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: 1337883
Sex: F
Age: 38
State: TX

Vax Date: 04/05/2021
Onset Date: 04/08/2021
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: Ambien, tape, acyclovir

Symptom List: Dysphagia, Epiglottitis

Symptoms: Severe joint pain. Elbows, knees, toes, fingers, spine, shoulders. Menstrual cycle was late and different than usual. Less bleeding. Delayed start.

Other Meds:

Current Illness: None

ID: 1337884
Sex: M
Age: 17
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: n/s

Symptom List: Anxiety, Dyspnoea

Symptoms: Faint after vaccine roughly 15-30 seconds. Patient awake, alert after.

Other Meds: n/a

Current Illness: n/a

ID: 1337885
Sex: F
Age: 21
State:

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:

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

Symptoms: Patient passed out after receiving the vaccine. She had no problems with the first vaccine but has had a history of passing out with other vaccinations. Patient had just gotten to the waiting area after receiving her vaccine and sat down and her mom caught her from falling from the chair. Mom held her for a few minutes as she went in and out of consciousness. When she came back to we laid her on the ground. Patients BP was taken as she started to feel better and was 120/74. Patient and mom stayed with us as she gradually started to feel better. Mom drove her home.

Other Meds:

Current Illness:

ID: 1337886
Sex: M
Age: 12
State: MA

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Pt has history of passing out after shots. passed out brief;y after adminstration. did not fall or hit head. was given water and ice pack while mom attended to him. EMTs were called and took blood pressure did not bring to hospital

Other Meds:

Current Illness:

ID: 1337887
Sex: F
Age: 17
State: CO

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: Unauthorized use of Moderna Covid Vaccine in a 17 year old. No adverse reaction reported

Other Meds: none

Current Illness: none

ID: 1337888
Sex: M
Age: 22
State: IN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Headache, heavy around the chest area, cough, fatigue, muscle pain, and joint pain with nausea.

Other Meds: None

Current Illness: None

ID: 1337889
Sex: F
Age: 37
State: CT

Vax Date: 01/21/2021
Onset Date: 01/22/2021
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 reported

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I found out I was pregnant on my second dose vaccine. I had fatigued, muscle aches, chills. For my first dose, I experienced severe left arm soreness at the injection site. As of today, I do not have any of these symptoms.

Other Meds: None reported

Current Illness: None reported

ID: 1337890
Sex: F
Age: 42
State:

Vax Date: 05/07/2021
Onset Date: 05/07/2021
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: 15 minutes, subjective SOB and hot feeling, lasted 5 minutes

Other Meds:

Current Illness:

ID: 1337891
Sex: F
Age: 29
State:

Vax Date: 05/07/2021
Onset Date: 05/07/2021
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: tingling sensation down right arm. feeling pressure in the middle of her chest and palpitations.

Other Meds:

Current Illness:

ID: 1337892
Sex: F
Age: 25
State: CT

Vax Date: 04/11/2021
Onset Date: 04/20/2021
Rec V Date: 05/21/2021
Hospital: Y

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: About a week and a half after receiving the first and only dose of the Johnson and Johnson Covid-19 vaccine, I developed small bruises (Petechiae) on my chest and arm. I decided to consult my doctor just in case. My doctor did a blood draw and ran a CBC panel. The next day I was rushed to the ER as my platelet count was reported at 7. By the time I got to the ER my platelets had dropped even further to a count of 2. I was treated inpatient for 3 days 2 nights. At this time I was diagnosed with IPT (Immune Thrombocytopenia Purpura). It was treated with two rounds of IVIG (Intravenous immunoglobulin) and 75 mg of Prednisone daily (which I have been slowly tapering off of since). My platelets restored to a non-critical level and have continued to hold steady ever since.

Other Meds: Sronyx Birth Control

Current Illness: None

ID: 1337893
Sex: F
Age: 19
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: About 2 hours after the vaccine being administered, patient experienced hives, ger face became red and swollen, and she was itching all over her body. She went to the ER , her heart was racing, they gave her benadryl injectable. Soon after, she started to feel tired and sleepy, and during the next day she was feeling still tired. The day after, she is feeling much better, still experience a little bit of itchiness at forehead and arms, seldonly.

Other Meds:

Current Illness:

ID: 1337894
Sex: M
Age: 32
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1337895
Sex: F
Age: 50
State: AK

Vax Date: 05/14/2021
Onset Date: 05/14/2021
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: Lidocaine patch, Adhesive Bandage

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

Symptoms: Patient received 1st dose of mRNA COVID-19 vaccine on 4/15 and it was Pfizer and then received Moderna mRNA COVID-19 vaccine on 5/14. This was suppose to be the second dose of Pfizer.

Other Meds: Acetaminophen, Alendronate, Aspirin, Atorvastatin, Cholecalciferol. Diclofenac TOP, Famotidine, Fluoxetine, Fluticasone NASAL, Hydroxyzine, Ibuprofen, Insulin Determir, Lidocaine TOP, Loratadine, Losartan, Magnesium Lactate, Metformin, Met

Current Illness: none

ID: 1337896
Sex: M
Age: 41
State: CA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
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:

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

Symptoms: The same evening of when I received the shot, approximately 6 hrs after, I started to hear ringing in my left ear. It is now 17 days after my symptoms first appeared, and it has not gone away or gotten any better.

Other Meds:

Current Illness:

ID: 1337899
Sex: F
Age: 43
State:

Vax Date: 04/20/2021
Onset Date: 04/20/2021
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:

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

Symptoms: lump in throat, tongue numbness and rush sensation.

Other Meds:

Current Illness:

ID: 1337900
Sex: F
Age: 49
State: FL

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: IM
Vax Site: LA

Lab Data:

Allergies: Milk Bagel

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

Symptoms: Tongue swollen, but I?m able to breathe, since an hour after getting vaccinated. Previous to being vaccinated I had minor allergy to pollen where nasal passage swollen, sneezing and throat itches. I was not taking allergy medicine since allergy was previously manageable. Since vaccine dose 1, the allergy symptoms increased. Since tongue swelling, I have only taken ibuprofen two (2) times. Tongue is swollen, but has not increased swelling. I am monitoring tongue, nasal passages and throat closely.

Other Meds: None

Current Illness: Had minor to pollen where nasal passage swollen, sneezing and throat itches. Since vaccine dose 1 the allergy symptoms increased. Also, tongue swelled up, but I?m able to breathe, since an hour after getting vaccinated.

ID: 1337901
Sex: M
Age: 45
State: NE

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

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

Symptoms: Shortly after receiving the vaccine the patient fainted and bumped his head from the fall. He was very pale, clammy, hot and somewhat disoriented from the reaction. After some water, food, and sitting patient recovered almost fully. He does report having similar reactions to other vaccines/blood draws. He was checked on by phone that same night and about 36 hours later and overall was doing ok.

Other Meds:

Current Illness:

ID: 1337902
Sex: F
Age: 34
State:

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Received the Moderna vaccine (1st dose) on 4/21/21 at the vaccine site -- suffered aches, flu-like symptoms, menstruation occurred 2 days earlier than usual/ much heavier flow starting on 4/23/21. Following second dose, 5/19/21 at the same location -- suffered severe muscle aches, fever (approaching 100 degrees) and flu-like symptoms. Bedridden for a day.

Other Meds:

Current Illness:

ID: 1337903
Sex: F
Age: 24
State: MD

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient felt hot, reports trouble breathing Patient believes it is anxiety No interventions, left in stable condition @12:40 p.m.

Other Meds:

Current Illness:

ID: 1337904
Sex: M
Age: 62
State: CA

Vax Date: 04/03/2021
Onset Date: 04/04/2021
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: none

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

Symptoms: The initial dose of Phizer Covid vaccine exacerbated a preexisting condition. It caused significant hearing loss and made mild tinnitus very severe. Currently being treated with Rozerum sleeping aid and was just prescribed lidocaine patches

Other Meds: Acyclovir

Current Illness: none

ID: 1337905
Sex: M
Age: 32
State: FL

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe

Other Meds:

Current Illness:

ID: 1337906
Sex: F
Age: 47
State: MD

Vax Date: 12/29/2020
Onset Date: 02/16/2021
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: VITILAGO ON THE SKIN AND VERTIGO SYMPTOMS STATRED

Symptom List: Unevaluable event

Symptoms: DISCOVER VERTIGO KIND OF SYMPTOMS AS STANDING UP LOOSING MY BALANCE, NAUSEA, DIZZINESS, BLURRED VISION.

Other Meds: VITAMIN B-12

Current Illness: NONE

ID: 1337907
Sex: F
Age: 25
State: SD

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: doxycycline, penicillin, egg, lactose, isovue 128

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

Symptoms: Patient reported fainting at the 5 minute post vaccination point

Other Meds: nuvigil, Effexor, armodafinil, buspar

Current Illness:

ID: 1337908
Sex: M
Age: 52
State: IL

Vax Date: 05/05/2021
Onset Date: 05/07/2021
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: NONE

Symptom List: Injection site pain, Pain

Symptoms: TWO DAYS FOLLOWING THE INJECTION IN THE LEFT ARM, PATIENT STARTED TO EXPERIENCE LEFT HAND SWELLING AND STIFFNESS. HAS WEAKNESS INTO THE HAND, DROPS OBJECTS. THE HAND IS VERY PAINFUL ALSO. NO FEVERS OR CHILLS. NO OTHER JOINT OR MUSCLE PAINS. NO RASHED. HAS SOME NUMBNESS, NO TINGLING INTO THE HAND. NO TREATMENTS TRIED. NO CHANGE WITH POSITION. NO SIGNIFICANT CHANGE OVER TIME FROM WHEN THE SYMPTOMS FIRST STARTED TO PRESENT DAY TODAY 05/21/2021.

Other Meds: NONE

Current Illness: NONE

ID: 1337909
Sex: F
Age: 62
State: MI

Vax Date: 03/23/2021
Onset Date: 04/10/2021
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: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: I had a skin rash on my wrists and inside my elbows on both arms, also around my waist. When I received my second dose the rashes disappeared in a day.

Other Meds: levothyroxin, glucosamine, echinacea

Current Illness: none

ID: 1337910
Sex: M
Age: 20
State: VA

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Fainting / Unresponsive-Severe, Systemic: Fainted, recovered within seconds. Gave water and monitored-Severe

Other Meds:

Current Illness:

ID: 1337911
Sex: F
Age: 59
State: PA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: LA

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Severe shaking chills with muscle spasms for 2 hours on 1/22/2021. Fever ranging from 99.5 to 102.0 F for 46 hours in a row, even with Tylenol 1000 mg every 6 hours regularly during that time. Fever never went to normal temp. Time period was starting at 07:30 pm 1/22/21 until 05:30 pm 1/24/21. Additional symptoms during that time period was headache, nausea, loss of appetite, muscle weakness all over, muscle aches all over, pain in hip joints, localized pain at injection site without redness. After 1/24/21 5:30pm dry cough and shortness of breathe developed for following 5 days, causing me to stop with heavy breathing after 1 flight of stairs which normally I can climb without any heavy breathing. Heavy breathing with this same activity level continued then for 3 additional weeks, but I would not have to stop the activity, just breathe heavily. And intermittent dry cough continued also for this time period (total of 3 weeks 5 days).

Other Meds: Synthroid 100 mcg daily, Magnesium 500 mg daily, Vitamin D 5,000 unit daily, multivitamin 1 tablet daily

Current Illness: none

ID: 1337912
Sex: F
Age: 34
State: AR

Vax Date: 01/28/2021
Onset Date: 01/30/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I woke up that morning, I went to stand up and my leg gave out because my ankle was in a lot of pain. I had to call in to work. I called my doctor the next day and they told me to ice it, elevate it, and rest. The doctor thought it was a sprain. That day I went to work with a brace. It was hurting but then after about 4 days it went away. I still experience it very randomly first thing in the morning, is when it hurts. I am also having short term memory loss. I am not sure if it is related to the vaccine or not.

Other Meds:

Current Illness:

ID: 1337913
Sex: M
Age: 41
State: NY

Vax Date: 05/20/2021
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: 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: I am experiencing tinnitus, which is not something I had before.

Other Meds: Vitamin D

Current Illness: None

ID: 1337914
Sex: M
Age: 70
State: WI

Vax Date: 05/12/2021
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: RA

Lab Data:

Allergies: Unknown

Symptom List: Nausea

Symptoms: According to the client's caregiver, his daughter picked him up the day following his vaccination to drive him to a visit with the his elderly father a few hours away. The client apparently displayed increased confusion and was unable to walk. Care was sought at a nearby healthcare facility and the client was admitted for observation. He was feverish and a chest x-ray showed mild Pneumonia. The client received fluids and IV antibiotics. His confusion improved during this period. The client's caregiver added that, according to a physician's note following his first dosage of COVID-19 vaccine, he had no side effects.

Other Meds: Unknown

Current Illness: The client reported that he is receiving care an assisted living facility because he has experienced episodes of passing out since he was diagnosed with COVID-19.

ID: 1337915
Sex: F
Age: 13
State:

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1337916
Sex: F
Age: 66
State: IA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
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: Cymbalta Demerol Penicillin V Talwin Cipro Peanuts Clindamycin HCl Ambien Aspirin

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

Symptoms: On May 21, 2021, the Public Health notified me, that on May 7th patient named above was given the first Pfizer vaccine. The patient named above has been a Visiting Nursing Association patient for many years and I had called her to ask if she was interested in receiving the J&J vaccine as we could come to her home to provide. (We are currently vaccinating homebound patients). She indicated she would like us to provide the vaccine. On Monday, May 10th, I called to let her know that we would be coming to her home on Wednesday, May 12th to provide the vaccine. She was accepting of that appointment. Prior to making an appointment with the patient, our Immunization system, IRIS was checked and we did not find that she had had any vaccine. Being informed of this today, the 21st, the Nurse assigned to had called her to ask if she has had any side effects and to offer education. The patient's physician will also be notified today. Completion of this report is for notification of two COVID vaccines being given 5 days apart.

Other Meds: Clindamycin HCl Oral one hour before and six hours after dental appt as needed SUMAtriptan Succinate 50 MG Every . Day(s) Oral as needed for headache (1 Tablet of 50 MG) at onset of headache. May repeat in 2 hours if continues x 1 Acetamino

Current Illness: None known

ID: 1337917
Sex: F
Age: 46
State: CA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: At 18:40 pt chief complaint is tingling sensation radiating from R side of her neck up to the top of her head, head feeling heavy, and dizziness. Pt transitioned from sitting position to laying down. Vitals taken at 18:45 are: Temp-98 HR-74 RR-16 BP-110/90 O2-100%. Pt feet propped up and remained in observation. Pt vitals taken at 18:55 are: Temp-97.5 HR-68 RR-14 BP-125/90 O2-100%. Pt reports tingling sensation to be coming and going and remains feeling dizzy. At 19:08 pt reports feeling like she is going to pass out. Pt is still laying down and being observed. Vitals taken at 19:09 are: Temp-98 HR-95 RR-18 BP-132/84 O2-99%. At 19:30 pt reports tingling sensation is resolved and transitions from laying to sitting. Pt reports feeling slight dizziness but remains sitting independently and stable with observation RNs on standby. Vitals taken while sitting are: Temp-98.2 HR-80 RR-15 BP-124/78 O2: 99%. At 19:35 pt reports resolution of dizziness and feels steady enough to stand. Pt offered EMS follow up, but pt denies. Pt is discharged in the care of her husband and son, advised to follow up with urgent care in the event of any further symptoms experienced at home.

Other Meds: None

Current Illness: None

Date Died: 05/14/2021

ID: 1337918
Sex: M
Age: 69
State: MO

Vax Date: 04/09/2021
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: Unknown

Symptom List: Tremor

Symptoms: Unaware of any adverse events between administration and death. Reporting agency became aware of patient's expiration on 05/14/2021.

Other Meds: Unknown

Current Illness: Unknown

ID: 1337919
Sex: F
Age: 17
State: FL

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient has no symptoms. Patient notified staff day after vaccines were administered that she was pregnanant.

Other Meds:

Current Illness:

ID: 1337920
Sex: F
Age: 40
State: NE

Vax Date: 04/01/2021
Onset Date: 04/18/2021
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:

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

Symptoms: Muscle twitching in legs

Other Meds:

Current Illness: cold

ID: 1337921
Sex: F
Age: 16
State: NM

Vax Date: 04/23/2021
Onset Date: 04/25/2021
Rec V Date: 05/21/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: 48hrs post-vaccine began with polyarthralgia, progressed to myalgias, arthritis, weight loss, abdominal pain/diarrhea, mucosal ulceration, and dyspnea, now admitted for evaluation which is suggestive of systemic lupus erythematosus.

Other Meds: None

Current Illness: No reported concurrent or antecedent illness

ID: 1337922
Sex: F
Age: 37
State: WI

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: Penicillins, strawberries, cherries, apples, dairy sensitivity, environmental allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: My heart started to race a few hours after vaccination. That lasted approximately 24-48 hours and was beating at a rate of 100-120 bpm.

Other Meds: metoprolol 25 mg daily, prenatal vitamin daily, clonazepam 0.5 mg as needed

Current Illness: n/a

ID: 1337923
Sex: F
Age: 18
State: MN

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None reported

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

Symptoms: Patient fainted three minutes after receiving the Moderna vaccine. Patient's mom was at clinic with her and reported after the patient had fainted that the patient had played an outdoor La Crosse game in the heat & humidity the evening before receiving the MODERNA vaccine & had not eaten breakfast or had much to drink the day of the MODERNA vaccine. Provider who responded to take care of the patient indicated the patient was most likely dehydrated & needed IV fluids. Blood pressure was 97/58; pulse 64; Oxygen saturation 96%. Patient became responsive within 30-45 seconds from fainting but then fainted a second time when being transferred from a wheelchair to an exam room table. Patient was very tired and would be awakened & responsive when patient mom speaking to her, but faded in & out. 911 called & patient transported to hospital for hydration with IV fluids.

Other Meds: Unknown

Current Illness: None reported

ID: 1337924
Sex: F
Age: 32
State: IL

Vax Date: 03/18/2021
Onset Date: 05/14/2021
Rec V Date: 05/21/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient transferred from outlying hospital for higher level of care. Patient had previously presented to ED with complaint of localized pain in the right calf for 4-5 days. Patient also noticed swelling in R calf. CT chest showed acute pulmonary embolism within distal right pulmonary artery extending into the segmental arteries to both right upper and right lower lobes. Patient was treated with heparin drip. Echo showed EF 68% and hypokinetic free right ventricular wall and apex. Echo also showed reduced right ventricular function. Patient underwent bilateral lower extremity duplex ultrasound which showed acute right femoral, popliteal, posterior tibial and peroneal vein thrombosis. Patient was transitioned and discharged to home. Patient received J&J COVID-19 vaccine in March 2021. Patient denies cigarette smoking/vaping, illicit drug use, ETOH use. Denies recent travels or long distance travels. Denies use of oral contraceptives.

Other Meds:

Current Illness:

ID: 1337925
Sex: M
Age: 59
State: WI

Vax Date: 04/06/2021
Onset Date: 04/13/2021
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: Client was seen by his doctor on April 13th related to severe headaches . He stated that he had headaches prevaccine and was given Tropromax for it which he only took for 2 days as it caused him dizziness. He had CT scan of Head and MRIs on April 13 and 14th and then again on April 27th. The scan on April 27th showd a blood clot with 80% blockage in carotid artery and was dxd with a blood clot via CT scan. . He was told to get to Hospital where he was admitted to ICU for 4 days Client was also dxd with Factor5 Leiden at that time. Per client he ha a stroke and is recovering. Per client still unable to work r/t poor balance and dizziness

Other Meds:

Current Illness:

ID: 1337926
Sex: F
Age: 14
State: MA

Vax Date: 05/14/2021
Onset Date: 05/14/2021
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: nka

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

Symptoms: pts neck started swelling after taking the vax. she was having a hard time breathing due to the swelling. she went to Hospital ER. pt was triaged and then left due to the situation at the hospital. Pts mother gave her Advil and was monitored all night. The swelling seemed to be better the next day. She had fatigue that lasted about 3 days. Parents called the Pediatrician. They were advised to call her Endocrinologist. They recommended her back to Pediatrician due it being a immune reaction. They called an infectious disease specialist which recommended her to an allergist. Pt has follow up appts next week for thyroid.

Other Meds:

Current Illness:

ID: 1337927
Sex: F
Age: 24
State: VT

Vax Date: 05/11/2021
Onset Date: 05/11/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: She got her vaccine, after the 45 minutes her hands started swelling up, and her throat started tightening, about to close kind of feeling. She took some Benadryl and passed out for the rest of the day. Then about a week later the injection site started getting puffier and the whelp is now the size of her fist and is red and purple. She saw her PCP who is calling her in something stronger than Benadryl.

Other Meds: Geodon, Ibuprofen.

Current Illness: None.

ID: 1337928
Sex: F
Age: 67
State: AK

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: Sulfa drugs, sporin drugs (i.e., cortisporin, lidosporin), morphine makes me violently ill

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

Symptoms: 3/9/21 Received vaccine around 3:53 pm. 3/10/21 12:30 am - awoke feeling hot and sweaty and having a slight headache and muscle aches. Went back to sleep but awoke two or three more times throughout the night, each time feeling a little worse. 3/10/21 5:30 am - Got up to try to go to work: Had significant vertigo, headache was now much worse (felt like a migraine), nausea and severe body aches. Still felt very hot. 3/10/21 8:00 am - Went to work. Temperature was 100.7. Went directly home. 3/10/21 8:15 am - Back at home. 3/10/21 8:15 am - 3/11/21 6:00 am - Headache was very severe. Vomited. Went to bed to try to sleep. Headache and nausea kept waking me up. I didn't have a thermometer at home but I continued to feel extremely hot and sweaty. I'm usually very cold. Could not even sip liquids or it caused vomiting. 3/11/21 6:00 am - 6 pm - vision was impaired. It looked like my room was filled with smoke. Nausea continued. Slept most of this time 3/11/21 6:30 pm - Woke up. Nausea was much less. I was able sip liquids. Headache was less. 3/12/21 6:30 am - Woke up. Nausea only slight. Headache only slight 3/13/21 6:30 am - Much better

Other Meds: None taken

Current Illness: Experienced illius for the first time, ever, on 2/27/21 and was hospitalized overnight.

ID: 1337929
Sex: M
Age: 73
State: WI

Vax Date: 01/12/2021
Onset Date: 01/20/2021
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: Neomycin-Bacitracin-Polymyxin Topical (Neosporin?): Allergic contact dermatitis

Symptom List: Vomiting

Symptoms: Diagnosed with Guillain Barre Syndrome Hospitalized from 1/21/2021 through 2/24, discharged to long term care facility 2/24

Other Meds: Aspirin (Aspirin Low Dose?) 81 mg Tablet, Delayed Release (E.C.), 2 Tablet(s) by mouth twice daily Atorvastatin (Lipitor?) 10 mg Tablet, 1 Tablet(s) by mouth once daily Clobetasol Topical 0.05 % Cream, Apply as directed topically twice da

Current Illness: None

ID: 1337930
Sex: M
Age: 64
State:

Vax Date: 02/19/2021
Onset Date: 05/18/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt completed Pfizer COVID vaccine in feb 2021. Pt found COVID + on 5/18/2021 and admitted to the hospital same day for COVID treatment

Other Meds:

Current Illness:

ID: 1337932
Sex: F
Age: 14
State: DC

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: RA

Lab Data:

Allergies: none

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

Symptoms: Patient developed a headache similar to her chronic migraines (bifrontal, rated 4/10) with no associated nausea/vomiting, altered mental status, LOC, shortness of breath. She preferred to leave with mom (who agreed that her symptoms were similar to chronic headaches) and were going to take medication when she got home. Mom was going to bring her back if the symptoms worsened or were not resolved with her regular medication.

Other Meds: imitrex for headaches

Current Illness: none

ID: 1337933
Sex: M
Age: 19
State:

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Lighted , loss of sight. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1337934
Sex: M
Age: 0
State: NY

Vax Date: 07/08/1988
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: none

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

Symptoms: patient passed out, he was pale and sweaty

Other Meds: none

Current Illness: none

ID: 1337935
Sex: F
Age: 45
State: WA

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Pt. here for second pfizer dose, complaint of dizziness nausea and lightheadedness. Describes as "carsick feeling". Pt reports history of reynauds. Pt. cleared by EMS.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm