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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1337468
Sex: M
Age: 20
State: TX

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Patient received a COVID-19 vaccine at the COVID vaccination clinic. The vaccines were shipped to destination from starting point, addressed to 2 people who were hosting the vaccination clinic. The vaccination were alarming in transport and both Pfizer and other company both told the people that the vaccines were no longer viable and should not be given to the patients. Due to a lack of and miscommunication, 5 patients received the vaccines.

Other Meds: None

Current Illness: N/A

ID: 1337469
Sex: F
Age: 23
State: IN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Bananas, citrus fruit

Symptom List: Anxiety, Dyspnoea

Symptoms: Headache, slight fever, lethargy, loss of appetite Around 7am when I woke up, took an advil for the headache

Other Meds: Benadryl

Current Illness:

ID: 1337470
Sex: F
Age: 57
State: VA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: nka

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

Symptoms: pt had a rash develop immediately after taking vax. pt noticed her left arm was swelling from the injection site down to her hand with a knot forming on the outside of her arm. She states her arm is sore and has shooting pain going from her arm to her shoulder and her vision is becoming blurry. Pt also has a headache and will contact her PCP if her symptoms get worse.

Other Meds: Lasix, potassium, metoprolol, ibuprofen x 2,

Current Illness:

ID: 1337471
Sex: F
Age: 20
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I had no issues with the 1st dose, except for a sore arm. The person who administered the 2nd shot seemed to have injected it way too fast, I noticed a burning sensation as it was injected, and I also noticed that when the needle was removed, the medicine was dripping down arm. A few hours after receiving my shot (5:30 pm), I started to notice a bad headache, feelings of exhaustion, nausea, and hot flashes. I checked my temperature and it was 99.6 degrees, which is higher than I normally run so my body was doing something. I noticed a hard, swollen, red bump at the injection sight on my right arm - which has progressively gotten worse as the days have gone by. I still have the low grade fever, exhaustion, headache, nausea, and swollen/sore arm.

Other Meds: N/A

Current Illness: N/A

ID: 1337472
Sex: F
Age: 17
State: NM

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/21/2021
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: Received Moderna, <18yr.

Other Meds: None

Current Illness: None

ID: 1337473
Sex: M
Age: 76
State: GA

Vax Date: 05/07/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: SEIZURE

Other Meds:

Current Illness:

ID: 1337474
Sex: F
Age: 34
State: RI

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: I am currently 19 weeks pregnant. My due date is around 10/21. I had my second dose of the Covid 19 vaccine yesterday 5/19/21 at 10:05 am. I had it administered on the right arm and I left right after. I got a call from the pharmacist right when I left, stating that he didn?t believe I got the vaccine, either that it was empty to begin with or that it broke open. He said that he came to this conclusion because he didn?t feel any resistance when he gave me the shot. I went back in after ending the phone call and he administered another full dose of 0.3ML into the same right arm.

Other Meds: Claritin and prenatal vitamins

Current Illness: None

ID: 1337475
Sex: F
Age: 52
State: MI

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 05/21/2021
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: PT states since receiving vaccine on 4/13/21 she has been sore and in pain in vaccination arm

Other Meds:

Current Illness:

ID: 1337476
Sex: F
Age: 19
State: PA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: patient felt very light headed, sick to her stomach, face was very pale, vomited up some water she had just drank

Other Meds: none

Current Illness: none

ID: 1337478
Sex: F
Age: 58
State: IL

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/21/2021
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: Allergy to certain bug bites in Mexico

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Had stinging in arm upon injection. Had a softball sized lump on injection site and had red layer around injection site as a hotspot. Put hydrocortisone on bump for itching. Has had cellulitis before. Moderna second dose, still has bump, red spot as big as 2 ? inches. Has a fever of 99.7. Doctor has asked her to continue with cortisone and has prescribed steroids.

Other Meds: None

Current Illness: None

ID: 1337479
Sex: F
Age: 50
State: FL

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 05/21/2021
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: Patient said she could not articulate words to make sense, said random words without meaning lasting about 10 minutes. Patient had ear pain, throat hurt, and eyeballs hurt for 2 days afterward. Patient had skin sensitivity for a day and a half afterward. Patient had vomiting that lasted 2 days followed by nausea and diarrhea. Symptoms lasted a total of 4 days. Patient was told to call moderna as well.

Other Meds:

Current Illness:

ID: 1337480
Sex: M
Age: 25
State: TX

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: NO

Symptom List: Rash, Urticaria

Symptoms: Patient received a COVID-19 vaccine at the COVID vaccination clinic. The vaccines were shipped to location from other location, addressed to 2 clients who were hosting the vaccination clinic. The vaccination were alarming in transport and both Pfizer and organization both told the clients that the vaccines were no longer viable and should not be given to the patients. Due to a lack of and miscommunication, 5 patients received the vaccines.

Other Meds: NO

Current Illness: NO

Date Died: 05/21/2021

ID: 1337481
Sex: F
Age: 89
State: TN

Vax Date: 05/19/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Codeine

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

Symptoms: Resident had been experiencing cognitive decline over approximately the last month. Resident was treated for UTI on 4/29/21, labs were obtained on 5/3/21 and were unremarkable. Resident had seizure like episode at approximately 0830, resident was DNR Comfort Measures and resident's family did not want resident sent to hospital. Resident expired at 0920 on 5/21/21.

Other Meds: Celexa 20mg po daily Famotidine 20mg po daily Plavix 75mg po daily Lorazepam 0.25mg po at bedtime PRN sleep Levothyroxine 75mcg po daily Metoprolol 12.5mg po TID Prilosec 20mg po daily

Current Illness: Resident had been experiencing a cognitive decline over approximately the last month. Treated for UTI on 4/29/21.

ID: 1337482
Sex: F
Age: 50
State: IN

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 05/21/2021
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: Sulfa drugs, bananas

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

Symptoms: Chills until 3:00 am on May 9th. Fatigue from 9:00 am May 9th until i woke up the next morning.

Other Meds: no

Current Illness: no

ID: 1337483
Sex: M
Age: 13
State: MD

Vax Date: 05/19/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Nosebleedx2 - pressure with a tissue in his nose, nosebleed stopped in less than 15 minutes headache - tylenol, Aleve, improved

Other Meds: Cellcept, Guanfacine, Adderall XR, Lexapro Albuterol (but hasn't used for several years)

Current Illness: None

ID: 1337484
Sex: F
Age: 29
State: NH

Vax Date: 05/12/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Penicillin

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

Symptoms: Red swelling rash around injections shot in left arm. Shoulder joint tenderness. Elbow tenderness. Left arm soreness. Left side pain.

Other Meds: No

Current Illness: No

ID: 1337485
Sex: F
Age: 41
State: LA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: penicillin and sulfa

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

Symptoms: Patient started 10 minutes after the dose with tingling in tongue and roof of mouth which progressed to a lump in throat and feeling like she was having trouble swallowing. She had no respiratory symptoms. Pulse ox 100% HR 65 RR 14 BP124/78 She was given Benadryl 25mg IM. Symptoms resolved within 10 minutes of injection. Follow up at 30 minutes show complete resolution of symptoms.

Other Meds: Cipro for uTI

Current Illness: UTI

ID: 1337486
Sex: M
Age: 45
State: TX

Vax Date: 04/27/2021
Onset Date: 05/09/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: penicillin, pecans

Symptom List: Ear pain, Hypoaesthesia

Symptoms: fever up to 102.8, cough, tired, sore throat, chills, sweats that soak sheets, puffy face, phlegm stuck in throat

Other Meds: none

Current Illness: none

ID: 1337487
Sex: M
Age: 63
State: PA

Vax Date: 04/30/2021
Onset Date: 05/02/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Rocephin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Myalgia and head pain for nine days.

Other Meds: None

Current Illness: none

ID: 1337488
Sex: M
Age: 71
State: KS

Vax Date: 05/18/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Allergic to 1 type of blood pressure medication, patient cannot remember what this medication is.

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

Symptoms: Patients left side of tongue swelled, no difficulty breathing , starting at 11:30 am on 5/20 and ending at 7pm on 5/20

Other Meds: Carvedilol 12.5mg - Amlodipine 2.5mg - Atorvastatin 40mg - Turmeric - Vitamin D - Apple Cider Vinegar

Current Illness: No

ID: 1337489
Sex: F
Age: 54
State:

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/21/2021
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: Previous known allergy to ASA, Morphine. Intolerances to Baclofen, Sucralfate

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

Symptoms: 4/9 BIBA from home to ED for abdominal pain, emesis ~24hrs after vaccination, pt had syncopal episode 4/9 morning (no fall as pt son assisted her to the floor). Fever to 101.8F. Emesis started 4/8. Hx of Endometriosis, gastritis/GERD, IBS, hiatal hernia, tachycardia, thyroid nodule. Previous known allergy to ASA, Morphine. Lipase, Panel 7, LFTs all WNL, Hemogram w/ differential notable for High Neutrophils and Low Lymphocytes. Per MD, likely a result of having her COVID vaccine 4/8. EKG does not show any ischemic changes, unlikely ACS. EKG without evidence of dysrhythmia. Electrolytes are stable. No evidence of metabolic derangement. H&H are stable. Patient responded well to fluids and Zofran. Medications at the time of vaccination include acetaminophen, Ca carbonate, dicyclomine, Lomotil, famotidine, fluoxetine, Flonase, hyoscyamine, loratadine, omeprazole, simethicone, tizanidine, and oral Turmeric.

Other Meds: Medications at the time of vaccination include acetaminophen, Carbonate, dicyclomine, Lomotil, famotidine, fluoxetine, Flonase, hyoscyamine, loratadine, omeprazole, simethicone, tizanidine, and oral Turmeric.

Current Illness:

ID: 1337490
Sex: M
Age: 6
State: MA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/21/2021
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: Unevaluable event

Symptoms: Pt experienced severe arthus reaction from DTap requiring PO steroid His arm was very red, a little swollen a few hours after the vaccine was administered Over the weekend the swelling got a lot worse - extended from the injection site down his arm to just past his elbow He couldn't bend or move his arm Symptoms improved in 24 hours after PO Prednisone

Other Meds: none

Current Illness: none

ID: 1337491
Sex: M
Age: 30
State: AL

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Coconut

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

Symptoms: Syncope about 10 minutes after the COVID19 Vaccine was received, followed by a brief state of disorientation, nausea, lightheadedness and diaphoresis. No vomiting. Patient's initial SBP was 99 and it quickly dropped to 88. HR 32, Epinephrine administered. SBP rose to 91, HR to 42. 2nd dose of Epinephrine was administered and EMS called and took patient to the ED at hospital.

Other Meds: No meds

Current Illness: No acute or recent illness.

ID: 1337492
Sex: F
Age: 32
State: CA

Vax Date: 12/29/2020
Onset Date: 02/01/2021
Rec V Date: 05/21/2021
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: I had no reactions. I received a swollen lymph node a few weeks after receiving the vaccine. I went to Dr., to check my lymph nodes.

Other Meds: Tamoxifen; Prenatal

Current Illness:

ID: 1337493
Sex: F
Age: 22
State: MD

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Peanuts

Symptom List: Injection site pain, Menorrhagia

Symptoms: COVID VACCINE possible Reaction: given in office today: BP 112/88 P;78/min at 11;54 am approx 15 min s/p J & J COVID Vaccine had sensation of throat tightening, no respiratory no chest pain tongue swelling, no headache vomiting, rash. Given Benadryl 25 mg x 1 po and symptoms resolved immediately. Observed 45 minutes, states no symptoms . Hx Peanut allergy. Advised to contact us at anytime if worse reviewed side effects with patient and her mother who was present to drive home with her. Follow up 90 minutes later. Patient called states feels fine now. TC 6:00 PM 6 HRS AFTER VACCINE LEFT MESSAGE advised to contact us if any symptoms as discussed.

Other Meds: Syeda 3 mg

Current Illness: No

ID: 1337494
Sex: M
Age: 18
State: GA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Seasonal Allergies

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

Symptoms: Patient received a COVID-19 vaccine at the COVID vaccination clinic. The vaccines were shipped to vaccine site, by 2 employees who were hosting the vaccination clinic. The vaccination were alarming in transport and both Pfizer and both told of the employees stated that the vaccines were no longer viable and should not be given to the patients. Due to a lack of and miscommunication, 5 patients received the vaccines.

Other Meds: N/A

Current Illness: N/A

ID: 1337495
Sex: F
Age: 43
State: CA

Vax Date: 05/13/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: "Covid Arm" the area around the site of injection is red and itchy. Approximately 2" diameter.

Other Meds: Lexapro 10ml

Current Illness: None

ID: 1337497
Sex: F
Age: 35
State: TX

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Drugs

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I started to get a really bad head ache body aches I couldn't move, fever and chills body aches stopped me from moving , I was that way till around 5 or 6am the next morning, I was still achy but I could moving I still had body aches but I as able to move better

Other Meds: Prenatal Vitamin

Current Illness: no

ID: 1337498
Sex: M
Age: 55
State: MD

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 05/21/2021
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: Penicillin Sulfa medications Biaxin

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

Symptoms: Severe tinnitus. It as not stopped since March 22, 2021 when it started. Very high pitched ringing inside my head. It never stops.

Other Meds: Multivitamin Omeprazole (20 mg/day) Atorvastatin (40 mg/day)

Current Illness: None

ID: 1337499
Sex: F
Age: 14
State:

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Pt seen ER Dr this moring 5/21, Vaccine reaction, initial encounter, dysphagia and pain with swallowing, received Pfizer first covid vaccine yesterday, some pain in arm after vaccination, no initial issues noted, went to bed, woke up in night complaints of painful and difficulty swallowing water, no shortness or breathe or difficulty breathing, no rash, mom gave bendayl at home this morning, able to swallow food and water now, no issues with prior vaccines, pt does have seasonal allergies, pt. discharged home with mom, continue over the counter allergy med like claritin or zyrtec for next few days, follow up with PCP for recheck prior to decision about 2nd vaccine.

Other Meds:

Current Illness:

ID: 1337500
Sex: M
Age: 61
State: CA

Vax Date: 04/27/2021
Onset Date: 05/09/2021
Rec V Date: 05/21/2021
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: Injection site pain

Symptoms: Debilitating Gout in BOTH Feet and Left Knee. Went to Kaiser ER after all home remedies did not work. Was placed on IV with Steroids. Worked well for two days... came back.

Other Meds: Ambloid benazapine, hydralazine, flax husk, men's multi vitamin

Current Illness: None

ID: 1337501
Sex: F
Age: 30
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Sulphate

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

Symptoms: Within 12 hours of getting the shot, I developed periods of chills and periods of fevers and profuse sweating. 15-16 hours after the shot I had headaches that prevented me from doing any activity. I missed one day of work for the headaches I?m particular. My body was sore but the worst feeling was the intensity of the headache. Two days after the shot, a mild headache remains.

Other Meds: N/a

Current Illness: N/a

Date Died: 05/21/2021

ID: 1337502
Sex: F
Age: 67
State: KS

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: Macrodantin

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

Symptoms: Death, code blue at home, received COVID vaccine 5/20/21. No known health issues

Other Meds: Synthroid, Furosemide

Current Illness: no

ID: 1337503
Sex: F
Age: 36
State: OH

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Zithromax

Symptom List: Tremor

Symptoms: Patient called in stating she had redness and swelling entire left deltoid and top of shoulder 4-5 inches long and wide. Tingling in left hand between thumb and pointer finger. Started 2 hours after receiving vaccine and still present at time of report 5/21/2021 12:00pm. Aches and fatigue within first 24 hours that have since subsided.

Other Meds: Xanax, Vitamin D, apple cider vinegar gummies, Norco PRN

Current Illness: None

ID: 1337504
Sex: F
Age: 55
State: MD

Vax Date: 05/15/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: green apple- itchy throat

Symptom List: Erythema, Pruritus

Symptoms: patient had headache, fever, arm pain the next day after vaccine but then 7 days later at 2 am she began to develop urticaria throughout body, mouth swelling and felt pressure on throat (minimal), eyes were swollen when she woke up this morning

Other Meds: ergocalciferol once weekly capsule

Current Illness: none

ID: 1337505
Sex: F
Age: 60
State: NC

Vax Date: 04/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/21/2021
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: Hearing loss

Other Meds: Lipitor, Zolof

Current Illness: NO

ID: 1337506
Sex: F
Age: 61
State: NY

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Started with a bad headache, then had chills so bad I was shivering. Later that night, I started throwing up and had diarrhea. Took my temperature, it was 101. Had hot sweats and then cold chills. The throwing up and diarrhea lasted til the next morning. But the headache, chills and fever lasted most of the day. Took Tylenol and some pepto. It is now Friday the 21st and I am feeling pretty much back to normal today.

Other Meds: Zoloft Claritan Daily vitamin

Current Illness: none

ID: 1337507
Sex: F
Age: 15
State: IL

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/21/2021
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: 3 days of severe abdominal and pelvic pain that was debilitating. Patient was hardly able to walk - she had extreme pain with urination and defecation. She also had headache, fatigue, arm pain, fever and rash - hives, with pruritus of scalp.

Other Meds: Zyrtec

Current Illness: None

ID: 1337508
Sex: M
Age: 50
State: WI

Vax Date: 04/16/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Patient tested positive for COVID-19, he is asymptomatic. There are 10 members in his household, 9 of them have tested positive and 3 are fully vaccinated.

Other Meds:

Current Illness:

ID: 1337509
Sex: F
Age: 43
State: MD

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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:

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

Symptoms: Patient reported experiencing chest tightness and coughing. she experienced pruritus to the chest that quickly subsided. she also reported a hoarse voice and was slightly shortness of breath. she was also light headed for few seconds. she denies throat tightness , difficulty breathing and any other cutaneous symptoms. her symptoms subsided after approximately 10 minutes. she was instructed to wait full 30 minutesand the is free to leave if symptoms resolved

Other Meds:

Current Illness:

ID: 1337510
Sex: F
Age: 70
State: MT

Vax Date: 03/03/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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:

Symptom List: Pain in extremity

Symptoms: Patient was admitted for fall at home and confusion

Other Meds:

Current Illness:

ID: 1337511
Sex: M
Age: 15
State: NY

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: ? Food Allergies

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

Symptoms: Syncopal episode with Loss of Consciousness for several seconds . Radial pulse was weak Heart rate was 48 / min and BP 85/60 . Heart rate and BP improved 112/80 Struck back of head during fall

Other Meds: None

Current Illness: History of syncope following phlebotomy

ID: 1337512
Sex: F
Age: 45
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/21/2021
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: Pt returned for her second dose of Moderna on 5/20. Pt reports that about ten minutes after the first dose of Moderna on 4/22, she experienced some swelling inside her throat with no trouble breathing and no rash. She drank cold water which gave her temporary relief, but the swelling continued to return repeatedly over the next few hours before resolving completely. She has no other known allergies. She was counseled that she is allergic to the vaccine, and after counseling, elected instead to get the J&J vaccine today (5/20) instead of the second dose of Moderna.

Other Meds:

Current Illness:

ID: 1337513
Sex: F
Age: 80
State: NY

Vax Date: 04/01/2021
Onset Date: 04/08/2021
Rec V Date: 05/21/2021
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: My arm was in pain. I experienced back pain for two days. I had a fever, chills, neck & shoulder pain, and I felt cold. I took Tylenol and Icy Hot. I already had a prior appointment scheduled to see the doctor so I did not see the doctor for this adverse event. But I told my doctor about my fever and they said the vaccine may have caused it.

Other Meds: Metoprolol, Atorvastatin calcium, Xarelto

Current Illness:

ID: 1337514
Sex: F
Age: 43
State: MO

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 05/21/2021
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:

Symptom List: Vomiting

Symptoms: severe persistent headache developed, went to ER on 4/20/2021, CT/MRI found cerebral vein thrombosis in lower left brain. treatment of blood thinner (warfarin) started. advised to delay second dose.

Other Meds:

Current Illness:

ID: 1337515
Sex: F
Age: 49
State: FL

Vax Date: 05/03/2021
Onset Date: 05/10/2021
Rec V Date: 05/21/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Latex, penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Within 1 week, it triggered a bad MS attack. It should not be given to autoimmune people. First I got numbness in one hand, then the other. My mri showed an enhancing cervical spine lesions cotreslsting with these symptoms. Then a week later I lost sensation in my foot, then the other, then spreading up my leg, I?m in the hospital now on days of high dose steroids. My nurse told me I?m not the only one she sees here this happens to as well as other autoimmune patients of other autoimmunity. I think those of us autoimmune who are not taking immune suppressing drugs get even worse flare ups. This needs to be a warning to people. They could become permanently disabled G-d forbid.

Other Meds: Sleeping pill

Current Illness: Multiple sclerosis

ID: 1337516
Sex: F
Age: 40
State: MN

Vax Date: 04/02/2021
Onset Date: 04/15/2021
Rec V Date: 05/21/2021
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: Penicillin

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

Symptoms: Shingles on left-side of face, on V2 dermatome. blisters appeared on eye lid, lips, upper lip, temple area, nose

Other Meds: Singulair (for allergies), IUD,

Current Illness: None

ID: 1337517
Sex: M
Age: 74
State: MA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Penicillin, Ibuprofen

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After vaccine my toes got extremely sore and it was bad by midnight and felt like I wanted to lose my ten toes, on the scale of 1 - 10 the pain level was a 6 or 7. When I woke up I had a little pain in my right foot and it went away.

Other Meds: Synthroid 175mcg, Atenolol 25mg, Lisinopril 5mg, Multi Vitamin

Current Illness: No

ID: 1337518
Sex: F
Age: 59
State: FL

Vax Date: 05/11/2021
Onset Date: 05/15/2021
Rec V Date: 05/21/2021
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 antibiotics and soy

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

Symptoms: After having pins and needles and numbness at different areas all over my body and inside of my mouth and my tounge...I had an onset of a high pitched ringing in both ears. This has remained steady until the time of this report. I have contacted my PA to get an appointment to be seen my an ENT.

Other Meds: Flovent, pro air inhaler, multivitamin, fish oil, cinnamon

Current Illness: None

ID: 1337519
Sex: F
Age: 53
State: IN

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 05/21/2021
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: shellfish, contrast dye

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

Symptoms: The same day after first inject got a sore arm as expected. The arm continue to stay sore up until second injection which I had doubted getting but did receive in the same arm on March 17,2021. My arm continued to hurt and went to see my general practice doctor who gave me naproxen to take in april 2021. On follow up appointment the arm still continued to be very sore and it was injected with a steroid. My arm never got better even after steroid so I made an appointment with Orthopedics. They took an xray, assessed it, and gave a diagnosis of frozen shoulder. I was prescribed a solumedrol dose pack which I completed this week but feel the soreness coming back after 3 days off dose pack. I have a follow up appointment on Monday 5/24/21 to evaluate effectiveness of steroids and other possible treatment plans.

Other Meds: hydrochlorothiazide, norvasc

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm