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: 1321608
Sex: M
Age: 43
State:

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
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: Heart racing Pulse: 87 Respirations :16 SPO2: 100% BP 130/78 Drunk water, rest to normal then discharged tp home

Other Meds:

Current Illness:

ID: 1321609
Sex: M
Age: 39
State: OH

Vax Date: 05/13/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Approximately 24 hours after 2nd COVID vaccination, patient woke during the night and was unable to walk due to worsening/recrudescence of his previous MS symptoms of leg weakness. No associated fever, chills, or other flu-like symptoms. Weakness improved without specific treatment within 24 hours.

Other Meds: Tysabri

Current Illness: Multiple Sclerosis Obstructive Sleep Apnea

ID: 1321610
Sex: F
Age: 36
State: IN

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

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

Lab Data:

Allergies:

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

Symptoms: Felt a small bump or swelling under the injection site in the first few minutes. 8 hours later I had severe body aches and elevated heart rate. Hot and cold. Writhing in bed. This was the worst of it, and the worst pain lasted about half an hour. Aching arm. The following day I still had aches, exhaustion, and 2 more less-severe episodes of aches and hot with chills. Also a light bruise (the size of a nickel) at the site of injection, with splotchy red marks around it, arm still swollen. I woke up 2 hours ago cautiously feeling better, arm hurts less this morning.

Other Meds: Women's daily vitamins and CBD

Current Illness:

ID: 1321611
Sex: M
Age: 39
State: VT

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
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: pt felt like he was going to pass out , then got very hot and started to sweat . He stated he hadn't slept much and had worked out earlier and my be dehydrated ... he was not sure this event was related to the vaccine ... these symptoms started about 10 minutes following the vaccine

Other Meds: hydroxyzine at night

Current Illness:

ID: 1321612
Sex: M
Age: 63
State: PA

Vax Date: 04/10/2021
Onset Date: 05/08/2021
Rec V Date: 05/16/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Exactly 4 weeks after vaccination, I experienced severe enlarged hemorrhoids lasting more than one week (8 days at the moment). One of the hemorrhoids is bluish/blackish which I'm told indicates a thrombosed hemorrhoid. I have never had series issues with hemorrhoids -- previous issues have been very minor and lasted only a matter of hours, perhaps only 2 or 3 times per year. There have been no dietary changes, nor changes in work or leisure habits.

Other Meds: None

Current Illness: None

ID: 1321613
Sex: F
Age: 77
State: FL

Vax Date: 02/19/2021
Onset Date: 04/14/2021
Rec V Date: 05/16/2021
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: Diagnosed with serious serum sickness from flu vaccine approximately 15 yrs ago. CDC involved via phone consultation. Advised by rheumatologist to never take another vaccination again as it was not possible to determine what ingredient caused the reaction and next exposure could cause death. Have been experiencing another autoimmune reaction. Never has psoriasis in past. Am wondering if this could be related to the vaccine. I consulted with a new rheumatologist and an allergy specialist prior to taking the covid vaccine. They felt the mRNA basis would be different enough that it was worth the risk. I agree. But I do wonder if I should continue to avoid all vaccines in the future.

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

Symptoms: Am waiting for appointment with dermatologist

Other Meds: Atorvastatin,, ezetamibe, mesalamine

Current Illness: None.

ID: 1321614
Sex: M
Age: 21
State: IN

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Chills and 102 degree fever that began around 10 pm the night of the 14th and lasted until around 9 am the morning of the 15th. On the 15th I woke up with a massive headache and fatigue that lasted the entire day until the morning of the 16th.

Other Meds:

Current Illness:

ID: 1321615
Sex: M
Age: 30
State:

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
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: Dizzy, lips tingling. Rest, resolved spontaneously to discharge home. Pulse: 100 SPO2 98% BP 120/86

Other Meds:

Current Illness:

ID: 1321616
Sex: F
Age: 58
State: NJ

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies: sulfa shellfish

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Tinnitus, brain fog, blurred vision/double vision, ear pain, ear congestion, fatigue, fever, body aches

Other Meds: synthyriod .88 NAC vitamin C Zinc

Current Illness:

ID: 1321617
Sex: M
Age: 56
State: CA

Vax Date: 04/17/2021
Onset Date: 05/04/2021
Rec V Date: 05/16/2021
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: Zero

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Right medial knee pain Dull ache Effects gait No swelling no redness My brother in Arizona has the same exact pain w Moderna vaccine shot as well. Same right knee & symptoms.

Other Meds: None

Current Illness: Zero

ID: 1321618
Sex: F
Age: 36
State: IN

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Body aches. Flu like symptoms

Other Meds:

Current Illness:

ID: 1321619
Sex: F
Age: 19
State: FL

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: fever, body ache, nausea, lightheadedness, sneezing, stuffy nose

Other Meds: citalopram

Current Illness:

ID: 1321620
Sex: F
Age: 63
State: OR

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

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

Lab Data:

Allergies: Cortisone

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

Symptoms: that night, work from sleep with rapid heart beat, headache, sweating, nausea, took aspirin, drank more water, work just feeling off, slight headache and nausea, and left arm pain, concern of blood clots.

Other Meds: armor thyroid, normal Zinc, Vitamin D Quercetin

Current Illness: none

ID: 1321621
Sex: F
Age: 69
State: IN

Vax Date: 04/24/2021
Onset Date: 05/06/2021
Rec V Date: 05/16/2021
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: Steroids

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

Symptoms: + Homan?s Sign Right upper LE localized tenderness Warm to touch No MCR part A until 7/1/21 so not sought tx Taking ASA 325 mg qd Thigh high compression Leg elevated/ bedrest

Other Meds: None

Current Illness: None

ID: 1321622
Sex: F
Age: 33
State: OH

Vax Date: 05/13/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Two days after my second shot I started my menstrual bleeding violently and two weeks early. That night I woke in the middle of the night and my ears were ringing and my vision blacking at the edges and I was loosing a lot of blood. I started shaking so hard my teeth chattered, and was unable to get out of bed without feeling like I was going to pass out. My husband brought me juice and crackers, and it lessened within a half hour.

Other Meds: Women?s multivitamin

Current Illness: None

ID: 1321623
Sex: M
Age: 26
State: IN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
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: Fever started about 12 hours after shot and lasted about 18 hours.

Other Meds: None

Current Illness: None

ID: 1321624
Sex: M
Age: 42
State: IN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
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: N/A

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

Symptoms: Injection site pain started on 5/14. Woke up on 5/15 with the additional symptoms: Low grade fever Body aches Chills Headache Lasted thru most of the day, subsiding in afternoon. Feeling much better on 5/16.

Other Meds: Trulicity Jardiance Metformin

Current Illness: None

ID: 1321625
Sex: F
Age: 40
State: IN

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Around 2000 got very tired and chilled. At 2100 took temp and it was at 100.5. Took advil and went to sleep. Woke up at 0630 on the 16th to no fever but slight muscle weakness.

Other Meds: Advil and cbd oil

Current Illness:

ID: 1321626
Sex: F
Age: 39
State: TN

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

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I was riding in the car and suddenly my heart felt like it stopped and then started pounding and my vision was going black from the outside to the inside. I wasn?t stressed or anxious before it happened. I felt my heart continue to pound and my husband coached me through deep breathing. My vision came back and I continued to feel light headed and feeling my heart pound. We stopped at a gas station to get a snack not sure what to do. I had eaten but almost felt like blood sugar drop. I don?t have issues with that but didn?t know what to do.

Other Meds: Levothyroxine, singular for allergies

Current Illness: Cold where I took night quill

ID: 1321627
Sex: F
Age: 51
State: VA

Vax Date: 04/26/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: I woke up the morning of May 14, 2021 and my right side of my face was drooping and I had a throbbing pain in my right eye. I couldn't eat, or drink right. I was rushed to the hospital because I thought I was having a stroke. I was met in the emergency room with 2 stroke nurses and a doctor and then was taken to get a CT Head WO Cont. I was diagnosed with Bell's Palsy with no other symptoms

Other Meds: none

Current Illness: none

ID: 1321628
Sex: M
Age: 27
State: IN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
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: N/A

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

Symptoms: Fever starting around 10pm the day of the vaccine. Fatigue and fever lasting until around 10pm the next day. Symptoms subsided around 11pm.

Other Meds: N/A

Current Illness: N/A

ID: 1321629
Sex: F
Age: 44
State: SC

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline, Bentley, allergic (bad reaction - rapid heart palpitations) to most anti-depressants.

Symptom List: Unevaluable event

Symptoms: Very sore arm - 5 days Body aches - 5 days Very low pulse - resting pulse 41- ongoing (as of today, 10 days) Cold sweats - 10 days so far, ongoing Extreme abdominal pain - 9 days until present Severe constipation - ongoing (10 days) High pitched ringing in ears - ongoing, so far 10 days. Brain fog - ongoing, so far 10 days Vertigo - dizziness - 7 days Nausea - 5 days Involuntary twitching - 10 days (ongoing) Mixing up words and inability to think of words - ongoing (so far 10 days)

Other Meds: Synthroid, Methadone, Valium, Lyrica

Current Illness: None that I?m aware of.

ID: 1321630
Sex: F
Age: 61
State: NC

Vax Date: 03/05/2021
Onset Date: 04/15/2021
Rec V Date: 05/16/2021
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

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

Symptoms: Ringing in the ear started 10 days after my 2nd dose of Moderna. I went to my general physician and he sent me to an Ear Nose and Throat Specialist. From there, I started doing research and saw other posting online regarding these effects from the vaccine.

Other Meds: Synthroid 200mcg

Current Illness: Knee pain

ID: 1321631
Sex: M
Age: 54
State: NC

Vax Date: 05/03/2021
Onset Date: 05/06/2021
Rec V Date: 05/16/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: pain in left foot and left calf feels like cramping...has continued since 3 days after the shot. still happening.

Other Meds: metformin, lisinopril, jardiance, januvia, glemipiride pravistatin vitamin d

Current Illness:

ID: 1321632
Sex: M
Age: 20
State: PA

Vax Date: 05/15/2021
Onset Date: 05/16/2021
Rec V Date: 05/16/2021
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: Fever of 102.4, chills, soreness at injection site, throwing up, nausea, head ache, uncontrollable shaking, stuffy nose.

Other Meds: None

Current Illness: None

ID: 1321633
Sex: F
Age: 58
State: PA

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
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: Swollen in the joint in the hand of the harm that I received the shot . Painful swollen joints ....

Other Meds: None

Current Illness: None

ID: 1321634
Sex: M
Age: 43
State: IN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Swollen & itchy eyes Sneezing

Other Meds: Metolazone Metoprolol Succ Allopurinol Spironolactone Furosemide Entresto Bumetanide Potassium

Current Illness: None

ID: 1321635
Sex: F
Age: 29
State: IN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
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: Ear throbbing and pressure, 24 hours on and off Fever(101-102.8), 48 hours on and off

Other Meds:

Current Illness:

ID: 1321636
Sex: F
Age: 49
State: NJ

Vax Date: 05/08/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
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: Injection site is red, very sore, very itchy. Body aches all over.

Other Meds: Lexapro and Zyrtec

Current Illness: No

ID: 1321637
Sex: F
Age: 77
State: IN

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Penicillin Codeine

Symptom List: Nausea

Symptoms: Fever, chills, achy, exhausted.

Other Meds: Insulin Dexalant

Current Illness:

ID: 1321638
Sex: F
Age: 33
State:

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 05/16/2021
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: Injection site pain

Symptoms: SOB, rapid breathing. tachycardia on examination. Rest, normal to go home.

Other Meds:

Current Illness:

ID: 1321639
Sex: F
Age: 26
State: WA

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

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

Lab Data:

Allergies: Adhesive, mild reaction.

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

Symptoms: Received shot. Saw black dots, pain spread from arm to chest, got up to let the pharmacist know woke up on the floor shaking, head felt like it was bleeding but I didn?t hit me head. Saw black spots and waves of blur in my vision for hours. Meds came decided to observe at home. Did NOT have anxiety. I suffer from anxiety and panic attacks I am well aware of the feelings, coping techniques etc that come with them. Now I have major anxiety that I got a injected with some that may hurt me.

Other Meds: B12, one a day women?s multi vitamin, omega 3, vitamin d, magnesium. Cannabis extract, vaped 4 hrs before.

Current Illness: None

ID: 1321640
Sex: F
Age: 52
State: VA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 05/16/2021
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: Sulfa, morphine

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

Symptoms: Vaccine received at another facility than where patient receives medical treatment It is two months post-vaccine and my vision problems which started same day as vaccine received amd were documented have not alleviated. The nerve pain/tingling in hand has also not gone away. Patient presented with facial, shoulder and hand numbness l, red itchy arm rash and vision problems immediately and within days of receiving vaccine #2 that are fully documented in medical records. Patient volunteers to have FDA review these side effects either through Hospital or through patient who will give consent.

Other Meds: Zocor

Current Illness:

ID: 1321641
Sex: F
Age: 36
State: IL

Vax Date: 05/07/2021
Onset Date: 05/11/2021
Rec V Date: 05/16/2021
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: Cipro and sulfa medications

Symptom List: Tremor

Symptoms: May or may not be related, but I thought it was worth reporting in case there turns out to be a correlation that shortly after receiving my second Pfizer COVID vaccine, o failed a one-hour glucose test given during my 28th week of pregnancy. Other than being older than 30, I have no risk factors for gestational diabetes and am an otherwise healthy adult (good diet and physically fit). Due date is August 3rd. No gestational diabetes with previous pregnancy.

Other Meds: Daily: Pre natal vitamin, 5000 IU D3, 500 mcg B12, Cingulair (for seasonal allergies), Pepcid (twice daily)

Current Illness: None

ID: 1321642
Sex: F
Age: 57
State: FL

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 05/16/2021
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: Tea products containing Hibiscuses or Rose Hip Tai Tea

Symptom List: Erythema, Pruritus

Symptoms: 1 st shot: Swelling in arm/Pain, headache. Tired, Muscle aches. lasted 2 days. (No Fever). 2 nd shot: Swelling in arm/Pain, Extreme Headache, Fever 101.5, Extreme muscle aches, nausea, vomiting. These symptoms lasted 2 days.

Other Meds: Paxil

Current Illness: None

ID: 1321643
Sex: F
Age: 42
State: IN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
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: Body aches, chilling, head fog

Other Meds:

Current Illness:

ID: 1321644
Sex: F
Age: 33
State: IN

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
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: Certain medications

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

Symptoms: Fatigue, headache, chills, and full body soreness

Other Meds: None

Current Illness: Multiple sclerosis

ID: 1321645
Sex: M
Age: 46
State: OR

Vax Date: 04/24/2021
Onset Date: 04/26/2021
Rec V Date: 05/16/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Ear pain, pressure and fullness in both ears, but left side worse. Constant ringing in both ears. Dizziness and nausea. 10 days of antibiotics and Sudafed, 5 days of prednisone, and multiple days of allergy medications have not worked or helped alleviate symptoms.

Other Meds: Nexium

Current Illness: No

ID: 1321646
Sex: F
Age: 38
State: IN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
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: Cats, dogs

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

Symptoms: 39 Weeks and 1 day pregnant, estimated due date May 20, 2021. One previous successful pregnancy. Reaction to first shot, sore arm. Reaction to second shot: Vomiting, fever (99.9), lethargy, throbbing joints, headache, tinnitus, 36 hours of nausea, tiredness, sore arm and sweating.

Other Meds: Prenatal vitamins, Flinstones with Vitamin D

Current Illness: None

ID: 1321647
Sex: M
Age: 46
State: KS

Vax Date: 04/25/2021
Onset Date: 04/28/2021
Rec V Date: 05/16/2021
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: no

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

Symptoms: Symptoms for 4 days...Pt reported rashes that would come and go every 5 to 10 minutes, itching on hands and feet, itching/burning inside lungs, and swelling of jaw.

Other Meds: Mucinex post vaccine

Current Illness: no

ID: 1321648
Sex: M
Age: 25
State: IN

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

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

Lab Data:

Allergies: Penicillin

Symptom List: Pain in extremity

Symptoms: Body aches- occurred around 4:00 pm Chills- occurred around 9:00pm Headache- occurred around 7:00pm Vomiting- occurred at 01:00am the following morning g

Other Meds: Montelukast, xzyal, Tylenol(500mg)

Current Illness: None

ID: 1321649
Sex: F
Age: 33
State: IN

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

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

Lab Data:

Allergies: Lactose

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

Symptoms: Severe arm pain and swelling, arm was hard at the injection site, fever, chills, body aches, headache for more than 24 hours

Other Meds: Birth control

Current Illness: None

ID: 1321650
Sex: M
Age: 33
State: IN

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Chilly, body aches, sensitivity to movement, general feeling of malaise, low grade fever Took ibuprofen and felt much better

Other Meds: Lisinopril Allegra

Current Illness:

ID: 1321651
Sex: F
Age: 38
State: OH

Vax Date: 05/07/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: ?Covid arm? - itchy oval shaped rash at injection site, slightly raised and hot to the touch, slightly painful to the touch

Other Meds: None

Current Illness: None

ID: 1321652
Sex: F
Age: 19
State: IN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/16/2021
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: Penicillin

Symptom List: Vomiting

Symptoms: Nausea, fever, chills, weakness

Other Meds:

Current Illness:

ID: 1321653
Sex: F
Age: 43
State: IN

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/16/2021
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: Nauseous Fever Body aches Headache Constipation

Other Meds: Tylenol after shot

Current Illness: None

ID: 1321654
Sex: M
Age: 13
State: VA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/16/2021
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: Season allergies

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

Symptoms: Although this is not a significant adverse reaction, it seems important that state and CDC advise families that COVID-19 Pfizer vaccine in youth can cause abnormal blood sugars including lows. We did have two days of unusual lows which required we treat with standard 15-15 method. Given that we utilize a CGM, we were able to constantly monitor but I would have been concerned for families that do not have this technology. After noting lows, I contacted multiple peers whom also have T1D children whom have had similar experiences. I clearly believe the benefit outweighs the risk and will have my son complete the series of vaccines but do believe it is important that families are notified to monitor blood glucose levels more frequently post vaccine.

Other Meds: Sertaline Novolog Basaglar

Current Illness: None

ID: 1321655
Sex: F
Age: 29
State: OH

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 05/16/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient said felt throat staring to close and we administered epi-pen 0.3 mg. Patient was transported to hospital, checked out and released later same day.

Other Meds:

Current Illness:

ID: 1321656
Sex: F
Age: 57
State: IN

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

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

Lab Data:

Allergies: Codeine, onions

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

Symptoms: Ravenous hunger on first day, lethargy, nausea and loss of appetite 2nd day, headache for about 36 hours

Other Meds: N/A

Current Illness: N/A

ID: 1321657
Sex: F
Age: 42
State: MN

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/16/2021
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: Morphine: Nausea

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

Symptoms: Bone crushing pain, horrible headache, extreme fatigue, diarrhea, nausea, sweats, chills, fatigue

Other Meds: Citalopram, deuloxotine, breo

Current Illness: Sinus infection

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm