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: 1338384
Sex: F
Age: 24
State: TX

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: LA

Lab Data:

Allergies: SULPHUR

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient temporarily fainted, and immediately came back, she was sweating, was given gatorade. Checked her blood pressure it was initially 87/58 at 4:21 pm. Sat with her and checked pressure again at 4:30 pm, and bp had returned to 113/75. she was fully recovered by 04:45pm and she left the pharmacy.

Other Meds: N/A

Current Illness: N/A

ID: 1338385
Sex: F
Age: 58
State: ID

Vax Date: 05/13/2021
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: Adhesion tapes

Symptom List: Anxiety, Dyspnoea

Symptoms: Redness swelling hot and hard to touch, took Benadryl clairitin and put ice on it, started 7 days after shot

Other Meds: NP THYROID 120MG. Bystolic 10 MG. Norco 5 MG. Vit c. Vit B DHEA 25 MG 5htp 100 MG Spirolactane 25MG, Vit D , Turmec digestive enzymes Horse Chestnut Extract Dandelion root

Current Illness: None

ID: 1338386
Sex: F
Age: 31
State: WA

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: None

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

Symptoms: Adverse event: PT abruptly felt lightheaded approximately 14 minutes after receiving Moderna COVID vaccine at 1235. PT lowered herself to the floor to lay on her left side. PT presented with pallor and diaphoresis. RN responding called for aid at 1249, aid arrived at 1251. SPO2 was 97% on RA. PT reported a history of syncope, especially after injections, denies significant medical history and was unsure of baseline BP. EMTs prompted PT to sit in chair, PT was able to rise without difficulty, but continued to c/o 'lightheadedness'. EMTs provided education on vaso-vagal response, provided juice and water to PT. PT reported feeling "stable, but a little warm" and then reported increasing nausea. PT provided emesis bag and chose to lay down once again, reporting that she felt better laying down. At 1304, PT reported that her nausea was resolved, and that she felt 'normal'. Denied vision changes, vertigo when moving head side to side. Color improved. EMTs medically cleared PT at 1313 to be driven home by husband. Treatment: Juice and water were provided, EMTs assessed/treated (Vitals at 1250: Bp 100/P laying, HR 106, SPO2 97% RA. 1255: BP 100/P sitting, HR 92, SPO2 99% RA. 1303: BP 96/52 laying. 1308: BP 102/60 sitting). Pupil check at 1300 WNL, PT declined CBG check. Education provided on s/s to watch for, when to seek medical care provided by RN. Outcome: PT was medically cleared by EMTs at 1313, driven home in private vehicle by husband. HCP Responding: RN, EMT, EMT, RN

Other Meds: Reports she takes 'birth control'

Current Illness: Unknown

ID: 1338387
Sex: F
Age: 13
State: NJ

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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Severe pain starting in left forearm extending down to the hand and tingling/numbness in hand. Pain started to travel up the arm towards the bicep.

Other Meds: Concerta, Zoloft, Guanfacine - Taken in the morning Advil - Taken at 8:30 pm at the Urgent Care Also is on Clonidine and Melatonin which is taken at bedtime.

Current Illness:

ID: 1338388
Sex: M
Age: 41
State: LA

Vax Date: 04/13/2021
Onset Date: 04/14/2021
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: None

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

Symptoms: Shortness of breath, light headed, rapid pulse, fatigue on and off for 3 days.

Other Meds: Albuterol, one a day vitamins, ostho-bioflex

Current Illness: Sinus infection

ID: 1338389
Sex: F
Age: 30
State: MS

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: Patient received her second Covid shot IM right arm. She said she felt hot. I told her to stay seated until she felt better. She fell out out the chair and hit her forehead on the floor. I helped her back up to the chair and she said she still felt hot. She had a bump on her forehead. She said she was thirsty so I got her some water and an ice pack for her head. We called management and they arrived in a few minutes and brought a fan to keep her cool. She called her boyfriend to come pick her up. She stayed here until he got here and she said she was feeling fine. She didnt want to go to ER.

Other Meds: none

Current Illness: none

ID: 1338390
Sex: F
Age: 60
State: CA

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

Lab Data:

Allergies: HCTZ, Nitrofurantoin, Vasotec, Coumadin, Diltiazem, Metformin, Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Severe left leg cramping.

Other Meds: Attached to this report

Current Illness: Attached to this report

ID: 1338391
Sex: M
Age: 22
State: PA

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

Lab Data:

Allergies: nka

Symptom List: Pharyngeal swelling

Symptoms: patient's friend's alerted me that he was feeling dizzy about 2:10pm. I went over to patient just as he was passing out. small muscle jerk was noted. I obtained assistance to place patient on the floor. He regained consciousness before we could put him on the floor. He was out only 5-10 seconds. he was given some water and proceeded to sit for 20 more minutes. Patient was feeling fine. He did state he had fainted receiving flu shot previously. Patient walked home and called to inform us he made it home safely and was feeling fine. He was instructed to hydrate and take it easy for the day. He refused offer to call the squad

Other Meds: unknown

Current Illness: n/a

ID: 1338393
Sex: F
Age: 40
State: FL

Vax Date: 04/23/2021
Onset Date: 04/24/2021
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 missed period and had irregular breakthrough bleeding. Loss of voice next day. Fatigue. Dizziness for 3 days

Other Meds: unknown

Current Illness: none

Date Died: 05/10/2021

ID: 1338394
Sex: M
Age: 39
State:

Vax Date: 04/07/2021
Onset Date: 05/07/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Death N17.9 - Acute kidney failure, unspecified FATIGUE CHEST PAIN NAUSEA

Other Meds:

Current Illness:

ID: 1338395
Sex: M
Age: 46
State: CA

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

Lab Data:

Allergies: No

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

Symptoms: Feel very very very sick not improved over time

Other Meds: Tylenol

Current Illness: UTI

ID: 1338396
Sex: M
Age: 51
State: CA

Vax Date: 05/11/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: NKDA

Symptom List: Rash, Urticaria

Symptoms: bells palsy

Other Meds: amlodipine, lisinopril-HCTZ, motrin, flexeril, tramadol

Current Illness: none pertinent

ID: 1338398
Sex: F
Age: 39
State: WA

Vax Date: 05/01/2021
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:

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

Symptoms: I had bloody noses for 3 days after my vaccine of J and J.

Other Meds: Prenatal vitamin

Current Illness:

ID: 1338399
Sex: F
Age: 12
State: PA

Vax Date: 05/14/2021
Onset Date: 05/15/2021
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: None

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

Symptoms: On 5/15, at 4:00pm while in the shower, patient had a pre-syncopal episode with dizziness, and heaviness in her arms and legs. Before she fell I was able to assist her to a sitting position. Her skin was pale and clammy, pulse thready 90bpm, bp 80/50. Symptoms improved after 15 minutes. On 5/21, at 10:00am was outside at a school sports activity. She began to feel slightly dizzy. She ran a short race and the dizziness was worse. She was pale, hr 120, bp 100/60. She drank fluids and rested but still felt unwell and a headache started so she came home. The headache evolved into a severe migraine with several episodes of vomiting. She also felt heart palpitations, which is unusual with her migraines. Hr was 100 and regular. Bp 100/60. Discussed with pediatrician, who patient had seen 5/20. Appointment scheduled with cardiology 5/26

Other Meds: Migrelief supplement, occasional Tylenol

Current Illness: None

ID: 1338400
Sex: F
Age: 47
State: MI

Vax Date: 04/21/2021
Onset Date: 04/22/2021
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: Bees, Latex, Wheat Gluten, Bovine, Chocolate, Strawberry, Evergreen, Mushrooms, Cauliflower, Menthol, Abutherol, Formaldehyde,

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

Symptoms: Dose 1. Swelling at injection site plus from shoulder to wrist. Fever x2 days. Dose 2. Swelling round circular raised painfully sore to touch, weakness in that arm. Exhaustion, Fever, Headache,

Other Meds: Elderberry

Current Illness: Anemia, Hashimoto hypothyroidism, Vitamin D Deficient

ID: 1338401
Sex: F
Age: 17
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Attendee developed tingling in the left arm and felt slightly dizzy 5 minutes after receiving the vaccination. Assisted to a cot and her legs were elevated. HR 69 BP 118/62 RR 18 O2Sat 99%. One minute later reported that her left leg was also tingly. One minute later she was given some water and she said that she was feeling better. She was assisted to a chair and her vital signs were Hr 80 BP 120/60 O2Sat 100%. 15 minutes after receiving the vaccine she denied symptoms and was discharged to home with her mother. They were both educated on adverse reactions and she was advised to rest and drink plenty of water. Attendee walked out of the clinic independently with her mother at 5:15 pm.

Other Meds:

Current Illness:

ID: 1338403
Sex: F
Age: 28
State: IN

Vax Date: 04/27/2021
Onset Date: 04/27/2021
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: Triggered menstruation to occur and then bled for almost three weeks.

Other Meds:

Current Illness:

ID: 1338404
Sex: F
Age: 38
State: IL

Vax Date: 03/15/2021
Onset Date: 05/07/2021
Rec V Date: 05/21/2021
Hospital: Y

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

Lab Data:

Allergies: Bactrim- rash, Norco- rash, and penicillin-rash

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Presented to the ED for evaluation of heart palpitations, bilateral lower leg pain, bilateral arm pain, and headache onset two weeks (6 weeks from vaccine) Patient got a CT angiogram of the chest which indicated faintly visible peripheral subsegmental emboli within the left greater than right lower lobe pulmonary arterial distribution. Patient received 0.9% sodium chloride 250 mL and apixaban 10 mg.

Other Meds: Biotin, buspirone, lorazepam, multivitamin, lactobacillus, noregestimate-ethinyl estradiol

Current Illness: None

ID: 1338570
Sex: F
Age: 46
State: OR

Vax Date: 01/16/2021
Onset Date: 01/16/2021
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: Erethromycin, Dairy

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: This injection caused frozen shoulder. The pain started the same day and I assumed it was normal to have pain at the injection site. The pain got worse and worse and never resolved. I thought about having the second shot done on the right shoulder since the left side soreness never went away. But I had in on the left side and although it got sore, that soreness from the second shot dissipated in two days. The soreness from the first shot still hadn't resolved and the shoulder had started losing ROM after the first injection but I didn't really notice until it became "frozen" and very painful in March. I have been seeing a chiropractor, acupuncturist and saw an orthopedic doctor. I am scheduled to start PT in 2 weeks. It is still very painful and very limited ROM. I am hoping this isn't a permanent disability because this started right after the injection in January and here we are in May!

Other Meds: none

Current Illness: None

Date Died: 05/17/2021

ID: 1338572
Sex: F
Age: 69
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Death E87.1 - Chronic hyponatremia N17.9 - AKI (acute kidney injury) (CMS/HCC) J18.9 - Pneumonia of right lower lobe due to infectious organism

Other Meds:

Current Illness:

ID: 1338573
Sex: F
Age: 36
State: TX

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

Lab Data:

Allergies: None

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

Symptoms: Fatigue, swelling and tenderness at injection site. Red swelling 2 inches across and 1.5 inches wide. Painful enough to wake me in the night. Some relief from Tylenol.

Other Meds: None

Current Illness: None

ID: 1338574
Sex: M
Age: 29
State: SD

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:

Symptom List: Unevaluable event

Symptoms: Patient was given the immunization and within minutes he fainted and fell to the floor. Patient did not receive any additional medication. Shortly after the patient fainted, they came back to and were cared for and monitored.

Other Meds:

Current Illness:

ID: 1338575
Sex: M
Age: 15
State: IN

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: Oxcarbazepine, Strattera

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

Symptoms: 2 minutes after administration, the patient was speaking to his father, dozed off to one side and had tremors. Patient immediately was able to open eyes and was shaking. Pharmacist advised patient to take deep breaths and relax until paramedics arrived. Patient had a few sips of water while waiting. Patient was fine after 15 minutes.

Other Meds: Flaxseed, Melatonin, Jornay PM, Vitamin D, Zinc, Selenium, Trucalm, Stahist

Current Illness: None

ID: 1338576
Sex: F
Age: 29
State: GA

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: Patient asked for Pfizer vaccine and was accidentally administered Moderna vaccine for her 1st dose

Other Meds: none

Current Illness: none

ID: 1338577
Sex: M
Age: 50
State: OK

Vax Date: 05/01/2021
Onset Date: 05/20/2021
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: Injection site pain, Menorrhagia

Symptoms: Redness, soreness, swelling @ injection site, tiredness, nausea, low grade fever, chills, night sweats, muscle soreness, joint aches

Other Meds:

Current Illness:

ID: 1338579
Sex: M
Age: 72
State: FL

Vax Date: 03/30/2021
Onset Date: 03/31/2021
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: none

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

Symptoms: Severe headache like an ice pick into the side of my head, starting the day after second injection. Lasting ever day for 8 days, duration 3-8 seconds of severe pain, then gone. After 8 days the headaches were not as severe, normally occurring every other day, some times daily. Still occurring. Normally lasting 3-8 seconds. One day I had 15 headaches with a 3 minute period. Not high intensity, but enough to stop me walking across the room.

Other Meds: Famotidine 20mg, Lansoprazole 15mg, Metoprolol 100 mg, Losartan 25mg, Atorvastatin 40mg, Trazodone 100 mg, dorzolomide, Restasis, Calicium, Aspirin 81, Glucosamine, Naproxen

Current Illness:

ID: 1338580
Sex: M
Age: 37
State: CO

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fever, body aches, headache, lethargy for approx 30 hours

Other Meds: No

Current Illness: No

ID: 1338581
Sex: F
Age: 69
State: NJ

Vax Date: 05/01/2021
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: RA

Lab Data:

Allergies: Asperin, bactrim ,flagly

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chills,fever 101,covid arm

Other Meds: None

Current Illness: None

ID: 1338582
Sex: F
Age: 16
State: CA

Vax Date: 04/06/2021
Onset Date: 04/12/2021
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: 6 days following vaccination, patient was exercising for the first time. started feeling dizzy. She had some water and realized that her skin was red. She had a rash on face and puffy lips. Mom came to get her she stood up and was extremely dizzy. Mom did not notice that her lips were swollen but did notice that her skin was rashy and red. Mom, who is a nurse, also thought she appeared pale and diaphoretic. By the time they got the ED she was hypotensive. She got a cocktail of meds in the ED including a couple doses of EPI. She got IV fluids. She started to improve quickly after giving the medications.

Other Meds: None

Current Illness: None

ID: 1338583
Sex: F
Age: 70
State: GA

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: RA

Lab Data:

Allergies: epinephrine/novocaine

Symptom List: Nausea

Symptoms: After the vaccination, the patient was directed to our waiting area and sat down in a waiting chair (which does have arms). After <5 minutes, patient passed out and fell face forward out of the chair onto the floor. She hit her head and was unconscious. We ran to assist her, after about 15 seconds she came to, but was in and out of consciousness. She developed a baseball sized hematoma on her forehead and was sweating profusely. We called 911 and got the AED machine. She then passed out again and threw up, so we placed her on her side. We monitored her closely and kept her conscious until the paramedics arrived. By the time they arrived, she did not have recollection of the event but was alert. They transported her to the hospital.

Other Meds: unknown

Current Illness: unknown

ID: 1338584
Sex: F
Age: 20
State: ME

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: Extreme discomfort at injection site, extreme tiredness, nausea, headache, painful to move

Other Meds: Vyvance, serequel, vitamin d and b12

Current Illness:

ID: 1338585
Sex: F
Age: 72
State: FL

Vax Date: 02/12/2021
Onset Date: 02/19/2021
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: Advil, Aimovig, Aspirin, Bactrim DS, Benadryl, Codeine, Cipro, Compazine, Dilaudid, Doxycycline, Fosamax, Ketoconazole, Minocycline, Nystatin, Percocet, Sudafed, Synthroid, Tramadol, Zenpep

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

Symptoms: Rash reported all over body, started a few days after vaccine. Patient reported needing to go to doctor.

Other Meds: Escitalopram, NP Thyroid, Quetiapine

Current Illness:

ID: 1338587
Sex: F
Age: 23
State: CA

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

Lab Data:

Allergies: none

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

Symptoms: Patient felt pain and nausea right after receiving second dose vaccine. Patient was throwing up and sweating. Blood pressure is in normal range but heart rate is 102. Patient was feeling better after. Following up with patient in afternoon, patient is feeling much better. Patient just feels tired.

Other Meds: unknown

Current Illness: unknown

ID: 1338588
Sex: M
Age: 14
State: CA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NONE

Symptom List: Tremor

Symptoms: Patient appeared to be fainting, shook back and forth in a repeated manner after sitting down for observation following the COVID vaccination. Did not have any blurred vision, was responsive. To be safe, an ambulance was called. This occurred minutes after being vaccinated, the ambulance arrived about 30 minutes afterwards and picked the patient up.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1338589
Sex: F
Age: 47
State: CA

Vax Date: 04/22/2021
Onset Date: 05/03/2021
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: Shrimp, pennicillin

Symptom List: Erythema, Pruritus

Symptoms: My arm all the way to my neck on the left side was painful for a week after vaccination. What bothers me is the pain in the left side of my breast (cheek close to my left arm) it was painful like someone punched me in that area for about 2 weeks.

Other Meds: Prenatal vitamins, calcium 600mg, gingko biloba

Current Illness: None

Date Died: 05/20/2021

ID: 1338590
Sex: F
Age: 76
State:

Vax Date: 03/05/2021
Onset Date: 04/29/2021
Rec V Date: 05/21/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Death Thrombocytopenia Subdural bleeding HEADACHE DIZZINESS

Other Meds:

Current Illness:

ID: 1338591
Sex: F
Age: 57
State: CO

Vax Date: 04/16/2021
Onset Date: 04/16/2021
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: Penicillin, Arithamiacine, Tetracycline

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

Symptoms: April 16th one after the Phizer vaccination first shot I had numbness and tingling in my gums, lips, and jawline. I felt out of sorts similar to a heavy brain fog including confusion. Legs were weak, I stumbled as I walked, motor skills significantly slowed. Next tip of tongue numb and throat tightening. Dizziness including spinning sensation. Headache borderline migraine. Went to ER . Intravenous treatment Benadryl and Pepcid. I was instructed to continue taking Benadryl over the counter and Pepcid over the counter. and schedule follow up appointment with general practitioner. April 20th GP advised to continue Benadryl and follow up with Neurologist and/or Physical Therapy if symptoms continue. Afternoon of April 20th left jawline and lower face developed clear welts/hives. Red cobblestone rash on neck, jawline and lower face. GP on call prescribed Prednisone 20 mg instructions 2x for 3 days then 1x for three days. April 21st left arm went weak, brain fog, and confusion intensified, dizziness/spinning, gums, tip of tongue and jawline numb. Hives on jawline including cobblestone red rash, Headache borderline migraine. Stumbling, legs weakened and went numb, I could not stand. Called 911. UC intravenous diazapam for muscle spasms, blood draw, performed cat scan on legs , brain and spine MRI, referred to neurologist.

Other Meds: Sulindac 200mg, Tizanidine 4mg, Armour 120mg, D3 Vitamin, Biotin Micro Lozenges, Inositol 500mg, Folic Acid 1360 mcg, Magnesium Glycinate 400mg

Current Illness: none

ID: 1338592
Sex: M
Age: 11
State: IL

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: IM
Vax Site: LA

Lab Data:

Allergies: n/a

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Vaccine administered to underage 11 year old.

Other Meds: n/a

Current Illness: n/a

ID: 1338593
Sex: M
Age: 67
State: IL

Vax Date: 03/08/2021
Onset Date: 04/11/2021
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 then nor now

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

Symptoms: The POSSIBLE adverse reactions being reported, on the advice of the pharmacist are: stiffening left arm, stiffening left hand, head throbbing on left side. [The second vaccine was given on the Monday following my Thursday kidney surgery on March 4, 2021. Since then, have seen health care professionals and had numerous tests performed (e.g., hemoglobin blood test, CMP, EKG 2x, cartoid artery ultrasound). No known or explanable reason or reasons for my dizziness, head throbbing, arm weakness, etc., have been specifically stated, merely speculation on the part of all providers, resulting in experimentation with doses especially of the high blood pressure Rx (Labatol was Rx'd for a time, but discontinued, about 2 weeks ago). Regardless of the medicines prescribed, the dizziness, head throbbing have continued and the "heaviness" or stiffening in the L arm has increased, perhaps due to my sleep positions as a result of the uncomfortable sleep position tried after my surgery. (A hematoma developed and took a while to resolve, so perhaps, "bad sleep posture" is the casual factor in all of these symptoms???)

Other Meds: Blood pressure Rx (2 - Olmnesartin - spell? & Metoporol - spell?), Flomax, fish oil, OTC daily vitamin, Vit D, Vit B-12

Current Illness: On March 4, 2021, my left kidney was successfully removed as a result of early-stage cancer, non metastasized.

ID: 1338594
Sex: F
Age: 60
State: OR

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Codiene

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

Symptoms: Very sore arm and muscles. Extremely tired the following day

Other Meds: Vitamin D, fish oil

Current Illness: No

ID: 1338595
Sex: F
Age: 62
State: MO

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: Latex Poison ivy

Symptom List: Pain in extremity

Symptoms: Headache, tired all day 5/20/21 Hard, pink welt at shot area evening 5/20/21

Other Meds: Atorvastatin Esomeprazole Aller-Tec Calcium with Vitamin D Melatonin Centrum multi vitamin Alaway eye drops

Current Illness: None

ID: 1338597
Sex: F
Age: 19
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: N/A

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

Symptoms: Patient got fainted after getting 2nd dose of vaccine that lasted for 1-2 seconds and after that patient was fine.

Other Meds: N/A

Current Illness: N/A

ID: 1338599
Sex: M
Age: 18
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NO

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

Symptoms: patient had the first dose moderna vaccine. Came to the pharmacy and pharmacist gave patient pfizer covid 19 vaccine.

Other Meds: NO

Current Illness: NO

ID: 1338600
Sex: F
Age: 40
State: GA

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Headache, severe fatigue, arm pain, loss of appetite, GI upset, low grade fever, light headacheness, back pain,

Other Meds: Protonix

Current Illness: GERD, iron deficiency

ID: 1338601
Sex: F
Age: 16
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Knumbness and tingling in fingers and toes. Both feet knumb. Large swollen lump under armpit on same arm as injection.

Other Meds: None

Current Illness: None

ID: 1338603
Sex: F
Age: 57
State: CO

Vax Date: 05/10/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: nka

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient describes arm swelling, lump, and pain which started approximately 9 days after injection. Patient was seen by her provider and was advised to take tylenol.

Other Meds: na

Current Illness:

ID: 1338604
Sex: M
Age: 32
State: FL

Vax Date: 05/17/2021
Onset Date: 05/17/2021
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: NKA

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

Symptoms: Patient fianc?e stated patient passed out while driving, but regained consciousness. Patient was advised to go to nearest urgent clinic or call 911.

Other Meds: Unknown

Current Illness: Unknown

Date Died: 05/06/2021

ID: 1338605
Sex: F
Age: 80
State:

Vax Date: 03/12/2021
Onset Date: 03/21/2021
Rec V Date: 05/21/2021
Hospital: Y

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: Death Acute kidney injury

Other Meds:

Current Illness:

ID: 1338606
Sex: M
Age: 79
State: CA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient got first dose Moderna on 04/29/2021. On 05/21/21, he came to pharmacy to pick up refills. He mentioned to pharmacist that he still got rash and blood on the injection site since the day of injection. The size of the rash was like a penny with redness and a small dark spot in the middle probably a small scab there, He said there was blood there before. No fever no pain. Pharmacist told him to consult his primary care doctor and put ice over the area in the meantime.

Other Meds:

Current Illness:

ID: 1338607
Sex: F
Age: 92
State: CA

Vax Date: 03/06/2021
Onset Date: 04/12/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin

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

Symptoms: Acute stroke due to embolism

Other Meds: Metoprolol Tartrate (LOPRESSOR) 25 mg Oral Losartan (COZAAR) 50 mg Oral Lipitor 40 mg

Current Illness: Chronic Hep C, HTN, osteopenia

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm