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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1343639
Sex: F
Age: 40
State: FL

Vax Date: 05/20/2021
Onset Date: 05/22/2021
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: patient stated that approximately 36 hours after receiving vaccine that she broke out all over her body with hives and is experiencing extreme urticaria. she has been taking benadryl by mouth every 4 to 6 hours and has contacted her primary care provider for further treatment

Other Meds:

Current Illness:

ID: 1343641
Sex: F
Age: 43
State: CA

Vax Date: 05/06/2021
Onset Date: 05/07/2021
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: No known allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient states she woke up from sleep after receiving the vaccines with chest pain. Per provider note: "having a tightness in her chest in the middle and to the left. She experienced the same thing after her first dose. It has been on and off since the first dose (she did not make the connection until she got the second dose). No association with foods. She is able to breathe okay and is taking it easy today. Last night she woke up at 3am and she has had it since that time. Feels like a muscle pain that seems to go away and come back."

Other Meds: None known

Current Illness: None known

ID: 1343642
Sex: M
Age: 67
State: VA

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: PENICILLIN, ASPARTANE, PEANUTS

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

Symptoms: PT SAID HE HAS SEVERE MUSCLE ACHES, JOINT PAIN, COUGHING, HAD TROUBLE BREATHING AND WENT BLIND FOR A PERIOD OF TIME. ALSO NOTED HE HAS COUGHED UP STUFF SINCE THEN. DID NOT SEEK MEDICAL ATTENTION .

Other Meds: PLAVIX, ZOCOR, CYMBALTA, BUSPAR, PROSCAR, SYNTHROID, LOPRESSOR, COQID

Current Illness: STATED ON 5/24/21 THAT HE HAD SEVERE SORE THROAT OVER A MONTH AGO THAT LASTED FOR ABOUT 3 WEEKS

ID: 1343643
Sex: F
Age: 16
State: OR

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

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The EMT gave a dose of the Moderna vaccine to an individual who is 16. The age restriction is 18 and older.

Other Meds:

Current Illness:

ID: 1343644
Sex: F
Age: 64
State:

Vax Date: 05/14/2021
Onset Date: 05/14/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: tinnitus for 10 days non stop

Other Meds:

Current Illness:

ID: 1343645
Sex: M
Age: 69
State: PA

Vax Date: 03/07/2021
Onset Date: 03/20/2021
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 approximately 20 days after extremely burning sensation over whole nose searing hot lasted about 25 min, Called Family Dr. He ordered Zpack antibiotics , Second dose approximately 25 days bowel habits changed lots of mucus appears to come in bowel movements

Other Meds: None

Current Illness: Bulging disc lower back

ID: 1343646
Sex: F
Age: 59
State: NY

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

Lab Data:

Allergies: nka

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: pt states the next day she had a painful left arm. She had a developed a red rash on her neck. She noticed a red rash on upper part of her right chest area. After she showered she noticed another red patch of bumps in other areas on her body. It is now more like hives and itching. The rash if from her scalp to her feet. Pt will contact her PCP.

Other Meds:

Current Illness:

ID: 1343647
Sex: F
Age: 74
State: FL

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, Old Tetanus

Symptom List: Pharyngeal swelling

Symptoms: Dizziness, brain fog, weakness, sever indigestion, headaches (lasting more than 3 days)

Other Meds: Acyclovir, Inderal, Levothyroid

Current Illness:

ID: 1343648
Sex: F
Age:
State:

Vax Date:
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: - threw up at 5am morning after vaccine -rash on face since 05/23 -sore arm since 05/22 -clammy morning of 05/23

Other Meds:

Current Illness:

ID: 1343649
Sex: M
Age: 65
State: PA

Vax Date: 03/15/2021
Onset Date: 05/17/2021
Rec V Date: 05/24/2021
Hospital: Y

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: Stroke due to blood clot in artery at the base of the brain

Other Meds:

Current Illness:

ID: 1343650
Sex: F
Age: 33
State: NH

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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin, Sulfa

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

Symptoms: Patient reported dizziness after first dose, was asked to stay for 30 minuted of observation following second dose. Patient progressed from dizziness (BP taken at this time, was normal) to nausea/dry heaving, with coughing and shortness of breath/chest tightness, which was not alleviated by her Albuterol inhaler. The contents of one Epipen was administered to the patient and she was transported to the hospital via ambulance.

Other Meds: Escitalopram, Albuterol HFA, Desloratadine

Current Illness: Seasonal allergies

ID: 1343651
Sex: M
Age: 63
State: OR

Vax Date: 05/01/2021
Onset Date: 05/01/2021
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: None.

Symptom List: Rash, Urticaria

Symptoms: He got his vaccine, immediately where the needle went in he had a bruise and just stayed the same. Then a few days later he started feeling stiffness and pain in his right neck and shoulder area. He did not have any rash, fever or other symptoms. He does still have the swelling at the injection site. He has taken Aleve for the discomfort. He has not called his doctor. He is able to work, but is having the pain in the neck and the shoulder every day.

Other Meds: None

Current Illness: None.

ID: 1343652
Sex: F
Age: 66
State: PA

Vax Date: 03/16/2021
Onset Date: 05/08/2021
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: Morphine Reglan Vicodan Dust

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

Symptoms: I developed an itchy rash initially on my abdomen and then it spread to my arms. It looked like papular hives to me but also had fine smaller rough areas.. I did not go to my doctor's office as I am a retired nurse practitioner and this was not severe. It was minimally responsive to benedryl, clariton and topical steroid cream and it was self limiting to about 10 days then started to fade. I am reporting this because it occurred within 2 months of my second vaccine, 3/16/2021, and I was on no new medicines, had eaten no new foods and was not in contact with anything different.

Other Meds: Vitamin D Welbutrin Citrucel Miralax Tylenol

Current Illness: Out patient surgery March 2 , 2021

ID: 1343653
Sex: M
Age: 43
State: CA

Vax Date: 05/13/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: NONE

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

Symptoms: After the first inoculation, I started having the side effects two weeks in with fever, chills and muscle pains throughout the body. I also experienced a certain mental restlessness and adrenaline rush while feeling physically tired. It went away after 3-4 days. Following the 2nd shot, I started feeling hazy and mentally restless again with physical fatigue the day after the inoculation. A week later, I had really strong stomach cramps with numbness in the entire right shoulder where I got the 2nd inoculation. Mental restlessness and physical fatigue were also common daily,

Other Meds: MAGNESIUM, B12, MELATONIN, VITAMIN B, C, ZINC, OMEGA 3 (VEGAN), BCAA, MILK THISTLE, GYMNEMA SYLVESTRE

Current Illness: NONE

ID: 1343654
Sex: F
Age: 30
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Pt stated she "felt funny" then developed Hives on her Arm.

Other Meds: None

Current Illness: Chronic Obesity

ID: 1343655
Sex: F
Age: 41
State: MN

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

Lab Data:

Allergies: codeine, strawberries, shrimp

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

Symptoms: abdominal cramping, similar to my reaction to codeine. Some itching

Other Meds: synthroid, multi-vitamins

Current Illness: none

ID: 1343656
Sex: F
Age: 54
State: OH

Vax Date: 05/15/2021
Onset Date: 05/18/2021
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: None

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

Symptoms: Itching began on Tuesday May 18 at 10pm on my thighs; then itching continued to back of the legs and knees with a slight swelling feeling. So much that I needed to look and see if I had gotten bit or something. I changed out of jeans and then saw my legs had developed rashes in large sections; some looked like hives, some like little red bumps, some with just read splotches. I washed my legs thinking maybe a bug or allergen and put anti itch cream on one leg to see if it would help or if I needed anything else. I went to bed shortly after and then woke at 6am (Weds. May 19) and when I changed out of pj's, noticed rashes also at the injection site; the itching continued to come and go and when it would begin to itch, the rash/bumps would appear without scratching. The rashes would continue on primarily the legs and glutes but also injection side and a little on the shoulder/back of the same side of the injection site and small rash on each ear. This continued for three days intermittently. The rashes stayed for about 1-2 hours then new ones would appear as the old ones faded. Friday, I was finally itch-free by later in the evening. I did not take any medication or apply any more anti itch cream despite the intense itching sensation. I took pictures for documentation if you need them.

Other Meds: Magnesium Citrate Blueberry Extract Zinc Vitamin C Glucosamine Chondroitin L-carnitine Collagen B-12 Probiotic Dulcolax

Current Illness: None

ID: 1343657
Sex: M
Age: 64
State: OH

Vax Date: 04/12/2021
Onset Date: 04/20/2021
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: My blood pressure has been under control for 44 years. I'm not overweight. My blood pressure has been all over the place. Up to 200/100, staying in the 150s to 170s/ 90s.

Other Meds: Ditilezam 240mgs

Current Illness:

ID: 1343658
Sex: M
Age: 55
State: CT

Vax Date: 04/12/2021
Onset Date: 05/10/2021
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: Rapid heartbeat, fatigue

Other Meds: None

Current Illness: None

ID: 1343659
Sex: M
Age: 69
State:

Vax Date: 03/01/2021
Onset Date: 03/05/2021
Rec V Date: 05/24/2021
Hospital: Y

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: Patient presented to the ED on 3/5/21, 3/11/21, and 3/23/21. Patient presented to the ED on 5/10/21 and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1343660
Sex: F
Age: 30
State: NC

Vax Date: 05/23/2021
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: PCN

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

Symptoms: Injection sight swelling, small pimple sized pustules with inflamed surrounding capillaries. ?Rash? is not itchy and spreads from injection-site arm (left) across and down upper chest and breasts. Noted approximately 22 hours after second dose. No reaction to first dose, other than mild arm tenderness.

Other Meds: None

Current Illness: None

ID: 1343661
Sex: F
Age: 22
State: OH

Vax Date: 04/16/2021
Onset Date: 04/16/2021
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: None

Symptom List: Unevaluable event

Symptoms: Blood pressure immediately dropped. Continued dropping. Told to go home and drink plenty of liquids and get rest. Began vomiting that evening. The vomiting, being dizzy and sleeping continued for days. Went to Urgent Care on April 20, 2021. They gave me nausea medicine and said I should expect to feel this way for about one week. The nausea medicine helped with the vomiting, but did not help with being dizzy and sleepy. Making a trip to the ER for more answers.

Other Meds: Birth control; Claritin D

Current Illness: None

ID: 1343662
Sex: F
Age: 51
State: IN

Vax Date: 04/07/2021
Onset Date: 04/09/2021
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 that aware of

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

Symptoms: When I received the first dose 4/7/21, I had a burning sensation go up my left arm to my face. My face felt hot and then my chest. I felt scared like I could be having something wrong but I continued on. I then got very tired. The next day I felt achy knees. Two days later I started having buzzing in my ears but didn't realize it could be a side effect. I went to a Urgent Care and was treated for a possible ear infection and given antibiotics. That did not help or cure my condition. The buzzing/ringing is on the same side/left as my injection. On 5/5/21, I went for my second injection and asked if the buzzing/ringing or being on antibiotics was a problem, they said no. The buzzing/ringing increased. I went to my regular Primary Care doctor who didn't see anything wrong. She referred me to an ENT. The ENT ran a hearing test. The hearing test seemed to come back ok but I still have the Tinnitus. The Tinnitus is worse at night and in the morning when everything is very quiet. Some days are worse than others and I have seen no improvement. I also am experiencing hot flashes. They also happened after the first shot and increased after the second. The Tinnitus is very bad at time and I want it to go away. It is like buzzing in my left ear that is always there but sometimes I can tune it out. I think it is important to report this as I have not had anyone tell me it is a possible side effect. If it is than this needs to really be investigated and studied and communicated with people. It is very disturbing as I have never had Tinnitus before. I hope and pray it goes away and there are no other side effects.

Other Meds: Vitamin D

Current Illness: None

ID: 1343663
Sex: F
Age: 40
State: AZ

Vax Date: 05/14/2021
Onset Date: 05/14/2021
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: BENADRYL: Bradycardia - asthma BUSPAR: Dizziness (Moderate to severe) - vertigo PERTUSSIS VACCINES: Other (Severe) - hx of grand mall seizures PNEUMOCOCCAL VACCINE: Other - arm swelling, redness, pain TRAMADOL: Hives (Moderate) TYLENOL: Other (Moderate to severe) - hx of non alcoholic fatty liver disease

Symptom List: Injection site pain, Pain

Symptoms: about 1 hour after receiving vaccine had swelling in throat resolved on own in 15 minutes. then 7 hours later returned with difficulty swallowing and breathing. started wheezing, felt light headed and dizzy, took epi injection.

Other Meds: advair levothyroxine vit D topiramate sertraline Montelukast tumeric

Current Illness: was not sick at the time

ID: 1343665
Sex: M
Age: 18
State: CA

Vax Date: 05/17/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Myocarditis

Other Meds: None

Current Illness: None

ID: 1343666
Sex: M
Age: 22
State: FL

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Abdominal Pain-Severe, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Medium, Systemic: Nausea-Severe, Systemic: Vomiting-Severe, Additional Details: AFTER RECEIVING THE VACCINE, AROUND 3PM, PT SEEMED AOX3, AFTER ABOUT 5 MINUTES, PATIENT BECAME EXTREMELY PALE AND BECAME EXTREMELY FLUSHED, AND WAS PERSPIRING. PATIENT CONCOMITTANTLY BECAME NAUSEOUS WITH ABDOMINAL PAIN, AND HEADACHE, AFTER WHICH (~5MIN) PROCEEDED TO VOMIT. PATIENT LEFT STORE AFTER ABOUT 30 MINUTES AFTER HE BEGAN TO FEEL BETTER. SPOKE WITH PT BRIEFLY THIS MORNING (5/24/2021) AND PT STATED HE IS FEELING MUCH BETTER, AND HAD NO ADDITIONAL S/Sx OF VACCINE REACTION.

Other Meds:

Current Illness:

ID: 1343667
Sex: F
Age: 43
State: NH

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Shellfish

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Bilateral Arm and Leg Urticaria- raised itchy rash

Other Meds: Fluoxetine, Advair, Singulair

Current Illness: none known

ID: 1343668
Sex: M
Age: 16
State: CO

Vax Date: 04/14/2021
Onset Date: 04/14/2021
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: 16 year old was given a Moderna vaccine instead of a Pfizer vaccine. Based on the CDC recommendations, we had the patient return for their second dose of Moderna on 05/11/2021 even though he was out of the age range.

Other Meds:

Current Illness:

ID: 1343669
Sex: M
Age: 54
State: TX

Vax Date: 04/06/2021
Onset Date: 04/08/2021
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: Remicade, mycelex

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

Symptoms: patient complains of hoarse voice, that is still present on 5/24/2021. The day after shot developed fever of 102, aches, chills.

Other Meds: ) ACYCLOVIR 800MG TAB TAKE ONE-HALF TABLET BY MOUTH ACTIVE TWICE A DAY FOR INFECTION 2) ADALIMUMAB 40MG/0.8ML INJ PEN KIT INJECT 40MG (0.8ML) ACTIVE UNDER THE SKIN EVERY WEEK FOR INFLAMMATORY BOWEL DISEASE 3)

Current Illness:

ID: 1343670
Sex: M
Age: 19
State: MO

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

Symptom List: Nausea

Symptoms: Patient experienced dizziness about 10 minute after injection. Laid down on floor with feet up. Given some juice since had not eaten yet for the day. Patient feeling better in about 5 minutes.

Other Meds: Flonase nasal spray

Current Illness: unknown

ID: 1343671
Sex: F
Age: 45
State: MA

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

Lab Data:

Allergies: Nickle

Symptom List: Injection site pain

Symptoms: Rash on arms, legs, backside. Looks and feels like the start of poison ivy but the bumps are smaller and not quite as itchy. While the rashes are large, I'd call them minor as they aren't terribly disruptive. I marked item 20 as not recovered because it just showed up yesterday. I don't know how long to expect the rash to remain. This does not seem to need medical attention.

Other Meds: Combipatch

Current Illness: none

ID: 1343672
Sex: M
Age: 20
State: CO

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: LA

Lab Data:

Allergies: None

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

Symptoms: Pt received his vaccine and returned to the waiting room. Within 5 minutes he slumped to the floor, he lost consciousness and had a brief seizure lasting less than 30 seconds There was a sheriff deputy in the waiting area that asked him his name, year, president and where he was. He was able to answer all questions, but was still shaking. We called 911 and EMTs were here within 2 minutes and took over. After assessing him and taking his vitals they decided to transport him to Hospital.

Other Meds: None

Current Illness: None

ID: 1343673
Sex: F
Age: 41
State: TX

Vax Date: 04/08/2021
Onset Date: 04/01/2021
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: I am not allergic to anything.

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

Symptoms: The morning after I received the vaccine, I started having chest pressure and acid reflux. There was a hard pressure in my chest and my heart was beating weird. I started to develop a headache. I had low blood pressure a couple days later. I went to the clinic and they said I may have a blood clot. I also went to Hospital and they took some blood and did an X-ray and they told me I was fine. I was told that it may be anxiety or stress. The chest pain started to go away, but now my teeth are hurting and are sensitive. I feel that the adverse event lasted for three weeks.

Other Meds: I was taking Lovastatin 20mg, a dietary supplement coq10, 100mg and Estroven.

Current Illness: I did not have any other illnesses.

ID: 1343674
Sex: M
Age: 37
State: IA

Vax Date: 04/12/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: On 4/13/2021, strong chills and mind racing followed by fatigue. Then on or about 5/3/21, onset of severe anxiety, panic attacks, raised blood pressure, buzzing in left thigh muscle, loss of appetite, frequent urination, strong urge to urinate, not able to sleep, feel on edge at all times, cannot focus, brain fog, fatigue. On 5/7 GP increased desvenlafaxine to 100 mg and prescribed lorazepam .5 to 1 mg to sleep. On 5/14, no improvement of symptoms, added buspirone 3 times a day. As of 5/24, no improvement in symptoms, muscle buzzing is worse, and hands are unsteady. Still no real appetite, constant cold sweats and headache.

Other Meds: 50mg desvenlafaxine; Zyrtec, 5-10 mg melatonin.

Current Illness: None

ID: 1343675
Sex: F
Age: 61
State: MD

Vax Date: 05/07/2021
Onset Date: 05/07/2021
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: lithium, abilify, gabapentin, olmesartan

Symptom List: Erythema, Pruritus

Symptoms: onset within 30 minutes of severe and persistent tinnitus

Other Meds: amlodipine, duloxetine, escitalopram, dalmane, mobic, flonase, claritin, lamictal, losartan, lasix, protonix, iron, melatonin

Current Illness:

ID: 1343676
Sex: F
Age: 18
State: MN

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

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

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: purple hands-Medium, Additional Details: Patient was very anxious prior to the moderna vaccine administration. Once given, she started feeling dizzy and faint. After about 10 minutes her hands were turning purple. She was asked if I can call 911 for help and she agreed. paramedics arrived within 5-10 min and took her in for care.

Other Meds:

Current Illness:

ID: 1343677
Sex: F
Age: 91
State:

Vax Date: 03/11/2021
Onset Date: 04/16/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. Diagnosis was acute respiratory failure with hypoxia and acute diastolic heart failure.

Other Meds:

Current Illness:

ID: 1343678
Sex: F
Age: 14
State: AZ

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient had episode of vasovagal syncope approximately 3 minutes after the vaccine. Pharmacist assisted dad in comforting patient. Patient was placed flat on the floor. 911 was called by technician. Patient aroused before EMS arrived on scene approximately 2 minutes after syncopal episode. Patient recovered. EMS did not take patient.

Other Meds: None

Current Illness: None

ID: 1343679
Sex: M
Age: 24
State: NC

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:

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

Symptoms: patient was hot and sweaty, passed out, came around and felt better over next 15-20 minutes, patient's parent contacted ems but when they arrived patient was much improved

Other Meds:

Current Illness:

ID: 1343680
Sex: F
Age: 49
State: PA

Vax Date: 05/21/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: nosebleeds

Other Meds: No

Current Illness: No

ID: 1343681
Sex: F
Age: 58
State: GA

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 05/24/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline (possibly) Eggs ( as a child, but no longer) Pollen Dust

Symptom List: Pain in extremity

Symptoms: I had headaches, chills (finger tips especially) and rapid heart beat. I began feeling winded going up and down stairs and/or walking. After a couple of more days, I began using an oximeter to check my pulse. The readings were 108 - 112 compared to my normal 60 - 82.

Other Meds: Vitamins

Current Illness:

ID: 1343682
Sex: F
Age: 60
State: FL

Vax Date: 05/13/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: na

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

Symptoms: ITP Rash (have pictures) the major concern. I had exceedingly intense pain in my hands, feet, and knees, shaking throughout the body. The more common side effects that I had were diarrhea, nausea, fever, and body pain. I know feel tingling in my toes. Several days later, I also had an event that lasted a few minutes where my right arm shook.

Other Meds: spironolactone, toprol, metformin, benedryl, famotidine, elidel cream

Current Illness: Had alergies - water eyes, nose, sneezing in days prior to shot. No fever

ID: 1343683
Sex: F
Age: 56
State: MA

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

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

Symptoms: acute pulmonary emboli.

Other Meds: atorvastatin, metformin

Current Illness: none

ID: 1343684
Sex: F
Age: 40
State: NJ

Vax Date: 05/20/2021
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:

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

Symptoms: Blood oxygen level dropped rapidly to 86 about 30min after shot. Caused a feeling of hypoxia and slurred speech.

Other Meds: Levothyroxine Prenatal Vitamins Zyrtec

Current Illness:

ID: 1343685
Sex: M
Age: 43
State: NC

Vax Date: 05/04/2021
Onset Date: 05/04/2021
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: Patient had Moderna shot for 1st dose. PT received Pfizer shot for 2nd dose

Other Meds:

Current Illness:

ID: 1343686
Sex: F
Age: 33
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt was vaccinated and released after 15 minutes. While walking out, she began to feel numbness in her R hand. No other symptoms reported. Pt reports that she fell 2 days ago, striking her R elbow and still has abrasion. Cap refill, sensation, and strength are intact and equal bilaterally. VSs normal. Pt released home, recommend follow up with PCP.

Other Meds: None

Current Illness: None

ID: 1343687
Sex: F
Age: 40
State: NY

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: RA

Lab Data:

Allergies: Dilaudid Lactose and dairy

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

Symptoms: 10:38 patient experienced slight numbness of the right cheek. Obtained history, not very good at giving info about history. 10:40 took BP 132/92. Denies hx of hypertension. denies having tightness of chest or difficulty breathing. 10:48 given benedryl 50mg. 10:58 reports feeling facial swelling improving, but complains of tunnel vision similar to when she has migraines. 10:59 assessed by NP at site location. Moved to Exam room for closer observation. NP informed patient if symptoms worsen she would be transport via EMS. 11:27 BP 135/85 pulse ox 98% pulse 76. Reports no further symptoms at this time and existing ones resolved. 11:31 patient allowed to leave with NP informing patient that if any symptoms return to be seen by a doctor. Talked with patient today at 11:30, to which she informed me that her arm was swollen and he face was slightly this morning. I asked her to see a doctor. She was going to call the Clinic and see NP that saw her Saturday during the clinic

Other Meds: none

Current Illness: none

ID: 1343688
Sex: F
Age: 68
State: CA

Vax Date: 03/20/2021
Onset Date: 03/25/2021
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: sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: arrhythmias

Other Meds: vitamins, metoprolol, benazepril

Current Illness:

ID: 1343689
Sex: F
Age: 17
State: IN

Vax Date: 05/16/2021
Onset Date: 05/16/2021
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: RA

Lab Data:

Allergies: Penicillin

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

Symptoms: My child was accidentally given moderna instead of Pfizer even though she is under 18. After the mistake was made she began to have nausea and vomiting, headache and lethargic. After 6 days she began to have chest pain, rapid heartbeat and the nausea continued. We have ended up in the hospital admitted because of the tachycardia.

Other Meds:

Current Illness: None

ID: 1343690
Sex: M
Age: 72
State: TX

Vax Date: 03/12/2021
Onset Date: 03/15/2021
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: nkda

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

Symptoms: hoarse voice

Other Meds: ALLOPURINOL 300MG TAB TAKE ONE TABLET BY MOUTH EVERY DAY ACTIVE FOR GOUT ASPIRIN 81MG EC TAB TAKE ONE TABLET BY MOUTH EVERY DAY TO ACTIVE REDUCE THE RISK OF STROKE & HEART ATTACK (TAKE WITH FOOD) ATORVASTATIN CALCIUM 80MG TAB TAK

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm