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: 1341838
Sex: F
Age: 63
State: CA

Vax Date: 04/29/2021
Onset Date: 05/13/2021
Rec V Date: 05/23/2021
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: Penicillin, codeine/opiates, latex, fish/seafood

Symptom List: Dysphagia, Epiglottitis

Symptoms: On day 14 post second vaccine, I spiked a 102 degree fever at 2am and experienced excruciating low back pain and body aches. Afraid that I somehow contracted COVID despite taking all precautions, I went to the urgent care center mid-day. Abbott rapid test negative. Chest and abdominal X-rays clear. Blood and protein in urine, so assumptive diagnosis was kidney infection. However, urine was very clear not cloudy and I never had any UTI symptoms. Received injection of rocephin and 7 day course macrobid. No symptoms after 3 days. Lab lost urine so no culture results. Seems very coincidental that occurred at exactly two weeks. Possible nephritis/kidney inflammation caused by immune response? Maybe not, but I thought it important to report in case there are other similar instances.

Other Meds: Losartan

Current Illness: None

ID: 1341839
Sex: M
Age: 52
State: NC

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 05/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Irregular, tachycardic heart rhythm lasting several hours on the second night after vaccination; this did not recur with the second dose of the same vaccine which was from Lot #EL9266.

Other Meds: sertraline 50mg qHS multivitamin 1 qAM

Current Illness: none

ID: 1341840
Sex: M
Age: 27
State: FL

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 05/23/2021
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: Ibuprofen, Azithromycin and Erythomycin

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

Symptoms: After injection, patient jolted and eyes fluttered. He seemed to be having a seizure like reaction. He then slumped to side and head hit side of wall since we had chair with side rails positioned against wall. He lost conscious for maybe 30 seconds and then eyes opened. I asked if he was OK and the first thing he asked for was water. He said he felt light headed and dizzy. I had my intern who was working grab him water from the deli and had him sit and rest. He started sweating and asked for paper towels. I grabbed him a couple of towels so he can wipe his face. I continued to check on him while doing my work. He seemed fine after that. After 30 minutes, I checked his blood pressure. It read 100/63. I continued to monitor him and he left after that. He did have friend with him the entire time who helped him.

Other Meds:

Current Illness:

ID: 1341841
Sex: M
Age: 58
State: TX

Vax Date: 05/06/2021
Onset Date: 05/16/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: Cats, seasonal allergies, anesthetics

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Swollen and sore throat, skin in throat coming out of mouth, bleeding tongue, body aches and pains.

Other Meds: Cephalexin 500mg 4x a day; Parotexine 20mg 1x a day; Doxycycline 100mg 1x a day; Metformin 500mg 1x a day; Lisinopril 20mg 1x a day; Almodipine 5mg 1x a day; Glyburide 5 mg 1x a day;

Current Illness: Bacterial operation on clavicle, swollen testicle

ID: 1341842
Sex: F
Age: 28
State: OH

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient stated that a large red, itchy rash appeared across her neck and chest the following day after the COVID vaccine. She has tried treating the rash with hydrocortisone cream, which has helped with the itchiness but the rash is still present. Patient returned to the pharmacy May 13, six days after the COVID vaccine was administered, to discuss the rash with the Pharmacist. Pharmacist noticed the large rash was still present on the patient's neck and across her chest. Patient was advised to take oral Benadryl and contact her physician regarding the rash and whether receiving the second COVID vaccine dose would be appropriate. Pharmacist followed up with patient May 22 regarding the rash and patient states rash is 98% gone.

Other Meds: Ibuprofen, Clindamycin, Tylenol

Current Illness: N/A

ID: 1341843
Sex: F
Age: 54
State: MA

Vax Date: 04/24/2021
Onset Date: 05/03/2021
Rec V Date: 05/23/2021
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: Large circular red area about 3+ inches in length and 2+ inches width appeared on my arm 10 days after my vaccination. The area was warm/hot to the touch and uncomfortable when touched. It lasted a few days before disappearing.

Other Meds: None

Current Illness: None

ID: 1341844
Sex: M
Age: 18
State:

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/23/2021
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: Dizziness, lightheadedness, nearly fainted Given crackers, water and juice

Other Meds:

Current Illness:

ID: 1341845
Sex: M
Age: 32
State: SC

Vax Date: 04/09/2021
Onset Date: 04/21/2021
Rec V Date: 05/23/2021
Hospital: Y

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: I was diagnosed with Transverse Spinal Myelitis at ER in town on April 27th. I had been suffering from sever back and neck pain for over a week. I reported to the ER due to the inability to void my bladder. I had full back, neck, and Brain MRI?s after being admitted to the hospital and neurologist Dr. made the diagnosis of Transverse Spinal Myelitis. I spent 3 days in the hospital and received 5 IV steroid treatments to treat my condition.

Other Meds: Zoloft 25mg daily

Current Illness: None

ID: 1341846
Sex: M
Age: 20
State: IL

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/23/2021
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 LISTED

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: PATIENT DID NOT INDICATE (VERBALLY OR IN THE VAR FORM FILLED OUT) THAT HE HAS HAD ANY REACTIONS TO VACCINATIONS IN THE PAST. HE RECEIVED HIS VACCINE, SAT DOWN AS INSTRUCTED AND WITHING FEW MINS, PASSED OUT AND FELL FACE DOWN ON THE GROUND UNCONSCIOUS FOR A FEW SECS. HE WAS ATTENDED TO IMMEDIATELY BY THE RPH ON DUTY. PATIENT GAINED CONSCIOUSNESS WITHIN A FEW SECS AND WAS TAKEN TO THE HOSPITAL BY PARAMEDICS AS HE ENDED UP GETTING A GASH ON HIS FOREHEAD FROM THE FALL.

Other Meds: NOT AWARE OF ANY

Current Illness: NOTHING MENTIONED BY THE PATIENT

ID: 1341847
Sex: F
Age: 70
State: OK

Vax Date: 01/29/2021
Onset Date: 02/04/2021
Rec V Date: 05/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: broke out in shingles 3 years after receiving 2 does of Shingrex vaccination

Other Meds: 2 12.5 mg Irbesar, 5 mg amlopidine, 50 mg sertraline, OTC esomeprazole magnesium, 50 mg Vitamin D, 30 mg zinc, 81 mg aspirin

Current Illness: none

ID: 1341848
Sex: F
Age: 68
State: KS

Vax Date: 02/16/2021
Onset Date: 02/20/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: Naproxen

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

Symptoms: Pain and swelling and redness in vaccine area and fatigue (commonly reported side effects) but the unusual reaction that experienced after abut 4 or 5 days after having received the vaccine were red, distinct eruptions that resembled pustules and about a day later there were spike-like, pointy protrusions that resembled thin thorns(rough to the touch) that emerged from middle of the red bumps. in the mid area of the inner arm (both above and below the elbow joint, I pulled some of those "spikes" but not all and decided to take a picture.

Other Meds: Metformin 500 mg (2 x/day) ., Atorvastatin 20 mg ; Vitamin D3 (5000 IU), Host Deense Lion's Mane mushroom (2 caps/day), Hykyurinuic Acid 200 mg. , Mega EFA Fish Oil

Current Illness:

ID: 1341849
Sex: F
Age: 23
State: KY

Vax Date: 05/07/2021
Onset Date: 05/11/2021
Rec V Date: 05/23/2021
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: Coreg and mangoes, plus seasonal allergies

Symptom List: Rash, Urticaria

Symptoms: Severe fatigue, headache, arm pain that lasted 5+ days, and severe heart fluttering (kept feeling like it was pounding out of my chest and skipping a beat). I made sure my blood pressure was stable (usually reading 128-135 systolic) and tried taking my propranolol for anxiety to stop the effect. Nothing really made it go away. This is not normal for me, but unfortunately I had to work so I worked through it. Would cause me to feel out of breath at times. It finally went away for the most part on the Monday of the next week, but it comes back occasionally.

Other Meds: Bupropion XL 300mg, Escitalopram 20mg, Propranolol 20mg, Spironolactone 50mg, Lisinopril 40mg, HCTZ 12.5mg, Levoxyl 88mcg, Vitamin D 50,000u, Rizatriptan 5mg PRN, Cranberry supplement

Current Illness: Rhinitis sparked from seasonal allergies

ID: 1341850
Sex: F
Age: 58
State: LA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: Potassium Iodide, black elderberry

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

Symptoms: Fever, sore arm, headache, nausea, exhaustion

Other Meds: Lantus, trulicity, Novolog Jardiance, levelbuterol

Current Illness: None

ID: 1341851
Sex: M
Age: 40
State: CO

Vax Date: 04/26/2021
Onset Date: 05/15/2021
Rec V Date: 05/23/2021
Hospital: Y

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 reported

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: patient presented to urgent care reporting shortness of breath, cough, and chest pain. Transferred to emergency department then admitted to current facility for a management of new onset heart failure with possible etiologies of myocarditis or sarcoid. Also found to have LV thrombus, anemia, and lymphadenopathy. Patient initiated on medications to manage heart failure and anemia and anticoagulated. Patient improved and discharged to home medically stable.

Other Meds: albuterol inhaler

Current Illness: None reported

ID: 1341852
Sex: F
Age: 36
State: IN

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/23/2021
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: Erythromycin

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

Symptoms: Fever as high at 102.4, nausea, aches and pains, chills and hot flashes / sweating, headache, dizziness, shaking, sore arm all the way to my finger tips.

Other Meds: Zyrtec, Elderberry, Phillips probiotic, VitaFusion women?s gummies, VitaFusion fiber gummies, Junel

Current Illness:

ID: 1341853
Sex: M
Age: 49
State: CA

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 05/23/2021
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: None

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

Symptoms: Fever and chills beginning 1 am lasting 9 hours muscle soreness in legs.

Other Meds: None

Current Illness: None

ID: 1341854
Sex: F
Age: 21
State: IN

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/23/2021
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: NKA

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

Symptoms: Symptoms started roughly five hours after receiving the vaccine. It began with cold sweats, where I was shivering but sweating. Then I began experiencing nausea overnight coupled with a headache.

Other Meds: Xulane Transdermal Birth Control

Current Illness: NONE

ID: 1341855
Sex: F
Age: 30
State: MI

Vax Date: 05/07/2021
Onset Date: 05/18/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drug allergy, indoor/outdoor allergies, animal dander allergy, and cows milk allergy.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pain in left arm where injection was done lasted about 4-5 days. Starting 5/18/21 I got a cold sore and it has progressively gotten worse and still present today. It is now on moth the top and bottom lips in the corners. Right side is more severe than left side. Worst cold sore outbreak I have ever had. First time it has spread to the skin above my lip. Also first time one of my cold sores has been pus-filled. I received prescription of generic valtrex 1 gram yesterday, 5/22/21. And took two pills, upon waking this morning there is no improvement and today is when I first noticed one of the sores being pus-filled. I started using abreva as soon as the tingle started. These medications used to help significantly and keep the sores from spreading. It has only been getting worse. I believe this could be related to receiving my first Moderna vaccine shot, as this is unlike any other outbreak I have had. I received the valtrex prescription from a doctor over telehealth appointment.

Other Meds: Allegra-D 24 hour, multi-vitamins, vitamin d3 1 per week, and vitamin b12.

Current Illness:

ID: 1341856
Sex: F
Age: 67
State: FL

Vax Date: 04/05/2021
Onset Date: 05/10/2021
Rec V Date: 05/23/2021
Hospital: Y

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

Lab Data:

Allergies: amoxicillin, atarax, codeine, Cymbalta, Demerol hcl, farxiga, grass, Keflex, lactulose, lyrica, metformin, metoprolol, milk of magnesia, Mobic, nsaids, perfume, smoke, tizanidine, Toprol-XL, tradjenta, ultram ER, Zithromax.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: pt was having shortness of breath and becoming hypoxic. came through ED on 5/20/21.

Other Meds: Tylenol, Tessalon perles, diltiazem, Benadryl, potassium, anastrazole, bentyl, Lasix, melatonin, Dexilant, levothyroxine, magnesium oxide, Robaxin, Zofran, pravastatin, cyanocobalamin, cholecalciferol, Norco.

Current Illness:

ID: 1341857
Sex: M
Age: 53
State: DE

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: pseudoephedrine, Benadryl.

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

Symptoms: 1st day after vaccine. Chills, fever, fatigue, headache, 2nd day- stiff neck, headache. 3rd day after vaccine - left side of face sore, headache, earache. 4thday -Chest pains,- very quick, sharp, very tired, had heart skip/ palpations went to ER @ 11:30pm. Had EKG, blood work, stress test from cardio dept. Followed up with Dr. with cardio dept. received Zio patch Heart Monitor and wore for 2 weeks. Currently waiting the results.

Other Meds: N/a

Current Illness: fast heart beat.

ID: 1341858
Sex: F
Age:
State:

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 05/23/2021
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: No

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

Symptoms: Chills, tiredness, sore arm. All gone the next day.

Other Meds: Prenatal vitamins

Current Illness: Nonr

ID: 1341860
Sex: F
Age: 40
State: NY

Vax Date: 03/23/2021
Onset Date: 05/01/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: Nut allergies

Symptom List: Unevaluable event

Symptoms: still checking by doctor because we dont know what is the story.

Other Meds:

Current Illness:

ID: 1341861
Sex: F
Age: 27
State: KY

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Lymph node has become painfully swollen

Other Meds: None

Current Illness: None

ID: 1341862
Sex: F
Age: 39
State: NY

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient reports arm soreness and neck swelling. Has slight rash by left collarbone. Effects started at some point after vaccine and were still present in afternoon of 5/22/21

Other Meds:

Current Illness:

ID: 1341863
Sex: M
Age: 13
State: OH

Vax Date: 05/21/2021
Onset Date: 05/23/2021
Rec V Date: 05/23/2021
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: My son woke up the day following his vaccine and had mild complaints of headache and ?feels like I have a touch of the flu?. He hydrated with water that day very well and I gave him 500 mg of Tylenol. On Sunday (2 days after vaccine) we were at church celebrating outdoor Mass. about 20 minutes into church my son said he didn?t feel well and needed water. He was standing at the time he said this. He had been standing under and umbrella the entire time to shade him from the sun. About 1 minute later he fainted. He visually looked very pale at the time. We treated him with by having sit down, moved him to air conditioning. It took about an hour before he felt back to baseline.

Other Meds: None

Current Illness: None

ID: 1341864
Sex: F
Age: 29
State:

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/23/2021
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: amoxicillin

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

Symptoms: Urticaria

Other Meds:

Current Illness:

ID: 1341865
Sex: F
Age: 42
State: WV

Vax Date: 03/06/2021
Onset Date: 03/08/2021
Rec V Date: 05/23/2021
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: Penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Severe shoulder pain, and arm pain, tenderness in arm, limited range of motion, arm weakness, shoulder stiffness, limitations of daily activities, reaching, driving, and disturbed sleep, going on over 2 months now

Other Meds: Vumerity Vitamin D Biotin Centrum Lo Lo Estrin Fe

Current Illness:

ID: 1341866
Sex: F
Age: 53
State: FL

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Dizziness, confusion, extreme agitation and heart racing. I felt like I was going to have a seizure as sounds were loud, and I felt like I was losing control of my body and mind! It lasted for almost 6 weeks. I couldn't look at my computer, phone, puzzle, books, tv or anything that made my eyes move as it made the dizziness worse. I was very foggy and lethargic for weeks afterwards with panic/agitation attacks. I HAVE NEVER HAD PANIC ATTACKS OR AGITATION LIKE THIS IN MY LIFE - IT WAS UNBEARABLE AND FRIGHTENING. My head was heavy, it felt like a weight was in it, it caused a broken blood vessel in my eye. I also had extreme pain in my big toe to the touch.

Other Meds: Mesalamine

Current Illness: NONE

ID: 1341867
Sex: M
Age: 22
State: WA

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/23/2021
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:

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

Symptoms: PATIENT GOT A SECOND DOSE OF JOHNSON AND JOHNSON COVID 19 VACCINE WHEN ITS ONLY SUPPOSED TO BE ONE DOSE. IT WAS EXPLAINED TO THE PATIENT THAT THIS VACCINE IS SINGLE DOSE ONLY BUT HE DID NOT SAY IT WAS HIS SECOND DOSE ALREADY. WE FOUND OUT WHILE BILLING THE SECOND DOSE.

Other Meds:

Current Illness:

ID: 1341868
Sex: M
Age: 51
State: FL

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

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

Lab Data:

Allergies: nkda

Symptom List: Nausea

Symptoms: Approximately 4 hrs after vaccine administration, dark, red, raised rash appeared on torso, arms, buttocks, and legs. So severe that dexamethasone started. Rash did not improve for weeks and steroids continued during that time. Patient noted to then go into congestive heart failure, had 2-3+ pitting edema, "ground glass"/pulmonary congestion in lungs, rapid A-fib with RVR 170-180s. treated at Hospital with admission from 5/15-5/17/2021. Patient complained of chest pain and trouble breathing starting 5/13/2021. Patient has mostly recovered, and is at home now. Now on high dose beta-blockers and eliquis for the new onset A-Fib.

Other Meds: famotidine 20mg prn lorazepam 1mg prn diphenhydramine 25mg prn metoprolol 50mg daily

Current Illness: none

ID: 1341869
Sex: M
Age: 72
State: TX

Vax Date: 05/12/2021
Onset Date: 05/14/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: fever, chills, chest pain/dizziness for 4 days starting 48 hours after vaccine - dizziness - SOB since

Other Meds: vitamin c medications for heart failure & hypertension

Current Illness: none

ID: 1341870
Sex: F
Age: 49
State: CA

Vax Date: 03/03/2021
Onset Date: 04/19/2021
Rec V Date: 05/23/2021
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 known

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

Symptoms: Starting on April 19, 2021 to date, I have had extreme swelling in my eyes and lips. In addition, my lips have been drier than they ever have previously (dried, cracking, etc.) and have had welts and the outer edge of both my upper and lower lips. I have also had "raccoon eyes."

Other Meds: Birth control pills

Current Illness: None known

ID: 1341871
Sex: F
Age: 72
State: PA

Vax Date: 03/25/2021
Onset Date: 04/10/2021
Rec V Date: 05/23/2021
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: Codien Valium

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

Symptoms: Lost the vision in my left eye. Taken to Hospital in on April 10th at 6:00 in the morning and over the next 3 days had a CT scan, MRI, Heart monitor and Heart Test w/ Bubble. and the veins in my neck tested. Nothing abnormal was found to have caused an CRAO. Since then I have had family members tell me of three other people who had a similar situation happen to them after the second shot and within several weeks of receiving the second shot. I have not regained the sight in my left eye. I had no symptoms of anything before this happened.

Other Meds: Synthroid Tamoxifen Prolia shots twice a year

Current Illness: none

ID: 1341872
Sex: M
Age: 16
State:

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 05/23/2021
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, age 16, received Jansen Covid vaccine rather than Pfizer Covid vaccine

Other Meds: none

Current Illness: none

ID: 1341873
Sex: F
Age: 45
State:

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 05/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: erythromycin

Symptom List: Erythema, Pruritus

Symptoms: Patient (DOB 8/19/1975) received dose 1 of the Pfizer COVID vaccine (lot EW0182, exp 8/2021) at approximately 1320. Patient reported to EMT at 1530 that she felt lightheaded and sweaty. Patient moved unassisted to zero-gravity chair monitored by EMT. EMT alerted PHN while EMT 2 started the assessment. Vital signs: blood pressure 104/63, pulse 63, O2 97%. Allergy to erythromycin. Patient denied medications nor medical conditions. PHN offered patient Benadryl, patient declined. At 1540, patient was provided with a snack and water after patient reported only having a smoothie as she felt anxious in the morning prior to vaccine. At 1545, patient reported improvement in symptoms and sat up. Vital signs: blood pressure 117/82, pulse 76, O2 98%. PHN encouraged patient to stay for 30min since onset of symptoms, to follow up with provider, and when to call 911. At 1555, patient reported symptoms had resolved. Patient left walking without assistance at 1600.

Other Meds: none

Current Illness:

ID: 1341874
Sex: F
Age: 55
State: TX

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/23/2021
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: latex iodine in seafood

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

Symptoms: fever body aches strong headache like something pressuring /squeezing my head inflammation of lymph nodes in my neck area diahrrea on 2nd day

Other Meds: buspirone oxcarpazepine carvedilol valsartan D3 vitamin c vitamin e folate zinc copper

Current Illness: none

ID: 1341875
Sex: F
Age: 53
State: MI

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/23/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Unable to reach patient yet. Patient received 3 doses of pfizer covid vaccine. Patient received 1st dose 12/22/20 at a different provider then was covid positive on 1/4/21. Patient received 2nd dose on 4/29/21 and a 3rd dose on 5/20/21

Other Meds:

Current Illness:

ID: 1341876
Sex: F
Age: 31
State: AZ

Vax Date: 04/15/2021
Onset Date: 04/18/2021
Rec V Date: 05/23/2021
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: Erythromycin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I had an reaction to the first dose of covid-19 vaccine. Within minutes I thought I was going to pass out. 3 days after the vaccine I noticed a lump with pain in my forearm. I suspected a blood clot in my forearm. I had a confirm ultrasound of a DVT in my right upper extremity brachial veins.

Other Meds: B-12 D3 Nortriptyline ( for migraines)

Current Illness: None

ID: 1341877
Sex: F
Age: 53
State: PA

Vax Date: 04/06/2021
Onset Date: 04/20/2021
Rec V Date: 05/23/2021
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: Penicillin, insect bites and stings, occasional reaction to various medications

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

Symptoms: Pox-like blisters began on right leg, then gradually spread. Rash on face, right leg, chest, arms, back. Rash/blisters minimal but spread rapidly after exposure to sun. Pox-like lesions are very itchy and painful simultaneously.

Other Meds: None

Current Illness: None

ID: 1341878
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1341879
Sex: F
Age: 27
State: WA

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: Penicillin & amoxicillin

Symptom List: Pain in extremity

Symptoms: Heart issues. Tightness in chest, irregular heartbeat, pain in chest

Other Meds: Birth control

Current Illness: No

ID: 1341880
Sex: F
Age: 47
State: CA

Vax Date: 05/14/2021
Onset Date: 05/23/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: Aspirin Salicylate derivatives including high salicylate foods like chili, peppers, tomatoes, raisons, prunes...and many spices like mint, wintergreen etc Beta blockers NSAIDS High Histamine foods

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

Symptoms: Moderna First 2 days arms sore - then itch developed. Nine days later, a big rash appeared all over upper arm. Not sure if it will continue to spread. It is already significant in size.

Other Meds: B12 microdoses 2 x a week D3 microdoses 2 x a week B6 microdoses 2-3 x a week Molybdenum 1 drop after sulpher rich foods Histminex b4 certain foods (like meat) Probiotics 3-4 times a week

Current Illness: Mast Cell Activation Serious Breathing issues to salicylates, histamine, pollen, sun

ID: 1341881
Sex: M
Age: 54
State: GA

Vax Date: 04/08/2021
Onset Date: 04/01/2021
Rec V Date: 05/23/2021
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: allergic to pollen, grass, dust. Any other allergies unknown

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

Symptoms: I am still having persistent chills, sore joints, swollen face, and brain fog (cognitive impairment). These symptoms have been persisting since I got the second shot and it has been 6 weeks now. I NEVER had these symptoms prior to the vaccine.

Other Meds: multi-vitamins

Current Illness: none

ID: 1341882
Sex: F
Age: 41
State: TX

Vax Date: 05/04/2021
Onset Date: 05/06/2021
Rec V Date: 05/23/2021
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: none

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

Symptoms: thur 5/6 800am_ woke up feeling very shaky from head to toes legs were tight when trying to stand up and felt my heart pulsating rapidly which i had to sit down and take deep breaths to calm my heart i was out of breath when walking /blood pressure was high/front neck was a bit swollen and tight/ my left arm which i had gotton the shot on had a red bump and was painfull to touch i massaged it andthe pain was gone/i had no chest pain / i had a lymph node that appeared below my left ear the size of a dime it was painful to the touch and reduced in size and pain on tues 5/11 fri 5/7 intence shaky especially when trying to sleep only 1 hour of sleep/same symptoms continued from 5/6 wed 5/12 8:30am went to see a doctor in the morning feeling high blood pressure/intense shaking/rapid pulsating heart/ doctor took blood work /ekg test and results were normal just had a high blood count/high cholesterol which i already knew but i never had any medical issues before and doctor stated it was normal to get a lymph node swell after getting a vaccine /she recommended a diet and medication or omea 3 vitiamin for my high cholesterol thurs 5/13 7:00am starting getting new symptoms heachaches /backpain /front of neck tightness moved to back of neck pain /pain was reduced with help of massage and low dose aspirin fri 5/14 8:00am while donating plasma lying down my legs were getting tight and i started to move my feet up and down slowly to help with my cirulation and my heart rate jumped up to 180 which showed on my smart watch my so i stopped and took deep breaths to reduce my heart rate sun 5/23 still feeling shaky and has not stopped but not as intense/ heart feels pulsating rapid but decreased in intensity/ i always take deeps breath now /head /back of neck/back pain and leg tightness are still there but they feel better when massaged and i have an appointment to see a chiroprator to help with the pain and tightness on moday 5/24 and hopes of helping my shaking and see how my heart feels after /my sleep in now at 3-4 hours max with the help of low dose aspirin and melatonin

Other Meds: vitamin c /one a day vitamin/zytec

Current Illness: none

ID: 1341883
Sex: F
Age: 38
State:

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/23/2021
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: Second COVID shot Directly after administration: Swollen arm for a few days, extreme tiredness for 3 days, swollen lymph node in clavicle area on right side for a few days. 12 days after administration: unexplained purpura/petechiae near left shoulder in area about the size of a silver dollar (no injuries or medications). Rash is still present, but is likely to resolve in a couple days and is getting fainter.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1341884
Sex: M
Age: 78
State: NY

Vax Date: 02/26/2021
Onset Date: 03/19/2021
Rec V Date: 05/23/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Sudden onset of severe pain in the left mid-thigh, medial area. Felt like knife wounds. Each episode, lasted several minutes and was partially relieved by deep massage of the area. No abnormalities were palpated in this area. This repeated, several times, over the next month, in the exact same area and then disappeared. One month later, this exact same thing, happened on the medial part of my right mid-thigh. It responded to the same treatment and lasted for the same duration. This right side pain returned several times over the course of the month, then disappeared. So far, those have been the only episodes. More recently, (05/10/21), a small, firm bump appeared on my left forearm - that was very sensitive to lightest touch and was itchy but not painful. Thankfully, this has not grown and is less sensitive.

Other Meds: None

Current Illness: None

ID: 1341885
Sex: F
Age: 64
State: OH

Vax Date: 04/27/2021
Onset Date: 05/04/2021
Rec V Date: 05/23/2021
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: n/a

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

Symptoms: 1 week after receiving the shot the patient was diagnosed with clots and prescribed Eliquis.

Other Meds:

Current Illness: Breast Cancer. Being actively treated with Chemo therapy

ID: 1341886
Sex: F
Age: 66
State: TX

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/23/2021
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: Methimizole

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Second evening after getting 2nd dose Pfizer covid; was reading when my vision went foggy for about 10 minutes. The next day I saw there was blood around half the iris of my right eye. The blood was not coming from the corner of my eye it appeared to only be pooled around half the iris. It is still there just not as bright red.

Other Meds: Propythiouricil

Current Illness: NONE

ID: 1341887
Sex: F
Age: 28
State: IN

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/23/2021
Hospital:

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

Lab Data:

Allergies: Latex

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

Symptoms: Woke up early the next day to neck pain. Not on the front sides like glandular but more in the back where my neck and skull meet. Hurts to turn my head. Like when you've slept on in really wrong but the pain is both sides and the back.

Other Meds:

Current Illness:

ID: 1341888
Sex: M
Age: 20
State: PA

Vax Date: 05/23/2021
Onset Date: 05/23/2001
Rec V Date: 05/23/2021
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: tamiflu

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

Symptoms: patient received the vaccination. asked him to wait for 15 min. during his waiting period fell and hit his head. he said he feel light headed . we called EMS and took him for evaluation

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm