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: 1355272
Sex: F
Age: 26
State: AK

Vax Date: 05/19/2021
Onset Date: 05/22/2021
Rec V Date: 05/27/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever Sweats, Body Aches, Headaches. Lump in left Breast.

Other Meds: N/A

Current Illness: N/A

ID: 1355273
Sex: F
Age: 55
State: NY

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 05/27/2021
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: I started with a terrible headache on the afternoon of 4/21. On 4/22 I became nauseous, had a mild fever, terrible headache, slept most of the day/evening and that morning my legs developed multiple blister type spots that itched. There was around 25 spots on each leg. I used calmine lotion for the itching. The blisters started to dry up and go away after 3 days. The first day was the only day that the blisters appeared and only on my legs. All the other symptoms went away after 4/23 and I felt fine.

Other Meds: multi vitamin calcium cranberry pill

Current Illness: none

ID: 1355274
Sex: F
Age: 38
State: TX

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 05/27/2021
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: NOT REPORTED

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

Symptoms: FIRST DOSE PATIENT WAS GIVEN A PFIZER DOSE ON 2/6/21. SECOND DOSE PATIENT WAS GIVEN A DOSE OF MODERNA ON 4/2/21.

Other Meds: NOT REPORTED

Current Illness: NOT REPORTED

ID: 1355275
Sex: F
Age: 23
State: NJ

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Swelling of hands, feet, and some of face. When I saw the pt her face had resolved but her hands and feet were slightly swollen. Her hands were swollen to the point where her rings were tight and her feet were swollen to the extent that her shoes were tight but she was able to wear them. I saw her 3 days after her vaccine

Other Meds: None

Current Illness: None

ID: 1355276
Sex: M
Age: 40
State: NV

Vax Date: 04/03/2021
Onset Date: 04/17/2021
Rec V Date: 05/27/2021
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: no

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

Symptoms: April 17th, felt chest pain and fatigue and shortness of breath. After about two weeks of it, I went to ER on the 26th. I was diagnosed with blood clot on my heart. I spent a week at the hospital Heparin blood thinners and antibiotics - discharged on May 2, 2021. They sent me home with Warfarin regiment. I am still on that. I still have some days where I'm good but some days, I can barely stand and get out of bed due to short of breath, fatigue but not as much chest pain. I think the blood thinners are working. I just have to take it easy and make sure to have some calm days. It could take weeks to months to have the blood clot totally dissolve from the system.

Other Meds: Glipizide; bumetanide; Insulin: Humalod; Basaglar - slow acting insulin; Intresto; Potassium; Omeprazole; 24 hour OTC allergy pill; Metolazone

Current Illness: no

ID: 1355277
Sex: F
Age: 26
State: WA

Vax Date: 02/13/2021
Onset Date: 03/01/2021
Rec V Date: 05/27/2021
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: About 2 weeks after second dose started having chest pain, shortness of breath. Still having symptoms 3 months later, however, fewer and further in between and more mild

Other Meds: birth control loratadine

Current Illness: none

ID: 1355278
Sex: F
Age: 52
State: MD

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: swollen lymph nodes in right armpit appeared after about 24 hours from vaccination, the bulge grew the size of chicken egg over th e next 2 days+ fullness/swollen ear canals, both ears. arm pit nodes returned to almost normal condition after 5 days from onset of symptoms, some discomfort remains under armpit but transient (sometime tender nodes are present and other times not). swollen ears remains a problem 2.5 weeks later, partial hearing loss due to swelling. no medical treatments

Other Meds: none

Current Illness: none

ID: 1355279
Sex: F
Age: 43
State: CO

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Seasonal, Fire Ants, Compazine, Reglan, Duloxetine, Gabapentin, Lyrica, Augmentin

Symptom List: Pharyngeal swelling

Symptoms: Migraines - phonophobia, photophobia, Nausea, Diarrhea, tinnitus. Has history of tension headaches from neck/shoulder pain although generally mild in nature and self-limiting within 1-2 days. Initial vaccine on 4/8/21 lead to similar symptoms although milder with worsening of overall symptoms within 2 hours of 2nd Modera vaccination.

Other Meds: Pantoprazole, Vitamin D, Iron, Ambien

Current Illness:

ID: 1355280
Sex: F
Age: 49
State: FL

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: milk, pollen,cat,dog, roach

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Redness, pain and swelling on the area of injection and radiated to all the arm up to the hand.

Other Meds: Zoloft,Clonazepam,Abilify and Singulair

Current Illness:

ID: 1355281
Sex: F
Age: 49
State: FL

Vax Date: 03/09/2021
Onset Date: 04/08/2021
Rec V Date: 05/27/2021
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: Codeine & Mangoes

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 4/8 Extreme lowers abdominal pain began 4/10 Admitted to Emergency Room at St Joseph?s Hospital North 4/10 Diagnosed with a 3cm hemmoragic ovarian cyst. 4/23 new ovarian cysts development NO PRIOR OVARIAN CYSTS TO THIS EVENT

Other Meds: Singulair, Zyrtec, Flonase, Synthroid

Current Illness: None

ID: 1355282
Sex: M
Age: 37
State: DC

Vax Date: 03/17/2021
Onset Date: 04/21/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Developed a rash on 4/21/2021 after several days of muscle pain. Was diagnosed with Shingles on 4/23 and prescribed Valtrex (took for 2 weeks). Experienced significant pain associated with shingles from roughly 4/25 to 5/1. Rash is still healing but largely scarred over.

Other Meds: Topical treatment with Azelex and Metrogel

Current Illness: none

ID: 1355283
Sex: F
Age: 38
State: WA

Vax Date: 05/04/2021
Onset Date: 05/18/2021
Rec V Date: 05/27/2021
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 known

Symptom List: Rash, Urticaria

Symptoms: -Chest pressure and pains, difficulty breathing, left side tingles in arm and leg -Inflammation -Severe migraine -Indigestion -Began inside 2 weeks of receiving vaccine. -This is after the initial flu-like symptoms I experienced from day 1 to day 6.

Other Meds: Lamotrigine 100mg Alprazolam XR 4mg Green tea

Current Illness: None

ID: 1355284
Sex: F
Age: 40
State: WV

Vax Date: 05/18/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Tree Nuts

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

Symptoms: I became very light headed and passed completely out. I do not remember anything leading up to this or while it was happening. When I came too, I couldn't hear, had ringing in my ears, couldn't walk on my own, and my husband said I was very cold. Two days later and i still have dizzy spells and extreme fatigue.

Other Meds: Zyrtec, Losartan, Hydrochlorothiazide

Current Illness:

ID: 1355285
Sex: F
Age: 46
State: WV

Vax Date: 01/15/2021
Onset Date: 03/01/2021
Rec V Date: 05/27/2021
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: sulfa drugs

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

Symptoms: Heart palpitations, chest pain, fluttering of heart

Other Meds: Synthroid, singular, tolterodine, fluticasone, Multivitamin, Vitamin d

Current Illness: none

ID: 1355286
Sex: M
Age: 68
State: FL

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 05/27/2021
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: Reglan, Keflex.

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

Symptoms: He got his vaccine, and had to go from the roof to the parking lot. He was in his car and thought he had put his car in park, but it was in neutral and he hit another car, which he thought he was hit. The gentleman informed him that he was the one that hit him as he had watched him slowly advance to hitting him. He did not know or was aware that he was even moving. He has headaches normally but they have gotten worse since then. He also has motion sickness but has learned to deal with it and get used to the side effects. He also has blurry vision and just not feeling normal. He did go see his PCP and she put him on Meclizine for the dizziness, which works about 50%, but not completely. He did have the 2nd vaccine on 2/22/21 and still had the symptoms, which have stayed since then as well. He then saw his PCP a week ago and she is scheduling for a CT scan to see if he has any blood clots. He did have an aneurysm in his brain 28 years ago and they felt that he would not be able to survive it and deemed that he would be left as a vegetable, but has survived that and does have a little residual headache, but nothing severe. He now is still having these three symptoms that he did not have prior to the vaccine.

Other Meds: Triamterene/HCTZ, prednisone, Oxybutynin, Hydroxyzine, Simvastatin. OTC, Allegra and Zyban.

Current Illness: None.

ID: 1355287
Sex: F
Age: 64
State: NY

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/27/2021
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: Latex, Morphone Sulfate.

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

Symptoms: Rash, Hives, difficulty breathing and chest tightness.

Other Meds: - Omeprazole 40 milligram once daily - Albuterol inhaler as needed. - Symbicort inhaler two times daily - Montelukast 10 milligram once daily - HCTZ 25 milligram once a day. - Vitamin D - Vitamin B12 - Amatiza 24 milligram two times daily

Current Illness: Asthma, HTN, IBS, Constipation, Allergic Rhinitis.

ID: 1355288
Sex: F
Age: 60
State: WA

Vax Date: 04/03/2021
Onset Date: 04/10/2021
Rec V Date: 05/27/2021
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: Oxycodone

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

Symptoms: Patient received COVID-19 vaccine on 4/3/21 subsequently admitted from 4/10-21-4/12/21 for acute pericarditis.

Other Meds: buproprion, cholecalciferol, estradiol, fluticasone nasal, menaquinone, tumeric, vitamin E

Current Illness: fever, cough, malaise since 3/31,21

ID: 1355289
Sex: F
Age: 19
State: TN

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 05/27/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I got extremely sick. I was hot and cold. I was nauseas and threw up. I lost feeling in both of my legs. I had shocking pain in both of my legs.

Other Meds: Actemra Infusion

Current Illness: No

ID: 1355290
Sex: F
Age: 21
State: NH

Vax Date: 04/28/2021
Onset Date: 05/03/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Date of vaccination (4/28), fever of 102 F, resulting in loss of sleep. A week later (5/03), singular hives began to appear on arms and legs, resulting in loss of sleep. Much worse the next day (5/04)- clustered hives accompanied with burning rash all over arms and legs. Benadryl anti-itch cream only enflamed them more. Vomited the next morning (5/05) and made an appointment with healthcare clinic, despite hives and rash subsiding overnight. Doctor ruled vomiting as an effect of prescription medication, but rash and hives as a result of a reaction to the vaccine. Next day and the day after,(5/06-5/07), had a few single hives appear on body. Haven't had any more appear since then, and I've felt fine.

Other Meds: Birth control- brand name: Alyacen 1/35

Current Illness: None known

ID: 1355291
Sex: F
Age: 16
State: NY

Vax Date: 06/11/2018
Onset Date: 06/29/2018
Rec V Date: 05/27/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

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

Symptoms: Severe movement disorder and inability walk. Arm and leg jolts. Full body tremors.

Other Meds: Zyrtec, singular, multivitamin

Current Illness: Concussion

ID: 1355292
Sex: F
Age: 64
State: CA

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 05/27/2021
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: amlodipine- rash shellfish- angioedema sulfa- unknown.

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

Symptoms: Acute disseminated infectious encephalomyelitis. Symptoms included headache, weakness, fatigue, difficulty concentrating, body aches, chills, arm and leg numbness. Treated with solumedrol infusion.

Other Meds: lisinopril-hctz 20-12.5 mg daily atenolol 50 mg twice daily

Current Illness: none

ID: 1355293
Sex: F
Age: 74
State:

Vax Date: 01/20/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
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: following vaccination, pateints CMML progressed to CMML-1

Other Meds:

Current Illness: CMML-0

ID: 1355294
Sex: M
Age: 59
State: SC

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: the patient reported that he took Tylenol for the pain in his arm but that it is still hurting into his shoulder and down his arm 21 days after receiving the immunization

Other Meds: none disclosed

Current Illness: none

ID: 1355295
Sex: M
Age: 12
State:

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: fatigue/ tiredness

Other Meds:

Current Illness:

ID: 1355296
Sex: F
Age: 33
State: IN

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache at 5pm 5/25 Abdominal cramps at 9 am on 5/26 Fever 100 degrees at 10 am on 5/26 Muscle weakness at 5:30pm 5/25 throughout 5/26 Light nausea 6pm 5/25 Heavy nausea 9 am 5/26

Other Meds: Sertraline: Hydroxyzine

Current Illness: None

ID: 1355297
Sex: M
Age: 43
State: TX

Vax Date: 04/30/2021
Onset Date: 05/03/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Three days after my second shot (on 05/03/2021) I started to feel pain in my left arm, tightness in chest, and I became very light headed. I tried to go to shower but I could not walk and laid down. My ears felt very tingly and I thought I was going to pass out but as far as I know, I did not. I went to my primary care doctor and he has me taking baby aspirin daily (in case blood clot) and wanted to see if it got better I am going to follow up with a cardiologist. I've never had a problem with heart before and get an annual physical at work.

Other Meds: Multivitamin

Current Illness: None

ID: 1355298
Sex: F
Age: 76
State: VA

Vax Date: 04/07/2021
Onset Date: 05/09/2021
Rec V Date: 05/27/2021
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: PEG, Sulfa, Clindamycin, Macrodantin, Lunesta, Ambien, Senna, Cinnamon, Lisinipril

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Had noises in my ears like a clock ticking. I have titinus but this was not a ringing noise. A couple of weeks later I woke up with my right eyelid all swollen and bruised and went to the ER where there they did a CT scan to make sure I didn't have a blood clot and I did not. Also my platelets were in the normal range. It took a good week for the swelling and bruising to go down and the bruising even went down my face somewhat. I had an appointment with my eye doctor and he didn't know why it happened, but may have had something to do with my taking low dose aspirin. I did not have any contusion to the eye and it was not hit by anything.

Other Meds: Norvasc, Claritin, Kristalose, Lipitor

Current Illness: none

ID: 1355299
Sex: F
Age: 24
State: CA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
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: FELT FAINT, DIFFICULTY BREATHING, CHEST TIGHTNESS. PARAMEDICS CAME, VSS, HX OF FAINTING WITH BLOOD DRAWN. DID NOT EAT OR DRINK PRIOR TO VACCINATION. PROVIDED HYDRATION, SX RESOLVED. NO TRANSPORT.

Other Meds:

Current Illness:

ID: 1355300
Sex: F
Age: 51
State: CT

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: I was still having chest pain and breathing problems prior to getting it, so they wanted me to get the vaccine because if I got COVID, it would kill me. Over the weeks, my breathing worsened and I had terrible chest pains. They did another CT Scan to make sure I didn't have another embolism. The symptoms of my other conditions flared as well. I got the vaccine 3 or 4 days before the news was released about the blood clots. I'm still experiencing breathing issues, chest pains and dizziness. I'm now on additional meds for my lupus: Cymbalta and Lyrica. They're trying to help with the chest pain and polymyalgia. I was also given a Lidoderm patch to help with my chest pain. It just seems like everything got worse afterwards. I'm not sure if my lungs will ever function at 100% due to everything going on.

Other Meds: Eliquis Prednisone Spironolactone Vitamin D (prescription) Lasix Nurtec Emtality Trazadone Brio Albuterol

Current Illness: Double bilateral pulmonary embolism

ID: 1355301
Sex: F
Age: 76
State: OR

Vax Date: 04/17/2021
Onset Date: 04/24/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: morphine

Symptom List: Nausea

Symptoms: Acute Myocarditis

Other Meds: ALPRAZolam (XANAX) 0.5 mg tablet TAKE 1 TABLET BY MOUTH ONCE TO TWICE DAILY AS NEEDED FOR SEVERE ANXIETY aspirin 325 mg tablet Take 325 mg by mouth Daily. atorvaSTATin (LIPITOR) 20 mg tablet TAKE 1 TABLET BY MOUTH EVERY NIGHT cholecalcifero

Current Illness: toe amputation 4/9/2021

ID: 1355302
Sex: M
Age: 65
State: MI

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Allergies to Bee and Wasp Stings. Allergies to Fire Ant Stings. Allergies to Poison Ivy.

Symptom List: Injection site pain

Symptoms: I first noticed an increase in my Heart-Rate about 15 seconds after the injection. I also felt an unusual pain in my lower back area, down to the end of my spine. During my 30-minute waiting period after the injection the symptoms did not subside. Since I am allergic to Insect Stings, I had 25 mg Diphenhydramine Tablets and my Epinephrine Injector with me at the clinic. I took one 25 mg Diphenhydramine Tablet orally with water. My symptoms subsided after about 30 minutes. I waited an additional 30 minutes at the clinic. My wife and I left after that time period. I presently feel normal at this time.

Other Meds: None

Current Illness: None

ID: 1355303
Sex: F
Age: 54
State: IL

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

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

Symptoms: I started to feel a stiff neck and pain on the upper right part of my back about 4 hours after receiving the Pfizer vaccine on my right arm. I have continued to feel the problem with my neck for several days. When I called the doctor's office I was told to take Tylenol for the pain.

Other Meds:

Current Illness:

ID: 1355304
Sex: F
Age: 49
State: GA

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
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: None

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

Symptoms: Chills, low grade fever, severe body aches, fatigue, severe pain at shot site

Other Meds: Advair, lisinopril

Current Illness: None

ID: 1355305
Sex: F
Age: 54
State: FL

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 05/27/2021
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: Ant- Depressesants

Symptom List: Tremor

Symptoms: Starting with headache that turned into a 4 day SEVERE MIGRAINE with 2 hours of shot. Had some Flu like symptoms but it was the migraine that poor me down for almost 2 weeks. Need to ask people if they have history of these. Haven't had migraine this severe on several years. Scheduling second shot but so scared after what happened first time.

Other Meds: Thyroid, Blood pressure, anxiety

Current Illness: Auto Immune Hosimotos Hypothyroidism with a goiter. Anxiety and Panic attacks. PTSD after having 10 deaths in family in only 14 months. Allergic reactive asyma to strong fragrance and seasonal allergies from outside.

ID: 1355306
Sex: M
Age: 14
State:

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: fatigue/ tiredness

Other Meds:

Current Illness:

ID: 1355307
Sex: M
Age: 54
State: MN

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/27/2021
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: Received second dose one week early. Received at 21 days rather than 28.

Other Meds:

Current Illness:

ID: 1355308
Sex: F
Age: 11
State: MI

Vax Date: 05/26/2021
Onset Date:
Rec V Date: 05/27/2021
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: Vaccine administered to child under the age of 12. No adverse event.

Other Meds:

Current Illness:

ID: 1355309
Sex: F
Age: 50
State: GA

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/27/2021
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: Penicillins

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient had cataract surgery on 5/17/2021 on her left eye. She received her second COVID shot (Moderna) on 5/21/2021. Saturday night she started feeling under the weather. Sunday morning she had cloudy vision in her left eye. Monday her vision was almost completely gone. She was seen by the doctor that did her cataract surgery and he said that the vision loss was due to constricted vessels in her eye and that was caused by the COVID shot. The patient's vision has since fully recovered.

Other Meds: Trazodone 50mg, levothyroxine 125mcg

Current Illness: Patient had cataract surgery on 5/17/2021

ID: 1355310
Sex: F
Age: 45
State: SC

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/27/2021
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: gadobenate, iohexol, omnipaque, aspirin, gadavist, latex, shellfish

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

Symptoms: This is a 45-year-old female with past medical history of multiple sclerosis, hypothyroidism, pseudoseizures, conversion disorder, who presents to the emergency department from COVID-19 vaccination clinic after having a reported allergic reaction and seizure-like activity. She presents by EMS who reports that she was given intramuscular epinephrine as well as IV Benadryl for her symptoms. EMS reports that they saw generalized convulsive activity while the patient was alert and oriented, he reports this as "pseudoseizure-like activity". She was receiving her second dose of the COVID-19 vaccination today, she reports that she immediately thereafter got a rash to her torso and became short of breath. She was feeling well prior to the vaccination. She denies any other recent acute illnesses including fevers, chills, nausea, vomiting, diarrhea, chest pain. She says that she is currently undergoing a relapse of her multiple sclerosis and has been wheelchair-bound for 1 month. This is a 45-year-old female with past medical history of multiple sclerosis, hypothyroidism, pseudoseizures, conversion disorder, who presents to the emergency department from COVID-19 vaccination clinic after having a reported allergic reaction and seizure-like activity. She presents by EMS who reports that she was given intramuscular epinephrine as well as IV Benadryl for her symptoms. EMS reports that they saw generalized convulsive activity while the patient was alert and oriented, he reports this as "pseudoseizure-like activity". She was receiving her second dose of the COVID-19 vaccination today, she reports that she immediately thereafter got a rash to her torso and became short of breath. She was feeling well prior to the vaccination. She denies any other recent acute illnesses including fevers, chills, nausea, vomiting, diarrhea, chest pain. She says that she is currently undergoing a relapse of her multiple sclerosis and has been wheelchair-bound for 1 month.

Other Meds: baclofen, biotin, cholecalciferol, cladribine, clonazepam, galcanezumab-gnlm, hydrocodone/acetaminophen, lacosamide, lamotrigine, levothyroxine, lidocaine patch, linaclotide, mirabegron, mirtazapine, nortriptyline, oxycodone, oxycodone myri

Current Illness:

ID: 1355311
Sex: F
Age: 28
State: IL

Vax Date: 05/03/2021
Onset Date: 05/05/2021
Rec V Date: 05/27/2021
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: NKA

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

Symptoms: Fatigue, weakness, Acute kidney injury, shock liver, thrombocytopenia, pneumonia, syncope, wide complex tachycardia over last 2 weeks

Other Meds: Ibuprofen

Current Illness:

ID: 1355312
Sex: F
Age: 57
State: TX

Vax Date: 01/07/2021
Onset Date: 01/10/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Many allergies to food, chemicals, and environment

Symptom List: Pain in extremity

Symptoms: Her tongue felt funny and was swollen. Only lasted a couple hours. Her right eye started irritating her. Went to see an opthamologist who said she was having ocular migraines. Then she developed shingles. Dr. told her not to take the second vaccine and put her on medicine for a year.

Other Meds: Probiotics (Natures Bounty) 1xdaily Multivitamin- Kirkland adult gummies-2 gummies per day Turmeric 1000mg 1x daily Progesterone 200mg capsule 1x daily Levocetirizine 5mg 1xdaily amitriptyline 10 mg 1xdaily dim 200 mg 1x daily estradiol pa

Current Illness:

ID: 1355313
Sex: F
Age: 30
State: PA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Patient felt slightly dizzy immediately after administration

Other Meds:

Current Illness:

ID: 1355315
Sex: F
Age: 48
State:

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/27/2021
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: Lethargic; Lightheadedness; Other.

Other Meds:

Current Illness:

ID: 1355316
Sex: M
Age: 40
State: MI

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
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: N/A

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

Symptoms: The second dose of this vaccine was given earlier than recommended. The patient's first dose was 05/07/21 and therefore was due for the second dose 05/28/21. No adverse events were reported by the patient.

Other Meds: N/A

Current Illness: N/A

ID: 1355317
Sex: M
Age: 47
State: OH

Vax Date: 05/20/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
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: Sustained blood clots in left calf area approximately 6 days after receiving 1st dose.

Other Meds:

Current Illness: none

ID: 1355318
Sex: M
Age: 29
State: CA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
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: Janssen COVID-19 Vaccine EUA Pt lost consciousness after vaccine while waiting the 15 minutes before leaving. Father notified us at that time that he loses consciousness after all his vaccines. Pt is now okay and has left with father.

Other Meds: none

Current Illness: none

ID: 1355320
Sex: M
Age: 18
State: TX

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: At 12:45, AM, my son got chilled and began shaking uncontrollably. He began running a 103 fever,. The fever, would drop to 101 with Tylenol, but would spike as soon as it would wear off. He was very tired and slept most of today. Today, the fever is gone, but his back hurts and so does the injection site.

Other Meds: He did not take anything the day of the vaccine.

Current Illness: Seasonal Allergies.

ID: 1355321
Sex: M
Age: 34
State: NH

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/27/2021
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: Fevers on 5/18 (1 day after) up to 103 F and resolved on 5/19. Severe chest and affected arm pain on 5/19 resolved on 5/20.

Other Meds: adderall 15 mg PO daily

Current Illness:

ID: 1355322
Sex: M
Age: 24
State: FL

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: pt got dizzy; took bp 102/64 gave apple juice and cold pack

Other Meds: Unknown

Current Illness: None

ID: 1355323
Sex: F
Age: 35
State:

Vax Date: 03/04/2021
Onset Date: 04/27/2021
Rec V Date: 05/27/2021
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:

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

Symptoms: Eczema outbreak on right middle finger. Has lasted for several weeks, changing from dry flaky skin to weeping blisters. I normally get very mild eczema, this is worse than I?ve had in years.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm