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: 1338851
Sex: F
Age: 48
State:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: PATIENT HAD ONLY MILD BODY ACHE AND HEADACHE THE FIRST DAY, THEN NEXT DAY SHE STRATED TO HAVE RASHES ON HER CHEAST, BACK AND ARMS AND ON HER THIRD DAY AFTER THE VACCINE SHE STARTED TO FEEL LIKE SEVERE TINGLING SENSATION AND NEEDLE STICK LIKE ON HER ARMS AND FEET SHE TOOK BENADRYL AND STARTED TO FEEL BETTER

Other Meds:

Current Illness:

ID: 1338853
Sex: F
Age: 53
State: NC

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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever blister. Treating with blistex

Other Meds: None

Current Illness:

ID: 1338854
Sex: F
Age: 31
State: VT

Vax Date: 04/22/2021
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: 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: My period came 9 days early. (My period is always extremely regular at every 27-28 days.) I have never taken birth control. Period volume and cramps did not seem to be much different.

Other Meds: None

Current Illness: None

ID: 1338855
Sex: F
Age: 0
State: CA

Vax Date: 04/14/2014
Onset Date: 04/15/2014
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: Developed Fever, Blisters, and a Tic after shots. Would jerk ear down toward shoulder while wincing. Reported to the pediatrician. Eventually went away.

Other Meds: Tylenol, Prilosec, Elecare Elemental Formula.

Current Illness: Ostomy Reversal Surgery, Gerd.

ID: 1338856
Sex: F
Age: 67
State: CA

Vax Date: 05/18/2021
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: Soy, horse urine, cortisol

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

Symptoms: Patient had a rash on her face, palpitations , fever lasting 2 days now

Other Meds: Climara Pro, Prometrium, Ativan, Flovent

Current Illness: Sinus infection

ID: 1338857
Sex: F
Age: 58
State: GA

Vax Date: 05/06/2021
Onset Date: 05/10/2021
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: PENICILIAN

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

Symptoms: PRESSURE ON THE BRAIN WHEN I LAY DOWN WITH MY HAND PRESSED AGAINST IT, SHORT TERM MEMORY LOSS, LEG PAINS AND OPPOSITE SHOULDER PAIN. FEELS LIKE SOMETHING MAY BE IN MY THOUGHT

Other Meds: WATER PILL-HC

Current Illness: NONE

ID: 1338858
Sex: F
Age: 28
State: AZ

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: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient felt faint; lost consciousness; hypotension. First reading was too low for recognition; second reading 76/41 and pulse of 28; 4 minutes later, third reading 90/58 and pulse of 81. Patient appeared to have a small seizure (inhaling hard for air, loss of body coordination, injection site arm muscles seized and locked). 911 was called and evaluated patient. She declined further treatment at hospital. Eighteen hours later, patient had slight flu-like symptoms, but was feeling much better. Patient reported follow-up appointment with PCP scheduled for 5/24/2021.

Other Meds:

Current Illness:

ID: 1339031
Sex: F
Age: 17
State: NY

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: None

Symptom List: Pharyngeal swelling

Symptoms: Initially developed hives then swelling of lips, face and difficulty breathing with cough (anaphylaxis reaction). Treated by school nurse with epipen then ambulance paramedics arrived and administered nebulizer treatment, IM benedryl, dexamethasone and transported to ER for follow up stabilization. ER administered additional antihistamine. Patient was discharged from ER stable and in much improved condition.

Other Meds: Tylenol, EmergenC

Current Illness: None

ID: 1339032
Sex: M
Age: 54
State: NC

Vax Date: 04/09/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Ankle and knee swelling and pain

Other Meds:

Current Illness:

ID: 1339034
Sex: F
Age: 20
State: NH

Vax Date: 02/18/2021
Onset Date: 03/26/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I have had my period since I was 13 years old, and I am now 20, almost 21 in four days. I am fully up to date with all my vaccines and have NEVER had an effect like this before. Since the second dose of my Pfizer vaccine, I got my period four days after, which was normal at day 31. After this immediate period, my periods have been REMARKABLY LATE FOR THE PAST THREE, ALMOST FOUR MONTHS. Once this initial period was over, it took me 50 days to get my next period, and I am now on day 40 with no period. For the past seven years, my periods have been EXTREMELY regular like clockwork, 28-32 days every month. I called my OBGYN office, as I thought I must be pregnant even though I cannot recall engaging in vaginal intercourse. They told me if I skipped two cycles then I should come in and get checked out, and to take another pregnancy test the next week. I ended up taking five pregnancy tests, and they were all negative. I have tracked my periods on an app on my phone for years, and I have never been this late in my entire life. I am not exceedingly stressed, I am not strenuously exercising, I am not taking part in any sexual activity that would lead to pregnancy- I am not doing anything I can think of that would make my periods late. I cannot imagine any other reason for why my periods have been irregular for the past three months other than the Pfizer vaccine as this effect started after I received this vaccination. I have read accounts of this happening with other women, but only for one cycle. This has now not only effected me for one cycle but now two, and I am growing increasingly concerned. I will be bringing this up with my OBGYN.

Other Meds:

Current Illness:

ID: 1339035
Sex: F
Age: 26
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: The patient felt numbness on left arm (injection site) after getting the vaccine. Had patient rested for 30 minutes, pt started feeling her arm then left to work.

Other Meds:

Current Illness:

ID: 1339036
Sex: F
Age: 39
State: OH

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

Lab Data:

Allergies: None known

Symptom List: Rash, Urticaria

Symptoms: Shot on Wednesday afternoon, the Rash was noticed behind ears down sides of neck next morning with elevated temperature though out Thursday. Friday rash is itchy and has progressed down towards shoulders and chest area and moving up to chin and sides of cheeks. Prickly itchy raised bumps.

Other Meds: None

Current Illness: None

ID: 1339037
Sex: F
Age: 26
State: MA

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

Lab Data:

Allergies: Sulfa, Ceclor, Penacillion

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

Symptoms: After regular flu like symptoms (now recovered), I started having dizzy spells. I noticed my occipital lymph node is huge on the right side of my head. When I turn my head to the left, I am overcome with dizziness. The room spins. This has been going on for a week, not getting better

Other Meds:

Current Illness:

ID: 1339039
Sex: F
Age: 0
State: CA

Vax Date: 07/18/2014
Onset Date: 11/11/2014
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: Developed Hypotonic unresponsive episodes. Went to ER by Ambulance. Discharged after observation. Continues to have syncope spells for 3 more years. Later tested positive for metal poisoning most likely from an inability to clear the vaccines.

Other Meds: Prilosec, Tylenol, Elecare Elemental Infant Formula.

Current Illness: Cronic Constipation, GERD

ID: 1339040
Sex: M
Age: 31
State: WI

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: LA

Lab Data:

Allergies:

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

Symptoms: Patient was observed 30 minutes post vaccination, then returned to work. Came back after feeling unwell. Heart rate was taken and >100. Patient sent to holding area for further observation.

Other Meds:

Current Illness:

ID: 1339041
Sex: F
Age: 48
State: HI

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

Lab Data:

Allergies:

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

Symptoms: pt got 1st covid vaccine on 5/4/21 and developed swallowing difficulites. Felt flushed and had a sore throat. Complained of swelling in throat. Pt taken to ED. 48-year-old female presents from vaccine clinic with concerns about possible allergic reaction. No urticaria, no wheezing, no angioedema. Does have occasional bronchospastic cough. Patient reports she gets this with involved but felt a little bit of throat tightening and was worried she could be having an allergic reaction. Received Benadryl and Decadron here, reports that she would like to go home at this point in time, does not want to try albuterol that was ordered, will take over-the-counter allergy medicine as needed and return for any worsening. Unclear if this is truly an allergic reaction, patient advised that she still should get the second shot and be monitored closely.

Other Meds:

Current Illness:

ID: 1339042
Sex: F
Age: 17
State: WA

Vax Date: 04/23/2021
Onset Date:
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: 17 y/o at time of administration

Other Meds:

Current Illness:

ID: 1339044
Sex: F
Age: 37
State: IN

Vax Date: 05/07/2021
Onset Date: 05/10/2021
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: Fish oil

Symptom List: Ear pain, Hypoaesthesia

Symptoms: At 8 AM on 5/10/21 I experienced extreme shortness of breath and an elevated heart rate. I could not catch my breath and my heart was ?resting? at approximately 145 beats per minute. I went to the local ER at which time I was taken back for testing, approximately 10 hours later I was diagnosed with bilateral pulmonary embolism. My legs were checked and they could not locate any other blood clots - just in my lungs.

Other Meds: Metformin Spironolactone Atorvastatin Fenofibrate Wellbutrin Zyrtec Prilosec Multivitamin Orthotricyclen

Current Illness: None

ID: 1339045
Sex: F
Age: 47
State: IN

Vax Date: 04/09/2021
Onset Date: 04/11/2021
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: Had menstrual bloating, cramps and a period for the first time in a year and a half. Nausea (especially after eating) for a few days. Extremely tired for a week.

Other Meds: Allegra; Flonase; IUD

Current Illness:

ID: 1339046
Sex: M
Age: 33
State: WI

Vax Date: 05/20/2021
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:

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

Symptoms: This was patient's second dose. Patient reported after first dose she felt mild dizziness, but no loss of consciousness. After 2nd shot on 5-20-21 patient complained of dizziness. Patient sat in chair for observation after immunization for 30 minutes until medical team was called and took patient to observation room. Symptoms included dizziness and heart rate >100.

Other Meds:

Current Illness:

ID: 1339047
Sex: M
Age: 24
State: MA

Vax Date: 05/19/2021
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: 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: Sore arm (like the first shot?s side effects), but most notably, muscles aching in entire body, noticeable increase in body temperature (felt like a fever, temp was 99.5)

Other Meds: None

Current Illness: None

ID: 1339048
Sex: F
Age: 24
State: IL

Vax Date: 05/18/2021
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: Peanut/Tree-Nut

Symptom List: Unevaluable event

Symptoms: The day after I was vaccinated, I woke up and noticed my arm had a red, swollen, and hot rash (it almost looked like an infection). It appears almost scaly and looks like the ?COVID arm? in the pictures presented on various websites. The area continues to be red and swollen on 5/21/2021 at 11 PM. The area causes my arm to feel pressure under my armpit since it is located on the outer area of my arm. I still continue to become chilled and hot/sweaty randomly through out the day as of 5/21/2021 as well.

Other Meds: Prescription: Tri-Linyah OTC: Ibuprofen, Excedrin, Acetaminophen

Current Illness: None

ID: 1339049
Sex: M
Age: 51
State: CA

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:

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

Symptoms: An employee felt heart palpitation after her 2nd shot of Pfizer. We took her blood pressure reading and it was normal, then told her to rest more, drink fluid. Then 5-10 minutes later, she felt itchiness on her right leg. I checked and it was red and had 2 bumpy spots from her scratches. We gave her diphenhydramine 50mg/ml with 1 ml IM. I told her to rest and warned her of drowsiness. After 5 minutes, she started feeling better wanted to leave (used uber) before she get too drowsy.

Other Meds:

Current Illness:

ID: 1339050
Sex: F
Age: 4
State: CA

Vax Date: 05/01/2018
Onset Date: 07/10/2018
Rec V Date: 05/21/2021
Hospital: Y

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: Admitted overnight for stiff neck and headache. Treated with Tylenol and Ibuprofen.

Other Meds: None

Current Illness: None

ID: 1339051
Sex: F
Age: 60
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs, Ciprofloxicin, anti depressants, antipyscotics

Symptom List: Injection site pain, Menorrhagia

Symptoms: Bad headache, 103? fever, dry eyes, eye pain, both ears hurt, unable to do any activity. Chills,Severe bone, muscle pain, no appetite. Fever rose from 99.2? to 103? during day. Evening sweating, weakness, dizziness

Other Meds: None

Current Illness: None

ID: 1339052
Sex: F
Age: 33
State: OR

Vax Date: 05/10/2021
Onset Date: 05/16/2021
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: Patient should have received a second dose of Pfizer and was instead given Moderna

Other Meds:

Current Illness:

ID: 1339053
Sex: F
Age: 70
State: MD

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: Codeine, Sulfa-based drugs, Aspirin, Benedryl. Fruits belonging to the ragweed family, such as apples and cantaloupe (minor). Hayfever.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vaccine received approx. 11am; returned home. Felt sleepy around 3pm. Took nap until 6:15pm. At that time, generalized joint pain and skin pain was reported, which was reported at 3-4 pain (distracting to distressing), as well as a notably stiff left arm and discomfort at injection site. This worsened gradually until the time of this report filing at 11:42pm and has increased to 5-6 (very distressing to intense). Minor nausea, but no vomiting. No treatment has been sought at this time. Patient took 500mg of Acetaminophen twice. One tablet at 7:00pm and TWO tablets at 11:30pm. We intend to seek professional medical intervention if symptoms progress further.

Other Meds: Levothyroxine - 50mcg, 1/day (half of a 100mcg tablet) Levothyroxine - 56mcg, 1/day (half a 112mcg tablet) Calcitriol - 0.5mcg, 1/day Calcium - 600mg + D3, 3/day (patient has no parathyroid) Kirkland Allertec - 10mg, as needed for seasona

Current Illness:

ID: 1339054
Sex: F
Age: 39
State:

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: Gluten

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Dose 1; 1/15/21; About 8 hrs post, itching/rash upper body; 1/16/21, Itching and on and off dizziness; 1/17/21 Itchy on and off dizzy; 1/18/21; Trip to ER dizzy, nauseous vertigo.

Other Meds: Metoprolol 25mg; Vit C; Sulfasalazine

Current Illness: N/A

ID: 1339055
Sex: F
Age: 56
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Allergic to naproxen, ibuprofen, acetaminophen, aspirin, oral acyclovir

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

Symptoms: I have clusters of hives on the back of my head ,neck, legs and i have pictures.

Other Meds: None

Current Illness: Regularly take benadryl for hives

ID: 1339056
Sex: F
Age: 40
State: WA

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: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: 101 fever, vomiting, pain behind knees, armpits neck, swollen bump on collar bone, headache

Other Meds: Sertriline, levothyroxine

Current Illness: None

ID: 1339057
Sex: F
Age: 44
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain

Symptoms: After initial shot I saw stars and/or eye floaters.

Other Meds: None

Current Illness: None

ID: 1391765
Sex: F
Age: 13
State: FL

Vax Date: 05/16/2021
Onset Date: 05/16/2021
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: 0 NKA

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

Symptoms: *Per patient's mom's report* After leaving pharmacy, Pt c/o throat swelling/difficulty swallowing. Within 45 min, angioedema + tongue swelling. Benadryl + prednisone given orally @ home. Dad rushed Pt to ER, IM Epi given, Pt admitted for observation over HS.

Other Meds: Claravis 20 mg Qd

Current Illness: N/A 0

ID: 1407127
Sex: M
Age: 25
State: HI

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

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

Symptoms: -2nd Dose given 6 days early

Other Meds: none

Current Illness: none

ID: 1407248
Sex: F
Age: 16
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Pt received vaccine and was walking around the store and passed out. Pt was responsive , alert and oriented. 911 was called. Paramedics arrived and was checked out. They released her to go home without additional followup.

Other Meds: N/A

Current Illness: None

ID: 1407252
Sex: F
Age: 45
State: OK

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: NKA

Symptom List: Erythema, Pruritus

Symptoms: Generalized flushing, Urticaria upper torso and sparse to uppe thighs, No SOB,NO STRIDOR Lungs clear Treated with Epi 0.5mg IM, and Benadryl 50mg IM Right Deltoid Sent via EMS to the ER

Other Meds:

Current Illness:

ID: 1407255
Sex: M
Age: 11
State: NJ

Vax Date: 01/01/1970
Onset Date:
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: None

Other Meds:

Current Illness:

ID: 1407258
Sex: F
Age: 19
State: VT

Vax Date: 04/24/2021
Onset Date: 04/27/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: A few days after the Moderna COVID19 vaccine she started having a metalliac taste to her mouth, sensation of rotten smells in her nose and down her throat. Causing her to have nausea and vomiting, decreased appetite and malaise. Lack of food from taste is causing headaches, fatigue, malaise as well.

Other Meds: zyrtec 10mg once a day; clinda gel topically BID

Current Illness: none

ID: 1407293
Sex: U
Age: 18
State: MA

Vax Date: 03/28/2021
Onset Date: 05/12/2021
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: PCN, Cephalosponn

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: "Brain fog", fatigue, dizziness, insomnia, trouble concentrating.

Other Meds: See attached

Current Illness:

ID: 1339059
Sex: F
Age: 29
State: IL

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
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: Amoxycillin

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

Symptoms: Woke up in the middle of the night with body aches, shivering. Fever of 101 (fever has continued to persist ranging from 100-101 whilst taking acetaminophen), Vomiting/nausea, Significant tenderness at injection site, Fluctuating between feeling very hot and very cold.

Other Meds: Sprintec, omeprazole

Current Illness: N/A

ID: 1339060
Sex: F
Age: 58
State: CA

Vax Date: 04/15/2021
Onset Date: 04/19/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Spontaneous nosebleeds. Severe and several times a day. Lasting around 30 minutes each time.

Other Meds: None

Current Illness: None

ID: 1339061
Sex: M
Age: 53
State: CA

Vax Date: 04/28/2021
Onset Date: 05/14/2021
Rec V Date: 05/22/2021
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: Pain in extremity

Symptoms: Patient came in for swelling and pain to left calf, he also had a nodule to the medial posterior aspect of the calf. He reported the symptoms were since approx the 5/17/21. Pt said it possibly started sooner on the 15th. Pt came in today 5/21/21 because he received an ultrasound at a clinic by referral from his pmd and was dx with a DVT to the left calf. His pmd then referred him to come to ER where I triaged him in the triage department. He mentioned that began feeling bad after the Moderna Shot he received on 4/28/2020 and stated the now he has this new problem that he never had in the past. Only hx was mild htn he said.

Other Meds: none

Current Illness: none

Date Died: 05/17/2021

ID: 1339062
Sex: M
Age: 85
State: SC

Vax Date: 04/15/2021
Onset Date: 05/04/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, anti-psychotics

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

Symptoms: Patient appeared to have had suffered a stroke. Admitted to hospital, tests determined no stroke. Patient had pneumonia, and severe inflammatory response. Sepsis.

Other Meds: Insulin, Aricept, KLONopin, Trazodone, Zoloft, Depakote, Hytrin

Current Illness:

ID: 1339063
Sex: F
Age: 40
State: WA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/22/2021
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: Moderna COVID-19 vaccine second dose was given 21 days after first dose.

Other Meds: None

Current Illness: GERD

ID: 1339064
Sex: F
Age: 36
State: PA

Vax Date: 04/06/2021
Onset Date: 04/21/2021
Rec V Date: 05/22/2021
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: Dairy, latex, drug: tequin

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

Symptoms: I had recovered about 90% (with medication) since having COVID in December when I received my first dose of the COVID vaccine. Thirteen days after the vaccine I began to experience symptoms like when I had COVID. On day 13 I started to itch and my BP dropped and I became light headed. My vision started to go and I had a hard time breathing and forming words for my husband to help me with some water. This lasted about 20 min. Since then I have been having heart rate increases up into the 150s with minimal effort. Bending like doing dishes or putting away groceries makes me extremely light headed. I have become so tired just folding a little bit of laundry. It wasn?t until a few weeks in that I noticed this was all exactly like when I had COVID. Including being okay in the morning but having so many issues by the evening. So weird. I?m 3 weeks and 4 days past my second shot and finally starting to have some better days again but no day has been symptom free. I wish could know if this is happening to other long haulers and that it will most likely resolve, I have been starting to wonder about disability and really having a hard time facing the fact that I no longer can complete simple house hold chores like I used to.

Other Meds: Zyrtec, Pepcid, Zoloft, Adderall XR

Current Illness: Considered a covid Long Hauler, with autonomic instability since catching covid December 2020. I am under the care of a neurologist and have documented everything with her.

ID: 1339066
Sex: F
Age: 21
State: FL

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 05/22/2021
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: Not any known of.

Symptom List: Vomiting

Symptoms: I took the vaccine on April 6th around 8:40 PM, and the next day around 2:30 AM I noticed multiple pumps on my chest area and the back part of my thighs, and they were quite itchy. On April 8th, I woke up with my lips completely swollen, very tingly, and feeling warm - I, unfortunately, had a college test on that exact day and could not go to the hospital straight away. They told me to go get it checked and go to the hospital in case I have trouble breathing. My lips ended up going back to normal eventually. I went to three different doctors after a couple of days because I kept getting sick and also to explain the situation and ask if I could even take the second dose of the vaccine since it was approaching. All three doctors told me not to because my body could go into anaphylactic shock, so I did not take it.

Other Meds: Women's multivitamins. Birth Control Pill.

Current Illness: None.

ID: 1339067
Sex: F
Age: 21
State: NV

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/22/2021
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: Sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: "Covid arm"- large and red raised patch on skin. Warm to touch with minimal itching and pain.

Other Meds: N/A

Current Illness: No

ID: 1339068
Sex: F
Age: 27
State: MD

Vax Date: 05/14/2021
Onset Date: 05/22/2021
Rec V Date: 05/22/2021
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: "COVID arm" painful rash on my arm. Didn't start until over a week past the injection

Other Meds: Emgality, Trokendi

Current Illness:

ID: 1339070
Sex: F
Age: 35
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/22/2021
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: Amoxicillan

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I experienced numbness in my right hand. It switched between my hand and 2 middle fingers. Since I have had covid, my nose would run off and on. My head would hurt and I always had some type of congestion and high bpm. When I received the shot, my congestion and runny nose dried up. It felt as if the shot was pulling something through my veins and drying up the congestion instantly and clearing up my head congestion as well.

Other Meds: Claritin D 24 hrs

Current Illness:

ID: 1339071
Sex: F
Age: 36
State: OR

Vax Date: 04/23/2021
Onset Date: 04/25/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: sulfa based drugs macrobid

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

Symptoms: large painful lymph nodes above and below left clavicle,

Other Meds: Euthyroid 150 mg Asprin 81 mg

Current Illness: none

ID: 1339072
Sex: F
Age: 37
State: CA

Vax Date: 05/01/2021
Onset Date: 05/04/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: 3 days after vaccine on left arm, woke up with large bumps covering right arm. Throughout the day, the rash/bumps worsened and spread over my whole body. That night, aches/chills began. The next day the rash was very severe, red bumps covering body, with it slowly spreading up next onto face. Most concentrated and severe on stomach, sides, upper thighs and creases of knees, buttocks, elbows. That day, aches and chills were severe and could not get out of bed. Heavy chest occurred later that day. These symptoms lasted 2-3 days, with the rash lasting over a week. Doctor prescribed oral steroids (30 pills total) to get rash under control. Also had lack of appetite and bad headaches

Other Meds: Wellbutrin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm