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: 1358215
Sex: M
Age: 25
State:

Vax Date: 05/27/2021
Onset Date: 05/28/2021
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: Loss of smell

Other Meds:

Current Illness:

ID: 1358216
Sex: F
Age: 59
State: PA

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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: morphine, compazine, reglan, zofran, lisinopril

Symptom List: Anxiety, Dyspnoea

Symptoms: About 45 minutes after vaccination. patient noted "dizziness" and some difficulty walking. She noted she has had similar vertigo symptoms with previous URIs. Mild nystagmus noted on physical exam. Epley maneuver was performed that resulted in the marked improvement of symptoms. She was counseled to rest and stay hydrated. Fiance will accompany her home. Counseled that if symptoms persist or worsen to seek further medical attention.

Other Meds: Protonix, aspirin, iron, oxybutin, metformin, atenolol, doxasozin, zyprexa

Current Illness:

ID: 1358217
Sex: F
Age: 20
State: VT

Vax Date: 05/17/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: one day 5 feet swelled with a red, itchy rash and were painful to stand on. This lasted 5 days. Currently, lymph nodes in neck are swollen and painful.

Other Meds: Birthcontrol

Current Illness: None

ID: 1358218
Sex: M
Age: 58
State: NJ

Vax Date: 05/14/2021
Onset Date: 05/16/2021
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: Very loud and debilitating ringing in my ears. I?ve always had ringing in my ears for the last 36 years from my time spent board the flight deck of an aircraft carrier, however, shortly after receiving the vaccine the sound is very very loud and debilitating

Other Meds: None

Current Illness: None

ID: 1358219
Sex: F
Age: 51
State: MA

Vax Date: 05/03/2021
Onset Date: 05/03/2021
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: amoxicillin (hives) PCN (unknown) albuterol (GI intolerance, headache)

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

Symptoms: As of Day 25 post-vaccination, patient has experienced the following: - HA (slightly improved, no longer occurring daily) - facial spasms (worsening of chronic condition, now more frequent and lasting longer when they occur) with associated drooling - migraines (hasn't had in >10 years prior to vaccine) - fatigue, feeling just wiped out (before able to 1 hour w/o fatigue, now 10 min lucky) - myalgias - subjective fever/chills (that measures as low as 96.1 ?F) - rash (intermittent, transient, palm-sized patches of erythema/pinkness located primarily on extremities, none currently) - left deltoid redness x5 days -- > persistent soreness with palpation - tinnitus (daily) - pelvic cramps that remind her of period pain, but LMP 13 months ago - more frequent BMs (7x/day max) - more gassy after meals - previously had nausea and night sweats, but these improved over the course of the past week

Other Meds: OTC daily multivitamin

Current Illness: None

ID: 1358220
Sex: F
Age:
State: CA

Vax Date: 03/11/2021
Onset Date: 03/13/2021
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: none

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

Symptoms: Patient reports Frozen shoulder on the arm that was vaccinated and is receiving physical therapy

Other Meds: none

Current Illness: none

ID: 1358221
Sex: F
Age: 18
State: VT

Vax Date: 05/10/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fever, with extreme body aches - lasted 24 hours

Other Meds: Birth control

Current Illness: None

ID: 1358222
Sex: M
Age: 17
State: MA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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: Pharyngeal swelling

Symptoms: Patient did not have any adverse outcomes. Received 2 doses of Moderna. Moderna authorized at the time for 18 years of age and older.

Other Meds:

Current Illness:

ID: 1358223
Sex: F
Age: 79
State: OH

Vax Date: 02/09/2021
Onset Date: 02/11/2021
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: Levaquan antibiotic and others in that class

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Inflammation of mouth and gums started on 2nd day after 1st vaccination. Mouth inflammation cleared in about 8 days. Inflammation returned in May and has worsened. Gums and front teeth are very sensitive. Some days are worse than others. Front center right tooth feels loose off and on during the day.

Other Meds: Hydrochlorothiazide 25Mg Losartan tab 25Mg Centrum multivitamin Ester C 1000Mg Vitamin D3 50 mcg

Current Illness: None

ID: 1358224
Sex: F
Age: 18
State: VT

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fever, Extreme body aches and pain

Other Meds: Birth Control

Current Illness: None

ID: 1358225
Sex: F
Age: 45
State: PR

Vax Date: 05/12/2021
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: aspirin

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

Symptoms: I haven't had my period for about 2 and a half years. I started bleeding vaginal on the 24th of May, about 12 days after the first dose of the covid 19 vaccine. On May, 25th I started having menstrual cramps, I felt nauseous, tired and general malaise. the bleeding is very heavy. today is the fifth day and I'm still bleeding.

Other Meds: none

Current Illness: none

ID: 1358226
Sex: F
Age: 79
State: OR

Vax Date: 02/24/2021
Onset Date: 02/26/2021
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: Corn and corn products, opiods

Symptom List: Rash, Urticaria

Symptoms: Over the next two months, 4 instances of piercing headache accompanied by blurred vision lasting for more than 2 hours and resistent to regular strength acetimeniphan. Over the same two months, continuous low level headaches, chills, disrupted sleep.

Other Meds: thyroid supplement, Multi-vitamin

Current Illness:

ID: 1358227
Sex: F
Age: 67
State: CT

Vax Date: 02/24/2021
Onset Date: 04/07/2021
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: right hand pain and left hand swelling. Seen by my hand doctor. Had an Mri and blood work . Mri cam back Mri with effusion right wrist. ANA Positive for autoimmune disease. Seeing a rheumatologist asap . Prior to the vaccine I had none of these problems. was given a 6 day prednisone pack which reduced the sweeling inthe left hand but swelling cam back immediately after stopping the pack

Other Meds: centrum silver 81 mg aspirin

Current Illness:

ID: 1358228
Sex: F
Age: 48
State: VA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: I do not have any allergies.

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

Symptoms: I was getting at home treatments and I was using a lot of medications because I could not get my head to stop hurting. I called my neurologist to schedule and appt. I was having IVIG treatments and the headaches became uncontrollable. I saw Dr. and he advised to continue my medicine and to schedule a f/u. He noticed I developed a rash and he said he thinks it was an autoimmune reaction and I would have to let it run it's course. I received a shot of Torodol and it helped. It aborted the cycle that I was in. I finally felt like I was able to get everything under control. Overall, my joints still hurt, but I feel that I can manage. My days seems to end early because of extreme fatigue.

Other Meds: I was taking Gabapentin, Nexium, Benadryl, Magnesium, Calcium, Vitamin D, Plavix, Trokenvi, Adavan, Percocet, IVIG, Tapentadol, Pilocarpine and Flonase.

Current Illness: I did not have any illnesses.

ID: 1358229
Sex: F
Age: 30
State: CO

Vax Date: 02/03/2021
Onset Date: 03/26/2021
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: penicillin, amoxicillin

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

Symptoms: Extremely painful and heavy menstrual cycles followed the vaccine (March 25th, April 28th, May 27th). This is not the norm for my body to experience.

Other Meds: None

Current Illness: none

ID: 1358230
Sex: F
Age: 14
State: WI

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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: Dizzy, fell to ground from chair. BP 128/68 at 12:05. BP repeat at 12:10 is 122/70. Recovered and Father came to pick her up from school.

Other Meds:

Current Illness:

ID: 1358232
Sex: F
Age: 17
State: MA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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:

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

Symptoms: In retrospective chart review it was determined that the patient received the Janssen vaccine at age 17. Currently authorized for 18 years of age and older.

Other Meds:

Current Illness:

ID: 1358233
Sex: F
Age: 45
State: HI

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Unfortunately, I did react to the shot and was seen in the ER for monitoring. I had shortness of breath (felt like a mild asthma attack which I do have asthma), high blood pressure and my face/lips turned red. After about an hour I had returned to my office and took 2 Benadryl. Came back a couple of hours at the end of my day to check. Breathing was better yet face and lips remained red. Had Dr. walk over to my office from the ER to check. Per his recommendation, I had checked in to the ER to be monitored and reactions documented

Other Meds:

Current Illness:

ID: 1358234
Sex: F
Age: 38
State: IN

Vax Date: 05/01/2021
Onset Date: 05/27/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever, cold chills, extremely weak, headache.

Other Meds: None

Current Illness: None

ID: 1358235
Sex: F
Age: 19
State: TX

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/28/2021
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: latex, lactose, cobalt, kiwi

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

Symptoms: Persistent high fever for five to six days after vaccine with sever headache. Fever required hospitalization to rule out meningitis

Other Meds: none

Current Illness: none

ID: 1358236
Sex: F
Age: 83
State: OH

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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: Levaquin, Myrrbetriq, Statins, Zofran, Sulfa

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

Symptoms: Shakes, chills, temperature, joint and muscle ache and pain, nausea, vomiting, fatigue. We do not know why my platelate count dropped so low. I was not ill before I had the vaccine. I only know that after my reaction to the second Moderna Vaccine, I had side effects and never felt well after the vaccine. My bloodwork done for my Wellness Checkup showed low platelet and as time went by my white count went higher and higher above normal. Weekly bloodwork and testing of my blood showed that "something" caused my platelets to fight, thus dropping my count to a low of 21. What caused the platelets to attack? We will never know. Now, with all the study done by my Oncologist, I am beginning to heal. It all started after my Moderna Vaccine. Do you think that the vaccine may have caused my health issues?

Other Meds: amlodipine; lisinopril-hydrochlorothiazide, ipratropium bromid Calcium 600 and Vitamin D3 500, 81 mg of aspirin.

Current Illness: none

ID: 1358237
Sex: F
Age: 20
State: NJ

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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: n/a

Symptom List: Unevaluable event

Symptoms: 4/23 right after recieving the vaccine, felt really fatigued, then had chills all night and couldn't sleep 4/24 started throwing up stomach acid and had chest pains, after calling, they said to go to ER, had multiple tests since my heart rate was really high so they wanted to monitor me and make sure I was okay, was there from like 4-5pm to around 9pm and felt fine after that

Other Meds: cymbalta 60mg

Current Illness: n/a

ID: 1358238
Sex: F
Age: 30
State: IN

Vax Date: 05/26/2021
Onset Date: 05/26/2021
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: Severe body aches, sensitivity and fatigue

Other Meds: Abilify, Wellburtrin, Amoxicillin

Current Illness:

ID: 1358239
Sex: F
Age: 62
State: FL

Vax Date: 03/23/2021
Onset Date: 03/26/2021
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: None.

Symptom List: Injection site pain, Pain

Symptoms: After the vaccine, a few days later , in the evening, my right leg felt sluggish / lazy. The next morning visited ER clinic from there I was admitted with possible stroke. From there, I was admitted to Hospital. MRI confirmed I had a mini-stroke. Was recommended physical therapy for right leg and to take 80 mg aspirin daily. Was hospitalized from 03/27/21 to 03/29/2021

Other Meds: Paroxetine, multiple vitamins, Metformin, Fish oil, Ginkgo biloba

Current Illness: None.

ID: 1358240
Sex: F
Age: 71
State: TX

Vax Date: 01/20/2021
Onset Date: 01/29/2021
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: Scapoline

Symptom List: Injection site pain, Menorrhagia

Symptoms: I had very high blood pressure over 185/120 not my normal blood pressure.

Other Meds: None

Current Illness: None

ID: 1358241
Sex: M
Age: 63
State: CA

Vax Date: 04/30/2021
Onset Date: 05/14/2021
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: Patient states he experienced hives bilaterally on his forearms two weeks after receiving first dose of Pfizer vaccine. Patient states symptoms lasted "a few days" and resolved on their own without intervention. Patient did not seek medical care. Patient received dose #2 of Pfizer on 5/28/2021.

Other Meds:

Current Illness:

ID: 1358242
Sex: F
Age: 73
State: FL

Vax Date: 02/17/2021
Onset Date: 02/25/2021
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: Lidocaine--Iodine--Latex--Creon

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: HEADACHE FOR 3 WEEKS-----PAIN IN LEFT ARM DUE TO SHOT------ ---SHARP HEART PAIN FOR COUPLE OF WEEKS------ABNORMAL CARDIOGRAM

Other Meds: BREO------Benicar------Nadolol----Protonix-----Vitamin D----Multi vitamin----Vitamin C----B12----

Current Illness: no

ID: 1358243
Sex: M
Age: 32
State: OR

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient reported tunnel vision and subsequently passed out, seized for 5 seconds, and then regained consciousness. Patient afterwards reported having a history of this type of reaction to vaccines, tattoos, and dental work. Patient became very warm, received water, and an ice pack. Patient was cooled down and left 30 minutes after the event.

Other Meds: nicotine products

Current Illness:

ID: 1358244
Sex: M
Age: 45
State: CA

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

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

Symptoms: Patient received a mixed series of Moderna and Pfizer.

Other Meds: N/A

Current Illness: N/A

ID: 1358245
Sex: F
Age: 40
State: VT

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: flouride

Symptom List: Nausea

Symptoms: within moments red dot, turned to red arm and severe itching, moderate swelling next day, incredible headache, body aches, bone pain, feeling of spine splitting in low back. tylenol every 4 hrs, advil every 4 hours (alternating). low grade fever for 5 days- right around 100F after medication. development of vertigo 5/14/21- question of relationship

Other Meds: levothyroxine, leothyroxine, estrodial, concerta

Current Illness: none

ID: 1358246
Sex: F
Age: 28
State: ME

Vax Date: 05/21/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Gluten

Symptom List: Injection site pain

Symptoms: I began experiencing symptoms of shingles within 48 hours of receiving my second dose of the Covid vaccine. I am 28 years old with no chronic health conditions and no prior history of shingles. As of 5/26/21 I was officially diagnosed with shingles by a medical doctor and was prescribed and have been taking Valtrex 1 gram oral tablets every 8 hours and have 20 tablets in total along with using Lidoderm 5% topical films 12 hours on 12 hours off. I am still experiencing symptoms and outbreaks of shingles and today is 5/28/21.

Other Meds: Vitamin D, Vitamin B complex, Fish Oil

Current Illness: None.

ID: 1358247
Sex: M
Age: 52
State: CT

Vax Date: 04/23/2021
Onset Date: 04/28/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: right sided Bell's Palsy that started 5 days after second vaccine

Other Meds: tadaladfil as needed

Current Illness: none

ID: 1358248
Sex: M
Age: 17
State: TX

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Patient under age 18 was vaccinated with Moderna, which is a vaccine error. (If the person may receive a second dose, it will be per policy off-label use for a 17-year old). Troubleshooting: Scribe and vaccinator did not validate age; screeners at the beginning of the process did not ask or turn away. Parent validated age as 18. Unreported as error, found in data mining.

Other Meds:

Current Illness:

ID: 1358249
Sex: F
Age: 41
State: PA

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Moderna COVID?19 Vaccine Late in the day on 24MAY2021, I started to experience the side effects of the COVID19 Moderna vaccination with which I was familiar: redness/tenderness around the injection site, sore arm muscle, hot/cold flashes, slight fever. However, the next morning (25MAY2021, between 7-745am) after receiving the 2nd COVID19 Moderna vaccination, I had a blood-tinged vaginal discharge. I was expecting my next menstrual cycle to start on 30MAY2021. It would be extremely odd for me to start my next cycle 5 days early. I am pretty regular with my cycle - every 28 days plus or minus 1-3 days. To be 5 days early would be atypical for me. As such, I decided to wait to see if it progressed. It did not - on Tuesday or Wednesday. I finally officially started my menstrual cycle on 27MAY2021, 3 days early, which is typical for me. As it could be construed as a side effect from the vaccination, I wanted to report this event.

Other Meds: Women's Multi-Vitamin - 1 pill daily, Women's Rogaine - foam used daily, Cetirizine Hydrochloride Tablets (10mg) - 1 tablet daily

Current Illness: None

ID: 1358250
Sex: M
Age: 79
State: OH

Vax Date: 03/16/2021
Onset Date: 05/26/2021
Rec V Date: 05/28/2021
Hospital: Y

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

Lab Data:

Allergies: Tdap

Symptom List: Erythema, Pruritus

Symptoms: Breakthrough covid positive (sympomatic) with outpatient positive test on 5/21/21 (symptom onset) and worsening symptoms with positive repeat test and hospitalization on 5/26/21.

Other Meds: cinnamon, multivitamin, aspirin, niacin, omega3, fiber, simvastatin

Current Illness: none noted

ID: 1358251
Sex: F
Age: 27
State: IN

Vax Date: 05/26/2021
Onset Date: 05/27/2021
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: 102 degree temperature from 4 a.m. until 8 p.m. the same day. Treated with Tylenol. Awful headache.

Other Meds: Women?s multivitamin

Current Illness: None

ID: 1358252
Sex: F
Age: 71
State: CA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: No known allergies

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

Symptoms: Patient developed hives and itching all over her body that are starting to resolve after using Zyrtec 4 times per day. No other symptoms of anaphylaxis. Second dose not recommended.

Other Meds: None reported

Current Illness: None reported

ID: 1358253
Sex: M
Age: 80
State: CO

Vax Date: 01/07/2021
Onset Date: 05/27/2021
Rec V Date: 05/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Iodinated Contrast (Anaphylaxis), Latex (rash)

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Moderna COVID Vaccine D#1 (1/7/21) and D#2 (2/4/21) -- > tested COVID (+) 5/27/21 and hospitalized

Other Meds: Rituximab, Temozolomide, Apixaban, Atorvastatin, Bupropion HCl, Desvenlafaxine, Restasis, Levothyroxine, Dupixent

Current Illness: Dyslipidemia, Hypothyroidism, DVT (1/2021), and CNS lymphoma on chemotherapy (rituximab, temozolomide, and dupilumab)

ID: 1358254
Sex: F
Age: 31
State: CA

Vax Date: 03/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/28/2021
Hospital:

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

Lab Data:

Allergies: Phenegran

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

Symptoms: chest congestion. sneezing, mucus symptoms, insomnia , exhausted

Other Meds: Itires by Pekana, Ricura by Pekana Gamma O3 by Biopure Thuja by Pekana Virus Nosode by PF Ion Gut Health Supren by Pekana Pectaclear by Eco Eugenics Heart/Fatigue Thyrotain NAC by Pure Encapsulations apo-STRUM by Pekana Itires Ointment 35g

Current Illness: NO

ID: 1358255
Sex: M
Age: 52
State: CT

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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: vasovagal 10 mins after vaccine shot

Other Meds: none

Current Illness: none

ID: 1358256
Sex: M
Age: 37
State: NM

Vax Date: 05/24/2021
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: Pseudoephedrine

Symptom List: Pain in extremity

Symptoms: On the following night of the booster shot of my vaccination (May 24), I had symptoms similar to COVID-19 (fever, body pain, and fatigue). The symptoms were reduced after taking Ibuprofen (200 mg) in the morning (May 25). On May 26, I felt postnasal drip in the morning and I took a Fexofenadine (180 mg) in the morning. It did not help much and I took Zyrtec (10 mg) in the evening. It did not help either and during the same night, I had a soar throat. In the morning of 27th May, I had the feeling of sinuses infection (thick yellowish mucous, pain in the left cheek and teeth, pressure in my head, fatigue). Was seen by a nurse practitioner who was suggesting me taking some OTC medicine, but considering my past history of sinuses and ineffectiveness of OTC against it, I did not take any of those OTC medicine. Then she prescribed me Amox-Clav (875 mg) twice a day. On May 28, I woke up with mild body pain, nasal congestion, pressure in my head and I took my Multivitamin, Biotin, ibuprofen (400 mg), and second dose of Amox-Clav.

Other Meds: Multivitamin, Biotin, Melatonin (taken 14 hours before vaccination)

Current Illness: None

ID: 1358257
Sex: F
Age: 58
State: KY

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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: Patient has not yet reported adverse events

Other Meds:

Current Illness:

ID: 1358258
Sex: F
Age: 43
State: CO

Vax Date: 03/29/2021
Onset Date: 03/29/2021
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: Glycerin or soy, morphine, NSAIDS, Legumes, latex, sulfas.

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

Symptoms: Around 8 PM STARTED WITH A massive headache and then overnight I started to swell when I woke up the next morning 03/30/2021 I had angioedema and severe whelps, and my eyes closed shut, my lips were twice their size, and my throat was really tight. Within 24 Hours I looked and felt horrible. The reaction continued for 2 weeks (around 04/09/2021)and then my doctor put me on a heavy dose of prednisone and other drugs to stop the reaction. I still have hives every night and facial swelling. My doctor advised me to not get the second shot of the vaccine until she can. It has impacted my work severely. This also happened to my brother who received the vaccine.

Other Meds: None.

Current Illness: Chronic hives

ID: 1358259
Sex: F
Age: 58
State:

Vax Date: 03/21/2021
Onset Date: 05/13/2021
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: Oxytetracycline. Preservative in prescription medication eyedrops

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

Symptoms: Post-menopausal vaginal bleeding. I've also just thought of something else that may be connected, I collapsed in a faint and was unconcious for several seconds 0n 8/3/21. Was directed to Hospital by 911

Other Meds: HRT

Current Illness: None.

ID: 1358260
Sex: M
Age: 43
State: PA

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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: No Known allergies

Symptom List: Vomiting

Symptoms: Case received vaccine at 10:30AM and at approximately 10 minutes into recovery stated he "feels a little dizzy" Case requested a drink of water. Vital signs stable at temp 97.6 Pulse 88 Respirations 16. Pulse ox 99% BP 128/70. He denied any shortness of breath, chest pain, difficulty swallowing itching or scratchy throat. He was advised to be observed for another 15 minutes and stated he was feeling better and returned to work at 11 AM At approximately 11:50 AM patient returned to clinic with boss stating he vomited in the rest room. Patient taken to recover room cot was placed in supine position on cot vital signs continued to be stable with 97.6 88 16 120/70 He complained of funny feeling in his throat. He was give Benadryl Liquid 50mg PO and continued with stable vital signs 97.6 88 20 120/70. He continued to complain of the funny feeling in his throat he was given Epinephrine IM .5ml, He did appear anxious and tearful after speaking with his friend on the cell phone. Vital signs remained stable of 99% SAO2 Pulse 83 Respirations 22 BP 128/70. Throughout entire event he was able to speak in clear sentences with the interpreter assistance. Patient was advised to go to ED for further evaluation and observation. He consented and 911 was called. EMS arrived at approximately 12:30 PM and report was given to EMT on patient event at clinic along with written information on vaccine and vital signs.

Other Meds: None Known

Current Illness: No medical illnessed

ID: 1358261
Sex: M
Age: 27
State: CA

Vax Date: 04/07/2021
Onset Date: 04/09/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Loss of libido- erectile dysfunction. It is harder to get an erection- possible, but requires more effort. Loss of blood flow to the penis

Other Meds: Multivitamin for men, irish moss, moringa, spirulina, kelp powder, burdock root, maca root, chlorella

Current Illness: None

ID: 1358262
Sex: U
Age: 17
State: OR

Vax Date: 05/26/2021
Onset Date: 05/26/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Patient verbalizes being fearful of "shots"; this nurse attempted to explain getting the vaccine would be quick and fairly painless. After several minutes an attempt to give vaccine was noted. The patient did pull his arm away to stop needle. The needle was partially inserted into the arm causing a small amount of bleeding, no medication was injected. (this section completed)

Other Meds:

Current Illness:

ID: 1358263
Sex: M
Age: 50
State: PA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: C/o shoulder pain day of vaccination. Increasing pain over two weeks. Has seen ortho and is trying conservative treatment but is still in pain and will follow up again for more treatment.

Other Meds:

Current Illness:

ID: 1358264
Sex: F
Age: 45
State: CA

Vax Date: 05/04/2021
Onset Date: 05/10/2021
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: none

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

Symptoms: FIRTS: TIREDNESS, ARM PAIN, ONE WEEK LATER: FEVER, MUSCLE ACHE, HEADACHE, EAR ACHE, THIRST

Other Meds: none

Current Illness: none

ID: 1358265
Sex: F
Age: 45
State: NY

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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: Denies

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

Symptoms: Covid 19 Pfizer vaccine second dose given 14 days early (7 days after dose 1) No adverse S/S, Patient denies S/S, SOB, dizziness. Patient states he feels good.

Other Meds: No known medication

Current Illness: Denies

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm