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: 1343230
Sex: F
Age: 41
State: WI

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/24/2021
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: I had severe joint pain, headache, nausea, and extreme fatigue. And symptoms that went on for a month were dizziness and brain fog.

Other Meds:

Current Illness:

ID: 1343231
Sex: F
Age: 31
State: MO

Vax Date: 05/20/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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: Patient developed all over body rash 4 days after receiving vaccine. She took a benadryl and called the pharmacy.

Other Meds:

Current Illness:

ID: 1343232
Sex: F
Age: 59
State: FL

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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: Penicillin Mango, papaya, passion fruit

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

Symptoms: Fever ranging from 102.1 on the day after receiving the injection to current temp of 99.8 on day three. Severe headache, chest tightness; constant dry cough; severe body aches; severe pain in arm of injection site, unable to lift arm on day following injection and although the pain has lessened, the injection site is still extremely red, swollen, sore and hot to touch and itchy.

Other Meds: Losartan HCTZ; Zyrtec; Vitamin D; Vitamin K; probiotic

Current Illness: None

ID: 1343233
Sex: F
Age: 40
State: NY

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data:

Allergies: The last known allergic reaction was to Morphine in 2007 during birth.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I started to have headaches which continued until 05/20/2021 and Ultimately had a fever (100.6) at 10:30 pm with chills. Tylenol and Advil were taken throughout the process. On 05/21/2021 at 09:45 am, I noticed the droopyness to my left side of the face. I tested negative for Covid-19 at 11:00 am. On the same date at 11:30 am I met with my PCP who suggested that I go to the Emergency room. At 12:30 I went to the Hospital and was treated for Bell's Palsy. I have been taking Prednisone (20mg) 3x a day and Valacyclovir (1Gm) 3x a day.

Other Meds: No medications were being taken at the time of the vaccination.

Current Illness: There were no illness to be reported at least 6 months prior to the vaccination.

ID: 1343234
Sex: F
Age: 47
State: GA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/24/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Dizziness - pharmacy technician did not give me the option to wait - it was not offered or recommended. Immediately after the vaccination was given, I was free to go. I had a few things to pick up in the store and as I was headed up the aisle to the checkout, I immediately became dizzy and had to hold on to the shelf to keep myself upright. As I approached the counter, I noticed the pharmacy staff was heading out on break. I stopped one of the reps and explained that I didn't feel well and asked if I should go and sit down until the dizziness subsided. She replied yes and explained that they were on lunch but the pharmacist may come out. As I head back to the rear of the store, I continued to feel dizzy. The pharmacist was coming from the back (an office outside of the pharmacy) to accept a delivery and I explained that I was dizzy and was going to sit down. He shook his head yes, but never came back to check on me. I waited approximately 20 -25 minutes then left the store. *After talking with relatives and friends, all of them were required to wait at least 15 minutes before becoming mobile. Perhaps this option wasn't given to me since it was close to the time when the pharmacy closes for lunch. Later that day, my left leg began to hurt near my calf and it was extremely difficult for me to walk. I googled the side-effects and read that muscle cramps were possible, so I did not seek further medical attention. The pain was intense but had resolved by Saturday morning.

Other Meds: Metoprolol HTZ Metformin

Current Illness: N/A

ID: 1343235
Sex: F
Age: 31
State: CA

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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: First Dose 7 days later rash in the site of injection (treated with a shot of dexamethasone). Second dose 8 hours after the second dose the rash appears (red, itchy), also fever and muscular pain.

Other Meds: None

Current Illness: None

ID: 1343236
Sex: M
Age: 72
State: CT

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
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: 72 yo man received Dose 1 Pfizer covid vaccine prior to acute admission. On 5/11/21, patient was admitted for lower extremity osteomyelitis unrelated to vaccinations. During this stay, Dose 2 Pfizer covid vaccine became due. On 5/21/21 a vial of Pfizer covid vaccine was sent to the patient care area for administration. The nurse drew up and administered 0.3 mL without first diluting. The patient did not experience any adverse reactions or adverse effects as of 5/24/21. Discharge is planned for 5/24/21.

Other Meds:

Current Illness:

ID: 1343237
Sex: M
Age: 39
State: FL

Vax Date: 05/20/2021
Onset Date: 06/05/2021
Rec V Date: 05/24/2021
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: A lot of headaches for 48 hours. Dizziness. Severe pain in arm for 72 hours or more. A lot of tiredness for 48 hours. 4 days later, the headache pain is almost a zero, pain in arm lessened considerably but it still hurts, tiredness has lessened but I still feel it, Headache has lessened but there is still a slight sensation.

Other Meds: None

Current Illness: None

ID: 1343238
Sex: F
Age: 66
State: MA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/24/2021
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: Allergies to codeine and NSAIDS

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient began experiencing some shortness of breath 15 minutes after the injection with audible wheezing. This nurse assessed her and found the following: LS tight/rhonci whole L side w/wheezing in bilat upper lungs, O2 sat 96% on RA, skin pink/warm, no change in color, no diaphoresis noted, HR regular/98. Patient was able to converse. 911 was activated, paramedics heard air movement throughout lungs, still 96% on RA, BP 141/92. Taken by ambulance to ED due to long history of asthma and no recue inhaler on her person.

Other Meds: Prednisone taper, albuterol inhaler

Current Illness: Chronic asthma, frequent pneumonia, transient afib

ID: 1343239
Sex: F
Age: 30
State: TX

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
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: Low grade fever for 24 hours. Pain in muscles and joints, similar to flu. Pain in left ear still present 48 hours later. Fogginess of mind for first 24hours.

Other Meds: Zoloft, Trileptal, Trintellix

Current Illness:

ID: 1343240
Sex: M
Age: 29
State: WI

Vax Date: 05/07/2021
Onset Date: 05/12/2021
Rec V Date: 05/24/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: loss of smell

Other Meds: none

Current Illness: none

Date Died: 05/03/2021

ID: 1343241
Sex: M
Age: 60
State: FL

Vax Date: 03/29/2021
Onset Date: 05/03/2021
Rec V Date: 05/24/2021
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

Symptom List: Rash, Urticaria

Symptoms: Outcome : patient died Cause : cardio respiratory arrest Had previously tested for any heart problem but his heart was in excellent conditions

Other Meds: Prednisone Ipratropium bromide and albuterol sulfate Fenobribrate Acetylcysteibe Rybelsus Humalog Levemir Metformin

Current Illness:

ID: 1343242
Sex: F
Age: 15
State: TX

Vax Date: 05/14/2021
Onset Date: 05/20/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: iodine

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

Symptoms: Day 6 post vaccine patient began complaining of bilateral anterior ankle pain, and L hip pain. She had a low grade fever of 99.8 at that time. The following day Day 7, she had general fatigue, bilateral angle pain, and malaise. On Saturday, Day 8 she was unable to stand for periods of 15 minutes or longer due to pain in both ankles, and her knees, and elbows began to hurt. On this day she was given advil 400mg without relief, she then took Tylenol 650mg and the joint pain decreased from a 9 to a 6. We have had to continue alternating tylenol and advil since Saturday and she is unable to stand or walk for prolonged periods.

Other Meds: none

Current Illness: none

ID: 1343243
Sex: M
Age: 52
State: IA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Employee came to for 2nd COVID19 vaccine dose. The MA drew up a full vial that was not diluted. Therefore, the employee received more vaccine than he should have. Once discovered, the employee was contacted by the Medical Director, was told about the incident and what to expect, and was instructed to call or the medical director with any concerns. Pharmacy were notified. administrative oversight for were also notified. The vaccine vial had been sitting in an opaque bag on the counter as it needed to be at room temperature for 15 minutes before reconstitution. The vial (lot number EW0179) was intact and no expiration sticker was on it. Since this event, the clinic has changed practice of drawing up each dose as needed and will draw up all 6 doses from a vial, label/date them, and place in an opaque bag ready for use. The syringes will be good for 6 hours as verified with pharmacy. The clinic administers many vaccines, all of which are unit dose. Drawing up all syringes from a COVID19 vial will more closely align with this practice.

Other Meds:

Current Illness:

ID: 1343244
Sex: M
Age: 48
State: TN

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/24/2021
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: No

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

Symptoms: About three weeks ago began to experience swelling in lower right arm, above wrist (he had vaccine in left arm), fever, cough at nighttime and tingling to point of pain from right shoulder to elbow, and left little finger numb

Other Meds: None

Current Illness: No

ID: 1343245
Sex: M
Age: 49
State: CT

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/24/2021
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: MRI injection dye, pollen, ragweed and animal dander.

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

Symptoms: Excruciating pain in right foot. Very similar to gout attack. Was it a gout attack? My prior gout attacks affected right big toe.

Other Meds: Claritin. Multi-vitamin.

Current Illness: None

ID: 1343246
Sex: M
Age: 18
State: CA

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/24/2021
Hospital: Y

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: chest pain, ECG ST changes, depressed biventricular functions on cardiac echo

Other Meds: None

Current Illness: None

ID: 1343247
Sex: F
Age: 34
State: DC

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/24/2021
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: Very sore and tender arm at site of injection, swollen lymphnodes under arm on that side 36 hours after injection, headache starting 4 hours after injection, fatigue, menstrual cycle much heavier than normal

Other Meds: Sprintec, prenatal vitamins, B and C vitamins

Current Illness: None

ID: 1343248
Sex: M
Age: 43
State: TX

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient fainted after receiving first dose of moderna, patient came to immediately with no confusion, he was able to answer all questions

Other Meds: unknown

Current Illness: unknown

ID: 1343249
Sex: M
Age: 41
State: TX

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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: ~15-30 mins post vaccine dose, patient developed seizure and transferred to outside hospital emergency room via ambulance. Unknown if patient admitted.

Other Meds:

Current Illness:

ID: 1343250
Sex: M
Age: 51
State: IN

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 05/24/2021
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: Approximately 12 hours after receiving the second dose, I spiked a fever of 101, felt body aches and chills. This lasted for about 1 day. On day 3, I woke with stiff, achy and sore joints in my right hand. On day 4, these symptoms remained in my right hand and moved to my left. Over the next week, stiff joints moved into my toes. EXTREME FATIGUE and mental fogginess also developed as did blood pressure spikes. On week 2, move joints started aching including knees, elbows and shoulder. On week 3, my fingers were so sore and stiff it became difficult to use door knobs. I contacted a virtual doctor to ask for direction. He assumed in was side effects and prescribed me Diclofenance Sodium 75 mg for pain. Two days later, I went to the emergency room as the pain, fatigue and fogginess was becoming very concerning. On week 4, I was finally able to see my family doctor. He assumes it is a overactive immune response to the vaccine and prescribe Prednisone 20 mg to overcome the symptoms. The course of Prednisone has decress the severity of my symptoms but on week 5 I continue to have stiff, painful joints, mental fogginess.

Other Meds: Hydroclorithiazide 25 mg. Omeprozole 40 mg, Famotidine 20 mg, multivitamin

Current Illness: None

ID: 1343251
Sex: F
Age: 57
State: CA

Vax Date: 04/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/24/2021
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: Inflamed joints. Big toe on left foot. Both thumb joints are inflamed and very sore. Right side thumb is worse. Knees inflamed.

Other Meds: Hydrochlorothiazide, Allegra, dymista

Current Illness: None

ID: 1343252
Sex: F
Age: 45
State: MI

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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: Sulfa drugs

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

Symptoms: Throat felt tight when I swallowed. Chills, severe headache, body aches, muscle weakness, menstral cramps (without menses), nausea, loss of appetite. Rash on roof of mouth.

Other Meds: None

Current Illness: None

ID: 1343253
Sex: M
Age: 27
State: CA

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/24/2021
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: N/A

Symptom List: Injection site pain, Pain

Symptoms: 5 min after shot. Warming sensation spread from arm across my entire body. Felt nauseous and blacked out. Passed out face first on the floor. No fear of needles. I have records of getting previous flu vaccines without passing out. I have been experiencing hot flashes, nausea and fatigue for 6 days now.

Other Meds: N/A

Current Illness: N/A

ID: 1343254
Sex: F
Age: 49
State: MN

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: morphine, ceclor, erythromyicen

Symptom List: Injection site pain, Menorrhagia

Symptoms: body aches, temp of 101 even while alternating advil and tylenol, swollen lymph nodes, red painful swollen rash on arm that burns and itches

Other Meds: Metformin, zyrtec ,hydrochlorothiazide

Current Illness: none

ID: 1343255
Sex: M
Age: 20
State: PA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Immediately following vaccination, patient began to feel lightheaded. He was guided to the floor then lost consciousness Smelling salts were administered. LOC approx 30 sec. Pt was brought back to Med Obs 1 via liter, given water and crackers. Vitals 10:44 HR 82, Resp 16, BP 147/67 O2 100, Vitals 1050 HR 80 Resp 16 BP 134/64 O2 100 Pt discharged to home himself h/o LOC with vaccines as child

Other Meds: None

Current Illness: none

ID: 1343256
Sex: M
Age: 51
State: TX

Vax Date: 04/07/2021
Onset Date: 04/11/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: DURING REM SLEEP - NIGHT TERROR; HALLUCINATION; DIFFICULTY WAKING UP FROM DREAM; PHYSICAL DURING DREAM. REQUIRED TRIP TO EMERGENCY ROOM FOR STITCHES IN ARM AND INJURED FOOT.

Other Meds: LOSARTAN, GABAPENTIN, NORTRIPTYLINE, MULTIVITAMIN, CALCIUM, B-COMPLEX VITAMIN

Current Illness: NONE

ID: 1343257
Sex: F
Age: 63
State: AL

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Sulfur

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 2 days after 2nd shot, left side of neck swelled, lymph nodes in that area also swollen and hard. Neck is still swollen as of today may 24, over a month later. I have a tingling sensation though out the day. It started going up my neck. The tingling now goes up my neck, into my left arm and down into my chest.

Other Meds: Percocet, Tizanidine, calcium carb vit D3, Synthroid, Meloxicam, simvastatin, Lotrel, sertraline, montelukast, certirizine, tolterodine, gabapentin, lidocaine patches, fluticasone nasal spray, indomethacin, colchicine

Current Illness: Seasonal allergy problems

ID: 1343258
Sex: F
Age: 54
State: NC

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/24/2021
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 products, ham, blue cheese, bee stings, mold, mildew, all pollens/trees/grasses,

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

Symptoms: 10 mins post, severe syncope, and headache, severe ringing in ears * Severe headaches every morning * continued moderate ringing ears * Severe dehydration every morning * Frequent heartburn * lungs tight, a bit shallower breathing * Vertigo all day and night * Chills and hot flashes but no fever * Nausea every morning until I eat; have to eat every few hours to avoid nausea * random dry raspy cough * 100+oz. H20 daily+powerade(S/F)p * urine near clear by afternoon * using RR 3x/night, but avg 5a wake-up with severe headache & PARCHED with very dry mouth

Other Meds: Zyrtec allergy meds

Current Illness: None

ID: 1343259
Sex: F
Age: 52
State: NC

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
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

Symptom List: Nausea

Symptoms: Fever, Chills, Nausea, Headache, Hives (rash) on lower extremities - started at 4:30 a.m. following day (about 13 hours after injection), lasted approximately two days. Hives still present day 3.

Other Meds: Lisinopril Lunesta

Current Illness:

ID: 1343260
Sex: F
Age: 69
State: AZ

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/24/2021
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: Local swelling, pain 2 weeks Fatigue 5 days Body aches 3 days

Other Meds: Celexa Mvt

Current Illness: None

ID: 1343261
Sex: F
Age: 36
State: TX

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: Patient has not had a menstrual cycle in over a year. Two days after receiving her first dose of Moderna COVID-19 vaccine she started bleeding heavily for five days; she then bled lightly for eight days.

Other Meds: n/a

Current Illness: none

ID: 1343262
Sex: F
Age: 49
State: PA

Vax Date: 04/21/2021
Onset Date: 05/07/2021
Rec V Date: 05/24/2021
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: NKDA

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

Symptoms: She was stable with her MS and then after the second shot after a period of time her symptoms worsened.

Other Meds: Ocrevus Baclofen Clonazepam Lexapro

Current Illness: MS

ID: 1343263
Sex: F
Age: 55
State: PA

Vax Date: 05/21/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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: Approximately 72 hours after my 2nd Moderna vaccine, I noticed a large , warm, red patch on my left arm slightly below where I believe the injection sight was. At this point it is just painful and not itchy.

Other Meds: Tylenol Vitamin D Vitamin C Zinc

Current Illness: None

ID: 1343264
Sex: M
Age: 17
State: OH

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 05/24/2021
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: Erythema, Pruritus

Symptoms: The person is 17 years old and received the Janssen vaccine. No adverse effects occurred in the 15 minute observation period post the administration of the vaccine.

Other Meds: None

Current Illness: None

ID: 1343265
Sex: M
Age: 32
State: FL

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/24/2021
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: The first 10 minutes everything was fine then started sweating uncontrollably, vision went very white and hearing felt like I was in a tunnel. Felt some pressure in my heart and my heart still feels different, best way to describe it is I feel my heart beating which is something I never had before.

Other Meds: none

Current Illness: none

Date Died: 04/19/2021

ID: 1343266
Sex: M
Age: 55
State: CO

Vax Date: 04/01/2021
Onset Date: 04/18/2021
Rec V Date: 05/24/2021
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: Cipro

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

Symptoms: On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen. When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock. Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well

Other Meds: Ibuprofen prn for back pain, tums very rarely

Current Illness: none

ID: 1343267
Sex: M
Age: 78
State: MN

Vax Date: 03/24/2021
Onset Date: 04/03/2021
Rec V Date: 05/24/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Coumadin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Stroke, Hemmoragic Numbness, tingling on left side Went to emergency room at the Hospital Forwarded by ambulance to different Hospital Placed in Nuerology Intensive Care Unit (ICU) at hospital Released from ICU to Nuerology ward Released from Nuerology ward to Rehab Unit Released from Rehab to home for outpatient rehab

Other Meds: Amlodipine, Atorvaststin, Gabapentin, Montelukast, Propranolol, Omeprazole, Xaralto, Aller-tec, Multivitamin, Naicin, AREDS Multivitamin, Pseudoepherin (sp?), CoQ10, Fish oil

Current Illness:

ID: 1343268
Sex: F
Age: 14
State: NY

Vax Date: 05/19/2021
Onset Date: 05/23/2021
Rec V Date: 05/24/2021
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: No

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

Symptoms: Horrible headache on Sunday, tears from pain, took rizatriptan and amitriptyline and did not help, Monday could not lift head off pillow due to headache still there. Started day with 2 naproxen

Other Meds: Sertraline, amitriptyline, magnesium

Current Illness: None

ID: 1343269
Sex: F
Age: 62
State: OH

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data:

Allergies: Trileptal, Dilantin, Tegeitol, Neurontin, Prednisone, multiple others.

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

Symptoms: She got her vaccine in the left arm, and felt fine. She went shopping in the store and noticed that she was short winded when she was leaving, but felt that it was possibly asthma and left. She had a temperature between 102 and 103 for a couple of days and having fever and chills as well. She continued with the shortness windedness, and had company and on 5/9/21 they left and she started having severe pain, felt like it was either on the right side kidney or the lung, and was spasming horribly and knocking her down with the pain. She went to the ER and they did a CAT Scan thinking it was kidney stones, but told her that she had three blood clots in her lungs, lower base right and lower base left and mid right and part of her lung has apparently died due to this. They put her on blood thinners, Xarelto. She was admitted on 5/10 early morning and released on 5/12/21. The doctor in the hospital said that it did not make sense that she had blood clots in her lungs, but nothing in her legs. She told her that she was short winded, and he told her to report her reaction. Since being home she has been coughing a lot due to possibly the blood clots. She was told that she will be on the Xarelto for a very long time. She was also informed that she had lymph node enlargement as well.

Other Meds: Drisdol, Synthroid, Meloxicam, Norflex, Osteobiflex, Vitamin D.

Current Illness: Severe muscle and arthritis joint pain ongoing for 4-5 months starting in early February.

ID: 1343270
Sex: F
Age: 49
State: LA

Vax Date: 03/01/2021
Onset Date: 04/03/2021
Rec V Date: 05/24/2021
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: Pollen, dust, dog & cat, some foods, fresh cut grass

Symptom List: Pain in extremity

Symptoms: I developed septic arthritis of the hip within a week of getting the second Moderna vaccine. No symptoms or signs.

Other Meds: Toujeo Insulin, Victoza, Lisinopril, Bayer aspirin, Tylenol, Ferrous Gluconate, Linzess, Vitamin B12 & D, Percocet, Zanaflex, Lyrica, Furosemide, Benadryl.

Current Illness: None

ID: 1343271
Sex: F
Age: 54
State: CA

Vax Date: 04/01/2021
Onset Date: 05/14/2021
Rec V Date: 05/24/2021
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: This is not adverse, but noteworthy. I?ve had a bad tooth for roughly six months - pain with biting and I did not chew on that side. No visible signs on gum. I finally booked my root canal with a dentist. ONLY after the vaccine, I noticed exterior gum redness coincidentally around the same sore tooth. A few weeks go by after being vaccinated, and I notice my tooth doesn?t hurt anymore. I kept the dental appointment anyway, but no treatment required. The timing can only point to the vaccine probably ramping up my immune system and fighting whatever infection I was harboring in that tooth. While this may not be related to covid, the immune response factor was interesting to me - and hopefully you. There is no other explanation in my mind; and given the length of time it was sore, it doesn?t seem to be a coincidence.

Other Meds:

Current Illness:

ID: 1343272
Sex: F
Age: 47
State: FL

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/24/2021
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: NKA

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

Symptoms: 5/24/21 53 years old female with past medical history of cardiopathy (murmur) presents with numbness to the right arm and leg post vaccination. Patient 12 lead EKG shows some PVC?s. Patient is hypertensive. Vital sign 175/89, 82 HR, 95%, 18 respiration rate, blood sugar is 88. Patient right fingers are very cold and are turning blue. Patient received second dose of Pfizer. Patient denies any reactions to previous vaccinations. Patient denies any chest pain and palpitations. NP and Paramedic by the stretcher monitoring patient. Vitals sign rechecked 163/103, 86, 95%, 19. Patient is still hypertensive. Patient denies any history of HTN. Rescue transported patient to hospital.

Other Meds: NA

Current Illness: none

ID: 1343273
Sex: M
Age: 28
State: NY

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/24/2021
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: NKDA

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

Symptoms: Right after administration, pt experienced injection site redness, swelling, and warmth that subsided after 30 minutes of observation. Injection site bruise on left arm appeared two days after injection. Pt reported to pharmacy 6 days after injection about bruise; pt was counseled to take a photo of the bruise everyday to monitor changes in color or size. Pain not reported.

Other Meds: None

Current Illness: None

ID: 1343274
Sex: F
Age: 22
State: IN

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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:

Symptom List: Vomiting

Symptoms: Fever, muscle aches, sweat, chills, head ache

Other Meds:

Current Illness:

ID: 1343275
Sex: M
Age: 88
State: IA

Vax Date: 03/26/2021
Onset Date: 04/17/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Bell's Palsy developed more than two weeks after the first dose. The patient had postponed his second dose due having what his wife described as a severe GI flu. On the day he was originally scheduled to come in for his second dose he developed drooping on one side of his face and his wife took him to the ER suspecting a stroke. Testing ruled this out and he was diagnosed with Bell's Palsy. He was treated with valacyclovir and prednisone.

Other Meds: Pantoprazole, levothyroxine, atorvastatin, Symbicort, amlodipine

Current Illness: GI flu

ID: 1343276
Sex: F
Age: 58
State: NV

Vax Date: 05/12/2021
Onset Date: 05/16/2021
Rec V Date: 05/24/2021
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: PCN (angioedema), ZOFRAN (akathisia) , ULTRAM (hypotension), echinacea (hives) Watermelon (throat itchy & edema)

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

Symptoms: Blurred vision suddenly onset. Right eye diagnosed with posterior vitreous detachment and left eye liquefaction. Both eyes have floater with right eye very significant visual disturbance. No safe treatment (surgical) so it is wait and see to determine if retinal will be affected

Other Meds: BHRT (bioidentical hormone replacement therapy) Pellets - SubQ Q 4 mo: *estradiol 10 mg *testosterone 100 mg ~progesterone 200 mg PO QHS BHRT (replacement) ~melatonin 3 mg PO QHS (GERD and sleep) ~Calcium 1000 mg PO BID (replacement) ~gluc

Current Illness: Non

ID: 1343277
Sex: F
Age: 55
State: IN

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
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: 0

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Redness at injection site which spread to entire upper arm combined with swelling & pain. Still exists today. On night after vaccine fever of 102 combined with chills for several hours

Other Meds: Keppra, xcopri, aspirin, losartain

Current Illness: 0

ID: 1343278
Sex: M
Age: 21
State: CO

Vax Date: 05/08/2021
Onset Date: 05/10/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Myocarditis, Pericarditis

Other Meds:

Current Illness:

ID: 1343279
Sex: F
Age: 36
State: NC

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/24/2021
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: seasonal to pollen

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

Symptoms: Patient reported tingling/numbness of her right face at the corner of her lips and right temporal area. She did not reports or demonstrate any paralysis. She did not report or demonstrate any cardiorespiratory symptoms. She was observed for 30 minutes and released in stable condition. Later that day she reported resolution of symptoms after about 1.5 hours.

Other Meds: Claritin - D

Current Illness: none reported

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm