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: 1334338
Sex: F
Age: 54
State: CA

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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Client received the 1st COVID vaccine (Pfizer Lot #EW0185 expiration 05/22/2021) at 1503. At 1515 client alerted EMT that she was feeling nauseas and asked for him to take her blood pressure. Nurse responded. Client stated that she was feeling nervous about receiving the vaccine prior to receiving it. Client offered water and she accepted and drank some. She also stated that she normally has high blood pressure and takes Lisinopril for it, and she took her medication this morning at her scheduled time. Client was alert and oriented, skin was appropriate to skin tone, and warm to the touch. EMT unable to obtain blood pressure. Nurse and EMT escorted client to the zero gravity chair. Vital signs taken by nurse at 1524 (blood pressure 120/88, heart rate 76, oxygen 98%). Client vocalized that she did not want to stay and wanted to go home, and that the nausea was gone. Nurse advised the client of the recommended 30 minute observation period, and client deferred. Client insisted on going home. Nurse provided education to the client to call emergency services if life threatening symptoms appear and what those symptoms are, and to follow up with primary care provider. Client has high blood pressure, is taking Lisinopril, and stated that she has no allergies. Client left with her husband unassisted with a steady gait at 1527.

Other Meds: Lisinopril

Current Illness:

ID: 1334339
Sex: F
Age: 22
State: ME

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient given the vaccination at approximately 5:25pm and around 5:27pm she stated she felt as though she was going to pass out. I went out to the waiting area to encourage her to lie down. She slouched and lost consciousness within seconds of me approaching her. She was unresponsive for approximately 10 seconds. While unresponsive, Patient seemed to shake and her arms tensed up a bit. Once she gained consciousness, she immediately knew where she was and what she was here for. I gave her water and an ice pack because she stated she was hot. I monitored her blood pressure, which was elevated at first, but came down within 15 minutes of regaining consciousness. Patient did not want emergency services to be contacted because she stated she felt fine. She did report some nausea following the event. Patient was driven home by a family member around 6:00pm.

Other Meds: Unknown

Current Illness: Hypercholesterolemia

ID: 1334340
Sex: M
Age: 42
State: NJ

Vax Date: 05/14/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Left ring finger - red rash from broken blood vessels covering about half of top of finger

Other Meds:

Current Illness:

ID: 1334341
Sex: F
Age: 48
State: CA

Vax Date: 04/16/2021
Onset Date: 05/05/2021
Rec V Date: 05/20/2021
Hospital: Y

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

Lab Data:

Allergies: ace inhibitors, morphine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient presented with side pain on 5/5/21, found to have multiple subsegemental PE

Other Meds: amlodipine, ferrous sulfate, levothyroxine

Current Illness: none known

ID: 1334342
Sex: F
Age: 24
State: CA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
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: None

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

Symptoms: Immediately after receiving the shot, her heart rate went up to 154 bpm. She mentioned that her heart was beating very fast and the technician responded that she would pass out. She was monitored at the facility for 15 minutes until her heart rate lowered to 90 bpm. The raised heart rate lasted for approximately 12 hours following dose #1.

Other Meds: Birth control - Trisprintec

Current Illness: No

ID: 1334343
Sex: M
Age: 22
State: ID

Vax Date: 04/10/2021
Onset Date: 04/12/2021
Rec V Date: 05/20/2021
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: None

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

Symptoms: Brain fog, general exhaustion during the day

Other Meds: None

Current Illness: None

ID: 1334344
Sex: F
Age: 53
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Upon injection, patient had immediate soreness at injection site, followed by swelling and pain radiating down her arm. She also experienced lightheadedness, dizziness, and nausea. We put an ice pack on the area and provided apple juice, as well as observing the patient for 30 minutes afterwards. The swelling and pain went down at the injection site to baseline levels and patient was no longer dizzy/nauseated upon leaving.

Other Meds:

Current Illness:

ID: 1334345
Sex: M
Age: 23
State: MD

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Patient reported sweating and blurred vision shortly after vaccine admin. Gave patient water . Observed patient. Called 911- They observed patient-patient was fine-no sweating. vision ok- EMT said patient had a Vagal response- nervous reaction to getting a vaccine. Patient reported having a similar reaction when younger and getting a vaccine.

Other Meds: none

Current Illness: none

ID: 1334346
Sex: F
Age: 25
State: MA

Vax Date: 05/12/2021
Onset Date: 05/13/2021
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: Allergic to spicy food

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: experienced nerve pain near the wrist 10 mins after the vaccination, and also experinced chills, fever, and arm soreness from the next day of vaccination

Other Meds: N/A

Current Illness: N/A

ID: 1334347
Sex: M
Age: 33
State: OH

Vax Date: 05/19/2021
Onset Date: 05/19/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Within 5 minutes of receiving vaccine pt lost consciousness falling and hitting head on floor

Other Meds: None

Current Illness: None

ID: 1334348
Sex: M
Age: 59
State: OR

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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: headache,pain,swelling,chills,fatigue my whole shoulder in pain bad headache feverish fealing started around 1am could not sleep due to pain took exedrin pain was reduced still had chills lasted all the next day 2days now over just a little soreness in arm,1st dose no side effects just sore arm.

Other Meds: metformen,lisiopril

Current Illness: none

ID: 1334349
Sex: F
Age: 35
State: IL

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Around 10 minutes after receiving vaccination, patient noticed warmth and itching. There were no changes in ability to breath. Discussed treatment options, such as applying cold compress, taking diphenhydramine orally or topically, or applying topical hydrocortisone cream. Instructed patient on when to contact primary care doctor or seek emergency medical care. Information was discussed with patient through virtual interpreter. Patient felt well enough to go home, and information was written down for future use

Other Meds:

Current Illness:

ID: 1334350
Sex: M
Age: 16
State: MA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
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: NONE

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

Symptoms: PATIENT WAS EXTREMELY NERVOUS, STATED DOES NOT LIKE NEEDLES. WITHIN 2 MINUTES FELT CHEST TIGHTNESS, LIGHTHEADEDNESS, STARTED SHAKING AND EYES ROLLED UP BEFORE PASSING OUT. COME TO WITHIN A FEW SECONDS BUT WAS NOT COHERENT. COULDN'T ANSWER BASIC QUESTIONS AND LOOKED AS IF WAS GOINT TO PASS OUT AGAIN. COULD NOT STAND, TALK ETC. HE WAS LIKE THIS FOR 10 MINUTES OR SO. CALLED 911 THEY STATED TO LAY PATEINT CAREFULLY ON THE FLOOR TO RECOVER BLOOD FLOW UNTIL THEY COULD GET THERE. PATEINT STARTED COMING BACK AROUND WITHIN THE NEXT 5 MINUTES. MOTHER REFUSED LEAVING IN AMBULANCE BELIEVED SON WOULD BE FINE.

Other Meds: n/a

Current Illness: NONE

ID: 1334351
Sex: F
Age: 54
State: NH

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: 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: Who: See above What: EMS called and patient transported to ED Where: vaccine site When: See above: Why: Anaphylaxis to first dose of Moderna. After vaccination pt presented with coughing, redness of the face and arms, and stated that it felt like her neck was swelling. She explained it as "it feels like someone has their hand on my neck and choking me." Pt has hx of anaphylaxis and has an Epi pen. HR was 120, RR 30, BP 170/90. Pts condition was getting worse so she was administered an adult epi pen. HR increased but after 5 min pt was coughing less and face became less red. She also said she felt better. Vitals were reassessed and pt handoff was given to

Other Meds: None

Current Illness: N/A

ID: 1334352
Sex: F
Age: 69
State: NJ

Vax Date: 04/07/2021
Onset Date: 04/28/2021
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: Sulfa Drugs

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

Symptoms: First adverse reaction was a headache behind right ear. This was a throbbing pain. Had low energy and a feeling of unwell. On 5/10/2021 had bad headache behind right ear. On 5/12/2021 I began swelling on the right side of my face with numbness on my right side lip area. On 5/13/2021 my face was fully distorted. On 5/13/2021 my neurologist diagnosed me with Bell's Palsy (G51.0). Neurologist ordered me on Prednisone 20mg three times per day for one week and initiate Physical Therapy. Ordered a blood test for Lyme disease.

Other Meds: MetforminER, Jardiance, Rosuvastatin, Gabapentin

Current Illness: None

ID: 1334353
Sex: M
Age: 19
State: CA

Vax Date: 05/19/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Moderna vaccine was expiring at 4:22AM on 5/19/21 (but it was till in the refrigerator), on the same day at about 10:45AM the pharmacist inject patient with the expired vaccine. Attention was brought to patient the following day, no adverse side effect per patient. A pharmacist spoke with a representative at Moderna, we were advised against revaccination. We will follow up with patient in the next week.

Other Meds:

Current Illness:

ID: 1334354
Sex: F
Age: 19
State:

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: Unknown

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

Symptoms: Nausea, light-headed, short of breath. Laid down, removed mask, gave water. Patient had not eaten since breakfast and had nausea prior to vaccine. Symptoms resolved very quickly, within 3 minutes.

Other Meds: Unknown

Current Illness: Change in diet

ID: 1334355
Sex: M
Age: 17
State: SC

Vax Date: 05/20/2021
Onset Date: 05/20/2021
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: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient was given a dose from an incorrectly reconstituted vaccination vial (stronger dose)

Other Meds: Vyvanse 30 mg capsules

Current Illness: None reported

ID: 1334356
Sex: F
Age: 40
State: CA

Vax Date: 05/19/2021
Onset Date: 05/20/2021
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: Sulfa drugs

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever, muscle aches, nausea, fatigue and tachycardia.

Other Meds: Armour Thyroid; Clonidine; Vyvanse

Current Illness: None

ID: 1334357
Sex: M
Age: 61
State: CA

Vax Date: 04/20/2021
Onset Date: 05/17/2021
Rec V Date: 05/20/2021
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: Dizziness, vertigo, vomiting

Other Meds: Prilosac

Current Illness: Kidney infection

ID: 1334358
Sex: F
Age: 50
State: MO

Vax Date: 03/19/2021
Onset Date: 04/11/2021
Rec V Date: 05/20/2021
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: Sulfur, eggs, naproxen, penicillin

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

Symptoms: I developed shingles. I now suffering with postherpectic neuralgia. I haven?t gotten my second dose because of this.

Other Meds: Lisinopril 10 mg, hydrochlorothiazide 25 mg, elderberry, one a day multivitamin gummies, fish oil

Current Illness: None

ID: 1334359
Sex: M
Age: 40
State: FL

Vax Date: 04/27/2021
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: Iodine.

Symptom List: Unevaluable event

Symptoms: on the 7 of may Allergic reaction (Rash) began on the left arm with just two dots similar to mosquito bites and the following days the rash spread to the forearm, it has been almost two weeks since it began.

Other Meds: NONE

Current Illness: NONE

ID: 1334360
Sex: M
Age: 47
State: TX

Vax Date: 05/04/2021
Onset Date: 05/11/2021
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: none

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

Symptoms: Bilateral tinnitus, right greater than left, developed 7 days following the second Pfizer Covid-19 vaccine and has persisted to date. No history of tinnitus, loud noise exposures, hearing loss.

Other Meds: none

Current Illness: none

ID: 1334361
Sex: M
Age: 22
State: ID

Vax Date: 05/09/2021
Onset Date: 05/10/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Chills, fever, exhaustion, soreness in left arm, small migraine behind eyes

Other Meds: None

Current Illness: None

ID: 1334362
Sex: F
Age: 70
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: Hay fever/Pollen

Symptom List: Injection site pain, Menorrhagia

Symptoms: It has been a couple of months since I filled this form out the first time so exact timing I have forgotten somewhat, but within 24 hours Or so I developed a raised red and itchy area at injectionsite, about 2-3? in diameter. It resolved slowly over the course of 5-7 days

Other Meds: Fosamax; Bone Up calcium supplement; Loratadine

Current Illness: N/A

ID: 1334363
Sex: F
Age: 46
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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: Amoxycillin Lisinopril CA flex

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

Symptoms: Immediately, I noticed that he gave it to me really close to my armpit, so my doctor thinks that my be the issue. I was tingling over my body and my heart was beating fast. From that day, I've had pain in my arm that doesn't stop. It even hurts to the touch. I had an appt two weeks later and my doctor told me to keep taking Tylenol, icing it and alternate hot/cold treatment. It's improved, but it has not gone away.

Other Meds: Metformin Atorvastatin Vitamins

Current Illness:

ID: 1334364
Sex: F
Age: 66
State: NM

Vax Date: 04/20/2021
Onset Date: 04/20/2021
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: Mupirocin, bacitracin, codeine, morphine, hydrocodone

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient reported suicidal thoughts after receiving vaccine. Since vaccination, she reports fecal and urinary incontinence. She has stated that she called her cardiologist and went to PCP. Patient has referral to psych.

Other Meds:

Current Illness: Sarcoidosis

ID: 1334365
Sex: M
Age: 61
State: TX

Vax Date: 05/05/2021
Onset Date: 05/10/2021
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: none except grass, ceder, cats

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The first Moderna shot on 4/6/2021 was fine with no reaction. The second Moderna shot on 5/5/2021...the arm one week later was red/sore... By the 11th of May, I had chills, joints were sore, slight fever, fatique....then within days... a head ache from my forehead that wrapped around down my left side of face (which was quite swollen under my eye (red) as well as cheek and painful to my left ear and back of head. This has lasted since the llth of May.. Went to doctor (primary) on the 18th of May and he took notes and gave me the antibiotic Azithromycin 250 mg. Today, the 20th, when I woke up my eye was still looking like it was pushed back. When I look in the m;irror, one eye looks bigger than the other and one looks like is has receded in my face..

Other Meds: losartan 100 mg once a day atorvastatin 20mg

Current Illness: There were no illnesses at the time of vaccination.

ID: 1334366
Sex: M
Age: 62
State: WI

Vax Date: 04/30/2021
Onset Date: 05/11/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: full body rash

Other Meds: none

Current Illness: none

ID: 1334367
Sex: M
Age: 24
State: ME

Vax Date: 05/04/2021
Onset Date: 05/07/2021
Rec V Date: 05/20/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Myocarditis - Inflammation of heart muscles. (Symptoms: Chest tightness & pain)

Other Meds: None

Current Illness: None

ID: 1334368
Sex: M
Age: 34
State: MO

Vax Date: 05/19/2021
Onset Date: 05/19/2021
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: Injection site pain

Symptoms: Patient received the COVID vaccine and within minutes became faint, dizzy and queasy. Blood pressure dropped to 74/53 and stayed low for about 10 minutes. It then bounced back to 110/73. Patient felt much better.

Other Meds:

Current Illness:

ID: 1334369
Sex: M
Age: 62
State: WI

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: Fast Heartbeat,Swelling in left hand and foot.In a six hour time frame.

Other Meds: none

Current Illness: no

ID: 1334370
Sex: F
Age: 75
State: TX

Vax Date: 03/03/2021
Onset Date: 05/05/2021
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: No

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

Symptoms: Sore spot from where vaccines were given (both were given on same arm 3 weeks apart). Then 2 days of flu-like symptoms I.e. chills, some fever, etc. This went away, except for the sore spot. Around early May, that soreness stayed and now at night lying horizontally the pain now goes to my neck.

Other Meds: Prevastatin, Levothyroxin, Metoprolal ER, Vitamin D 3, vitamin C, Calcium Nitrate, Vitamin E,

Current Illness: None

ID: 1334371
Sex: M
Age: 71
State: WA

Vax Date: 05/01/2021
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: None before the injection

Symptom List: Tremor

Symptoms: After the first dose, severe leg pain which still persists (Lot # EW0173 Rite Aide). After the second dose, a reaction in terms of a pressure headache, leg pain, severe chills first night and next day, nausea first day and night, diarrhea first evening, pain in injection site for first two days and first evening, and fatigue. There was only a low fever the first evening. I don't have normally any type of headache.

Other Meds: multi-Vitamin, ginger, garlic, red yeast rice, baby aspirin every other day, apple cider vinegar (1 table spoon every day), and Allergy Research Group Brain Storm. None of these products were taken the week of the injection.

Current Illness: None except a reaction to the first injection, suffering severe leg pain.

ID: 1334372
Sex: M
Age: 61
State: MI

Vax Date: 03/08/2021
Onset Date: 03/18/2021
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: Sulfa drugs

Symptom List: Erythema, Pruritus

Symptoms: About 10 days after the shot I could not breath. It came on over the course of a few hours to the point that my doctor told me to go to the ER. There they administered a nebulizer and a prescription for prednisone for 4 days which helped. 24 hours after the prednisone prescription was complete, the breathing difficulty resurfaced and I was back in the ER again. This time they gave me a longer course of prednisone (10 days) that reduced over that time. Once that course was complete the breathing difficulty started again, but not to the point of an ER visit. My GP then prescribed a smaller dose of Prednisone over 6 days combined with an inhaler. That has helped. I don't really know if this is related to the vaccine. My suspicion is that the vaccine may have revved up my immune system and because of my autoimmune disease it attached my airway. But that is just a guess.

Other Meds: Levothyroxine, Atorvastatin, Hydrochlorothiazide, Lisinopril, Vitamin D3, Probiotic

Current Illness:

ID: 1334373
Sex: M
Age: 61
State: FL

Vax Date: 05/19/2021
Onset Date: 05/19/2021
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: Penicillin

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

Symptoms: Pt walked in as a 'walk-up' for a COVID vaccine and was advised that this shot would be Moderna since that was the only COVID vaccine that we were administering that day. Pt signed consent form, signed out at the register and received his shot. Upon counseling for his return date and side effects to expect, he expressed that he thought this was the 'one-dose.' He seemed to be confused about which shot was which and told me 'the CDC said this would be the one-dose here.' He was very upset even though I exclaimed that we clarified this was the two-dose Moderna vaccine before the shot was given.

Other Meds: unknown

Current Illness: none

ID: 1334374
Sex: F
Age: 13
State: WI

Vax Date: 05/19/2021
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: LA

Lab Data:

Allergies: patient states she has allergies to many things and has used an epipen in the past

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

Symptoms: Stated she felt her throat closing up, SOB and anxiety. Was given 1 injection of epinephrine, declined calling an ambulance and was take to local ER by grandparent.

Other Meds:

Current Illness:

ID: 1334375
Sex: M
Age: 14
State: IN

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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore arm, stomach ache/nauseous, dizzy

Other Meds: None

Current Illness: None

ID: 1334376
Sex: F
Age: 90
State:

Vax Date: 03/01/2021
Onset Date: 05/01/2021
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:

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

Symptoms: Squamous cell carcinoma developed at injection site.

Other Meds:

Current Illness:

ID: 1334377
Sex: M
Age: 36
State: IN

Vax Date: 04/27/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None that I am aware of.

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

Symptoms: The current adverse even is prolonged pain deep within the injection site, as well as shoulder pain and fatigue in left arm. The pain has persisted for almost a month, and has not subsided. I also experienced a swollen lymphnode under left arm, which lasted about two weeks after the 2nd injection.

Other Meds: Adderall.

Current Illness: None.

ID: 1334378
Sex: F
Age: 54
State: MN

Vax Date: 02/12/2021
Onset Date: 02/13/2021
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: animal hair plant extracts shell fish

Symptom List: Pain in extremity

Symptoms: 12 hours after the first vaccine, patient had abnormal menstrual bleeding and clotting for 2 weeks after her second vaccine, the exact same thing happened. Patient was on depo injections and getting no periods at time of injections

Other Meds: Depo injection

Current Illness:

ID: 1334379
Sex: M
Age: 72
State: OR

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: NA

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

Symptoms: two different Vaccines provided

Other Meds: NA

Current Illness: NA

ID: 1334380
Sex: M
Age: 34
State: OR

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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:

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

Symptoms: Siezure in the middle of the night he has not had one in two years and then this it was not cool at all I will be talking to someone.

Other Meds: Oxcarbazepine. 600 mg twice daliy

Current Illness:

ID: 1334381
Sex: F
Age: 47
State: MI

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: Erythromycin, sulfa, Influenza vaccine, TB tine. Peanuts, mushrooms, tree nuts, oranges.

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

Symptoms: Starting about 6 hours after vaccination, loud buzzing noise that appears to be in top of head and ringing in left ear. This has been consistent to this date since the first vaccine.

Other Meds: Claritin daily. Multivitamin.

Current Illness: Seasonal allergies. Asthma.

ID: 1334382
Sex: F
Age: 65
State: TX

Vax Date: 02/22/2021
Onset Date: 03/07/2021
Rec V Date: 05/20/2021
Hospital: Y

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: Acute Pancreatitis, unknown cause. Hospitalized 5 days. Lipase enzyme levels beyond recordable amount. No food, no water taken orally for 5 days.

Other Meds: none

Current Illness: none

ID: 1334383
Sex: F
Age: 46
State: MI

Vax Date: 05/12/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: skin sensitivity to tape

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 2 inch red circle at injection site,

Other Meds: omeprazole and sodium bicarbonate 20mg/1100mg daily about 5pm

Current Illness: none

ID: 1334384
Sex: F
Age: 38
State: TX

Vax Date: 04/22/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: I am allergic phenergan.

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

Symptoms: My upper lip had swelling as a symptom of the vaccine.

Other Meds: I am taking a prescription.

Current Illness: No other illnesses.

ID: 1334385
Sex: F
Age: 70
State: IL

Vax Date: 05/06/2021
Onset Date: 05/06/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Passed out on a walk and broke my arm falling on the concrete. Have had stomach pains and diarrhea off and on since getting the shot.. very tired

Other Meds: None

Current Illness: No

ID: 1334386
Sex: F
Age: 39
State: PA

Vax Date: 05/07/2021
Onset Date: 05/08/2021
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: None

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

Symptoms: 13 days of vaginal bleeding, clots present. Rash and irritation on the face.

Other Meds: Magnesium carbonate

Current Illness: None

ID: 1334387
Sex: F
Age: 66
State: CA

Vax Date: 02/17/2021
Onset Date: 02/19/2021
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: ACUTE DIVERTICULITIS

Other Meds: Metformin Sertraline Ometrazole Amlopdipine. Losartan Vitamin D3 Vitamin B12

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm