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: 1343588
Sex: M
Age: 67
State: OR

Vax Date: 03/20/2021
Onset Date: 04/10/2021
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: Lisinopril

Symptom List: Dysphagia, Epiglottitis

Symptoms: Had a heart transplant 5 years ago. After vaccination, my calf muscles ached and I had to walk on the balls of my feet. I didn?t feel well and was achy, but all of that resolved after about 4 or 5 days. About 25 days after the vaccine, I woke up and my legs were hurting, swollen and lumpy. I went into the house and elevated my feet. I was sore from my calf to my ankles. I called the doctor and he told me to go the ER. After a 3 hour wait, one of the patients waiting almost threw up me, so I told them I was going home. Later, I went in to see the doctor about what was going on. After rubbing my calf vigorously, some of the lumps started to go away. The only thing my doctors came up with was that I was retaining water. I felt like I had gained some weight. I couldn?t stand long before my legs swelled. They prescribed a strong diuretic called Torsemide and I lost about 10 lbs. I currently wear compression socks every day, which helps with the swelling and my ankles hurt all of the time. I only take the meds as needed because it?s hard on my kidneys, which are already compromised due to my transplant meds.

Other Meds: Multivitamins Vitamin D Tums - to help my stomach deal with my med regime Amlodipine Besylate Bupropion HCL SR Rosuvastatin Calcium Gabapentin Sirolimus Famotidine Magnesium Oxide - 400mg

Current Illness:

ID: 1343589
Sex: M
Age: 15
State: CO

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

Lab Data:

Allergies: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: Moderna was inappropriately given to an individual <18 years of age. No adverse reaction to the vaccine.

Other Meds: N/A

Current Illness:

ID: 1343590
Sex: F
Age: 17
State:

Vax Date: 05/21/2021
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:

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

Symptoms: Pt c/o dizziness. BP 103/84, HR 90, RR 16. Pt stable and released from the vaccination site.

Other Meds:

Current Illness:

ID: 1343592
Sex: F
Age: 37
State: CO

Vax Date: 05/19/2021
Onset Date: 05/22/2021
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: no

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I got my Second dose on May 19 2021 around noon and from night I started getting slight pain on my arm and light headache and body aches ,then I took one DOLO tablet the same night and another DOLO tablet next day and I felt all ok .From Saturday mid day I started experiencing itching and did not bother much and by Saturday night Itching has increased little bit and By Sunday,rashes appeared all over my body especially it started with both arms and then both hands and then both thighs and then legs toeas and then upper back lower back and everywhere it increased

Other Meds: none

Current Illness: none

ID: 1343593
Sex: F
Age: 87
State: NY

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: After 1st dose on 3/4/21, she developed "brain fog" which gradually became worse. After 2nd dose on 4/1, she started showing many symptoms of "Rapidly progressive dementia". The only change in medication or change in her lifestyle was the Covid vaccine.

Other Meds: Celecoxib 200mg Omeprazole 40mg Fenofibrate 160mg Atorvastatin Irbesartan 150mg Carvedilol 6.25 mg 2x Hydrochlorothiazide 12.5mg Fluoxetine 20mg Asprin 81mg Fiber capsule

Current Illness: none

ID: 1343594
Sex: F
Age: 28
State: IA

Vax Date: 05/20/2021
Onset Date: 05/21/2021
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:

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

Symptoms: Sever fatigue , migraine, chest pain

Other Meds:

Current Illness:

ID: 1343595
Sex: F
Age: 17
State:

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: Pt c/o dizziness. BP 103/84, HR 90, RR 16. Pt stable and released from the vaccination site.

Other Meds:

Current Illness:

ID: 1343596
Sex: F
Age: 60
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sulfa drugs

Symptom List: Pharyngeal swelling

Symptoms: About 12 hours after vaccine was administered my arm at the vaccination site was very sore. I was extremely fatigued. Even so I had a fitful nights sleep feeling cold and under blankets. The next morning I was quite ill. I had a fever, aches and pains, extreme headache even after taking Motrin. My arm at the vaccination site was so painful that I had trouble moving my arm. I spent the day in a reclined position only getting up to go to the bathroom. The next night I slept better and my fever broke in the middle of the night. I woke up the next day feeling better but still had aches and pains and fatigue. I basically spent the day sitting around and taking naps. My arm was still sore but I could move it on this day. By the end of the day I felt much better. I was able to move my arm freely at this time. The next morning (today) I felt almost well but extremely fatigued.

Other Meds: No prescription meds. Vitamin C, vitamin D and echinacea. Motrin taken for pain and fever.

Current Illness: none

ID: 1343597
Sex: M
Age: 20
State: PA

Vax Date: 05/17/2021
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: cedax- antibiotic

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: In the middle of the night he stood up to go to the bathroom, turned the light on, felt dizzy and light headed. Passed out and woke up confused unable to speak correctly and unstable when trying to stand up. Eyes were dilated. After he layed down for a few minutes he was ok, could walk and talk fine. Migraine Chills Slightly warm

Other Meds: Vitamin C, D, Pristiq

Current Illness: none

ID: 1343598
Sex: F
Age: 28
State: MI

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient fainted and stated troubled breathing multiple times once regained consciousness. Epi Pen administered and symptoms resolved within 10 minutes. Patient did not need further medical attention.

Other Meds:

Current Illness:

ID: 1343599
Sex: F
Age: 39
State: MN

Vax Date: 01/19/2021
Onset Date: 05/19/2021
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 received 2nd dose of Pfizer COVID19 vaccine on 1/19/21. Patient reported new onset of COVID like symptoms starting 5/19/21 and tested COVID19 positive on 5/22/21 via PCR NP swab.

Other Meds:

Current Illness:

ID: 1343600
Sex: F
Age: 37
State: NE

Vax Date: 01/28/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: Unknown

Symptom List: Rash, Urticaria

Symptoms: Complaint of pain at injection site, unable to raise arm above head and couldn't use the arm

Other Meds: Unknown

Current Illness: Unknown

ID: 1343601
Sex: M
Age: 27
State: CA

Vax Date: 05/15/2021
Onset Date: 05/17/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Extensive urticarial rash, pruritis

Other Meds: none

Current Illness: none

ID: 1343602
Sex: F
Age: 22
State: FL

Vax Date: 03/26/2021
Onset Date: 03/31/2021
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: none

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

Symptoms: myocarditis presented with chest pain. elevated troponins to 16,263 pg/mL, viral studies negative. MRI showed revealed late gadolinium enhancement involving the basal inferior, basal to mid inferolateral, mid anterolateral, apical lateral, apical septal, and apical inferior wall segments in a subpericardial distribution pattern, consistent with myocarditis

Other Meds: none

Current Illness: none

ID: 1343603
Sex: F
Age: 38
State: FL

Vax Date: 04/02/2021
Onset Date: 04/07/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Heart Arrhythmia , shortness of breath, Fatigue, skipped Hear beat

Other Meds: Levothyroxine

Current Illness:

ID: 1343604
Sex: F
Age: 58
State: NY

Vax Date: 04/07/2021
Onset Date: 04/14/2021
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: cat Scan Dye, Sulfur Drugs, Linisopril

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

Symptoms: Chest pain, Pericarditis diagnosis.

Other Meds: Synthroid, Cytomel, Zoloft, Bupropion, Amlodopine, Gabapentin, Proventil Inhaler

Current Illness: Hypothyroidism, Hearing Impaired, High Blood Pressure, High Cholesterol

ID: 1343605
Sex: F
Age: 53
State: OH

Vax Date: 04/09/2021
Onset Date: 05/21/2021
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: strawberry, Penicillins

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

Symptoms: PT admitted 5/21/21. SARS-COVID-19 resulted positive 5/21/21. Patient received Janssen covid vaccine 04/9/21 Lot 1808982. PT had presented to ER for with 1 week history of intractable nausea, vomiting and constipation. PT documented to be COVID -19 asymptomatic.

Other Meds: Vitamin D Weekly Dose: 1 tablet Weekly carvedilol Oral 25 mg Dose: 1 tablet(s) 2 Times A Day trimethobenzamide Oral 300 MG Dose: 300 MG After Meals PRN lisinopril Oral 5 mg Dose: 1 tablet(s) 2 Times A Day linaclotide Oral 290 mcg Dose: 1

Current Illness:

ID: 1343606
Sex: M
Age: 39
State: NY

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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: redness to L lower leg

Other Meds:

Current Illness:

ID: 1343607
Sex: F
Age: 60
State: MA

Vax Date: 05/13/2021
Onset Date: 05/20/2021
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: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Headache, Fever (99F), Ache in joints (+1 days from 2nd dose and lasting 2 days) Burning Rash on Torso, Back, Neck and Arms (+8 days from 2nd dose and still ongoing)

Other Meds: N/A

Current Illness: N/A

ID: 1343608
Sex: M
Age: 87
State:

Vax Date: 05/19/2021
Onset Date: 05/20/2021
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: feels sick when taking morphine

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

Symptoms: Clouded mental state, very "foggy". Trouble communicating verbally. Muscle weakness, trouble moving and standing. Very tired. Got better after a long night's sleep, mobility retuned as did mental capabilities.

Other Meds: Xeralto, magnesium l-threonate, vitamin d3, zinc, vitamin c, zrtec

Current Illness:

ID: 1343609
Sex: M
Age: 26
State: IL

Vax Date: 05/19/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Hay fever

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

Symptoms: Fever, fatigue, myalgia (for 24 hours) Frequent premature ventricular contractions (3-4 per minute) (peaked after 12-16 hours then subsided. Some residual still present but not as frequent) Headache (peaked around 12-16 hours) (still present with sneezing coughing or during chaining in head position (standing up or laying down)

Other Meds:

Current Illness: None

ID: 1343610
Sex: M
Age: 56
State: MA

Vax Date: 04/24/2021
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: NKDA

Symptom List: Unevaluable event

Symptoms: Presents with painful erythremic scaling rash in linear strip with blister formation around L lateral neck, L upper chest and L scapular area. Exam consistent with shingles herpes zoster rash. Will treat Valacyclovir as directed. Tramadol for pain due to hx of Gastric Bypass. Benadryl cream for itching. Patient seen on 5/13 and 5/24 for follow up, lesions resolving.

Other Meds: Painful itching rash to L neck, scapular and anterior chest area. He reports started of as burning and itching sensation after his COVID-19 vaccine to L Deltoid area. Rash developed a few days later. Diagnosed as zoster.

Current Illness:

ID: 1343611
Sex: F
Age: 21
State: DE

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

Lab Data:

Allergies: MULTIPLE ALLERGIES AS PER VERBAL COMMUNICATION TO THE PATIENT. NO ALLERGIC REACTION TO THE FIRST DOSE OF THE COVID -19 MODERNA VACCINE.

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

Symptoms: PT PRESENTED WITH THE REQEUST FOR 2ND DOSE OF MODERNA VACCINE. PHARMACIST /IMMUNIZER ENQUIRED ABOUT THE FIRST DOSE, IF THERE WERE ANY REACTION ? SHE REPLIED SHE JUST HAD FLU AFTER THE VACCINE, BUT NO ALLERGIC REACTION. VACCINE WAS ADMINISTERED. 10 MINUTES AFTER THE VACCINE, SHE COMPLAINED ABOUT BREAKING OUT IN HIVES. WITH HER VOICE CHANGING AND HAD TROUBLE SPEAKING. USE OF EPI PEN WAS RECOMMENDED , SHE ADMINISTERED AN EPIPEN TO HER THIGH. PHARMACIST WAS ABOUT TO CALL 911, WHEN SHE AND HER CAREGIVER SAID SHE DOESNT WANT ME TO CALL 911. THEY WILL GO TO THE ER THEMSELVES. CAREGIVER RUSHED HER OUT OF THE STORE TO HOSPITAL. 10 MINUTES LATER THEY SHOW UP AGAIN AT THE DRIVE THRU WINDOW TO PICK UP THEIR VACCINE CARDS. PATIENT LOOKED VISIBLY IN MUCH BETTER CONDITION THAN SHE LEFT. AN ER VISIT WAS RECOMMENDED ONCE AGAIN BY PHARMACIST AT DRIVE THRU. AS OF YET NOT SURE WHETHER SHE IS GOING TO EMERGENCY OR NOT.

Other Meds: NO INFORMATION AT THIS PROVIDER

Current Illness: NO INFORMATION AT THIS PROVIDER

ID: 1343612
Sex: F
Age: 36
State: TN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
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: Sulfa drugs

Symptom List: Injection site pain, Pain

Symptoms: Headache started about 5-6 hours after injection, intensity increased throughout the next 14-16 hours. Generalized achy muscles lasted for 24 hours. 3 days after injection, skin peeling noted around finger nails and under nailbed.

Other Meds: Vyvanse 30 mg daily Trintellix 20 mg daily Valtrex 500 mg daily

Current Illness: sinus infection- treated with Zpack and sinus cocktail shot

ID: 1343613
Sex: F
Age: 29
State: CA

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: Gluten, Dairy

Symptom List: Injection site pain, Menorrhagia

Symptoms: Arm on the side of injection going numb occasionally after injection. 12 hours after injection hand on the injection side was still going numb more frequently and starting to have stabbing pain. 24 hours after injection pain spread to the feet. 2nd morning after injection numbness and pain spread to both hands and both feet. Called the doctor at this point and was told to monitor for any increased "climbing" pains. The pains are not constant they come and go, if that changes I was told to come in. 3rd-morning pain and numbness are still in the injection side hand and occasional pains in the right foot, but has decreased.

Other Meds: Xanex .013 mg

Current Illness: n/a

Date Died: 05/24/2021

ID: 1343614
Sex: F
Age: 23
State: VT

Vax Date: 05/18/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: presented to ED dept confused, incr n/v, weakness. Received palliative carex4 days. deceased 05/24

Other Meds: xarelto, methadone, morphine, prochlorperazine, lorazepam, ondansetron, protonix

Current Illness: fibrolamellar hepatic carcinoma with metastatic disease

ID: 1343615
Sex: F
Age: 57
State: TX

Vax Date: 05/19/2021
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: LA

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Ran a fever of 105.2 from 2 a.m. until 6 p.m. nothing I tried including cooling measures would lower it.

Other Meds: Thyroid

Current Illness: none

ID: 1343616
Sex: F
Age: 50
State: CA

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: FEVER CHILLS BODYACHES HEADACHES

Other Meds:

Current Illness: NONE

ID: 1343617
Sex: M
Age: 20
State: FL

Vax Date: 03/02/2021
Onset Date: 03/04/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Symptoms: 2-day history of progressive chest pain, 2 days after receiving his second dose of the Moderna vaccine.

Other Meds: none

Current Illness: none

ID: 1343618
Sex: F
Age: 28
State: FL

Vax Date: 05/18/2021
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: None

Symptom List: Nausea

Symptoms: Lips, finger nails, and toe nails turned blue/purple. Body convulsions caused by feverish chills, fever of 102.4. Unresponsive moments.

Other Meds: Lisinopril 20mg, Effexor 75mg

Current Illness: N/A

ID: 1343619
Sex: F
Age: 69
State: GA

Vax Date: 02/27/2021
Onset Date: 05/01/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: My wife received both Pfizer shots Feb 5, and 27, 2021. About May 1, she still got Covid

Other Meds: None

Current Illness: Parkinsons

ID: 1343620
Sex: F
Age: 55
State: AZ

Vax Date: 05/09/2021
Onset Date: 05/23/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Pt having low grade fever Left breast tenderness Body aches headache

Other Meds: none

Current Illness: none

ID: 1343621
Sex: F
Age: 46
State: OH

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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: wheat cashews sulfa drugs bvitem

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

Symptoms: I started with body aches, head ache, chills then my fever got really high, vertigo, the worst headache I ever had in my life and my body pain was really bad I could get out of bed that night and the next day and it was 3 days before I was up and moving again

Other Meds: Allegra Pepside

Current Illness: no

ID: 1343622
Sex: M
Age: 31
State: GU

Vax Date: 05/20/2021
Onset Date: 05/23/2021
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: Amoxicillin

Symptom List: Tremor

Symptoms: 3 days later I started having sever shooting and stabbing pain on the entire left side of my face that would not go away. The pain started in my teeth, jaw, temple, eye and ear. The next day I went to the dentist thinking it was my wisdom teeth, they checked my teeth, did ex rays and checked for infection but found nothing. Went to my primary care flight doc and she was un sure what was going on. Then I went to the Emergency room and I was diagnosed with Trigeminal Neuralgia of the face.

Other Meds: None

Current Illness: None

ID: 1343623
Sex: F
Age: 78
State:

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Pt admitted to hospital from 5/21 to 5/22 discharged home, dehydration, atrial fibrillation, malaise, had second moderna covid vaccine 5/21, became ill 5/22 woke up with low grade fever, generalized weakness, malaise, no appetite, lightheaded, fall to ground stricking righ cheek, no LOC, baselilne memory losse, confusion improved, better on 5/22 morning, no need for follow up clinic visit. Can't get to fill in hospital information to unshade to fill in

Other Meds:

Current Illness:

ID: 1343624
Sex: M
Age: 84
State: WA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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: Demerol and morphine

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

Symptoms: could not urinated went to ER had Catheter put in, 24 hours later blood clots in Catheter bag and was in hospital for 10 days

Other Meds: Amiodarone, Metoprolol, Memantine( no longer taking Memantine)

Current Illness: had Uthera cancer removed from above bladder , things were going fine, Catheter was removed 2 weeks prior to Moderna vaccine all seemed fine.

ID: 1343625
Sex: F
Age: 47
State:

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

Lab Data:

Allergies: cephalexin

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

Symptoms: nausea, sharp intermittent epigastric pain, diaphoresis, dizziness

Other Meds: gabapentin, metoprolol sertraline, valacyclovir

Current Illness:

ID: 1343626
Sex: F
Age: 23
State: CO

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Fire ant bites, Tamiflu

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fatigue - onset: 2 pm after 10 am dose, lasting 48 hours Full-body muscle aches - onset: 7 pm after 10 am dose, lasting 15 hours Full-head headache - onset: 5 pm after 10 am dose, lasting 2 hours Hives on toes - onset: 8 am 48 hours after dose, lasting 1 day (still continuing) Itchiness and painful vaccination site - onset: 11 am after 10 am dose, lasting 72 hours

Other Meds: Mirena IUD, Tums

Current Illness: Urinary tract infection

ID: 1343627
Sex: F
Age: 34
State: MO

Vax Date: 03/27/2021
Onset Date: 04/06/2021
Rec V Date: 05/24/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: Around 1:30pm on Tuesday April 6th, I was sitting at my desk in my home office, working. I began experiencing moderate chest pain and shortness of breath. These symptoms continued to worsen for the next hour. I had difficulty breathing, and taking a full breath was painful enough to prevent me from doing so. I drove myself to the ER. While waiting in the ER, I began experiencing chills, severe joint pain, and moderate pain generally throughout my body beginning around 4:00pm, which I advised ER staff. While being examined by the ER doctor around 7pm, there was some tenderness noted in my right upper quadrant. My blood pressure was extremely high (205/130) and I developed an intense headache. I was admitted overnight and discharged the afternoon of April 7th. While the chills and pain improved on April 7th, my chest pain and shortness of breath continued for another week or so. The night of April 7th at home, I woke up several times with difficulty breathing and ended up sleeping fitfully while propped up at a 45 degree angle so I could at least breathe mostly normally. The chest pain and difficulty breathing slowly improved over about 10 days until I was no longer experiencing symptoms.

Other Meds: None

Current Illness: None

ID: 1343628
Sex: M
Age: 30
State: FL

Vax Date: 04/30/2021
Onset Date: 05/02/2021
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: none

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

Symptoms: chest pain 4 days after receiving his second dose of the Pfizer vaccine.

Other Meds: none

Current Illness: none

ID: 1343629
Sex: F
Age: 51
State: NJ

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: none

Symptom List: Pain in extremity

Symptoms: left lower extremity swelling,

Other Meds: none

Current Illness: none

ID: 1343630
Sex: F
Age: 13
State: NV

Vax Date: 05/21/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: She presents complaining of tenderness over the left breast. Pain began this morning and worsened after a friend socked her in the left arm. Pain is rated 7 out of 10. Approximately, 15 minutes after sucking a 325 mg ASA in the Office pain is down to a "2."

Other Meds: None.

Current Illness: No

ID: 1343631
Sex: F
Age: 46
State: NC

Vax Date: 03/31/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient reported received Pfizer COVID-19 vaccine 2 dose series 3/4/2021 and 3/31/2021. PT tested positive for COVID-19 5/20/2021 via nasal swab.

Other Meds:

Current Illness:

ID: 1343632
Sex: F
Age: 34
State: UT

Vax Date: 12/17/2020
Onset Date: 12/20/2020
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: Penicillin, amoxicillin, crandomicin, pseudoephedrine

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

Symptoms: After receiving the vaccine my arm felt numb and tingly, my fingers also felt a little numb. My heart felt as if it was racing a little fast as well. Around the third day after the vaccine I had a slight fever and a migraine, that is when I went to seek care about the migraine and was prescribed Tylenol and ibuprofen . After taking my medicine and resting for a few days since my job gave us a week off for receiving the vaccine they symptoms subsided. A few weeks later, I noticed that I didn't receive my monthly which should have shown up around the last week of each month. So when I went to my doctor for an appointment they gave me a blood test to check and make sure that I was not pregnant and the results came back negative.

Other Meds: Tylenol 325 mg 2x day, Ibuprofen 800mg 1x day, Benadryl 25 mg 1xday,

Current Illness: n/a

ID: 1343633
Sex: M
Age: 65
State:

Vax Date: 03/23/2021
Onset Date: 04/15/2021
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: Left mild to profound sudden sensorineural hearing loss 3 weeks after COVID vaccine. Associated tinnitus.

Other Meds:

Current Illness:

ID: 1343634
Sex: F
Age: 45
State: OR

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

Lab Data:

Allergies: Lactose, shellfish

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Heavy headache, body aches for a week with few occasion of diarhea

Other Meds: N/A

Current Illness:

ID: 1343635
Sex: M
Age: 54
State:

Vax Date: 04/27/2021
Onset Date: 04/28/2021
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

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

Symptoms: Experienced headaches and dizziness for 2 weeks after second shot and still experiencing dizziness after 4 weeks.

Other Meds: Lisinopril 10 Mg Atorvastatin 10 Mg Vitamin supplements B, C, D, E, calcium

Current Illness: None

ID: 1343636
Sex: M
Age: 30
State: CA

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: HEADACHES SORE ARM FEVER CHILLS FATIGUE

Other Meds:

Current Illness: NONE

ID: 1343637
Sex: F
Age: 32
State: TX

Vax Date: 05/22/2021
Onset Date: 05/23/2021
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: possibly penicillin

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

Symptoms: Severe stomach pain and diarrhea. Mild stomach pain started around 10 pm and got progressively worst. Pain did not subside until about 10 a.m the next day. A milder stomach pain was constant but a SEVERE stomach pain would come in waves. This was accompanied by nausea, I threw up one time. Pepto was taken but did not help. Also had chills and sweat spells.

Other Meds: Birth control - Lo Loestrin

Current Illness: none

ID: 1343638
Sex: F
Age: 39
State: NC

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

Lab Data:

Allergies: UNKNOWN

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

Symptoms: 39yr old patient with unknown PMH presented for first dose of COVID-19 vaccine on 5/17. Patient was administered COVID-19 Pfizer vaccine (LOT # EW0179), IM in patient's left deltoid. While walking away to waiting area, patient with dizziness. Patient tachycardic with HR 120s-130s and BP 157/95. Patient placed in reclining chair and monitored. Other symptoms denied. Reporter notes symptoms resolved within 15min but then prior to discharge, patient tachycardic again (HR 130s) and BP increased back to 137/85 with new feelings of dizziness and feeling faint. EMS contacted and transferred patient to ED. At 1542, BP 134/69 and HR 69. No interventions given in ED. At 1903, CMA documented "patient leaving ED". ecg 5/17/2021 NORMAL SINUS RHYTHM.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm