoms after PO fluids. Discussed symptoms of anaphylaxis with him. Released him to home after discussion of serious symptoms and what to contact ems for

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1321377
Sex: F
Age: 19
State: OK

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Patient previously had Pfizer Covid 19 vaccine on 4/21/21 but was given Moderna shot today. So far, there are no symptoms, signs or treatment.

Other Meds: Unknown

Current Illness: none

ID: 1321378
Sex: F
Age: 70
State: TX

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
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: Nausea Feeling sick Low blood pressure Clammy skin Signs and symptoms started 5 minutes after the administering the vaccine. Vaccine administered at 12:22. At 12:27, the consumer complaints of nausea and feeling sick. Consumer remained awake, alert, and oriented. The consumer denies shortness of breath, chest pain, or difficulty breathing. Vital signs checked: BP 80/50 (manually), 86/50 (electronically), heart rate 65, oxygen saturation 94-97%. Consumer admitted taking her cardiac medications 10 to 15 minutes before we arrived for the in-home vaccine administration. The EMS arrived around 1:00 pm, assessed the consumer, BP remains low. At 01:40 pm, the consumer was transported to the hospital by the EMS. NOTE: Consumer states, she took cardiac medication 10-15 minutes before the vaccine was administered. She verbalized, the medication has not been take for a while (about 6 weeks), just resumed medication on 5/14/2021. BP reading 12:28 80/50 manually, 86/50 electronically 12:48 - 60/45 Called 911, fluid offered 12:55 - 161/87 1:00 - 104/54 EMS Arrived 1:05 - 106/54 1:06 - 108/70 1:15 - 77/45 1:40 - Consumer transported to the hospital by the EMS. Consumer remains awake, alert and oriented. Denies shortness of breath, chest pain, or difficulty breathing.

Other Meds: Isosorbide mononitrate 10 mg Cilostazol 50 mg Tramadol 50 mg

Current Illness: Thyroid

ID: 1321379
Sex: M
Age: 27
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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 administered the Pfizer vaccine and was asked to wait around the pharmacy for 15 minutes post vaccination. After 5 minutes, patient started feeling dizzy and started to faint. He was accompanied by his parents, father tried waking patient up a few times but he was unresponsive to wake and started to tilt his head backwards and falling over. We called the paramedics and administered the epipen. Father did notify us that patient is fine and was discharged from the ER on the same day.

Other Meds:

Current Illness:

ID: 1321380
Sex: F
Age: 45
State: CA

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/15/2021
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: shot administrator, injected vaccine to high up on the arm/ shoulder , pain and loss of range a motion in right arm/shoulder 3 days after vaccine

Other Meds: none

Current Illness: none

ID: 1321381
Sex: F
Age: 47
State:

Vax Date: 04/16/2021
Onset Date: 04/19/2021
Rec V Date: 05/15/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: Bruises on right side of arm and leg developed 3 days after the vaccine. Patient had wart-like looking spots on the elbow that was itchy and burning. Patient experienced heavy breathing, but did not describe as "gasping for air" or an anaphylactic reaction.

Other Meds:

Current Illness:

ID: 1321382
Sex: F
Age: 29
State: IN

Vax Date: 04/26/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Extreme heavy period, blood clots larger than golf balls for over 24 hours, extreme fatigue,

Other Meds: CBD, vitamin B, vitamin E, evening primrose oil

Current Illness: NA

ID: 1321383
Sex: M
Age: 21
State: MI

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Allergy to bee venom (Thoat swelling)

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: receive vaccine at 12:20pm. At 12:27 patient felt his throat beginning to swell and throat was "really scratchy". After drinking some water patient stated his throat felt better. at 12:45 patient stated his symptoms were mostly gone. At 1:15 patient was allowed to go home after 30 minutes of no symptoms with recommendation that if symptoms returned to go immediately to the ER

Other Meds: Zoloft, Singulair, Epipen

Current Illness: None

ID: 1321384
Sex: F
Age: 67
State: NM

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: cefotaxime (anaphylaxis), inapsine, shellfish

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

Symptoms: 12 hours after vaccine started to have congestion, hives/welts (50-cent piece size) on head, neck and chest, itching, difficulty breathing, "bronchial asthma-type symptoms", GI cramping, throat felt like it was closing. She is still having difficulty breathing, congestion, itching, and hives are still present.

Other Meds: trazodone, furosemide, hydroxychloriquine, extra strength Tylenol, ibuprofen, multivitamins, metoprolol

Current Illness: none

ID: 1321385
Sex: F
Age: 60
State: MA

Vax Date: 05/12/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
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: Hay fever

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

Symptoms: Red itchy rash on the left arm.

Other Meds: Propranolul HCL ER 60mg

Current Illness: none

ID: 1321386
Sex: F
Age: 49
State: FL

Vax Date: 04/14/2021
Onset Date: 04/17/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Unevaluable event

Symptoms: After three days of the cycle completed, my legs were very weak. By the next week both arms started to hurt so bad specially in the middle of the nite, 2am, 3am and 5pm. Lastly for the past two weeks my hands were getting numbed and having restless legs syndrome. Also my past injuries have been hurting me a lot. So far it has been a month and I got worse, that is why I decided to go to the doctor this past Thursday , May 13. She has prescribed me some steroids and barbiturates in order to sleep because I can?t sleep during the night.

Other Meds: NA

Current Illness: NA

ID: 1321387
Sex: F
Age: 53
State: GA

Vax Date: 04/23/2021
Onset Date: 04/28/2021
Rec V Date: 05/15/2021
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: Swollen lymph node in the neck.Congestion and mucus green and yellow?s color

Other Meds: None

Current Illness: None

ID: 1321388
Sex: M
Age: 12
State: VA

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: Sulfa drugs

Symptom List: Injection site pain, Pain

Symptoms: Fever of 102.2 began 27 hours after the shot. Extremely sore arm, hurts to move it. Headache. Dry eyes. Fatigue - extremely tired, took a 3 hour nap. Cold - not chills, just cold in general. Gave motrin, but fever is still at 102.0 nearly 3 hours later.

Other Meds: Albuterol, Vitamin C, Zyrtek

Current Illness: None - entire household has been in strict quarantine since March 2020 due to being compromised.

ID: 1321390
Sex: F
Age: 61
State: CA

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: High fever, body pain, stuffy nose, dry cough, extreme tiredness

Other Meds:

Current Illness:

ID: 1321391
Sex: F
Age: 60
State: VT

Vax Date: 05/06/2021
Onset Date: 05/09/2021
Rec V Date: 05/15/2021
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: Meds: penicillin, cephalosporins, ibuprofen, imitrex Food: tree nuts, peanuts, avocado, shellfish allergy; gluten intolerance Other: latex

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

Symptoms: On 5/8/2021 I awoke several times with muscle spasms in my legs. On 5/9/2021 I noticed that my left 2nd toe was numb. Over the next three days the numbness spread to the 3rd and 4th toes, and adjacent skin on the dorsal aspect of the left distal foot. There is no motor deficit, only sensory. On 5/12/2021, I first experienced extreme tenderness over the lateral aspect of my left neck, at the site of the brachial plexus. On 5/13, this same extreme tenderness in my left axilla at the site of the brachial plexus. On 5/15 a raised, tender red welt appeared over the vaccination site on my left deltoid, and I noticed a few hives on my left upper extremity.

Other Meds: Levothyroxin 125mcg QD Omega-3 1280mg+ D-3 QD Nattokinase 100 mg QD Herbal tea: tumeric, ginger, meadowsweet QD

Current Illness: Right hip pain which I assumed was from Lyme disease for which I was treated in November, 2020.

ID: 1321392
Sex: F
Age: 52
State: AZ

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: No energy, extreme fatigue, lethargic, brain fog. Slept for 12 hours

Other Meds: Trazodone, sertraline, atorvastatin, lisinopril, spironolactin, turmeric supplements, probiotics supplement, ibuprofen

Current Illness:

ID: 1321393
Sex: F
Age: 28
State: MD

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Tree nuts Sulfa drugs

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever 101 Chills Body aches Nausea

Other Meds: N/a

Current Illness: N/a

ID: 1321394
Sex: M
Age: 15
State: OR

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 05/15/2021
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: No

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

Symptoms: No signs or symptoms noted

Other Meds: Unkown

Current Illness: No

ID: 1321395
Sex: M
Age: 15
State: CO

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Not long after receiving the vaccine, the pharmacist called me to say he had not diluted the vaccine correctly and he gave patient at least .8 mm instead of .3 mm. He then went on to say that because patient received a higher dose than he should have, the CDC advised that he would not require a second does of the COVID vaccine. Upon researching that myself, I see that CDC guidelines instead state that if an error is made with the first dose, the second dose should still be administered 21 days later. These are both serious errors.

Other Meds: None

Current Illness: None

ID: 1321396
Sex: F
Age: 60
State: MO

Vax Date: 05/07/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, penicillin

Symptom List: Injection site pain

Symptoms: Patient received dose on 5/7/21. She presented to the pharmacy 5/15/21. On 5/15/21, she was outdoors at a game and her arm started to itch. She was wearing lots of clothes to stay warm and wasn't able to look at her arm until she got home. Upon inspection, her arm was swollen and slightly red. The inflammation began near the injection site and worked down the arm in the shape of an egg. The size was a little smaller than a tennis ball but larger than a very large egg. She is to contact me if swelling gets worse, but will be trying cool compress and diphenhydramine in the mean time.

Other Meds: None aware of

Current Illness: None aware of

ID: 1321397
Sex: F
Age: 42
State: PA

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Shrimp, penicillin, inulin, adhesive

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

Symptoms: Armpit rash, trunk rash

Other Meds: Azithromycin, nasonex, singulair, claritin

Current Illness: Sore throat with post nasal drip during allergy season

ID: 1321398
Sex: F
Age: 38
State: DE

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 05/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Beginning the day after the first dose, I began having menstrual spotting. This had continued every day since.

Other Meds: Vyvanse 10mg

Current Illness: None

ID: 1321399
Sex: M
Age: 23
State: UT

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/15/2021
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: I got th eJassen COVID-19 Vaccine EUA at 10:50am. When the needle was removed, blood ran down my arm. That has never happened, but it might have been the nurse. I had nausea for a few minutes afterwards, but I think that was due to the blood. I didn't feel like eating after the shot. Hours later, around 5pm or so, I started to feel hypersensitive and weak. I also started to have a fever that went up to 102.2 farenheit before decided to take ibuprofen. I had shakes, a heartbeat of 146, and a headache. It lasted all through the night and into the next day. Around 11:20am, whenever I moved my head, I would feel pain in my head. By the end of this day, I started to feel more like myself. By the start of the third day, all I had was pain in my left arm from the shot. It was strange that the pain got worse from Day 1 to Day 3, but that might be from how the vaccine was given and the blood that ran down my arm at that time. Another thing is my appetite has gone down a lot. I don't want to eat and when I do, I just want to stop. It's been a couple days, so I'm hoping my appetite will come back.

Other Meds:

Current Illness:

ID: 1321400
Sex: M
Age: 25
State: NC

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: Erythema, Pruritus

Symptoms: At 3:00 AM on the day after I woke up with my right eyelid swollen and producing goop. Other than that I had fatigue, sore injection site, and a headache.

Other Meds: None

Current Illness: None

Date Died: 05/15/2021

ID: 1321401
Sex: F
Age: 76
State: CA

Vax Date: 05/12/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital: Y

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: nka

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

Symptoms: Pt presented with coffee ground emesis and acute st elevation myocardia infarction. She was DNR. She was admitted and expired in a few hours.

Other Meds: colace

Current Illness: uti

ID: 1321402
Sex: F
Age: 78
State: TX

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/15/2021
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: anti-inflam

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

Symptoms: Low grade fever, nausea, extreme pain in all joints, hands swollen and stiff, headache. diaherra for 2 days,, sleep on and off for 3 days. Just starting to feel a little better. It was hell. 10 days.

Other Meds: Leyothtroxine, Gabapentin, Baclofen, Cozaar, Lomotil, Desipramine, Robinul, Welchol, Align, Vitamin C, Calraye, Calcium, Vitamin D. Centrum Silver, B-12, B-15

Current Illness: none

ID: 1321403
Sex: M
Age: 13
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: 13 year old male who received his first dose of vaccination stated that he felt his throat was swelling and nausea. Vital sign were taken and they were all within normal limits including Oxygen saturation of 100%. No tearing, nasal discharge, no rash, No wheezing per EMS. EMS evaluated the sound of heart and the lungs and did EKG on the site. He was alert and oriented in place and time. He was able to communicate. EMS were on site and no medication were given. Patient and his parent chose to go to the ED by ambulance. He was stable when he left with the ambulance.

Other Meds:

Current Illness:

ID: 1321404
Sex: M
Age: 58
State: NY

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: Fever, malaise.

Other Meds: Atacand, Norvasc

Current Illness: Hay fever

ID: 1321405
Sex: F
Age: 30
State:

Vax Date: 03/07/2021
Onset Date: 03/14/2021
Rec V Date: 05/15/2021
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: N/A

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

Symptoms: Between my first and second vaccine, I experienced 10+ non-consecutive days of vertigo. I have never experienced vertigo in my life. I have no indication to believe my vertigo was caused by anything other than the vaccine. The vertigo was extreme including spinning walls and tipping ceilings, only to be consoled by sleep and bed rest. I also experienced a general feeling of unwellness for three weeks.

Other Meds: Valcyclovir, maxalt, excedrin

Current Illness:

ID: 1321406
Sex: M
Age: 33
State: AZ

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Per patient, NONE

Symptom List: Pain in extremity

Symptoms: After vaccination, patient was fine. He sat down for observation. 5 minutes passed and I heard "SOMEONE HELP". Patient was tensing up and unresponsive (looked like a mini-seizure). Patient peed on himself and after 3-4 seconds patient was fully responsive. Patient stated he was fine and didn't know what happened. Patient did not want me to call an ambulance and person with him told me not to call. We waited a little longer, patient complained of feeling really hot. He laid down on the floor and I gave him some water and a lollipop to increase sugar levels. After 3-5 minutes patient sat down on the chair and stated he was feeling much better. After a few minutes, he complained of wanting to vomit. As soon as I was able to give him a bag, he violently threw up. Patient stated that he was now feeling much better. He went to the bathroom and cleaned up. After a little longer observation, patient said he was fine and wanted to go home. They left. I called patient an hour later and he stated he felt fine and was just resting. Will follow up with patient tomorrow.

Other Meds: Per patient, NONE

Current Illness: Per patient, NONE

ID: 1321408
Sex: M
Age: 24
State: CA

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/15/2021
Hospital: Y

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

Lab Data:

Allergies: NONE

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

Symptoms: patient had chest pain and SOB Day 2 after vaccine and in ER has signs of myocarditis requiring hospitalization

Other Meds: testosterone injection Q2 weeks

Current Illness: NONE

ID: 1321409
Sex: M
Age: 52
State: OR

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 05/15/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Injection site pain still persists 3.5 weeks after injection. Pain in the shoulder and muscle below injection site.

Other Meds: Quetiapine Fumarate 50mg/day Celexa 20Mg/day

Current Illness: None

ID: 1321410
Sex: F
Age: 45
State: AZ

Vax Date: 04/23/2021
Onset Date: 05/10/2021
Rec V Date: 05/15/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: I had my first Shingles/ Herpes Zoster outbreak. The outbreak includes rash and nerve pain. I did have the chicken pox as a child. However, I have no other underlying medical conditions.

Other Meds: None

Current Illness: None

ID: 1321411
Sex: F
Age: 40
State: OH

Vax Date: 05/07/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
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: Swollen, elevated, itchy patch at the site where injection was done

Other Meds: Trintillex Wellbutrin Vistaril Lamictal

Current Illness: None

ID: 1321412
Sex: F
Age: 39
State: CA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/15/2021
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: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever, chills, fatigue, brain fog, sore, achy, sore at injection site,

Other Meds: Zinc, vit c, folate, biotin

Current Illness: N/A

ID: 1321413
Sex: F
Age: 22
State: OK

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: Pineapple

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

Symptoms: 103.4 degree F fever (Tylenol, ibuprofen) Headache (Tylenol, ibuprofen) Pain in arm (Tylenol, ibuprofen) Malaise (sleep)

Other Meds: Trokendi Sumatriptan

Current Illness: None

ID: 1321414
Sex: F
Age: 15
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 15 y/o F with no known prior medical conditions or NKDA presented for her first dose of Pfizer vaccine. 5-min post vaccination the patient began to feel dizzy and light-headed. The patient experienced a syncopal event resulting in an assisted fall from chair. The fall was atraumatic and the patient instantly regained consciousness. Patient was alert and oriented x3, and rapidly improved back to her baseline. Patient denied any SOB, difficulty breathing, throat swelling, itching, or HA. Parental guardian was advised to keep patient hydrated and educated on any signs or symptoms that would warrant urgent care.

Other Meds: OCP

Current Illness: None.

ID: 1321415
Sex: F
Age: 38
State: CA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Gold, dust mites, dust

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

Symptoms: The evening of my first vaccine I started getting pain in my hips which went down the back and side of my legs. Initially it felt like constant muscle pain, but the next day it gradually got worse to the point I could hardly move around the house and felt like it was shooting down my legs when I bent even a little bit. The location covered most of my hips, bottom and back of my thighs. It seemed to skip my knees and felt like a string of pain in my calves. Pain was strangely worse when I was sitting down or laying down in bed. The pain would randomly go away for a couple of minutes every once in awhile. Tylenol temporarily (about 2 hours) relieved the pain where I could at least function without a massager or ice.

Other Meds: Claritin

Current Illness:

ID: 1321416
Sex: F
Age: 43
State: CO

Vax Date: 05/07/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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: Erythramycin Sulfa

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

Symptoms: Rash on face, neck, R arm, legs and back. Red bumps, itchy

Other Meds: Vit C

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm