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: 1343332
Sex: F
Age: 46
State: MS

Vax Date: 04/01/2021
Onset Date: 04/19/2021
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: lactose and gluten intolerance

Symptom List: Dysphagia, Epiglottitis

Symptoms: hyptertension and swelling in legs, hands, feet. 4-19-2021 to current. No treatment. Monitoring BP and swelling.

Other Meds: Lexapro, Nexium. Pepsid, calcium, multi vitamin, black elderberry, vitamin B12, vitamin D3, probiotic

Current Illness: none

ID: 1343333
Sex: F
Age: 18
State: WA

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

Lab Data:

Allergies: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient passed out about 5 minutes after getting the covid vaccine. Pharmacist was called right away and the patient was found lain on the floor, coherent and talking to the mother. She rested there for a few minutes, drank some water. She looked ok and refused further EMS help when EMS arrived.

Other Meds: none

Current Illness: none

ID: 1343334
Sex: F
Age: 36
State: TX

Vax Date: 05/20/2021
Onset Date: 05/21/2021
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: Egg, Peanut, Penicillin

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

Symptoms: Bruising at injection site. Bruising still present 5 days later

Other Meds:

Current Illness:

ID: 1343335
Sex: F
Age: 43
State: IN

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

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

Lab Data:

Allergies: Compaazine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Felt heart was racing last night around 6:30,pm. started getting chills around 7pm. Woke up at 1am freezing and having muscle aches. I shook all night long and could not get comfortable. Woke up at 6am today and got a shower and felt nauseous. Went to work for about 30 min and then came home because I couldn?t stand up. I ache everywhere and cannot get comfortable.

Other Meds: None

Current Illness: None

ID: 1343336
Sex: M
Age: 59
State: NV

Vax Date: 03/29/2021
Onset Date: 04/06/2021
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: bee stings

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

Symptoms: shortness of breath, arrhythmia. Referred to Cardiologist. Recommended scope to check the heart for clots, shocked heart back to normal sinus rhythm.

Other Meds: Losartan

Current Illness: obesity, high blood pressure

ID: 1343338
Sex: F
Age: 82
State: WA

Vax Date: 02/09/2021
Onset Date: 02/24/2021
Rec V Date: 05/24/2021
Hospital: Y

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: Sulfa

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

Symptoms: Patient was admitted to the hospital 2 weeks following first Moderna Vaccine for COVID. Diagnosed with pericarditis/myocarditis. No other clear preceeding illness or precipitant.

Other Meds: Vitamin C, aspirin, vitamin D, glucoasamine, multivitamin, omega 3 fatty acids, pravastatin, metronidazole topical

Current Illness: None

ID: 1343339
Sex: F
Age: 15
State: NY

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

Lab Data:

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After 15 minutes of observation Pt. went to car, en route to car pt. started feeling throat tighten and felt trouble breathing. Pt. was escorted to the back where she was monitored for an additional fifteen minutes. Pt. stated that she was feeling better. Pt. left the facility with no further incident and was speaking in full clear sentences without any obvious difficulty.

Other Meds: N/A

Current Illness:

ID: 1343340
Sex: F
Age: 30
State: CO

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: clarithromycin, penicillins, sulfa, dragon fruit, grass, dust

Symptom List: Pharyngeal swelling

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: patient presents to allergy clinic for follow-up four months after immunization. Within five minutes of immunization patient reports diarrhea and throat itching. Within ten minutes reports injection site feeling hot, hives, rash, and itching all over body then developed tongue and lip swelling, coughing, and post nasal drip. Patient went to the emergency department, given epinephrine, famotidine, methylprednisolone, and diphenhydramine, monitored for a few hours, and discharged to home. Patient has not experienced any similar symptoms since immunization.

Other Meds: citalopram, gabapentin, propranolol, tizanidine, trazodone

Current Illness: none reported

ID: 1343341
Sex: M
Age: 33
State:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: BP147/83, patient reported tingling to R arm. Patient was administered 25mg of Benadryl Po. Complained of palpitations, probably related to anxiety. Ice pack was applied to back of the neck. Patient was discharged home.

Other Meds:

Current Illness:

ID: 1343342
Sex: F
Age: 29
State: CT

Vax Date: 04/27/2021
Onset Date: 04/29/2021
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: Penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I received the vaccine on 04/27/2021. I had a high resting heart rate (100+) with shortness of breath and went to the Emergency Department two days after receiving the vaccine (04/29/2021). They gave me fluids and monitored my heart rate until it came down into the 80s. However, since then, I have continued to have a high resting heart rate with occasional chest tightness and followed up with my primary care doctor who recommended seeing a cardiologist. On 05/09/2021, I also had a skin rash on my face, lips, arms, and hands (I think part of my chest/abdomen as well). I went to the Immediate Care Center and was prescribed hydroxyzine. With the medication, the rash went away within a few days.

Other Meds: N/A

Current Illness: N/A

ID: 1343343
Sex: M
Age: 16
State:

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

Lab Data:

Allergies:

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

Symptoms: Patient fell on another student after feeling faint. Stated he hit his knee. Patient was put in trendelenburger with feet up until less fit. Remined seated for 20 min for observation.

Other Meds:

Current Illness:

ID: 1343344
Sex: M
Age: 17
State: WA

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

Lab Data:

Allergies: Bee Stings

Symptom List: Rash, Urticaria

Symptoms: Insomnia (36 hours, Fever (highest at 101.5), body aches (36 hours), headache (on and off )

Other Meds:

Current Illness:

ID: 1343345
Sex: F
Age: 52
State: AZ

Vax Date: 12/21/2020
Onset Date: 03/16/2021
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: no

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

Symptoms: rash arms legs, itchy no desquamation or anaphylaxis occurring months later 3/16/2021

Other Meds: paroxitine, flovent, alberterol, zyrtec

Current Illness: no

ID: 1343346
Sex: M
Age: 93
State: VA

Vax Date: 03/31/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
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: lisinopril

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

Symptoms: Admitted to local hospital and found to have DVT lower extremity.

Other Meds: Senna, tramadol, lasix, metoprolol, MVI, venlafaxine, ferrous sulfate

Current Illness: none, stable

ID: 1343347
Sex: M
Age: 42
State: VT

Vax Date: 04/26/2021
Onset Date: 04/27/2021
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: N/A

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

Symptoms: The injection site became inflamed, and swelled to the size of a baseball. This condition lasted for 72 hours, and the inflamed portion was very tender during that period.

Other Meds: N/A

Current Illness: N/A

ID: 1343348
Sex: F
Age: 40
State: CT

Vax Date: 03/31/2021
Onset Date: 04/02/2021
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: amoxicillin

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

Symptoms: spinal cord inflammation causing drop foot, reflex deficiencies, back, hip leg and foot pain. Numbness and nerve pain in leg and foot

Other Meds: sertraline

Current Illness: none

ID: 1343349
Sex: F
Age: 34
State: VA

Vax Date: 05/13/2021
Onset Date: 05/16/2021
Rec V Date: 05/24/2021
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: Food: MSG, Kiwi, pineapple, tomato, latex

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

Symptoms: Chest pain

Other Meds: Multi-vitamin, Tylenol when needed for headaches

Current Illness: Gallstones

ID: 1343350
Sex: F
Age: 39
State: IN

Vax Date: 05/22/2021
Onset Date: 05/23/2021
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: Penicillin Lavender

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fatigue, swelling, body aches, fever, headache, itching at injection site

Other Meds: Fluoxetine Lamictal

Current Illness: None

ID: 1343352
Sex: M
Age: 55
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I developed a pneumonia after receiving the 2nd dose. Symptoms included: fever, chills, sweats, cough, rash, diarrhea shortness of breath.

Other Meds: Liptor, Vitamin D, Vitamin C,

Current Illness: Common Cold

ID: 1343353
Sex: M
Age: 24
State: MA

Vax Date: 05/05/2021
Onset Date: 05/06/2021
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: None known.

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

Symptoms: Initially I had experienced the standard adverse effects of drowsiness, a little difficulty sleeping, minor chills. The next day following my Dose 1 of the Moderna Vaccine, I started noticed chest pains on both sides of the chest. It wasn't from breathing and not very consistent or something I could re-create on command. It seemed to happen every hour for a few seconds and was a sudden, sharp pain. That was a concern for me so I did some basic internet searches and found that Chest pains are a symptom of the vaccine. I didn't think too much of it after that but It was a concern I kept in my head. My timeline gets a little foggy here but either that same day or the following day, the chest pains were still happening and I wasn't feeling 100%. One evening I went to take a bath. As I was laying in the water, my heart rate felt off, almost as if it was skipping a beat or not in the right rhythm. I remember laying in the bathtub, trying to count my pulse or seeing if I could "catch" the incorrect beat. Rather than one normal heartbeat it felt like there was 2 beats very closely timed with each other. My heart rate felt faster than normal considering I was only laying down in water and didn't do any exercises the past few days. Unfortunately I never was able to find a good way to track the pulse and timing, but I was sure that something was wrong. I had difficulty sleeping that night because I kept feeling something wrong with my heart rhythm. I got worried that I would need to go to the emergency room, but I told myself to sleep it off and if the chest pains and awkward heart beat continues for 5 days, I would go see a doctor. As for an outcome, thankfully I stopped noticing it around day 4 and haven't had chest pains since. I am extremely worried as to how my body will react to Dose #2.

Other Meds: Over the counter: Men's One A Day complete Multivitamin, NatureMade digestive Probiotics dummies, Omega 3-6-9 Flax, Fish, and Borage oils, and Benzoyl Peroxide 10% Wash (lotion). Prescription: Clindamycin Phosphate topical lotion. Altho

Current Illness: I tested positive and was experience symptoms of COVID-19 on April 07, 2021.

ID: 1343354
Sex: M
Age: 14
State: NY

Vax Date: 05/24/2021
Onset Date: 05/24/2021
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:

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

Symptoms: Patient felt dizzy and passed out, did not hit head, was lowered to the ground. All vital signs were normal throughout experience. Patient was transported with a wheelchair, ate some crackers and drank some juice. No concerns noted, patient left clinic site, self ambulated.

Other Meds:

Current Illness:

ID: 1343355
Sex: F
Age: 30
State: UT

Vax Date: 04/26/2021
Onset Date: 04/26/2021
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:

Symptom List: Unevaluable event

Symptoms: Around 2pm day of vaccine, started getting headaches, neck aches, nausea, fatigue, sore arm at injection site. By evening, had shivers and chills but no fever. Had to wear three layers of clothes for an hour to get warm. Had fatigue, headaches and neck aches for about 3 more days after. I had previously had Covid-19 a few months before..

Other Meds:

Current Illness:

ID: 1343356
Sex: F
Age: 31
State: PA

Vax Date: 04/23/2021
Onset Date: 05/19/2021
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:

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

Symptoms: Shingles - rash and severe hip pain on set approx 3.5 weeks after vaccine

Other Meds:

Current Illness:

ID: 1343357
Sex: M
Age: 17
State: NC

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

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Fever and headache 24 hours after vaccine. Continued fever and chest pain 48 hours after vaccine.

Other Meds: None

Current Illness: Upper respiratory tract infection 5/6/2021

ID: 1343358
Sex: M
Age: 49
State: AR

Vax Date: 05/21/2021
Onset Date: 05/22/2021
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: codeine, hydrocodone, grass, pollen.

Symptom List: Injection site pain, Menorrhagia

Symptoms: dizziness, weakness, sharp pain in right arm and right leg, fatique, cold chills.

Other Meds: plavix, lipitor, bystolic, flexeril, ropinirole, men's multivitamin, tumeric with ginger capsule, d3, B complex, loratidine.

Current Illness: none

ID: 1343359
Sex: F
Age: 52
State: FL

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

Lab Data:

Allergies: NKA

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

Symptoms: SEVERE HEADACHE AND LOWER EXTREMITY MUSCLE WEAKNESS

Other Meds: IBUPROPHEN 800 MG QID PRN PROTONIX 40 MG BID CARAFATE 1 GM QID OMEPRAZOLE 40 MG QAM ZOFRAN 4 MG Q 4-6 HOURS PRN

Current Illness: BARRETTS ESOPHAGUS, FIBROMYALGIA, ULCERS

ID: 1343360
Sex: F
Age: 29
State: CT

Vax Date: 04/27/2021
Onset Date: 04/29/2021
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: Penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I received the vaccine on 04/27/2021. I had a high resting heart rate (100+) with shortness of breath and went to the Emergency Department two days after receiving the vaccine (04/29/2021). They gave me fluids and monitored my heart rate until it came down into the 80s. However, since then, I have continued to have a high resting heart rate with occasional chest tightness and followed up with my primary care doctor who recommended seeing a cardiologist. On 05/09/2021, I also had a skin rash on my face, lips, arms, and hands (I think part of my chest/abdomen as well). I went to the Care Center and was prescribed hydroxyzine. With the medication, the rash went away within a few days.

Other Meds: N/A

Current Illness: N/A

ID: 1343362
Sex: M
Age: 24
State: OK

Vax Date: 03/15/2021
Onset Date: 03/16/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Approximately 12 hours after receiving the vaccine, I woke up around 2:00 a.m. or so with extreme body aches, fatigue, headache, nausea, dizziness, and slight fever. Around 9:00 a.m. or so that same morning, I went to Emergency room because I was so sick I didn't know what to do. They said I was just having a reaction to the vaccine, and it should go away in a day or so. They gave me Ibuprofen and Tylenol and a shot of toradol. I was then discharged and went back to my living quarters. I had covid already back on January 20th 2021. But the vaccine was five times worse than the virus.

Other Meds: Lithium 300mg 2x daily, Metoprolol 50mg 1x daily, Gabapentin 800mg 3x daily, Epclusa 400/100mg 1x daily, One-A-Day Fruit chew daily vitamins.

Current Illness: Hypertension, Hepatitis C, Some Mental Health Conditions

ID: 1343363
Sex: F
Age: 66
State: TX

Vax Date: 05/20/2021
Onset Date: 05/20/2021
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: Sulfa antibiotics, penicillins, Codeine

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

Symptoms: Within 5 minutes of vaccine administration, patient appeared shaky and reported tightness in throat. Pharmacy staff suspected anxiety/panic attack as symptoms appeared to be triggered by pharmacist stating that patient must remain on site for a 15 minute observation period in case of an immediate and serious reaction. Out of an abundance of caution, EMS was called and reported to the pharmacy. EMS stated airway was clear, and patient did not appear to be in anaphylaxis. Because patient was wheezing, epinephrine was administered, and patient was taken to local hospital. Patient was discharged around 10:00pm (approximately 5 hours after the incident).

Other Meds:

Current Illness:

ID: 1343364
Sex: F
Age: 17
State: MA

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

Lab Data:

Allergies: None listed

Symptom List: Nausea

Symptoms: Patient felt light-headed and was not responding to questions. She was lowered to the ground by the pharmacist and technician. She became responsive and was confused. EMS was contacted. Blood pressure measured 110/68. Patient remained on the floor until EMS arrived and took over care.

Other Meds:

Current Illness:

ID: 1343365
Sex: M
Age: 36
State: PA

Vax Date: 04/28/2021
Onset Date: 05/04/2021
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: no.

Symptom List: Injection site pain

Symptoms: I had done with my 2 dosses of COVID vaccination. It's been almost more than 3 weeks now that i had my 2nd dose of COVID 19 vaccine. There is a little arm pain where i had my vaccine for first couple of days and after that i did started my regular activities including my games (volleyball, etc.). After a week's time, I started to develop intense pain around the injected area and this pain is not regular. The pain starts after i return from my sporting activity or doing a regular home activity that involves arms. This is a routine till date and the pain's intensity might be the same or a level less compared to initial days. Still sees the soreness spot around the injected area even today. Dose 1 - Apr 7 (Pfizer - ER8729) Dose 2 - Apr 28 (Pfizer - EW0176)

Other Meds: No. Just taking the regular Adult calcium gummies twice daily. Also, have dust and pollen allergies this season and so taking outdoor allergy medicines - Zyrtec, Claritin now and then.

Current Illness: no except the dust and pollen allergies.

ID: 1343366
Sex: M
Age: 12
State: MI

Vax Date: 05/15/2021
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: gluten

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

Symptoms: Aaron did not experience any adverse events - he was watched for 30 minutes post administration. This report is just for documentation of patient receiving Janssen over pfizer at the clinic. Mom requested patient receive one shot of the J and J like dad, and intern administered J and J thinking the 12 years and older eligibility pertained to both vaccines.

Other Meds: n/a

Current Illness: n/a

ID: 1343367
Sex: F
Age: 77
State: FL

Vax Date: 04/02/2021
Onset Date: 05/15/2021
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: Statin's, Demerol, most of the Mycin's. Erythromycin, super - antibiotics cannot take, Sulfa.

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

Symptoms: She got her vaccine, a little diarrhea, a slight headache, foggy brain, overwhelming fatigue, slight nausea for a few days and then it stopped. She is having these symptoms again, and is having this for the third time which started a few days ago with the same reactoin, plus muscle weakness, just feeling sick like, crappy feeling.

Other Meds: Xanax, Bisoprolol.

Current Illness: None.

ID: 1343368
Sex: M
Age: 49
State: IL

Vax Date: 12/24/2020
Onset Date: 01/17/2021
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: Lactose Intolerant

Symptom List: Tremor

Symptoms: Large blood blister in soft palate after eating hot foods. This happed again several days later at a different location in the soft palate.

Other Meds: Lisinpril/HCTZ. Lipitor. Vitamin D. Zinc. Asmanax. Albuteral.

Current Illness: none

ID: 1343369
Sex: F
Age: 74
State:

Vax Date: 04/07/2021
Onset Date: 04/20/2021
Rec V Date: 05/24/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1343370
Sex: F
Age: 47
State: MD

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: Currently on Migraine Diet so only eating 20 foods to avoid headaches. Known intolerances are dairy, soy, gluten and nuts.

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

Symptoms: I received the injection at 10am. I felt fine until 3:15. Around 3:15, I started feeling like I was coming down with the flu. I could tell I was starting to run a fever because my eyes were feeling hot. That is how I always know I have a fever. By 6:30, I had to go to bed and was freezing cold with chills. My body was aching extremely bad as well. I was in flannel pajama's and covered in blankets but could not get warm. I just shook and shivered for hours. My highest temperature got to 101.7. I was not able to sleep during any of this time also. My body hurt no matter how I laid. At 12:15am, my fever broke and I was sweating. My body still ached and for a few hours I laid sweating. I was not able to go to sleep until about 3:45am that night. The next day I felt better but my body still ached some, but less that the night before. My neck however was really hurting. Could possibly have been due to the chills??? I had a migraine and had to take a Zomig to relieve the pain. Sunday my body was still aching a bit but better than the day before. Overall just tired and run down on Sunday.

Other Meds: zyrtec, Duloxetine, Trazodone, Zonisamide, Oxcarbazepine, Generic for Zomig as needed

Current Illness: None

ID: 1343371
Sex: F
Age: 50
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: 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: Patient said after vaccination a rash appeared on both her back and leg, she said it was not there before vaccination, we gave patient 25mg of Benadryl and had her sit for 15min. She felt fine after and left on her own accord.

Other Meds:

Current Illness:

ID: 1343372
Sex: M
Age: 62
State: NJ

Vax Date: 01/27/2021
Onset Date: 02/01/2021
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 known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Blotchy rash on arms and legs

Other Meds: ambien, lipitor, multivitamin

Current Illness: None

ID: 1343373
Sex: F
Age: 26
State: WI

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Patient worked the rest of her shift, but just informed me today when I passed her in the store that she had actually fainted 3 times when she got home.

Other Meds: Pirmella 1/35 tab

Current Illness: none

ID: 1343374
Sex: M
Age: 43
State: OH

Vax Date: 04/01/2021
Onset Date: 04/23/2021
Rec V Date: 05/24/2021
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: n/a

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

Symptoms: Blood clot in superficial vein behind right knee as well as vertigo and nausea. Currently on 30mg/day of XARELTO blood thinner (I've been taking since diagnosis on 5/5/21). Will continue to take 20mg/day for the next 30 days. Background: I started to notice my right calf get tight and sore approximately ~3 weeks following my vaccination. I had been doing a lot of running and hill training so I assumed it was a muscle strain/aggravation. After approximately 1-2 weeks I noticed the tightness worsen and also noticed significant swelling around my lower calf/ankle. I went to the doctor on 5/4/21 and was given a D Dimer blood test which came back 1.27 mcg/mL FEU (over the recommended 0.5 mcg/mL). The next day I had an ultrasound of my right leg where they discovered the SVT clot behind my right knee in a superficial vein (but near a major/deep vein intersection). I was immediately prescribed XARELTO blood thinner - to be taken for ~51 days. ~21 days of 30mg/day (15mg twice/day) followed by ~30 days of 20mg/day 1x per day. The morning of 5/20/21 around 6:30am I started to feel nausea and vertigo after returning home from walking my dog. I finished a low-intensity exercise routine at my home and around ~7:15am my symptoms worsened. I went upstairs to my bedroom to lay down on my bed and the room started spinning. I then went to the bathroom and vomited clear fluid. I started feeling a little better after vomiting but was still slightly dizzy and light-headed. I made an appointment and went to the doctor around 10:30am. The doctor suggested doing further bloodwork and a CT scan of my head. Both tests came back normal. The doctor suggested the vertigo and nausea were inner ear related and that I should continue taking XARELTO and to also start wearing a compression sock (especially during exercise/activity).

Other Meds: Zinc, daily supplement

Current Illness: n/a

ID: 1343375
Sex: F
Age: 15
State: DC

Vax Date: 05/14/2021
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:

Symptom List: Pain in extremity

Symptoms: Suddenly my vision got super bright and I could hardly see, and then I couldn?t hold myself up and I slowly collapsed onto the ground. It only lasted a few minutes, and then I was perfectly fine. It came on very suddenly and didn?t last long, but it was extreme during those few minutes. It was also very hot that day. And I had a mild migraine headache in the morning, but that wasn?t very bad, and I get migraines fairly regularly.

Other Meds:

Current Illness:

ID: 1343376
Sex: F
Age: 34
State: MI

Vax Date: 05/22/2021
Onset Date: 05/23/2021
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: MUSHROOM, MORPHINE & PENICILLIAN

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

Symptoms: I NOTICED MY LYMPH NODE WAS SWOLLEN AND TENDER IN THE ARMPIT AREA ON SUNDAY MAY 23 2021

Other Meds: none

Current Illness:

ID: 1343377
Sex: F
Age: 40
State: NM

Vax Date: 04/17/2021
Onset Date: 04/27/2021
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: Codeine

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

Symptoms: Pulsatile Tinnitus right ear, sinus pain and headaches.

Other Meds:

Current Illness:

ID: 1343378
Sex: F
Age: 50
State: IL

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: constant ringing in ears

Other Meds: prevastatin 20 mg

Current Illness: non

ID: 1343379
Sex: F
Age: 40
State: CA

Vax Date: 05/03/2021
Onset Date: 05/19/2021
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: Iodine, Shrimp

Symptom List: Vomiting

Symptoms: Pre-menstrual breakthrough bleeding, excessive cramping and discomfort during menstruation. No change in timing of menstruation.

Other Meds: Daily multivitamin, vitamin D, vitamin C, Fish Oil

Current Illness: N/A

ID: 1343380
Sex: F
Age: 46
State:

Vax Date: 01/30/2021
Onset Date: 02/14/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Since my second vaccine, I had irregular menstrual bleeding. At times this is light spotting, at times heavy spotting, I have gotten my period twice in 3-week cycles. I did finally seek an appointment with my FYN.

Other Meds: Imipramine 75 mg once daily; vitafusion multivitamin gummies 2 daily; sambucus elderberry 2 gummies daily; had a cortisone steroid injection two weeks prior to the vaccine for an injured shoulder

Current Illness: None

ID: 1343381
Sex: F
Age: 30
State: WA

Vax Date: 05/12/2021
Onset Date: 05/13/2021
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:

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

Symptoms: Pain and discomfort in lower chest near heart and Extreme breathlessness, fatigue and on May 13, 14. Breathlessness was worst on May 14. lasted at lower intensity over next week. Fever (100 degrees) on May 14.

Other Meds: Birth control pill Synthroid 75 mcg

Current Illness:

ID: 1343382
Sex: F
Age: 37
State: NY

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Since the second vaccine dose, she has felt periodically fatigue (minor to intense), dizzy, chills, headaches, pain in left arm (where vaccine was administered), and brain fog. These effects were felt minimally at first, then more intensely after several days. During the past three months, she has gone up to 9-10 days without experiencing symptoms, but these eventually return, frequently more intensely than before, for periods of up to 10 days. She is able to function and complete tasks, but the impact of these side effects is overall debilitating, both physically and, increasingly, psychologically. She is increasingly concerned that these symptoms will never go away. In April she contacted Pfizer regarding her side effects, but was referred to her general practitioner.

Other Meds:

Current Illness:

ID: 1343383
Sex: F
Age: 58
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin (trouble breathing), IV dye (trouble breathing), NSAIDs (rash). Per patient, she has never needed to use an EpiPen

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

Symptoms: Patient reports having an asthma attack ~5am this morning. She used her Albuterol inhaler shortly before receiving her vaccination. Patient reported shortness of breath and wheezing ~5 minutes after being vaccinated. Per patient, it felt like a "normal" asthma attack. She denied dizziness or swelling of the face/tongue/throat/etc. She was transferred to med obvs for further evaluation. Vitals remained stable. On exam, there were mild, diffuse expiratory wheezes. Patient was able to comfortably have a conversation with me without becoming dyspneic. There was no evidence of cyanosis. Per patient, her oxygen saturation is usually around 90%. Vitals as follows: 9:50- HR 98, BP 127/64, O2 92% 9:59- HR 98, BP 120/73, O2 93% 10:02- HR 94, BP 118/76, O2 93% 10:07 (sitting)- HR 94, BP 135/76, O2 94% 10:10 (standing)- HR 96, BP 134/86, O2 93% Pt released to home with her partner at 10:20

Other Meds: Albuterol

Current Illness: Asthma attack ~5am the morning of the vaccination

ID: 1343384
Sex: F
Age: 60
State: NC

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: No

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

Symptoms: After vaccination, the injection site was sore but a few days later I started having pain at injection site that progressively got worse. I started having a burning that went down my whole arm to my back and up shoulders and back area, and there was numbness in my fingers. I told the pharmacist I didn't know if I should get the 2nd dose in the same arm, but I did and everything intensified and the pain increased after I had my second dose. I reported it to my doctor and he thought it was just my muscle but it started after my vaccine. the doctor gave me Gabapentin and it kept getting worse and I couldn't use my arm, the doctor increased the gabapentin but it still didn't work and he referred me to a neurologist. I couldn't sleep at night, couldn't use the arm or lay on the arm and the doctor gave me prednisone and it helped a little, but when I stopped taking it, I went back to the same pain. I have tremors in the arm as well and it feels like there is a burning under the skin but it's not swollen, it feels like there is some numbness in it. He referred me to a specialist and I see them tomorrow.

Other Meds: Singular 10mg, Ampdopopine (Norvasc), Propranolol, HTCZ 12.5mg,

Current Illness: No

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm