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: 1357622
Sex: M
Age: 34
State: IN

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/28/2021
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: Chills and fever

Other Meds:

Current Illness:

ID: 1357623
Sex: F
Age: 50
State: IN

Vax Date: 05/23/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Keflex Claritin Alevert Allerest mainly garlic and corn

Symptom List: Anxiety, Dyspnoea

Symptoms: Red Itchy whelpy reaction spots all over about 50% of body. Started yesterday morning. Took 2 doses of benedryl so far.

Other Meds: Metoprolol Tart 100 mg Levetiracetam 2000mg Water pill ??? (not taking at the moment) Levothyroxine 125mg (not taking at the moment) Xyzal 10mg Turmeric Curcumin 2000mg Calcium 1200mg multivitamin

Current Illness: no, no illnesses

ID: 1357624
Sex: F
Age: 50
State: MD

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/28/2021
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: Site: Pain at Injection Site-Severe, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.), Additional Details: Patient states she has not been able to move her arm since vaccine was given- she says she has seen a doctor and will need to go to physcial therapy with a copay of 60 dollars everytime she goes

Other Meds:

Current Illness:

ID: 1357625
Sex: F
Age: 75
State: AL

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 05/28/2021
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: My mom never told me she got both vaccines. We all came for a funeral 2 weeks after she got her second dose. She is normally active and energetic but she was very lethargic and tired. Her heart was racing and her pulse was low. She literally started contemplating death and planning her funeral. She said this was the worse she had felt in years! Possibly ever! She didn't though thank God. It took her a couple months and heavy supplements to get back close to normal.

Other Meds:

Current Illness: Recovered from breast cancer in 04/2020. Had to get double mastectomy and recovered well. Fine before vaccine. Just scared of covid.

ID: 1357626
Sex: M
Age: 16
State: SC

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 05/28/2021
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: Chest pain, elevated troponin. No treatment, no cardiac dysfunction.

Other Meds:

Current Illness:

ID: 1357627
Sex: F
Age: 53
State: NE

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Systemic: Fainting / Unresponsive-Medium, Additional Details: Patient lost consiousness within one minute of receiving covid-19 vaccine. Regained consciousness within a few seconds. Checked vitals which were stable and had patient lie on floor with feet up. Monitored patient for at least 30 minutes and rechecked vitals which were stable. Patient reported no further issues upon follow-up a few hours later

Other Meds:

Current Illness:

ID: 1357628
Sex: M
Age: 78
State: NE

Vax Date: 05/19/2021
Onset Date: 05/24/2021
Rec V Date: 05/28/2021
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: Systemic: Allergic: Rash Generalized-Medium, Additional Details: Patient called on 05/27/2021 after receiving covid-19 vaccine on 05/19/2021 to report a rash on lower back and inner thigh. Patient says it is not itchy. Patient noticed it appeared around Monday 05/24/2021.

Other Meds:

Current Illness:

ID: 1357629
Sex: F
Age: 48
State: OH

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Bee Venom

Symptom List: Pharyngeal swelling

Symptoms: At approximately 9:45pm, c/o a headache while providing patient care, she then had an emesis that was greenish in color and went unresponsive. Emergency services was contacted, arrived approximately 5 minutes later to transport her to the local ER via stretcher. Facility received an update from patient's daughter later that night, informing staff that she had experienced a brain aneurysm and was being transferred to Hospital.

Other Meds: Unknown

Current Illness: Unknown

ID: 1357630
Sex: M
Age: 27
State: NY

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 05/28/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Diffuse urticarial rash involving right axilla and over bilateral shoulders, developed intense chest pressure and squeezing, heart racing and when those symptoms resolved pt. became very weak. Of note pt. stated was lightheaded for 15 mins after receiving the vaccine

Other Meds: None

Current Illness: None

ID: 1357631
Sex: F
Age: 60
State: MI

Vax Date: 05/03/2021
Onset Date: 05/08/2021
Rec V Date: 05/28/2021
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: Site: Pain at Injection Site-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Tinnitus-Medium, Additional Details: The patient reported left shoulder pain that radiated up her neck, with tinnitus in the left ear and chest tightness that has not resolved since getting the vaccine

Other Meds:

Current Illness:

ID: 1357634
Sex: F
Age: 21
State: GA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/28/2021
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: patient was administered an expired vaccine

Other Meds: unknown

Current Illness: none

ID: 1357635
Sex: M
Age: 39
State: FL

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Septra/Bactrim

Symptom List: Rash, Urticaria

Symptoms: Fever 100.5. Chills, fatigue, vomiting. Very much flu-like. Lasted about 24 hrs. Took Motrin then Tylenol. Rested and hydrated. I had the same reaction with the first shot, but this time, the symptoms came on faster and ended faster.

Other Meds: Flonase, Pepcid ac, multi vitamin

Current Illness: None

ID: 1357636
Sex: F
Age: 35
State: FL

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: patient was given 0.5 mL instead of 0.3 mL

Other Meds:

Current Illness:

ID: 1357637
Sex: F
Age: 32
State: NJ

Vax Date: 04/27/2021
Onset Date: 05/15/2021
Rec V Date: 05/28/2021
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: Ringing in left ear.

Other Meds: None

Current Illness: None

ID: 1357638
Sex: F
Age: 20
State: GA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/28/2021
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: Omnicef, Pineapples, and Coconuts

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

Symptoms: Hives on arms, left side of face, severe swelling in left leg , nose bleeds, and chest pain.

Other Meds: Multi-Vitamin and Concerta

Current Illness: N/A

ID: 1357640
Sex: F
Age: 26
State: NV

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Systemic: Nausea-Mild, Systemic: Seizure-Mild, Systemic: Vomiting-Mild, Additional Details: After Janssen vaccine shot given to patient.Patient lowered her face and body to our blood machine monitor and appear to experienced partial seizure with mild symptoms. Called 911. Patient was assessed her side effects and she told them that she had history of epilepsy and haven't had an episode for at least a year. Provide water to her and also garbage bin next to her due to Patient being nausea. Paramedics arrived about 3 minutes after they were called.

Other Meds:

Current Illness:

ID: 1357641
Sex: F
Age: 29
State:

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/28/2021
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: n/a

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

Symptoms: fever and fatigue and sweats x 9 days with development of urticaria at day 9

Other Meds: n/a

Current Illness: n/a

ID: 1357642
Sex: F
Age: 46
State: SC

Vax Date: 05/13/2021
Onset Date: 05/20/2021
Rec V Date: 05/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Burning eyes. Left eye worse than the right. Left face and eye swelling. Rash on face, neck. Random spots of rash on body

Other Meds: None

Current Illness: None

ID: 1357643
Sex: F
Age: 58
State: CA

Vax Date: 04/22/2021
Onset Date: 05/20/2021
Rec V Date: 05/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Site: Itching at Injection Site-Mild, Systemic: Patient came in on 5/20/2021 reporting that she got a bad shot on 04/22/2021. Pharmacist on duty asked patient what reaction did the patient get. Patient refused to answer and left the pharmacy. Pharmacist tried to follow up with the patient but phone num-Mild, Additional Details: Patient came in on 5/20/2021 reporting that she got a bad shot on 04/22/2021. Pharmacist on duty asked patient what reaction did the patient get. Patient refused to answer and left the pharmacy. Pharmacist tried to follow up with the patient but phone number is invalid.

Other Meds:

Current Illness:

ID: 1357645
Sex: F
Age: 67
State: FL

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: patient was given 0.5 mL instead of 0.3 mL

Other Meds:

Current Illness:

ID: 1357646
Sex: M
Age: 57
State: MO

Vax Date: 04/26/2021
Onset Date: 05/19/2021
Rec V Date: 05/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: I was diagnosed by Dr. on 5/27/2021 as having shingles. He did not communicate any connection to the virus. After researching online, I saw where there was some evidence of a connection, and to report it here. I was prescribed ValACYclovir which I began taking on 5/27/2021.

Other Meds: Atorvastatin Euthyrox

Current Illness:

ID: 1357648
Sex: F
Age: 68
State: GA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/28/2021
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: patient administered an expired vaccine

Other Meds: unknown

Current Illness: none

ID: 1357649
Sex: M
Age: 20
State: TX

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Seizure-Medium, Systemic: Vomiting-Severe

Other Meds:

Current Illness:

ID: 1357650
Sex: F
Age: 78
State: FL

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: patient was given 0.5 mL instead of 0.3 mL

Other Meds:

Current Illness:

ID: 1357651
Sex: M
Age: 54
State: GA

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 05/28/2021
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: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: First 10 days: High fever, chills, high blood pressure, headache, inability to swallow, entire left side numb (face, head, shoulder, arm), loss of voice Next 28 days and current: loss of voice, swallowing hard, shoulder pain, limited shoulder movement, tight neck in the left side

Other Meds: None

Current Illness: None

ID: 1357652
Sex: M
Age: 31
State: SC

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Severe

Other Meds:

Current Illness:

ID: 1357653
Sex: F
Age: 54
State: IL

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/28/2021
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: severe shoulder pain which is not getting much better almost a month after the injection.

Other Meds: vitamin D3, Zinc

Current Illness: none

ID: 1357654
Sex: F
Age: 63
State: NC

Vax Date: 04/06/2021
Onset Date: 04/25/2021
Rec V Date: 05/28/2021
Hospital:

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

Lab Data:

Allergies: Mango Garlic Melon Dust Mold Rag Weed

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 04/25 I had an upset stomach and at that point I notice that my blood pressure was really high and I took my blood pressure and it was 190/110 I thought it would go down it didn't on 04/29 I went to urgent care and they did run test and the did prescribe me the L-Prill I started taking it right away and it did take my blood pressure down 50 point they told me to go visit my PD and I ended up going in on 5/3 and they ended up doing a full check up and full blood work. and we talked about some course of action, I talked to them about the allergy medication that I was taking and they told me to stop taking the allergy meds, I felt my blood pressure racing when I went to lay down ( also allergic to wheat ). I determined that when I get into bed there is no reason for my blood pressure to be this high and 10 years ago I had another reaction to allergies meds. so I stopped taking it on 5/03, I still have upset stomach but I think it something that I ate. Since I stopped taking the meds my blood pressure has been yester, yesterday it was 144/71. In general I feel good.

Other Meds: Levocetirizine Montelukastsodium 10mg Loratavine

Current Illness: no

ID: 1357655
Sex: M
Age: 43
State: MA

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache Body Aches Lasted about 12 Hours

Other Meds: Atorvastatin, 10mg

Current Illness:

ID: 1357656
Sex: F
Age: 72
State: OK

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Site: Pain at Injection Site-Severe, Additional Details: Unable to lift arm due to pain. States pain is improving. Will follow up with patient in 3-5 days

Other Meds:

Current Illness:

ID: 1357658
Sex: M
Age: 40
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: patient was given 0.5 mL instead of 0.3 mL

Other Meds:

Current Illness:

ID: 1357659
Sex: M
Age: 17
State: NC

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/28/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Pt attended a health fair and was given Janssen vaccine. He does not meet the 18+ age requirement for this particular vaccine. No adverse reaction noted. Mother aware immediately following administration.

Other Meds:

Current Illness:

ID: 1357660
Sex: M
Age: 44
State: GA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/28/2021
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:

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

Symptoms: Patient experienced apprehension, flushing and numbness and tingling. Patient verbalized "Throat tightness" and elevated BP even though pt reports being on BP medications. O2 sat and pulse remained normal. Lungs CTA. Patient has a history of reactions to bee stings. Pt was given 50mg Diphenhydramine observed by staff and released

Other Meds:

Current Illness:

ID: 1357661
Sex: M
Age: 37
State: CO

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Tremor

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)

Other Meds:

Current Illness:

ID: 1357662
Sex: F
Age: 33
State: MA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Iodine, shellfish, bee venom, PCN, ampicillin, clindamycin

Symptom List: Erythema, Pruritus

Symptoms: Patient had a reaction to first Pfizer vaccine on 5-5-21 was treated and released with prescription for Prednisone. Patient was told by physician to receive her second dose but to pre-medicate with prednisone 50mg and Benadryl 25mg. Pt did as she was advised and received second Pfizer vaccine. She started exhibiting s/s of anaphylaxis within 5 minutes of the vaccine. Treated with 50mg benadryl and 2 epi pen injections of .3mg 5 minutes apart while awaiting EMS. Patient treated and released later in the day.

Other Meds: PREDNISONE 50MG TAKEN 1 HOUR PRIOR TO VACCINE AND 25MG BENADRYL TAKEN AT 1:00 pm

Current Illness: no

ID: 1357665
Sex: F
Age: 54
State: OH

Vax Date: 04/10/2021
Onset Date: 04/12/2021
Rec V Date: 05/28/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: None

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

Symptoms: Severe headache, ringing in ears, blurred vision, double vision, nausea, brain fog and unbalance.

Other Meds: Fish oil, Multi-Vitamin for Women, Loratadine, Turmeric and Calcium w/ Vitamin D3+

Current Illness: None

ID: 1357666
Sex: M
Age: 20
State: TX

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/28/2021
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: Systemic: Fainting / Unresponsive-Mild, Systemic: Seizure-Mild, Additional Details: While sitting on the chair, patient fainted and started to have seizure for 1-2 second then recovered completely by himself. Called 911 but patient did not want to have any medical attention. After that, patient sit for more than 30 minutes before going home.

Other Meds:

Current Illness:

ID: 1357667
Sex: M
Age: 80
State: NY

Vax Date: 05/18/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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, Penicillin. Bee stings.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: He got his vaccine and the next day had extreme fatigue and it did go away after a couple of days. Starting last night he has had diarrhea all night long, nausea and a runny nose that started yesterday. He is very tired, possibly due to the diarrhea. He has not called his doctor or taken anything for it.

Other Meds: Fish oil, Lotrel, Nurtec.

Current Illness: None.

ID: 1357669
Sex: F
Age: 16
State: PA

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: NKDA Barley

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

Symptoms: Maculopapular and scattered hives on legs, arms, torso

Other Meds: Childrens Chewable Vitamins Vitamin C 250 mg Chew one tablet daily

Current Illness: Past Medical History includes Tracheolmalacia - stridor; Murmur; Otitis Media; Bronchiolitis; Tooth Abscess

ID: 1357670
Sex: M
Age: 52
State: CA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/28/2021
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: None

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

Symptoms: Adverse immune system response. Redness and swelling under arms for more than a month and has not ceased

Other Meds: None

Current Illness: None

ID: 1357671
Sex: F
Age: 30
State: FL

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/28/2021
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: Patient is nursing baby . The baby developed rash 5 hours after mother received Moderna vaccination both doses. The rash lasted about 15 minutes and went away. No other symptoms for mom or baby. Mother did not report first dose rash.

Other Meds: none

Current Illness: none

ID: 1357672
Sex: F
Age: 25
State: TX

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Patient reported to have numbness and tingling from her left arm, start from elbow to little finger. Did not happen at the first shot. Advised her to talk to PCP if it's still happening after 1-2 days and if it's getting worse.

Other Meds:

Current Illness:

ID: 1357673
Sex: F
Age: 70
State: IN

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/28/2021
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: strawberries, pepto bismal.

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

Symptoms: ran fever, sick to stomach, diaria, started 4 hrs after shot and lasted 2 1/2 days.

Other Meds: woman vitamin, metformin; glipzide, atorvastatin, levetiracetam, omeprazole, oxybutyun, lisinopril, pioglitazone, ocuvite eye vitiman, complete vitamin for over 50, leg cramp pills when needed.

Current Illness: no

ID: 1357674
Sex: F
Age: 62
State:

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/28/2021
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: aspirin, cat dander, risperidone, vancomycin, gabapentin, phenytoin, Elavil, carbamazepine, keppra

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

Symptoms: Patient presented to vaccine clinic for second covid vaccine. Following first dose, patient had mild side effects in the observation area after the first dose of the covid, where she was observed in our reaction room area more closely, for feeling foggy and "just not right", however patient was fine to be able to be sent home. Patient was encouraged to contact physician to verify they should receive second covid vaccine. When patient was in observation area, after receiving her second covid vaccine shot, she told the observation nurse that she had a headache. The nurse immediately took her to our reaction room area and was closely observed. Patient was talking and acting fine. Within minutes, she started to have a seizure. Documentation in patient's chart regarding incident. Patient then transferred via ambulance to ED. Per EMS patient had 5-6 seizures requiring 4mg Ativan IM. Patient reports she has seizures, is seen by Neurology and takes Keppra and Depakote. On further documentation review, patient was seen by Neurology and was felt to not have seizures. She was also seen by psychiatry who noted that patient most likely has psychogenic nonepileptic seizure-like activity. Patient observed in the ED without further symptoms or episodes. Discharged to home.

Other Meds:

Current Illness:

ID: 1357675
Sex: F
Age: 27
State: MA

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 05/28/2021
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: Tree pollens Ba trim Oral allergy syndrome

Symptom List: Vomiting

Symptoms: Severe knee pain in both knees that has not gone away. It is constant and interfering with my activities of daily living. I can no longer exercise or work out. Started the dsy after my second Moderna shot and has t gone away.

Other Meds: Singular for pollen allergies Larissa oral Contraceptive

Current Illness:

ID: 1357676
Sex: M
Age: 15
State: PA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Systemic: Chills-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Visual Changes/Disturbances-Mild, Additional Details: PATIENT RECIEVED VACCINE AT 2P. Sat in waiting area for about 10 minutes. Our observer noticed that the patient was sliding in his seat and looked dizzy. Patient starting to flutter his eyes and lost consciousness for about 5 secs. He complained about blurry vision, feeling hot, sweating, but with chills. Patient was given water. After he drank the bottle of water patient felt fine. The ambulance was called and arrived, patient reported he felt fine. Patient did not eat/nor drink water today.

Other Meds:

Current Illness:

ID: 1357677
Sex: F
Age: 29
State: MA

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/28/2021
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: 1st night after vaccine: chills, fever, extreme weakness in limbs (arms and legs) and could not lift myself out of bed, 2nd day after vaccine: fever, extreme muscle pain and soreness in legs, fatigue, and head fog 3rd-7th day: Difficult time walking and supporting my weight (120 lbs), legs tingle below waist, extreme pain in muscles, knees swollen, right quad had a difficult time "activating"

Other Meds: None

Current Illness: None

ID: 1357678
Sex: F
Age: 76
State: NY

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 05/28/2021
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: Cats

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 1 week later: Fever 102 several days diahhrea

Other Meds: Crestor B Complex Vitamin D Magnesium Zinc Aspirin Low Dose Selenium Calcium CoQ-10

Current Illness:

Date Died: 05/15/2021

ID: 1357679
Sex: M
Age: 47
State: DC

Vax Date: 05/12/2021
Onset Date: 05/15/2021
Rec V Date: 05/28/2021
Hospital:

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

Lab Data:

Allergies: pcn

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

Symptoms: 3 days after 2nd dose of moderna patient presented to our er in cardiac arrest; lacking extensive cardiac history other than a-fib; he had reported anginal like symptoms to his wofe during the day and then collapsed in v-fub and was unrecusitatble; no autopsy or further information; unclear if vaccine is contributory but within 3 days i agreed with patient's wife in that the temporal relation should be reported

Other Meds: apixaban metoprolol

Current Illness: none

ID: 1357680
Sex: F
Age: 46
State: IN

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
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: None

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

Symptoms: Fatigue, chills, injection site pain, lethargic, called in sick at work

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm