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: 1324037
Sex: M
Age: 49
State:

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/17/2021
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: Unsure of reaction related to vaccination. Pt experienced nausea/vomiting 24 hours following vaccination with Janssen c-19 vaccine. Pt reports "food poisoning" when presenting to clinic >24 hr after receiving covid vaccine.

Other Meds:

Current Illness:

ID: 1324038
Sex: F
Age: 27
State: TX

Vax Date: 05/05/2021
Onset Date: 05/13/2021
Rec V Date: 05/17/2021
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: n/a

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient complained of nausea/vomitting, redness,tenderness, swelling at the injection site, fatique on day 8th after first dose of her covid vaccine. Recommended patient to continue hydrating, may take otc antiemetic. On day 12th, patient stated that her symptoms subsided, she feels much better now.

Other Meds: montelukast

Current Illness: n/a

ID: 1324040
Sex: M
Age: 33
State: MS

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/17/2021
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: Nexium and Phenergan

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

Symptoms: C/O feeling dizzy, pale, and cool clammy to touch. BP 110/78, P 60 and thready, resp 12 denies SOB or swallowing problems. EM serv notified and arrived @ site to assess.

Other Meds: Crestor, BP med

Current Illness: 0

ID: 1324041
Sex: M
Age: 61
State: TX

Vax Date: 01/20/2021
Onset Date: 05/03/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Tinnitus; ringing in the ears

Other Meds: COQ-10, baby aspirin, atorvastatin,

Current Illness: N/A

ID: 1324042
Sex: F
Age: 17
State: CA

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: Pollen

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

Symptoms: 5 minutes after receiving covid vaccine shot felt itchiness on injection site, left arm. 5 minutes later felt itchiness on right shoulder and arm. Monitored VS. Pt's mother & doctor at the bedside. 25 mg PO Benadryl given. pt discharged home per MD's order.

Other Meds: Zyrtec at home. Benadryl at injection clinic

Current Illness: n/a

ID: 1324043
Sex: F
Age: 36
State:

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/17/2021
Hospital: Y

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Employee had a seizure about an hour post vaccination. EMS was called and employee was transported to ER.

Other Meds:

Current Illness:

ID: 1324044
Sex: F
Age: 84
State: MN

Vax Date: 03/11/2021
Onset Date: 03/25/2021
Rec V Date: 05/17/2021
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: Patient presented to the ED on 3/25/2021. He presented to the ED again on 4/18/21 and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1324045
Sex: F
Age: 20
State: FL

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: no allergies

Symptom List: Pharyngeal swelling

Symptoms: patient fainted. smelling salts used, cold pack to neck area and pt put in lying position with feet up

Other Meds: unknown

Current Illness: none

ID: 1324046
Sex: M
Age: 24
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient's mom called at pharmacy on 5/17/21 to report patient experienced side effects like muscle aches, headache, 101.8 fever at night on 5/15/21, spine and teeth ache and injection site was elevated and hot to touch. Mom said patient felt better after taking Tylenol and most side effects have subsided, but she just wanted to report about side effects. Patient feels much better today (5/17/21) so mom said they are not planning to make doctor visit.

Other Meds:

Current Illness:

ID: 1324047
Sex: F
Age: 13
State: NY

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

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pharmacist gave my daughter all six doses. She used an undiluted bottle and shot her full of it. She has fever chills aches headaches green poop nausea

Other Meds: None

Current Illness:

ID: 1324048
Sex: F
Age: 31
State: CA

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: Peanuts, tree nuts, latex

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

Symptoms: Nauseas and knee numbness at the side after approximately 20 minutes. At the moment of trying to get up like bump on my head and huge headache like number 10 and dizziness.

Other Meds: None

Current Illness: None

ID: 1324049
Sex: F
Age: 49
State: NJ

Vax Date: 01/19/2021
Onset Date: 02/08/2021
Rec V Date: 05/17/2021
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: CT iodine contrast

Symptom List: Rash, Urticaria

Symptoms: I developed shortness of breath with exertion several weeks after the Moderna vaccine around February 8th. The shortness of breath became worse around the first week of April and I went to Non-urgent clinic on 4/4/21. Was given albuterol and recommended f/u with pulmonary specialist I also have had left-sided chest pain started around 4/20-4/21. I went to non-urgent clinic on 4/30/21 and chest pain felt to be costochondritis. Was recommended f/u with cardiology on routine basis.. I have not diagnosis yet. I am being followed by cardiologist and pulmonologist. I am reporting these symptoms because they started about 3 weeks-1 months after my first Moderna vaccine. I do not know if the Moderna vaccine caused these symptoms I am just stating it may be a possiblity.

Other Meds: 1)Lithium Carbonate 600 mg twice a day 2)Prozac 20 mg daily 3)Topiramate 50 mg twice a day 4)Multivitamin one daily 5)Magnesium Oxide 250 mg daily 6)Vitamin D3 1000 IU twice daily 7)Cetirizine 10 mg daily 8)Fluticasone 1-2 sprays each nost

Current Illness:

ID: 1324050
Sex: M
Age: 24
State: IN

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/17/2021
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: Fever, chills, and headache. Chills (which likely included a fever) the night of the 11th. Had a slight fever all day on the 12th with a slight headache. Took Acetominaphen to help.

Other Meds: Ostrophin Spanish Black Radish Fever Few Desiccated Spleen RNA

Current Illness: Covid-19 - two weeks prior

ID: 1324051
Sex: F
Age: 35
State: CA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 05/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: The evening after the shot I had chills and aches. This subsided after 24 hours. In the last two months since the shot, I have had a series of symptoms I?ve never had before including increased heart rate / heart palpitations, easily winded, I have a deep ache in my right arm where I got the shot feels almost in my bone, and I experience chills off and on every few days.

Other Meds: None

Current Illness: None

ID: 1324052
Sex: F
Age: 61
State: MI

Vax Date: 05/11/2021
Onset Date: 05/13/2021
Rec V Date: 05/17/2021
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: corticosteriods

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

Symptoms: patient stated on her survey that she experienced brain fog, loss of memory and hard to concentrate.

Other Meds: COQ10, Vitamin D-3, Synthroid, Lisinopril, Effexor, hydrochlorothiazide, KLOR-CON, Lipitor,

Current Illness: ED visit on 4/22/21 for vertigo, fatigue and malaise. Sees Physical Therapy for vertigo

ID: 1324053
Sex: F
Age: 33
State: KS

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
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: Adhesive, Codeine, Latex, Sulfa Drugs

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

Symptoms: Numbness and tingling in face, tongue, and hands. Fatigue. Pre-syncope.

Other Meds: Zoloft 225 mg daily, Vistaril 10 mg HS, Breo Ellipta 100 mcg-25 mcg/inh daily, Advair Diskus 250 mcg-50 mcg BID, Fluoxetine 20 mg daily, Wellbutrin XL 150 mg daily, Albuterol 90 mcg/inh PRN

Current Illness: None

ID: 1324054
Sex: M
Age: 61
State: NY

Vax Date: 01/27/2021
Onset Date: 02/11/2021
Rec V Date: 05/17/2021
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: I was working at my desk seeing patients via telehealth and had the sudden onset of extreme sweating, felt odd/dissociated. BP and P were normal sitting and standing. No other associated symptoms. I cancelled the rest of my day. Took about 3-4 hours to feel normal again. No recurrence.

Other Meds: Nexium, Levothyroxine, Liptor, Vit E, D, probiotic, Pentoxifylline

Current Illness: None

ID: 1324055
Sex: F
Age: 67
State: IA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I received a shingle shot on January 27, 2021 at a pharmacy. The shot was given in my upper left arm. Ever since that day my left arm muscle has caused me extreme pain. Sometimes it is fine but most of the time it is painful.

Other Meds: None

Current Illness: None

ID: 1324056
Sex: F
Age: 56
State: NH

Vax Date: 04/26/2021
Onset Date: 05/05/2021
Rec V Date: 05/17/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin- Hives

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Generalized Rash

Other Meds: none

Current Illness: none

ID: 1324057
Sex: M
Age: 19
State: CA

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
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: Patient was nervous before receiving the vaccine. During the 15min post vaccination period, patient started getting dizzy and looked like he was about to faint so the pharmacy staff ran out to observe his blood pressure and any signs of anaphylaxis. Blood pressure and breathing were normal. Patient was given water and the ambulance was called. They also monitored his blood pressure/breathing. After 20 minutes, patient was normal and was able to leave with his parent.

Other Meds: NONE

Current Illness: NONE

ID: 1324058
Sex: M
Age: 55
State: CA

Vax Date: 03/15/2021
Onset Date: 03/28/2021
Rec V Date: 05/17/2021
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:

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

Symptoms: On March 28th, started noticing symptoms. There was pain in my entire right leg, shin swelling; calf- swelling and skin discoloration; and right foot - swelling. On 4/1, I went to Urgent Care where I was seen, evaluated and treated by Dr. She ordered blood tests and an ultrasound within 20 minutes. I had 4 blood clots in 3 veins in my right leg/DVT. My blood platelet value was 267 and the standard range is 130 to 400. They didn't consider it low, but it's still an issue. I was given an injection of Enoxaparin Sodium Injection--1 ml injection twice a day for 5 days, which was started in the ER. I then switched to Pradaxa 150mg pill twice a day. I took that until around the 6th of this month when I noticed my right leg had gotten worse. I was instructed to go back to the urgent care. Another ultrasound was ordered and it showed I still had the 4 blood clots in 3 veins that seems to have worsened, so the meds were not working. He consulted with a vascular surgeon and they put me back on the injection once a day, which I am currently still on. I was told to follow up with my PCP in two weeks and that appt is on Thursday with Dr.

Other Meds: BP meds

Current Illness:

ID: 1324059
Sex: F
Age: 43
State: CA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 05/17/2021
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 reported

Symptom List: Unevaluable event

Symptoms: On 04-07-2021- I experienced a lump on my neck and developed pain to both of my shoulders. I went to the ER where x-rays and lab work was done. X-rays showed that my lymphatic glands inflamed. I also experienced a cramps from my neck that radiated upwards to the base of my head. My pain was so intense that I took OTC Tylenol to help with my pain. I went again to the ER eight days later because I was having pain to my heart, chest, neck and shoulders and x-rays again demonstrated lymphatic glands inflamed and was told to take Ibuprofen for pain. To this day I continue to have pain to my shoulders, neck and head but the pain is not as intense as before although the pain is still present daily. I can not work my full 8 hours of work due to my symptoms and can not over-exert myself in performing my daily tasks at work.

Other Meds: None reported

Current Illness: None reported

ID: 1324060
Sex: F
Age: 43
State: OR

Vax Date: 04/18/2021
Onset Date: 04/28/2021
Rec V Date: 05/17/2021
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: my period came a week early and I bleed like I was a teenager. VERY unusual.

Other Meds: birth control pill, calcium/mag/zinc/vitD, and kelp powder

Current Illness: none

ID: 1324061
Sex: F
Age: 32
State: NY

Vax Date: 05/15/2021
Onset Date: 05/16/2021
Rec V Date: 05/17/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Severe chest and back pains, abdominal pains that last for about 2 hours. Any physical movement caused severe pain. Pain levels severe enough to cause nausea and vomiting. Combination of ice pack and complete stillness finally alleviated symptoms. Any attempt to move after caused resurgence of pain.

Other Meds: methimazole 5mg

Current Illness:

ID: 1324062
Sex: F
Age: 23
State:

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: Vancomycin Compazine Caffeine Tree nuts Seeds

Symptom List: Injection site pain, Menorrhagia

Symptoms: I felt dizzy so I grabbed the edge of the bathroom counter, the next thing I knew I was on the bathroom floor and couldn't move. My mom said I was out for 1-2 minutes before she found me. I have never fainted before ever. This only happened once. But the following week my heart rate when standing would reach 130-145 bpm. The following weekend I experienced a longer than normal menstrual cycle with heavier bleeding than normal, even while I was still on my birth control.

Other Meds: Xulane Tylenol Naproxen

Current Illness:

ID: 1324063
Sex: M
Age: 57
State: OH

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/17/2021
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: denies

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

Symptoms: Patient completed CDC prevaccination checklist prior to immunization on 05/13/2021 indicating he had received no previous vaccines. Upon data entry in to state registry it was noted patient had previously received moderna vaccination 04/24/2021. No adverse reactions reported.

Other Meds:

Current Illness:

ID: 1324064
Sex: M
Age: 17
State: NJ

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/17/2021
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: Hives started 27 hours after on neck and spread over the entire body by the next morning. Hives were raised and red plus they itched.

Other Meds: none

Current Illness: none

ID: 1324065
Sex: F
Age: 16
State: TN

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 05/17/2021
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: 16 YRO Pt was administered Moderna vaccine approved for 18 >=YRO. Pt . Tolerated well. No adverse reaction noted. Pt. Returned for second dose on 05/12/2021 but was not administed the dose. Risk management is reviewing.

Other Meds:

Current Illness:

ID: 1324066
Sex: F
Age: 31
State: AZ

Vax Date: 04/20/2021
Onset Date: 04/25/2021
Rec V Date: 05/17/2021
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: Actemra

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

Symptoms: Shingles

Other Meds: Methotrexate, Xeljanz, hydroClorothiazide, folic acid, fenofibrate, promethazine, prednisone, omeprazole, norethindrone

Current Illness:

ID: 1324067
Sex: M
Age: 67
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Vaccine was administered with too little diluent.

Other Meds:

Current Illness:

ID: 1324068
Sex: M
Age: 80
State: CA

Vax Date: 02/27/2021
Onset Date: 03/01/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: Mild allergy to nuts (runny nose, sneezing)

Symptom List: Injection site pain

Symptoms: Mild rash with occasional itching on the forearms. No change since the shots (nearly three months ago). [This is not a serious problem. I am reporting it only because somebody said that you want to keep track of all side-effects, no matter how small.]

Other Meds: Lamotrigine, propranolol, Prozac

Current Illness: None

ID: 1324069
Sex: F
Age: 44
State: PR

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/17/2021
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 VK, Erythromicin, Cefzil

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

Symptoms: Patient came 05/17/2021 to the Pharmacy and reported the arm at vaccination site was swollen , hot, red and itchy. She said a nurse told her to visit an MD to be evaluated. She said she used the cold compresses and just had a little improvement but the area of redness was growing. She came to the Pharmacy to have the event reported

Other Meds:

Current Illness:

ID: 1324070
Sex: M
Age: 13
State: MI

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
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: Patient became very pale eyes rolled behind head and was unable to keep head up. Fainted for a few seconds before waking up again.

Other Meds: unknown

Current Illness: none

ID: 1324071
Sex: F
Age: 40
State:

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/17/2021
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: Throat itchiness from previous COVID Vaccine Dose

Symptom List: Tremor

Symptoms: Pt complains of itchy throat post vaccination. Itchiness is the same as prior COVID vaccine dose (did not require rescue medication). BP 125/71, HR 71, RR 18. Itchiness resolved, patient stable and released from the vaccination site.

Other Meds:

Current Illness:

ID: 1324072
Sex: M
Age: 61
State: TN

Vax Date: 03/30/2021
Onset Date: 04/06/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Itchy rash all over body. The Doctor said that it is psoriasis, which I didn?t have prior to the vaccine.

Other Meds: Prograf, Amlodipine Besylat, Rosuvastatin, Baby aspirin, Ursodiol, Valsartan, Repaglinide, vitamin D2, Alendronate Sodium, & Isosorbide

Current Illness:

ID: 1324073
Sex: F
Age: 52
State:

Vax Date: 05/14/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
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: rash - right knee - not hives

Other Meds:

Current Illness:

ID: 1324074
Sex: F
Age: 51
State: CA

Vax Date: 03/14/2021
Onset Date: 03/31/2021
Rec V Date: 05/17/2021
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: Zero

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

Symptoms: Loss of vision left eye

Other Meds: Zero

Current Illness: Zerp

ID: 1324075
Sex: F
Age: 14
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
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: Vaccine mixed with too little diluent

Other Meds:

Current Illness:

ID: 1324076
Sex: F
Age: 45
State: CA

Vax Date: 05/13/2021
Onset Date: 05/16/2021
Rec V Date: 05/17/2021
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:

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

Symptoms: This is not an adverse event report, but a vaccine administration error. Patient received first dose Moderna COVID vaccine 4/9 at other location, and was given Pfizer COVID vaccine as her second dose on 5/13 at Pharmacy. On the consent form, both Moderna and Pfizer were marked as first dose and the agency pharmacist couldn't recall the situation. We finally reach the patient on 5/16 and clarified her first dose was Moderna. Patient stated she felt tired after she received the vaccine, and while on the phone she stated she's feeling fine with a little sore arm. Pharmacist informed her per CDC, she doesn't need another COVID shot.

Other Meds:

Current Illness:

ID: 1324077
Sex: M
Age: 82
State: WI

Vax Date: 03/17/2021
Onset Date: 04/18/2021
Rec V Date: 05/17/2021
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:

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

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

Other Meds:

Current Illness:

ID: 1324078
Sex: F
Age: 15
State: IL

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Patient (15 yo) was given Moderna vaccine which is only approved for 18+ yo.

Other Meds: None

Current Illness: None

ID: 1324079
Sex: M
Age: 71
State: CA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Immediately after entering the 15 minute waiting room I experienced a nerve like sensation going from my left side of neck to the left ear. I have been experiencing severe tinnitus since then along with intermittent hearing loss and muffling.

Other Meds: none

Current Illness: none

ID: 1324080
Sex: M
Age: 16
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/17/2021
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: n/a

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

Symptoms: about 5 minutes after administration pt fainted. pt was in the company of his mother who stated pt quickly regained consciousness. we offered to call the paramedics pt's mother refused reassuring us her son was fine. several hours later we tried contacting pt at the phone number listed on their file but could not reach the pt and could not leave a message

Other Meds: n/a

Current Illness: n/a

ID: 1324081
Sex: F
Age: 11
State: MI

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/17/2021
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: Patient's guardian stated that patient's birthdate , but when billing insurance we found that the birthday was actually, meaning the patient was 11 at time of vaccination. We called the guardian and they confirmed that they lied about the birthday.

Other Meds: None

Current Illness: None

ID: 1324082
Sex: F
Age: 21
State: PA

Vax Date: 05/15/2021
Onset Date: 05/16/2021
Rec V Date: 05/17/2021
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: n/a

Symptom List: Vomiting

Symptoms: redness, swelling, pain, hot to touch

Other Meds: ammoxicillan, nuva ring, ofloxacin

Current Illness: n/a

ID: 1324083
Sex: M
Age: 31
State:

Vax Date: 04/21/2021
Onset Date: 04/25/2021
Rec V Date: 05/17/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Woke up in the middle of the night from sharp chest pain in center of chest, lasted approx. 2-3 seconds, dissipated for 10-15 seconds, then another 2-3 seconds sharp pain.

Other Meds:

Current Illness:

ID: 1324084
Sex: M
Age: 63
State: WA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/17/2021
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: Lisinopril, Fish, Seafood

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

Symptoms: Per resident he received the Pfizer vaccine in Jan or feb. of 2021. This information was noted after receiving the Janssen vaccine. No adverse effects have been noted.

Other Meds: traZODone HCl Tablet 50 MG, Furosemide Tablet 40 MG, Simvastatin Tablet 10 MG, Insulin Lispro Solution 100 UNIT/ML, Pantoprazole Sodium Tablet Delayed Release 40 MG, Ferrous Sulfate Tablet 325 (65 Fe) MG, Tamsulosin HCl Capsule 0.4 MG, Api

Current Illness: CVA, malignancy of breast, DM2, morbid obesity, depression, anxiety, heart failure, anemia, insomnia, HTN, hyperlipidemia, presence of pacemaker, BPH

ID: 1324085
Sex: F
Age: 40
State: TX

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/17/2021
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: Ceclore and Menacyclin (hives), Adhesive (rash)

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme fatigue, dizziness, and sore arm within 6 hours of receiving shot. Started feeling feverish a couple of hours later. Sweated off fevers continuously for the next 2-1/2 days. Headaches came and went during this time. Took Aleve every 4 hours until this all stopped.

Other Meds: Escitalopram 20mg, Bupropion 75mg, Propranolol 60mg ER

Current Illness: N/A

ID: 1324086
Sex: M
Age: 52
State: CA

Vax Date: 03/24/2021
Onset Date: 04/14/2021
Rec V Date: 05/17/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Sudden onset right cranial nerve 4 palsy with binocular diagnonal diplopia.

Other Meds: Vitamin D, Centrum multivitamin

Current Illness: Guillan Barre (onset 2005)

ID: 1324087
Sex: F
Age: 55
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 05/17/2021
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: 103.9 Fever, severe body aches, shortness of breath, migraine, extreme fatigue, diarrhea, lethargic and I had vomiting on the 5th day after vaccine was given. Basically all the symptoms I had when I had Covid 19 in late December and was sick for over 3 weeks.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm