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: 1329935
Sex: M
Age: 27
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1329936
Sex: F
Age: 36
State: MD

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/19/2021
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: Sulfa and ceclor

Symptom List: Anxiety, Dyspnoea

Symptoms: Migraine, fever, sore throat, dizziness, exhaustion, nausea/ vomiting. It has been 14 days since I got my vaccine and all of these symptoms have continued to come and go in waves.

Other Meds: Vitamin c, vitamin d, fish oil, gingko biloba, collagen, folate, biotin, milk thistle, hyaluronic acid

Current Illness: None

ID: 1329937
Sex: M
Age: 20
State:

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 05/19/2021
Hospital: Y

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

Lab Data:

Allergies: n/a

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

Symptoms: Patient with onset of sharp chest pain 1 day after second vaccination. Patient diagnosed with myopericarditis and admitted to the hospital for further evaluation and management. Patient with improved symptoms, but placed on several medications for continued management of inflammation.

Other Meds: Eletriptan PRN

Current Illness: n/a

ID: 1329938
Sex: M
Age: 48
State: NY

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
Hospital:

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

Lab Data:

Allergies: shell fish

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: reported tachycardia and sweating and headache 30 minutes following vaccine, observation time had ended patient stated it came and went quickly but was not observed at facility

Other Meds: beta blocker diabetic medications

Current Illness:

ID: 1329939
Sex: F
Age: 24
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1329940
Sex: F
Age: 46
State: MI

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 05/19/2021
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: Sulfa, Cephalexin & bactrum

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

Symptoms: I?m not sure if it was a rash or hives that started on my left arm and spread all the way across my chest. The lymph node under my left arm was the size of a small golf ball for five days. I had a headache for 12 days.

Other Meds: Melatonin

Current Illness: No

ID: 1329941
Sex: F
Age: 62
State: MD

Vax Date: 05/09/2021
Onset Date: 05/09/2021
Rec V Date: 05/19/2021
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: Pyrexia, White blood cell count decreased

Symptoms: flushing, high fever, persistent myalgias, and extreme pain and fatigue, hypereosinophilia, dysphagia, reflux, migrating pain,

Other Meds: Prilosec 40 mg BID, Carafate 1 gm BID

Current Illness: GERD-reflux

ID: 1329942
Sex: M
Age: 51
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1329943
Sex: M
Age: 59
State: NJ

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/19/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: 1ST Day , severe body aches , tired . 2ND day severe headache , disoriented , could not think clearly and very tired. This headache condition has persisted for the last 7 days. At times it is mild and at other times severe . It makes you on edge ,causes loss of focus and disoriented. I rarely ever get a headache , maybe a handful in my lifetime. As of today 5/19/21 @8:40 AM my headache is painful even after taking 2 Tylenol hours ago. i am still dizzy and disoriented and moody. The headache is focused on my front left side , it feels as if someone is sqeezing my head tightly. Today I may go to clinic . Not sure what they will do except say to stay in bed.

Other Meds: NONE

Current Illness: NONE

ID: 1329944
Sex: M
Age: 51
State: FL

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/19/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: reports having fever and intermittent dyspnea. (father calling for patient)

Other Meds: No medications

Current Illness: Bronchitis

ID: 1329945
Sex: M
Age: 1
State:

Vax Date: 05/10/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Pox rash at injection site

Other Meds:

Current Illness:

ID: 1329946
Sex: F
Age: 15
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Shakiness-Mild

Other Meds:

Current Illness:

ID: 1329948
Sex: F
Age: 76
State: NH

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

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

Lab Data:

Allergies: Celecoxib Dapsone Loop diuretics Sulfonamides / Sulfa Saccharin Tetracyclines Thiazide-type diuretics Tigecycline Triptans

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

Symptoms: 5:15pm: Light headedness and soreness along right forearm down to right hand. 5:30pm: BP 184/110. Pt sitting on ground. Alert and talking/laughing/normal breathing. Was told by EMS to not give pt water/food in case of exacerbation. 5:40pm: EMS arrived 6:30pm: Pt discharged, reported BP down to 140/??

Other Meds: Levothyroxine Lisinopril Hydrochlorothiazide

Current Illness: n/a

ID: 1329949
Sex: F
Age: 32
State: NY

Vax Date: 03/18/2021
Onset Date: 03/25/2021
Rec V Date: 05/19/2021
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: Rash on arm below injection site, warm to touch Tinnitus in left ear persisting for months

Other Meds: Lamictal 200mg lithium 900mg omeprazole 40mg

Current Illness: None

ID: 1329950
Sex: F
Age: 12
State: VA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1329951
Sex: F
Age: 50
State: FL

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: nka

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

Symptoms: pt states she was nauseated and then started getting the severe flu like symptoms. She was achy, her tongue was tingling and numb. She had a sore throat, was light headed, and had a 101 temp. She was having heart palpitations and fast heart rate and felt out of it. On 5/19/21 she is feeling better with a slight head ache. Pt will contact PCP if symptoms do not improve.

Other Meds: Motrin

Current Illness:

ID: 1329952
Sex: M
Age: 43
State: IN

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: No

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

Symptoms: Body & joint aches, fatigue, swollen muscle under right arm pit.

Other Meds: Tresiba, Novolog, Trulicity, Farxiga, Metformin ER, Omeprazole, Astorvastatin, Aleve.

Current Illness: None

ID: 1329953
Sex: F
Age: 63
State: MA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/19/2021
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: The morning after the second Pfizer shot, about 15 after I got up, I suddenly felt very weak and collapsed. I was out for less than a minute but felt very weak afterwards.

Other Meds: None

Current Illness: None

ID: 1329954
Sex: M
Age: 61
State: IN

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe body aches, shakiness, and fever up to 102

Other Meds: N/A

Current Illness: N/A

ID: 1329955
Sex: M
Age: 74
State: TN

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 05/19/2021
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: Swelling in muscle at vaccination site. Pain shooting from muscle down the left arm. Very painful to extend left arm toward back, e.g. to scratch back or to insert arm into sleeve of jacket or shirt, . Also, intermittent pain in the arm at various times of the day, sometimes bad enough to wake me up.

Other Meds: Metformin, Amlodipine, Atorvastatin, Clopidogrel, Losartin Potassium, Fish Oil

Current Illness: None

ID: 1329958
Sex: M
Age: 89
State: VA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1329959
Sex: M
Age: 29
State: FL

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 05/19/2021
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: N/A

Symptom List: Unevaluable event

Symptoms: I received the 1st shot of the pfizer covid vaccine on March 11, 2021. Within 2 days I began to feel extremely fatigued. The days following I experienced night sweats, nausea, extreme fatigue, fever. I went to urgent care with a 102 fever, jaundice, and anemia. Urgent care sent me to the ER. At the ER they admitted me to the hospital. I was in the hospital for 3 days with hemolytic anemia. After a lot of testing and ruling out any infections, they discovered I have a rare blood disorder: hereditary elliptocytosis. The pfizer vaccine created an immune response and since I have this blood disorder I was predisposed to this event occurring from the vaccine (hemolytic anemia/juandice) without knowing it. It was a result of the vaccine. I was told to not get the second shot because there is no guidance, but that I am a high risk individual now. I need medical advice from people who are familiar and know.

Other Meds: Breo Ellipta inhaler, Singulair, Vitamin D

Current Illness: N/A

ID: 1329960
Sex: M
Age: 34
State:

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Penicillin l, sulfa, z pak, shellfish

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

Symptoms: Whole body aches, vomiting, diarrhea,

Other Meds:

Current Illness:

ID: 1329961
Sex: F
Age: 17
State: NH

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Patient is 17.5 years old and received the Moderna Vaccine by outside RN staff during drive up clinic. Mother was contact and followed up.

Other Meds:

Current Illness:

ID: 1329962
Sex: F
Age: 48
State: PA

Vax Date: 05/03/2021
Onset Date: 05/17/2021
Rec V Date: 05/19/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Injection site pain, Menorrhagia

Symptoms: 2 weeks after first shot, "Covid Arm" with redness, itchiness, tenderness, swelling. Called doctor early this morning and the on call doctor called back and told me to apply a warm compress, take benadryl and ibuprofren and go to urgent care if not subsiding by 12 noon.

Other Meds: herbal supplements

Current Illness: none

ID: 1329963
Sex: F
Age: 49
State: FL

Vax Date: 04/23/2021
Onset Date: 05/04/2021
Rec V Date: 05/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt reports that she only experienced fatigue with the 1st dose for a day. With 2nd dose on 5/4/2021 was when her dizzy like symptoms begun, pt described it as vertigo-like symptoms that comes and goes. Pt reports that she'll experience tinnitus first before the dizzy spells comes on. During weekend pt started she had full blown episode of dizziness with nystagmus. Pt reports that the dizziness usually occurs first thing in the morning, and when she takes the Meclizine it helps with the dizzy spells but she'll be in bed all day because she'll get dizzy when she walks. Pt reports she took Meclizine and Dramamine and these provides relief for ~36-42 hours. Pt also reports she stayed pretty hydrated. Pt also reports that 12 hours post her 2nd dose she had experienced chills and ache, she took 1 Advil and 1 Tylenol and slept, when she woke up the next day the chills and ache was gone but felt a little sluggish.

Other Meds: Oxycodone Extended Release 1 tablet BID

Current Illness: Bone Injury

Date Died: 04/21/2021

ID: 1329965
Sex: M
Age: 77
State: PR

Vax Date: 02/19/2021
Onset Date: 04/21/2021
Rec V Date: 05/19/2021
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: Unknown.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Deterioration of condition.

Other Meds: Lovenoz, Benadryl, Bicitra.

Current Illness: Unknown.

ID: 1329966
Sex: M
Age: 38
State: IL

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/19/2021
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: The pain in my arm has been severe since a few hours after the second dose shot. Range of motion is extremely limited. Symptoms are not reduced by extra strength Tylenol. Cold compress provides temporary relief of pain, but not increased range of motion. Pain was less severe at the end of day 4, but has returned to very severe on the morning of day 5. I am unemployed and uninsured so I have not been able to seek medical care.

Other Meds:

Current Illness:

ID: 1329967
Sex: F
Age: 53
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1329968
Sex: M
Age: 43
State: IN

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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

Symptom List: Nausea

Symptoms: Strong injection site muscle pain, low grade fever, whole body joint & muscle aches: Lasted about 16 hours

Other Meds: One a Day Men's multi-vitamin

Current Illness: None

ID: 1329969
Sex: M
Age: 15
State: UT

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hyperventilation-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Shakiness-Mild, Systemic: Tachycardia-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Patient started experiencing numbness, tingling, and hand cramps minutes after receiving his pfizer vaccine. We sat him down in the chair and had him relax. I called EMS shortly after and they arrived quickly. They worked him up and concluded that he was having a panic attack related to being give the vaccine. Patient states that he wasnt anxious about it previous to administration nor did he seem anxious as well. He was calmed down by the EMS personnel and then was able to walk out of the store

Other Meds:

Current Illness:

ID: 1329970
Sex: M
Age: 19
State: NY

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever in excess of 102, violent nausea, multiple nausea events, severe headache and pain.

Other Meds: None

Current Illness: None

ID: 1329972
Sex: F
Age: 13
State: AZ

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 05/19/2021
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:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1329973
Sex: F
Age: 44
State: TX

Vax Date: 04/06/2021
Onset Date: 05/05/2021
Rec V Date: 05/19/2021
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: NOTE: the lot # is not legible. I'm unable to make out the 4th character in 041"A"Z1A. I have had a headache off and on for the last 2 weeks. I usually wake up with it, and have to slowly get out of bed. Last night (5/18/21) it was a little more intense, perhaps due to the storms/atmospheric pressure

Other Meds:

Current Illness:

ID: 1329974
Sex: M
Age: 32
State: MA

Vax Date: 04/23/2021
Onset Date: 05/03/2021
Rec V Date: 05/19/2021
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: N/A

Symptom List: Erythema, Pruritus

Symptoms: Full body rash started ~10 days after the first dosage of the Moderna Vaccine, beginning in the mid section (thighs and lower stomach) on the first day and then spreading to the legs, chest/back and arms over the course of 2 more days. Treatment- appointments with primary care and a dermatologist, Prednisone and Lexette were prescribe to treat the rash. Rash has subsided 95% in the following 7-10 days.

Other Meds: N/A

Current Illness: N/A

ID: 1329975
Sex: F
Age: 62
State: IN

Vax Date: 03/25/2021
Onset Date: 04/22/2021
Rec V Date: 05/19/2021
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: Flagyl Sulfas

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

Symptoms: Guillain Barre Syndrome Right Pulmonary Embolism

Other Meds: Proair Breo Calcium Allegra Prozac Microcode Probiotic Cozaar Singular Protonix

Current Illness:

ID: 1329977
Sex: F
Age: 43
State: VA

Vax Date: 04/19/2021
Onset Date: 05/03/2021
Rec V Date: 05/19/2021
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 known

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

Symptoms: Covid arm appeared 2 weeks after first dose. Raised red, itchy rash around site of injection. Took a few doses of benadryl and rash was gone after a few days

Other Meds: Daily multivitamin

Current Illness: None

ID: 1329978
Sex: M
Age: 27
State: CA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/19/2021
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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Additional Details: First BP reading was 108/49 pulse 45 at 4:08pm and second reading was 122/77 pulse 76. Patient experienced profused sweating, dizziness, and hypotension. After hydrating and laying down he gradually felt better.

Other Meds:

Current Illness:

ID: 1329979
Sex: F
Age: 25
State: IN

Vax Date: 05/12/2021
Onset Date: 05/15/2021
Rec V Date: 05/19/2021
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: N/A

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

Symptoms: A small rash appeared on my arms Saturday afternoon May 15. It spread to my ears and head. On Sunday morning, the rash was gone. By Sunday evening, the rash had reappeared on my arms, stomach, and waistline. Through Sunday night, I developed full body hives, including my head and going down to my ankles. I took Benadryl to help soothe the itching. The rash was still present Monday morning, but faded as the day progressed after taking Allegra and applying hydrocortisone cream. Tuesday morning the full body rash was present again, but disappeared as the day progressed.

Other Meds: Junel Fe, Armour Thyroid, Multi-Vitamin, Calcium

Current Illness: N/A

ID: 1329980
Sex: F
Age: 60
State: OK

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 05/19/2021
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: Raw cotton growing.

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

Symptoms: She got her vaccine, had no reaction. Then two days later she had low grade fevers that do not go back to normal, upset stomach, headaches, sometimes muscle aches, fatigue, sometimes gets out of breath when she's doing something. She is still having these symptoms every day. She has contacted her doctor who said that there was nothing that they can do to continue taking the fever reducers and let it run it's course. It's been 5 weeks right now, and she's not able to do things like go places or see people due to these symptoms.

Other Meds: Tizanidine, Promethazine, Effexor, Lorazepam, Lyrica.

Current Illness: None.

ID: 1329981
Sex: F
Age: 64
State: IN

Vax Date: 01/01/2021
Onset Date: 02/14/2021
Rec V Date: 05/19/2021
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: Pain in extremity

Symptoms: At first none, then tinnitus

Other Meds: none

Current Illness: na

ID: 1329982
Sex: M
Age: 22
State: MD

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Confusion-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Additional Details: Patient said he was not feeling well. When I responded to him he said he did not feel good. I told him to put his head between his knees, but before he could do it, he became non-responsive. He remained seated as I shook him gently asking if he was ok, his eyes were open. When he became responsive, he said he must have fallen asleep. He said he felt nauseated. He was sweating. We called 911. The paramedics came and checked vital signs. His BP was 110/68, blood glucose was 107.Pt left on his own.

Other Meds:

Current Illness:

ID: 1329983
Sex: F
Age: 53
State: MA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 05/19/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin

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

Symptoms: Was very fatigued and nauseated and became hyperglycemic. At 3:00AM Tandem insulin pump alarmed that is was no longer working and needed to be replaced. Called company or replacement and switched to injected insulin and old insulin pump in AM

Other Meds: insulin, levothyroxine, estrogen, lisinopril, vitamin D,aubagio, pravachol

Current Illness: no

ID: 1329984
Sex: F
Age: 49
State: IN

Vax Date: 05/16/2021
Onset Date: 05/17/2021
Rec V Date: 05/19/2021
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: Fever 101.2 for 2 days, severe headache, pain at base of my neck. Injection site is swollen almost 3 inches in diameter with blisters in the middle, its bright red, hard and itches. Spoke to a nurse practitioner who said it was an allergic reaction to injection and called it "Covid Arm"

Other Meds: None

Current Illness: None

ID: 1329985
Sex: M
Age: 36
State: PA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/19/2021
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: Patient anxious complained of arm pain with injection and approximately 3 minutes later patient had loss of consciousness for approximately 2 minutes. BP low normal 108/60. Patient pale, diaphoretic and cool to touch, Patient assisted to stretcher and on monitor and found to be bradycardic HR as low as 38 . CODE team arrived and within 5 minutes patient back to baseline

Other Meds: clondine, adderal, duloxetine

Current Illness: none

ID: 1329986
Sex: M
Age: 53
State: GA

Vax Date: 05/14/2021
Onset Date: 05/16/2021
Rec V Date: 05/19/2021
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: Posterior vitreous detachment in the left eye resulting in a vitreous hemorrhage. Examination showed bleeding near the optic nerve with no retina damage. Treatment is a follow-up in 3 weeks to monitor the retina and no heavy lifting or gym for 2 weeks. There is a large blood swirl/floater in the left eye.

Other Meds: Testosterone, tadalafil, anastrozole fish oil, vitamin d3, k, c, b6, curcumin, zinc

Current Illness: N/A

ID: 1329987
Sex: F
Age: 59
State: VA

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Nonel

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

Symptoms: Hot , itchy rash on DAY 2!!.....in addition to flu symptoms with major headaches

Other Meds: Hydro of one , aleve

Current Illness:

ID: 1329988
Sex: F
Age: 21
State: FL

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Medium, Additional Details: patient fainted and vomiting after receiving vaccine, ambulance was called patient was evaluated and vitals were within normal limits. Patient was contacted 6 hours after event and stated she was feeling much better. patient was observed after vaccine for 1 hour

Other Meds:

Current Illness:

ID: 1329989
Sex: M
Age: 55
State: VA

Vax Date: 04/09/2021
Onset Date: 04/15/2021
Rec V Date: 05/19/2021
Hospital:

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

Lab Data:

Allergies: Allergic to many perfumes in products. Grass and tree pollen.

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

Symptoms: Long term painful arm, then a crazy fluctuating fever with headache and chills for 5 days 3 weeks after shot, followed by congestion, coughing and then a growing red rash patch at sight of injection. Now 5 weeks later, hives all over my body including rash at injection site. Becoming itchier daily, not responding to antihistamines.

Other Meds: Alavert

Current Illness: None. Seasonal allergies

ID: 1329990
Sex: M
Age: 34
State: IN

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/19/2021
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: NA

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

Symptoms: Cold sweats; low-grade fever; exhausted; lack of appetite; injection site pain; low-grade headache.

Other Meds: NA

Current Illness: NA

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm