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: 1333776
Sex: M
Age: 17
State: RI

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/20/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt experienced an unwitnessed syncopal episode after first dose of Pfizer vaccine. After regaining consciousness pt produced small amount of emesis. Vitals were all within normal limits. Pt refused transport AMA.

Other Meds: fluoxetine claritin

Current Illness:

ID: 1333777
Sex: M
Age: 18
State: IL

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/20/2021
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: NONE REPORTED

Symptom List: Anxiety, Dyspnoea

Symptoms: PATIENT FAINTED IMMEDIATELY FOLLOWING THE VACCINE ADMINISTRATION. LAID PATIENT FLAT ON THE FLOOR, PUT HIS FEET UP AND PATIENT WAS OK WITHIN 30 SECONDS.

Other Meds: NONE

Current Illness: NONE REPORTED

ID: 1333778
Sex: F
Age: 33
State: CO

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/20/2021
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: None

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

Symptoms: I received my second dose of the Covid vaccine on the morning of April 8. Starting in the afternoon I began experiencing extreme arm pain, which improved after 2 days, but did not subside. 8 days later (over a weekend) I reported to my Dr that I was experiencing worsening arm / shoulder pain - it subsided slightly with ibuprofen, but has not gone away. As of today (5/20/21) I am still experiencing some real moderate pain in / around my shoulder joint that is affecting range of motion, and does not seem to be improving over time - ibuprofen helps but doesn't eliminate it.

Other Meds: Lamotrigine 200mg Adderall XR 10mg Nuvaring Methimazole 10mg

Current Illness: None

ID: 1333779
Sex: M
Age: 17
State: CT

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Recipient was 17yo when he received the first dose of COVID-19 Vaccine - Moderna.

Other Meds: unknown

Current Illness: unknown

ID: 1333780
Sex: M
Age: 64
State:

Vax Date: 03/06/2021
Onset Date: 04/19/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient positive for COVID-19 on 04/19/21 after completing vaccination.

Other Meds:

Current Illness:

ID: 1333781
Sex: M
Age: 53
State:

Vax Date: 04/02/2021
Onset Date: 04/11/2021
Rec V Date: 05/20/2021
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:

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

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1333782
Sex: F
Age: 33
State: TX

Vax Date: 04/13/2021
Onset Date: 05/18/2021
Rec V Date: 05/20/2021
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: Extreme depression after vaccine Delayed period, spotty dark blood, very large blood clots and heavy cramping for over 3 days

Other Meds: Ambien Clonazepam Dim B12

Current Illness: None

ID: 1333783
Sex: M
Age: 30
State: AZ

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/20/2021
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: First COVID vaccine 5/4/21, moderna. Had SE and pharmacist recommend doc recommendation for 2nd vaccine. Day of vaccine felt fine. Next morning 5/5/21 had headache. At 11am took nap and was having an episode almost like "sleep paralysis" where he would wake up feeling like he couldn't move and gasping for air. He reports he did this sleeping and waking for about 1 hour (he had no problems sleeping the night before.) He woke up after an hour and had vomited in his sleep - he thinks he choked a bit on it. But when he woke up his breathing was normal, movement normal. He then only experienced fatigue and headache for the rest of the day. Then by next day felt totally normal.

Other Meds:

Current Illness:

ID: 1333784
Sex: M
Age: 22
State: MN

Vax Date: 01/20/2021
Onset Date: 05/07/2021
Rec V Date: 05/20/2021
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 received the 2nd dose of the COVID19 Pfizer vaccine on 1/20/21. Patient reports a high risk community exposure to 2 COVID positive household members starting 5/5/21. Patient reports COVID like symptoms starting 5/7/21 and tested with a COVID PCR NP swab on 5/10/21, testing COVID positive.

Other Meds:

Current Illness:

ID: 1333785
Sex: F
Age: 33
State: WI

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/20/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient had swelling and tingling in lips and teeth. Unable to have normal bowel movement since vaccine. Cycle problems since administration. Patient reports being extremely tired for 5+ days. Unable to perform mcommon physical activities. Patient reports increased inhaler usage needed since vaccine. Patient used Benadryl for approximately 24 hours to resolve the swelling and tingling issues

Other Meds: unknown

Current Illness: none

ID: 1333786
Sex: F
Age: 53
State: TX

Vax Date: 05/12/2021
Onset Date: 05/14/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: ?After 1st day and a half was fine; then went down hill from there could not think clear.? Sunday felt like I had fever and did not take temperature could not get out of bed. On Monday went to work out ?Tired? and ?Chest tightness? and called husband. ?Hx of heart murmur? Called cardiologist yesterday; Dr., appointment scheduled tomorrow 05.19.21. She continues with headache, tired and nose running

Other Meds: Unknown

Current Illness: Apparent prior adverse drug rxn 1st COVID injection 04.07.21 with "Throat Tightening".

ID: 1333787
Sex: F
Age: 72
State: MD

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 05/20/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: At first I just had a sore arm, but then the sore arm did not go away. It got worse. The injection site was still hurting, then my shoulder and upper arm to the point where I had a hard time moving it. I thought this was just temporary so I had not gone to the doctor. I sent an email to their office about it and they replied that it would be just temporary . I cannot lift thinks with my left arm without it hurting. It still is sore at the injections site. I have trouble reaching behind me or stretching up or back. I keep thinking it is going to go away, but it hasn't.

Other Meds: Lisinopril, Atorvastatin

Current Illness: none

ID: 1333788
Sex: F
Age: 56
State:

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/20/2021
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: Patient coughing and wheezing. Epi pen x1 administered and simple face mask at 10 LPM applied and transported to ER.

Other Meds:

Current Illness:

ID: 1333789
Sex: F
Age: 87
State:

Vax Date: 03/09/2021
Onset Date: 04/02/2021
Rec V Date: 05/20/2021
Hospital: Y

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:

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

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1333790
Sex: F
Age: 64
State: MI

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient called to report that she had left arm pain post vaccination that she attributed to normal/expected injection discomfort "but worse" states it lasted until her second dose was due and given on 4/9/3021 . States she noted the placement of the injection was lower on her arm the second time , receiving it in the right arm for the second dose. States she saw her provider the week of 4/9 who prescribed pain meds and steroids which did not resolve her discomfort. She started physical therapy and states that is helping a little but that she still cannot sleep in her bed comfortably due to arm pain.

Other Meds:

Current Illness:

ID: 1333791
Sex: F
Age: 59
State: GA

Vax Date: 03/11/2021
Onset Date: 04/01/2021
Rec V Date: 05/20/2021
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: I have no allergies.

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

Symptoms: I woke up with a sore throat and congestion and as the days went by it became progressively worse. I also experienced sneezing, headaches and after Sunday I was so sick I could not get out of bed. I felt like I had zero energy. I felt very lethargic with terrible headaches. I have never felt this way before. I went to the Emergency Room and I tested positive for COVID-19. I tested negative in February and I was negative for antibodies.

Other Meds: I was taking Levothyroxine, Novalog 10 units with every meal, Tresiba 38 units first thing in the morning, daily and Trulicity.

Current Illness: I did not have any other illnesses.

ID: 1333792
Sex: F
Age: 62
State: CO

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/20/2021
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: guaifenesin-sodium citrate

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

Symptoms: Pzifer contacted, vaccine dilution error. Patient contacted had not adverse event at the time of reporting.

Other Meds: atorvastatin Benadryl cream benazepril CO-enzyme q-10 cyclobenzaprine fluoxetine Humalog Kwik-pen hydroxyzine Lantus SoloStar zetia

Current Illness: Unknown

ID: 1333793
Sex: F
Age: 61
State: FL

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient received vaccine and has had a red rash around the area starting the day after the vaccine. She said it has been itchy and hot to the touch.

Other Meds:

Current Illness:

ID: 1333794
Sex: F
Age: 14
State: NC

Vax Date: 05/14/2021
Onset Date: 05/17/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: Gluten

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Nausea and vomiting, onset 3 days after dose and lasting 48 hours.

Other Meds: None

Current Illness: None

ID: 1333795
Sex: F
Age: 85
State:

Vax Date: 02/26/2021
Onset Date: 03/09/2021
Rec V Date: 05/20/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1333796
Sex: F
Age: 81
State: WA

Vax Date: 04/22/2021
Onset Date: 04/27/2021
Rec V Date: 05/20/2021
Hospital: Y

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: Reported prior reaction to flu shot

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

Symptoms: Presented on 4/27/21 (5 days after 2nd dose of Pfizer COVID vaccine) with acute onset of chest pain around 7am the same morning. Testing ultimately confirmed the diagnosis of acute pericarditis.

Other Meds: Armour Thyroid

Current Illness:

ID: 1333797
Sex: F
Age: 46
State:

Vax Date: 03/31/2021
Onset Date: 04/23/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Patient positive for COVID-19 on 04/23/21 after completing vaccination. She had nonproductive cough, shortness of breath, and fevers.

Other Meds:

Current Illness:

ID: 1333798
Sex: M
Age: 17
State: IN

Vax Date: 04/23/2021
Onset Date: 04/26/2021
Rec V Date: 05/20/2021
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

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

Symptoms: First 48 hours was fever, chills, headache and fatigue, what we expected. Then the symptoms continued off and on for the next 3 weeks. Headache everyday, fever up and down between 99.3 to 100.7 and chills randomly with fatigue constantly for the next 3 weeks. He is in week 4 and the symptoms are starting to diminish. No more headaches, some fatigue and some chills randomly.

Other Meds: None

Current Illness: None

ID: 1333799
Sex: F
Age: 27
State: MA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/20/2021
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: Vomiting at 2am Nausea, chills, fever More vomiting over the course of the day (vomited about 7 times from hours 12 to 36), couldn't keep liquids down. Caused resurgence of recurring stomach acid issues.

Other Meds: Zyrtec Melatonin Vitamin D Yasmin 28

Current Illness:

ID: 1333800
Sex: M
Age: 42
State: CA

Vax Date: 04/02/2021
Onset Date: 04/06/2021
Rec V Date: 05/20/2021
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 reported

Symptom List: Injection site pain, Menorrhagia

Symptoms: I experienced three days later bilateral leg pain, left greater than right., I also had headaches that were constant. I went to urgent care where they did exams. I can say that to this day I still have leg pain, L>R and some headaches that come and go.

Other Meds: None reported

Current Illness: None reported

ID: 1333801
Sex: F
Age: 44
State: MA

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/20/2021
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: Clindamycin Penicillin Sulfa

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

Symptoms: Patient received 1st dose Moderna Lot#040B21A on 4/19/21 in left deltoid. No adverse reaction reported by the patient. On 5/17/21, patient was due to receive Moderna 2nd dose. Pt in error received Pfizer vaccine (lot #EW0158) instead of Moderna dose. On 5/17/21 around 4pm, patient reports that she started with red swollen itchy lips, headache, and nausea

Other Meds: Amlodipine 15mg daily

Current Illness: n/a

ID: 1333802
Sex: M
Age: 12
State: MN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/20/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Syncopal episode - fell and hit his head on door No loss of consciousness Patient was possibly dehydrated or had low blood sugar, states that he had not eaten since 11:00am and had been playing golf all day until he arrived at clinic at 5:30 pm. Patient's father was present and took him home after evaluation by medical staff and sign off by medical director.

Other Meds: N/A

Current Illness: N/A

ID: 1333803
Sex: F
Age: 59
State: MI

Vax Date: 02/09/2021
Onset Date: 05/20/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: Latex Lisinopril Vicodin Adhesives

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Heart irregular rhythm with PVCs Started occasionally 2 weeks previous and became more frequent and consistent on 5/20. Some shortness of breath and palpitations Sought evaluation and treatment at Hospital Emergency. Treated with IV fluids, non life threatening. Discharged home. Continue with symptoms.

Other Meds: Lexapro Trulicity Vitamin C

Current Illness: Diabetes

ID: 1333804
Sex: M
Age: 70
State: VA

Vax Date: 04/22/2021
Onset Date: 05/12/2021
Rec V Date: 05/20/2021
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: NKA

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

Symptoms: Headache, fatigue, chills, diarrhea, no appetite, and fever. No treatment. Symptom's on 5/12,5/13,and 5/14. Patient now complains of fatigue and just not feeling well.

Other Meds: Cholecalciferol (VITAMIN D-3 PO) Cyanocobalamin (VITAMIN B-12) 2500 MCG SL Tab ivermectin (STROMECTOL) 3 MG Tab lisinopril (PRINIVIL,ZESTRIL) 5 MG tablet metoprolol succinate (TOPROL-XL) 100 MG 24 hr tablet warfarin (COUMADIN) 2 MG tabletCh

Current Illness: None

ID: 1333805
Sex: M
Age: 84
State: GA

Vax Date: 03/27/2021
Onset Date: 05/20/2021
Rec V Date: 05/20/2021
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, Spironolactone, Latex, Ace Inhibitors

Symptom List: Nausea

Symptoms: One week after the vaccine, my dad noticed that his urine was darker than usual. Then over the weekend, he started having jaundice. He was seen by his PCP who ordered labs and then referred us to a GI specialist. He has had multiple labs and a liver biopsy.

Other Meds: Carvedilol, Losartan, Aspirin, Vitamin C, Vitamin D, Centrum Silver

Current Illness: My dad was feeling fine until he took the vaccine. He had COVID in January 2021 and was doing so much better until he took the vaccine.

ID: 1333806
Sex: F
Age: 71
State:

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 05/20/2021
Hospital: Y

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: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1333807
Sex: M
Age: 22
State: CO

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Pfizer contacted, vaccine diluted incorrectly by mistake, patient contacted and reports no adverse reactions at this time

Other Meds: fluticasone propionate prozac ranitidine

Current Illness: Unknown

ID: 1333808
Sex: F
Age: 61
State: AZ

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/20/2021
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: Next day, my lips swelled, upper and lower, and rash and small bumps broke out under lower lip

Other Meds: Doxycycline Mono 50 mg, Prednisolone Acetate 1% eye drops, Ciprofloaxin Ophthalmagic Solution .3% eye drops

Current Illness: None

ID: 1333809
Sex: F
Age: 31
State: NJ

Vax Date: 05/16/2021
Onset Date: 05/17/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: All symptoms began within around 12 hours after dose, and have not improved. Severe headache: intense, painful pressure that worsens with any movement, especially leaning down. It frequently becomes disorienting and unbearable. I cannot retrieve things from the floor/lower shelves without help, due to severe discomfort. Sometimes the pain radiates down the base of my skull and back of my neck, particularly the left side. This is the most bothersome symptom by far. Ibuprofen does improve it but doesn't remedy it completely. Fatigue: I am constantly tired but cannot sleep soundly. I wake up frequently (every few hours), which results in "sleeping" (staying in bed) for much longer periods than normal, while only getting poor quality sleep. Nausea: I have very low appetite, and when I try to eat anything, I quickly begin to feel nauseous. Throughout the day, I often feel nauseous and take Pepto to feel better. Chills/Low-Grade Fever: This was the first symptom that appeared. It has improved each day, but I do still experience it. It is most noticeable at night, when I will shiver and sweat while feeling like I'm both freezing and also overheating. I check my temperature when this happens, and it is usually around 101 degrees Fahrenheit. I take ibuprofen to reduce the fever. I sometimes feel chills during the day, but never as badly as at night.

Other Meds: none

Current Illness: none

ID: 1333810
Sex: F
Age: 46
State: OH

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 05/20/2021
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: Cipro

Symptom List: Erythema, Pruritus

Symptoms: I had my second dose of Pfizer vaccine on April 12, 2021. Approximately April 14, 2021 I began experiencing ringing in my ears that in constant since that time.

Other Meds: Lo Loestrin FE (birth control), prenatal vitamin, Fexofenadine for allergies, Flonase spray, Vitamin B6, Vitamin C, Vitamin D3, Elderberry, Apple Cider gummy supplement, Biotin

Current Illness: None.

ID: 1333811
Sex: F
Age: 61
State: LA

Vax Date: 02/26/2021
Onset Date: 03/26/2021
Rec V Date: 05/20/2021
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: No

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

Symptoms: Could not breathe, chills, entire body aches, headache, congestion in head, could not lay down due to breathing, lasted 12 hours with bad breathing, have never experienced a flu like this. Felt bad up to 3 weeks, still not breathing like before, also high blood pressure for a week until I took additional medication.

Other Meds: Folic Acid, Pantoprazole, Rosuvastatin, Enoxaparin, Alprazolam

Current Illness: Stage IV Lung Cancer, Hernia

ID: 1333812
Sex: F
Age: 41
State: PA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/20/2021
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: Penicillin, Latex, Almond Milk

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

Symptoms: Patient received 2nd dose of Pfizer Vaccination and stated she was having difficulty swallowing/throat closing. Pt stated they had TMJ. Pt was given water to swallow and felt of after sitting on bed for 45 min. Last vitals showed slight improvement to blood pressure. Pt was released at 1615. Original symptoms were resolved.

Other Meds: Adderall, VR, Tylenol

Current Illness: TMJ

ID: 1333813
Sex: M
Age: 22
State: CO

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient was given Menveo vaccine prepared with sterile diluent instead of proper diluent.

Other Meds: clonazepam

Current Illness: N/A

ID: 1333814
Sex: M
Age: 56
State: CO

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/20/2021
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: Tramodol

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

Symptoms: Patient developed swelling to eyelid approximately 15 minutes after injection. Developed voice hoarseness and salivating about 1 hour after vaccine

Other Meds: Current Outpatient Medications: ? acetaminophen (TYLENOL PO), Take 500 mg by mouth., Disp: , Rfl: ? multivitamin w/ minerals (THERAPEUTIC-M) 27-0.4 mg tablet, Take 1 tablet by mouth daily., Disp: , Rfl:

Current Illness: Active Ambulatory Problems Diagnosis Date Noted ? Intractable back pain 02/19/2021 ? Neck mass 02/19/2021 ? Spinal stenosis 03/12/2021 ? Obesity 04/26/2021 * Follicular cyst of skin and subcutaneous tissue; excised 05/05/2021

ID: 1333815
Sex: F
Age: 58
State: WI

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 05/20/2021
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: Cipro, sulfa

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

Symptoms: Persistent nausea - first week, post-eating; second ND and third weeks, constant

Other Meds: Raltegravir, atazanavir, levothyroxine, melatonin, vitamin d, fish oil, co-Q10

Current Illness: None

ID: 1333816
Sex: F
Age: 67
State: MA

Vax Date: 03/20/2021
Onset Date: 05/15/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: Scallops

Symptom List: Pain in extremity

Symptoms: Sudden complete hearing loss in left ear on May 15. Being treated by Dr., ENT with steroids and MRI follow-up.

Other Meds: Omeprazole, calcium, vitamin D, Iron, Fiber supplement, Vitamin C No prescription medications

Current Illness: None

ID: 1333817
Sex: M
Age: 68
State: AZ

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/20/2021
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: Arm was so sore could not use for about 10 days. Improving but 3 weeks later my bicep is still very sore

Other Meds: Levothyroxine Testosterone Lisinopril Simvastatin

Current Illness: None

ID: 1333818
Sex: M
Age: 41
State:

Vax Date: 03/31/2021
Onset Date: 04/18/2021
Rec V Date: 05/20/2021
Hospital: Y

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: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1333819
Sex: M
Age: 36
State: OH

Vax Date: 05/17/2021
Onset Date: 05/19/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient called 3 days after receiving vaccine, stating blurred vision in only his left eye. Advised patient should reach out to his PCP as soon as possible or go to urgent care if his symptoms worsen.

Other Meds:

Current Illness:

ID: 1333820
Sex: F
Age: 49
State:

Vax Date: 03/31/2021
Onset Date: 04/23/2021
Rec V Date: 05/20/2021
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:

Symptom List: Vomiting

Symptoms: Patient positive for COVID-19 on 04/23/21 after completing vaccination. Asymptomatic.

Other Meds:

Current Illness:

ID: 1333821
Sex: F
Age: 48
State: KS

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 05/20/2021
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: seasonal allergies - pollen

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: A few hours after vaccine, I had been sitting down at a table and I got up to walk and I stepped down on my right foot and it felt like someone kicked me in my lower left leg. Kind of in the shin, but in the inside of the shin. The ball that sticks out - four inches above that on the inside. Every time I took a step it felt like someone was kicking me with a metal toed sharp boot. I hobbled around that day and the next day I realized I couldn't move on it. The Urgent Care I was closest to that was open didn't do x-rays. So on Monday, I went to Urgent Care Center - could feel a little knot where the pain was. Pain lasted three and 1/2 days consistently and then that was it. I did keep it wrapped for two weeks like the doctor told me just in case. About 10 days after I had been to the Urgent Care, it happened on my left side - about four inches above the ankle bone on the inside of the shin, I had the same sensation of pain. So I used the wrap for that ankle. It wasn't as severe as the other side - it was about 30% pain - it felt like someone kicked me with a sneaker instead of a metal pointed boot. That lasted about a day and 1/2 (about 1/2 the time that the right side lasted). I had like something was biting my ankle - it got to be inflamed - I never had a reaction to a mosquito bite like that - I thought I had scabies. I went to my doctor and he didn't know what it was. It wasn't scabies - just a violent, insane reaction to a mosquito bite - it was inflamed, red, bumpy and hard - on my right ankle and also on my left ankle - started small and got to be the size of a quarter. I never reacted to mosquito bites like that in my life. My doctor told me to take Benadryl or Claritin. Normally I take one in the morning at this time of year and I was taking three a day to keep the itching manageable. She gave me a mild steroid cream to put on it - about four or five days after putting the cream on it that it was better. I don't have any pain above my ankles anymore and the area where the crazy bite reaction was, I can still see but it's 92% better and that has been almost four weeks ago that it happened. It's been about 3 weeks since I saw the dr about it.

Other Meds: Multi vitamin; Magnesium Supplement; Turmeric; Duloxetine - 20 mg

Current Illness: no

ID: 1333822
Sex: F
Age: 18
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/20/2021
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: NONE

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

Symptoms: PATIENT GOT THE VACCINE COVID 19 FIRST DOSE, SHE WAS TOLD TO SIT FOR 15 MINUTES BEFORE LEAVING! ABOUT FEW MINUTES LATER, SHE PASSED OUT AND DROP HER BODY ON THE FLOOR! WE PUT HER BACK IN THE CHAIR , GAVE HER SOME WATER. SHE FELT OK AFTER THAT, DENIED TO CALL AMBULANCE! HER VITAL SIGNS WERE OK, WE CALLED THE MOM TO PICK HER UP! FOLLOW UP CALL PATIENT IS DOING OK!

Other Meds: NO KNOWN

Current Illness: NONE

ID: 1333823
Sex: F
Age: 59
State: AR

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/20/2021
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 received the second dose of Moderna and started feeling bad later that evening. She said she felt like a truck hit her. She fainted on the way to the bathroom at home and hit her face on the floor. She said her neck was sore, she jammed her middle finger on her right hand, and she had a sore tooth. She fainted a second time, but her husband was able to catch her. She reported feeling a little better the next day and is still recovering.

Other Meds:

Current Illness:

ID: 1333824
Sex: F
Age: 34
State: FL

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/20/2021
Hospital:

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

Lab Data:

Allergies: Septra

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

Symptoms: Woke up with nausea, chills, sweats. Went to the bathroom, then fainted on the way back to bed. Sore arm, shoulder and armpit for two days following vaccine.

Other Meds: Hormonal birth control pill

Current Illness: None

ID: 1333825
Sex: F
Age: 39
State: KY

Vax Date: 04/26/2021
Onset Date: 05/12/2021
Rec V Date: 05/20/2021
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: Petechial rash (mild) developed approx. 2 wks after 2nd Covid vaccine.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm