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: 1342048
Sex: F
Age: 47
State: NJ

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

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Besides being sick in bed for 24 hours the entire next day after vaccination, there is something much more interesting that I want to report. My childhood chickenpox inoculation scar (the circular looking skin scar) has all swollen up and is read all around and hurts all around it. It looks like red bracelet on my arm . It is about 4 inches below my moderna shots, that are barely swollen or red and hurt little.

Other Meds: none

Current Illness: none

ID: 1342049
Sex: M
Age: 31
State: NY

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: No allergies noted

Symptom List: Anxiety, Dyspnoea

Symptoms: Immediately after the patient received the Janssen Covid-19 vaccine, the patient closed his eyes and became unresponsive for less than 10 seconds. Patient then opened his eyes and was conscious again. Patient stated that he always has this type of reaction every time he receives a vaccine. He did not disclose this information because he did not think it would happen since he had not received any vaccines for the last 3 year.s.

Other Meds: n/a

Current Illness: none

ID: 1342050
Sex: F
Age: 42
State: NY

Vax Date: 04/18/2021
Onset Date: 04/18/2021
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: None

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

Symptoms: Initially fever, tiredness, headaches, muscle aches which last approximately 2-3 days. After i had pretty much recovered from above I developed a rash lasting approximately 24 hours. 2-3 days after the vaccine developed severe pain and swelling under arms which lasted approximately 1 week but still reoccurs from time to time. Additionally 4 days after I was vaccinated we learned my minor son tested positive with no know exposures to Covid

Other Meds: None

Current Illness: None

ID: 1342051
Sex: F
Age: 30
State: TX

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

Lab Data:

Allergies: mango, cashew

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient complained of feeling flush in face and having tightness in throat. EMS was called and vitals taken. at 13:51 BP 138/88, Pulse 135, Resp 20, O2 Sat 98. Patient was breathing and talking without visible distress. At 13:56 BP 135/84, Pulse 110, O2 Sat 98 and patient breathing and talking without visible distress. EMS arrived at 14:00 and care was handed over to them.

Other Meds: Adderall

Current Illness: none

ID: 1342052
Sex: M
Age: 14
State: WI

Vax Date: 05/18/2021
Onset Date: 05/21/2021
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: possibly allergic to the *-cillin family of antiboitics (developed hives after amoxicillin at a younger age)

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

Symptoms: Heart Palpitations - Friday afternoon 5/21/21 about 72 hours after vaccination. Patient complained of heart palpitations after school Friday. he said he felt them after PE class. He also experienced them on Saturday, 5/22 about 96 hours post-vaccination. I didn't make the connection to his vaccine dose until his mom sent me a news report about it on 5/23.

Other Meds: sertraline 50mg

Current Illness: non

ID: 1342053
Sex: M
Age: 68
State: PA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: pollen seasonal

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

Symptoms: Sore arm for two days and insomnia for 50 hours I had the second shot on April 19, 2021 and the injection site is still sore five weeks later.

Other Meds: A multi vitamin and a Vitamin D daily

Current Illness: none

ID: 1342054
Sex: M
Age: 44
State: WA

Vax Date: 04/21/2021
Onset Date: 05/02/2021
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: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Although I have a history of Meniere's disease, the previous 18 months prior to the second Pfizer dose I had not had many episodes of lightheadedness and dizziness. A few days after the second shot, I started having regularly lightheadedness and dizziness. It often happens in the afternoon after lunch, but I didn't have this problem previously.

Other Meds: Lisinopril

Current Illness: None

ID: 1342055
Sex: F
Age: 74
State: WI

Vax Date: 03/01/2021
Onset Date: 04/06/2021
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: Raglan, fm/hrt

Symptom List: Pharyngeal swelling

Symptoms: Bells Palsy

Other Meds: Omeprazole, clonazepam, Fluoxetine, Align, Gas X, Fiber gummies

Current Illness:

ID: 1342056
Sex: F
Age: 68
State: WA

Vax Date: 03/28/2021
Onset Date: 05/09/2021
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: LA

Lab Data:

Allergies: lisinopril, sulfa, pollen

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The patient presented to the ER with chest pain on April 11, approximately 13 days after receiving the second dose of COVID vaccine. She then developed dyspnea about a month later and was subsequently found to have a moderate sized bloody pericardial effusion and pericarditis on May 18th, for which no alternate cause has been found.

Other Meds: amlodipine, cyclobenzaprine, fluticasone, fluticasone nasal spray, rivaroxaban., pantoprazole, rosuvastatin, sertraline

Current Illness:

ID: 1342057
Sex: F
Age: 51
State: MO

Vax Date: 05/10/2021
Onset Date: 05/12/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Sores/ulceration in back of throat and inside bottom lip

Other Meds: Multivitamin

Current Illness:

ID: 1342058
Sex: F
Age: 45
State: TX

Vax Date: 04/19/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Cipro and sulfa drugs

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

Symptoms: Abnormal and excessive bruising

Other Meds: Tylenol

Current Illness: None

ID: 1342059
Sex: F
Age: 50
State: AZ

Vax Date: 05/08/2021
Onset Date: 05/14/2021
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: AMOXICILLIN

Symptom List: Rash, Urticaria

Symptoms: MAY 8 - 13, NORMAL SIDE EFFECTS. BRUISE NEAR INJECTION, TENDERNESS AND MILD PAIN IN WHOLE ARM FROM ARMPIT TO HAND, FATIGUE. ABOUT A WEEK LATER, ON MAY 14, WOKE UP WITH REDNESS NEXT TO THE INJECTION SIDE, ABOUT THE SIZE OF A LEMON, TENDESNEES STARTED GETTING WORSE, THE HIVE STARTED GETTING BIGGER EVERY DAY AND LIFTING MY ARM WAS UNCOMFORTABLE. ON MAY 21st, ALMOST TWO WEEKS LATER, THE HIVE WAS FROM MY SHOLDER TO MY ELBOW SO WENT TO URGENT CARE. I WAS GIVEN PREDNISONE FOR 5 DAYS, BENADRYL AND NEXIUM. STARTED TAKING THEM YESTERDAY, MAY 22nd .

Other Meds: EMERGEN-C (DAILY)

Current Illness: NONE

ID: 1342060
Sex: M
Age: 50
State: TX

Vax Date: 04/30/2021
Onset Date: 05/03/2021
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

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

Symptoms: Bell's Pasley"right side of face disfigured with complications.

Other Meds: Metoprolol,Amlodipine,metformin.

Current Illness: None

ID: 1342061
Sex: M
Age: 41
State: CA

Vax Date: 04/15/2021
Onset Date: 05/18/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin possibly

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

Symptoms: Chest pain for about 60 minutes until I took Advil. It was extremely uncomfortable as I would rate it at 8/10 on a pain scale for about 20 minutes. Also mild body aches and headache.

Other Meds: OTC allergy medicine (generic Zyrtec, generic flonaise)

Current Illness: None

ID: 1342062
Sex: F
Age: 41
State: MD

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: 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: Itching of left arm,close to injection site. Reports no difficulty breathing. No visible rash. Remains in medical screening for monitoring beyond 15 minutes. No interventions. Patient left at 16:48.

Other Meds:

Current Illness:

ID: 1342063
Sex: F
Age: 30
State: TX

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Possible syncopal episode, fell twice. 2nd vaccine dose on 5/20/21 at approximately 2:30 pm. Woke up in the night on 5/21/21 approximately 2:00am, went to the restroom. Upon return, felt dizzy (blurry vision, unsteady) and nauseated, attempted to return to bedroom but fell to the floor twice. I remember falling the 1st time, but do not remember anything between when I fell the first time and when a family member found me on the floor (likely less than 1 minute) a short distance away from where I fell the 1st time. For the rest of the day on 5/21/21, felt lightheaded but no more syncopal or near syncopal episodes. Experienced fatigue, brain fog on 5/21 and smaller degree on 5/22 and 5/23.

Other Meds: 100 mcg Levothyroxine

Current Illness: None

ID: 1342064
Sex: F
Age: 47
State: NJ

Vax Date: 05/20/2021
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: none

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

Symptoms: I am refiling this because I made a mistake in VAERS E-report 530749. Besides being sick in bed for 24 hours the entire next day after vaccination, there is something much more interesting that I want to report. My childhood smallpox inoculation scar (the circular looking skin scar) has all swollen up and is read all around and hurts. It looks like a red bracelet on my arm. It is about 4 inches below my moderna shots that today are barely swollen or red and hurt little. Hence, my smallpox site is hurting and I cannot touch it. (In 530749 I mistakenly said chickenpox but then someone told me that it is smallpox inoculation scar.)

Other Meds: none

Current Illness: none

ID: 1342065
Sex: M
Age: 60
State: NH

Vax Date: 05/01/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Itchy rash in the crook of both elbows

Other Meds: None

Current Illness: None

ID: 1342066
Sex: M
Age: 55
State: ND

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

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

Lab Data:

Allergies: Not aware of any

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: headache, very tired, achy muscles, chills, fever, nausea, chest discomfort

Other Meds: Olmesartan Medoxomil Tabs 20Mg, Claritin Reditabs 10Mg, Symbicort Inhaler

Current Illness: None

ID: 1342067
Sex: F
Age: 19
State: IA

Vax Date: 05/23/2021
Onset Date: 05/23/2021
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: none

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

Symptoms: Patient received 1st COVID vaccine. She was then instructed to go to the counter to schedule her 2nd dose. While at the counter, (1-2 minutes post dose) she started stumbling. Our technician and pharmacist caught patient and lowered her to the ground as she was fainting (nothing hit the ground uncontrolled). Patient never lost full consciousness. Cold compress was applied to the back of her neck. Once she started feeling better (3 minutes), she sat up and drank some water. After 2 more minutes, she moved to a chair. She waited 15 additional minutes before leaving the pharmacy area. She reported she was feeling completely fine.

Other Meds: unknown

Current Illness: none

ID: 1342068
Sex: M
Age: 65
State:

Vax Date: 04/26/2021
Onset Date: 05/10/2021
Rec V Date: 05/23/2021
Hospital: Y

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: NKDA

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

Symptoms: Guillian barre Syndrome ~2 weeks following second shot of Pfizer vaccine ; ultimately resulting in intubation and invasive ventilation

Other Meds: ASA Lisinopril Metoprolol 100mg XL

Current Illness: h/o AFib etoh abuse

ID: 1342069
Sex: F
Age: 45
State: OH

Vax Date: 05/19/2021
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

Symptom List: Unevaluable event

Symptoms: Had only very mild tinnitus in the right ear prior to the vaccine and now I have severe tinnitus in the right ear.

Other Meds: Atenolol Omprazole Vitamin C D

Current Illness:

ID: 1342070
Sex: M
Age: 46
State: KY

Vax Date: 05/18/2021
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: Patient arrived to the Emergency Department today with facial droop and left sided facial/mouth numbness and headache.

Other Meds: None

Current Illness: None

ID: 1342071
Sex: F
Age: 14
State: CA

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

Lab Data:

Allergies: none reported

Symptom List: Injection site pain, Pain

Symptoms: Client was feeling "cold." Client was a 14-year-old female sitting upright in her observation chair, alert and tracking with her eyes. Client had a chief complaint of dizziness and feeling cold. Client stated that she began to feel cold and dizzy a few minutes after her observation had begun. This was the client's first dose of the Pfizer vaccine. Client denied any medical history or known allergies. Assessment revealed no swelling, hives, discoloration, shortness of breath or other signs and symptoms of anaphylaxis. Client stated that she felt "cold" and "dizzy." Client stated that her only meal was the snacks provided at the vaccination site. Airway, breathing and circulation were intact. Client's initial set of vitals at 1006 was 116/78 blood pressure, 80 heart rate, respirations 16, alert and oriented to person, place, date and event. Temperature 97.8*f. EMTs present were unable to obtain an O2 sat due to client's nail but client was negative for signs of shortness of breath. Client was asked to lie down until her complaint was resolved. Client was provided with food and was able to eat without difficulty. Client was reassessed every 15 minutes due to her stability. Vitals were as follows: 1011 - 108/78, 84, resp. 14 1021 108/78, 88, resp 14 1029 - 108/78, 80, resp 16. After approximately 10 minutes, the client denied any symptoms and was asked to sit up in an observation chair for the remainder of her observation. Client and her mother were instructed to seek emergency care if signs or symptoms of an allergic reaction occur later this evening.

Other Meds: None reported

Current Illness: none reported

ID: 1342072
Sex: F
Age: 49
State: FL

Vax Date: 05/14/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: No known drug, food allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: 1. Hives: Noticed 12-20 hours after vaccination (early next morning). Developed itchy, red welts on neck, abdomen, upper legs, back. Lasted for 7 days. 2. Light-headed, dizziness, loss of balance: Within 3-5 hours of vaccination. Lasted 3 days. 3. Facial swelling: Noticed 12-20 hours after vaccination (next morning on waking). Lasted 5-7 days. 4. Fatigue: Started within 3-5 hours and lasted 3-5 days. 5. Headache: Within 3-5 hours; Lasted 3 days; Ibuprofen started 24 hours after vaccination and taken for 3 days 6. Injection site pain: Within 1-2 hours and worsened over 24 hours. Lasted 7 days; Ibuprofen started 24 hours after vaccination and taken for 3 days.

Other Meds: No known drug allergies

Current Illness: No illnesses at time of vaccination and no illnesses one month prior

ID: 1342073
Sex: F
Age: 34
State: CA

Vax Date: 05/04/2021
Onset Date: 05/14/2021
Rec V Date: 05/23/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa, morphine, paraphenylenediamine

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

Symptoms: Myocardial infarction (NSTEMI)

Other Meds: Zoloft 50mg Drospirenone and ethynyl estradiol 3mg Cefuroxime 500mg

Current Illness: Ear infection

ID: 1342074
Sex: F
Age: 63
State: VA

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: PATIENT CALLED 18 DAYS POST FIRST DOSE OF VACCINE. SHE STATED THAT SHE IS STILL EXPERIENCING ARM PAIN THAT HAS RADIATED FROM THE INJECTION SITE DOWN TO HER ELBOW AREA. SHE STATED THAT HER ARM HAS A BURNING SENSATION, TENDERNESS, AND SENSITIVITY. SHE STATED DISCOMFORT WHEN HER ARM IS IN CERTAIN POSITIONS.

Other Meds:

Current Illness:

ID: 1342075
Sex: F
Age: 61
State: GA

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: swelling at injection site, cold compress applied

Other Meds: Cipr and Phenzaopyridine

Current Illness: UTI

ID: 1342076
Sex: F
Age: 15
State: CA

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

Lab Data:

Allergies: no

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

Symptoms: single episode of syncope 15 minutes after vaccine after standing up, likely vasovagal vs. orthostatic. completely resolved

Other Meds: na

Current Illness: no

ID: 1342077
Sex: M
Age: 17
State: NY

Vax Date: 05/14/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: OUTSIDE OF FDA APPROVED AGE RANGE

Other Meds: N/A

Current Illness: N/A

ID: 1342078
Sex: F
Age: 35
State: MA

Vax Date: 05/19/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, Ceclor, Nyquil

Symptom List: Injection site pain

Symptoms: Rash

Other Meds: Advair, Singulair, One-A-Day prenatal, CoQ-10

Current Illness: None

ID: 1342079
Sex: M
Age: 55
State:

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

Lab Data:

Allergies:

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

Symptoms: Received 2nd COVID vaccine on 5/20/21. Ten hours after vaccine, he developed fever, chills, severe muscle pains, severe headache, & felt eyes were going to pop out of his head. He was bedridden. Symptoms lasted 36 hours, and he missed a day of work.

Other Meds:

Current Illness:

ID: 1342080
Sex: F
Age: 53
State: CA

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

Lab Data:

Allergies: Sulfa

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

Symptoms: 12 hours after 2nd Modena I had a sudden/intense blackout experience

Other Meds: Vitamin C, Vitamin D, B Vitamins

Current Illness: None

ID: 1342081
Sex: F
Age: 52
State: IL

Vax Date: 05/20/2021
Onset Date: 05/22/2021
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: Penicillin Demerol Sulfa Levoquin

Symptom List: Tremor

Symptoms: Large lump under arm pit and rash on left side of face

Other Meds: Yaz Levothyroxine Sumatriptan

Current Illness: None

ID: 1342082
Sex: F
Age: 48
State: CA

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: inflamed arm for 5 days

Other Meds:

Current Illness:

ID: 1342083
Sex: M
Age: 21
State: NJ

Vax Date: 05/23/2021
Onset Date: 05/23/2021
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: None

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

Symptoms: Patient is fainting right after getting the vaccine and lasts for 1 minute and then recovered back after tapping on the patient and then fainting second time and then recover from fainting. Then he said he felt nauseous and after giving some water he recovered gradually. EMS was dispatched to the scene and they checked on his blood pressure and pulse oxygen and was confirmed to be going back to normal. He refused to go to the hospital then EMS and police left the scene

Other Meds: None

Current Illness: None

ID: 1342084
Sex: M
Age: 72
State: NY

Vax Date: 05/11/2021
Onset Date: 05/20/2021
Rec V Date: 05/23/2021
Hospital: Y

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

Lab Data:

Allergies: No known medications

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

Symptoms: Patient received 1st moderna vaccine on 4/13/2021. He then began to have urinary issues and diagnosed with a bladder tumor on 4/29. He then tested positive for covid 19 on May1st. He got his 2nd covid 19 vaccine on 5/11/2021 and was hospitalized on 05/20 with new onset rapid atrial fibrillation and NSTEMI. He reports he was healthy with no medical problems and took no medications prior to his vaccines. A pulmonary emboli was ruled out, no history or suspicion of sleep apnea.

Other Meds: None

Current Illness: Diagnosed with a bladder tumor 04/29/2021 in between first and second COVID vaccine

ID: 1342085
Sex: F
Age: 35
State: DE

Vax Date: 05/15/2021
Onset Date: 05/17/2021
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: N/a

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: My left hand became sore and swollen Monday evening. I have no recollection of jamming my middle finger or doing anything different with my hand that day. When I woke up Tuesday, I could barely open my hand as the tendon was extremely tight and sore. The finger was swollen, and my grip strength was significantly diminished. The pain and swelling decreased to almost normal by Friday, but on Saturday I adjusted my clothes as usual and felt a pop. The only change from normal was getting the vaccine.

Other Meds: N/a

Current Illness: N/a

ID: 1342086
Sex: F
Age: 74
State: AL

Vax Date: 03/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/23/2021
Hospital: Y

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

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

Symptoms: bilateral pulmonary emboli with right heart strain diagnosed on 5/23/21. Patient with no other known risk factors for PTE. Symptom onset ~5/19/21

Other Meds: lovastatin 20 mg daily, pantoprazole 40 mg daily, aspirin 81 mg daily, melatonin 5 mg qhs, vitamin D3, calcium, fish oil, vitamin C, CoQ10

Current Illness: none

ID: 1342087
Sex: F
Age: 61
State:

Vax Date: 04/14/2021
Onset Date: 04/17/2021
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: Penicillin and Sulfa drugs

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

Symptoms: Event: Red welt approximately 1" below injection site after 2nd shot. (There was no reaction after the first shot.) Timeline: After 2nd shot on Wed. did not notice welt until Sat. morning (3 days after shot). Welt was a red, well-defined area and warm, ~3" long and 2" wide. Over the next 24 hours it grew bigger, darker red and warmer; also a hard lump underneath the skin developed. Beginning on Monday (2 days after welt was noticed) and (slowly) over the next week welt became less defined, less red, smaller and not as warm. At times the arm was itchy or had some pain. After 7 days welt basically had disappeared. Lump underneath skin continued for 3 days (after it was first noticed and with no change in size) but then (on day 4) began to get smaller and was gone about 9 days after I first noticed symptoms.

Other Meds: Pantoprazole SOD DR 40mg; 2-200 mcg misoprostol (one at lunch, one at dinner); Diflunisal 500 mg 1200 mg calcium (2-600 mg pills), 1 multivitamin, 2 glucosamine chondroitin (osteo bi-flex)

Current Illness: None

ID: 1342088
Sex: F
Age: 52
State: IN

Vax Date: 05/14/2021
Onset Date: 05/18/2021
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: N/a

Symptom List: Pain in extremity

Symptoms: Swelling under left eye on May 18, swelling under nose om May 20, and top lip swollen on May 22...

Other Meds: Tylenol takin after vaccine

Current Illness: None

ID: 1342089
Sex: M
Age: 31
State: WA

Vax Date: 04/29/2021
Onset Date: 05/05/2021
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:

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

Symptoms: Caused temporary hearing loss in left ear and tinnitus.

Other Meds:

Current Illness:

ID: 1342090
Sex: M
Age: 30
State: NY

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:

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

Symptoms: Pt received the Janseen vaccine and two-three minutes later the patient fainted and regained consciousness intermittently as they were waiting for the 30 min post vaccine observation. Code white as called and was by the patient to make sure they did not fall out of the chair. EMS responded and took over as they called 911 to have the patient checked out. The ems confirmed the patient was stable and the patient did not need to be put in the ambulance. Pt was given orange juice and an ice pack. Pt was checked on before they left and they were ok.

Other Meds:

Current Illness:

ID: 1342091
Sex: M
Age: 68
State: CA

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

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

Lab Data:

Allergies: No

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

Symptoms: 02-20-2021 Heart Attack. 100% blockage of LAD artery, Stent, 4 day hospitalization at Medical Center. Recovered heart function. Cadiac rehab.

Other Meds: Flowmax, Crestor

Current Illness: No

ID: 1342092
Sex: F
Age: 38
State: WA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa, Mahi-mahi

Symptom List: Vomiting

Symptoms: Throat tightness following injection.

Other Meds:

Current Illness:

ID: 1342093
Sex: F
Age: 28
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: cough, itchy skin

Other Meds:

Current Illness:

ID: 1342094
Sex: F
Age: 43
State: OR

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

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

Symptoms: Vaccine leakage while it was being administered.

Other Meds: Multivitamin

Current Illness: None

ID: 1342095
Sex: M
Age: 78
State: CA

Vax Date: 03/30/2021
Onset Date: 05/01/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None. No allergies

Symptom List: Injection site swelling, Limb discomfort

Symptoms: My uncle had a stroke almost exactly one month after second moderna shot. He is/was one of the most healthy older men I have ever known. Avid bike rider and exercise buff usually runs circles around guys half his age. I?m talking biking in the hills fit. He does have a pacemaker now and has to tame things done, but I think he got the pacemaker because he pumped so much blood through that thing doing all those hills for all those years. Not on any other meds expect whatever might be expected for the pacemaker. He was at the gym on May 1 working out and sitting down doing some arm curls when all of a sudden he passed out, he regained consciousness as a couple of guys were helping him to his feet, that?s all he could remember. He managed to drive himself home and then couldn?t shake the headaches and on coming symptoms, so one of his sons took him to the emergency room. Within 30 minutes it was already determined the doctors needed to operate fast. The stroke nightmare and recovery has process has been ongoing ever since. He was transferred to a rehab on May 19th where it looks like he will stay for at least a couple weeks, hopefully. He looks like he aged fifteen years, speech is ok, but he?s slow almost as if he is not hearing me? I think his hearing is fine but it seems like he works to formulate the thought of what he wants to say as I write this summary on May 23rd. He?s got two staples in his head, one pretty much top center and the other just a little off to his right. Drain blood I assume as I?ve never seen a post stroke victim up close like that. Our family do not get strokes! Maybe too much tequila and stuff like that, but my huge family usually all live into their 90?s and a few into their 100?s like my grandparents and my 104 year old great grandma. But of course they did not grow up with flu shots and vaccines. My grandparent grew a substance and stored in jars of olive oil or canola oil and rubbed that stuff on their our bodies if ailments go really bad. Other than that it?s highly concentrate oil of oregano. Couple drops on your tongue will set your mouth on fire. That?s the concentration we are talking about! Anyhow, my uncle hasn?t done vaccines or flu shots in the past, but all this gloom and doom from the mainstream media convinced him to get the shot. This now make the second person to stroke out after these unicorn shots. Yeah thanks big pharma and you scandalous mainstream media for just reading your script and following along. No thanks to all you physicians and nurses out there that also know better, but are keeping your fat traps shut and your hand out receiving your paycheck. We wonder why there is vaccine hesitancy? It?s not hesitancy, it actually watching family and friend bite the bullet right before our very eyes. You healthcare providers are going to have to pay pounds of flesh to our creator for propagating this mess we are in. Your stronger delusion excuse will only carry you so far, before it becomes unforgiveable. God Bless and let?s see how long this report really take to get published on vaers. The world see this one! You better WelcomeTheEagle!

Other Meds: None other than what typical for a person with a pacemaker

Current Illness: None. Healthy as a horse

ID: 1342096
Sex: M
Age: 13
State: MA

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

Lab Data:

Allergies: no

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

Symptoms: Pt received vaccine in left upper arm. He was bleeding immediately more excessive than a usual bleed after shot. no medications history. he felt faint also. applied cold compress to head and mom applied pressure to arm with paper towel. bleeding stopped and he was feeling better . Checked in with mom on patient at home and he was feeling better

Other Meds: no medications

Current Illness: no

ID: 1342097
Sex: F
Age: 28
State: DE

Vax Date: 01/13/2021
Onset Date: 01/14/2021
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: RA

Lab Data:

Allergies: NKDA

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

Symptoms: I woke up the morning after the vaccine and it felt like someone was stabbing my head. Whenever I went to stand the pain would increase. My eight year old daughter called my mom and my mom left work to come to the house.. my mom reports that I was lethargic like. My husband ended up taking me to the arm because the pressure in my head was unbearable. He had to help me get in the car because I was unsteady on my feet. I went to the ER and they gave me medication. They sent me home on a few day supply.

Other Meds: I?m prescribed off brand Ritalin. It?s called Dexa

Current Illness: None that I was aware of

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm