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: 1360827
Sex: M
Age: 13
State: IN

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 05/29/2021
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, body ache, tiredness, headache

Other Meds:

Current Illness:

ID: 1360828
Sex: F
Age: 63
State: OH

Vax Date: 05/17/2021
Onset Date: 05/22/2021
Rec V Date: 05/29/2021
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: Penicillin Sulpha

Symptom List: Anxiety, Dyspnoea

Symptoms: Chronic itching and some hives (appeared five days after vaccination) Rosacea flare on face Pain and tingling in fingers and toes

Other Meds: Levothyroxin Loratadine Vitamin C Zinc Multivitamin

Current Illness: None

ID: 1360829
Sex: M
Age: 55
State: MA

Vax Date: 05/12/2021
Onset Date: 05/22/2021
Rec V Date: 05/29/2021
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: all mold spores

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

Symptoms: Redness in the arm that came out of nowhere one day more than a week later but continues to worsen now more than 2.5 weeks later, additional body aches almost all over but especially in the torso (it feels like someone has been kicking me) and fatigue and confusion and irritability and vision and chills

Other Meds: Adderall, Ibuprofen 800mg, Mag-Oxide 400mg, Protonix 40mg, Verapamil 240 ER, Vitamin B2 (rx), Vitamin B12 (rx), Vitamin C, Vitamin D3, Topamax 50mg

Current Illness: none

ID: 1360830
Sex: F
Age: 48
State: MD

Vax Date: 05/06/2021
Onset Date: 05/09/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: Stadol, Erythromycins, Bee Stings, Pollen, Pet Dander

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 3 days after receiving vaccine, rash developed at injection site that quickly spread to both arm then both legs. Rash started as red bumps and itchy patches on both arms, legs, neck and trunk and now forming clusters of fluid filled blisters on both hands. Rash progressed over three weeks with no improvement until I finally went to Urgent Care and was given a Prednisone Taper and Triamcinolone 0.1% cream.

Other Meds: Centrum Multivitamin, Cranberry Capsules, Tylenol 500mg PRN

Current Illness: N/A

ID: 1360831
Sex: M
Age: 16
State: CA

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/29/2021
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: none

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

Symptoms: Myocarditis

Other Meds: none

Current Illness: none

ID: 1360832
Sex: F
Age: 61
State: NY

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/29/2021
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: Statins Ezetimibe Levofloxacin Codeine Shellfish-Derived Products Sulfa Antibiotics Sulfites Sulfur Clarithromycin Tumeric Iodine

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

Symptoms: With in 10 minutes of the injection my thoart closed, my lips swelled and I was having trouble breathing. Benaydyl was given and an Epipen was used, I was taken by ambulance to the local hospital ER where an IV was started, steroid was injected. I was kept several hours for observation and sent home. The following day I had attacks of itching and rashes as well as occasional numbness in my lips, by Thursday evening it was worse, returned to a different hospitals ER at 2am Friday morning, more steroid was given and I was observed, and sent home with an prescription for an epipen as well as steroids. Continued to take Benadryl often taking two with in a half hour, Monday May 24 went to my own docotor, as I had a new reaction of pressure in both ears with pressure in my cheeks and around the back of my head. She give me a prescription for additional steroids and is still monitoring me as I am still reacting.

Other Meds: linsinopril, 10mg, omega-3-acid 1gm, multi vitamin, vitamin C, vitamin D, CQ10, Flaxseed oil

Current Illness: None

ID: 1360833
Sex: F
Age: 42
State: IN

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 05/29/2021
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: Pain in left armpit (lymph node area) started around 530pm Friday 5/28/21 and continued throughout the night. Took tylenol around 8pm but didn't help. Took ibuprofen around 2 am and it helped a couple hours later. Took ibuprofen again at 11am Saturday 5/29/21 and pain has subsided.

Other Meds: Vitamin A,B,C,D&E; Progesterone oil

Current Illness: Common cold 1 week prior

ID: 1360834
Sex: M
Age: 76
State: NM

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Patient made second appointment on line and chose pharmacy. He reported to pharmacy window, stating he had an appointment, confirmed, but did not have his initial vaccination record card. Pharmacy staff stated Moderna. Pt did not imply differnet vaccine. Not until verification of administration of vaccine did a report appear that Patient previously received the Pfizer. Patient notified via phone message on both land line and cell phone. Patient said he was fine . Patient told not to revaccinate.

Other Meds: None

Current Illness: None

ID: 1360835
Sex: M
Age: 58
State:

Vax Date: 02/17/2021
Onset Date: 02/28/2021
Rec V Date: 05/29/2021
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: Contracted shingles, required anti-viral drugs. Symptoms included very painful puss-filled rash across head, face, neck, shoulder. Lasted 3 weeks.

Other Meds: None

Current Illness: None

ID: 1360836
Sex: F
Age: 38
State: IL

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 05/29/2021
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: Patient received vaccine on 5/27/21 @ 4:15pm. Patient states that she noticed her arm was swollen, red, and hot to the touch starting in the evening on 5/28/21 and she also stated that it was hard to take a full deep breath due to pain in the left side of her chest. She reported side effects on 5/29/21 in the morning and they told her to seek care from doctors office or urgent care due to difficulty breathing.

Other Meds: Unknown

Current Illness: Unknown

ID: 1360837
Sex: F
Age: 41
State: TX

Vax Date: 05/02/2021
Onset Date: 05/05/2021
Rec V Date: 05/29/2021
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: Amoxicillin, Benadryl and Sulfa

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

Symptoms: Heavy period Trouble with vision Eyelids swollen Erratic Heart rate Blood pressure Shaking Throat swelling Tingling in feet/hands No appetite Weight loss Pressure on chest Cough Ulcers in mouth Neuropathy These symptoms have been going on and have not let up. Currently on Lyrica .

Other Meds: None

Current Illness: None

ID: 1360838
Sex: M
Age: 57
State:

Vax Date: 05/17/2021
Onset Date: 05/20/2021
Rec V Date: 05/29/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Presented to ED with complaint of chest pain onset 0800 this morning. He endorse shortness of breath and a cough that has been ongoing for three weeks.Patient even at rest has significant tachypnea usually in the 40s and sometimes even into the 50s breaths per minute. Sepsis present on admission. COVID-19 infection was diagnosed on the eighth of this month, now is negative. Has been on a ceftriaxone and azithromycin. Could be due to multifocal pneumonia and PE. Changed to cefuroxime,7-day course. Leukocytosis could be due to steroids, recommend to repeat CBC in about a week. Multifocal pneumonia: With underlying COVID-19 diagnosed on the eighth, now is negative. Completed azithromycin for 3 days and was on a ceftriaxone, changed to p.o. cefuroxime on antibiotic for suspicion for secondary bacterial infection, will complete the course. Acute bilateral pulmonary emboli: on Xarelto. Echo reviewed. Mild hemoptysis: Could be due to pulmonary emboli, infarcts, remains on anticoagulation. No recurrence. Left lower extremity DVT/SVT: Anticoagulation as above. Transaminitis: Denies use of alcohol, he has some nonspecific complaint on the right sided abdomen but negative Murphy and ultrasound shows normal gallbladder, normal liver, stable.

Other Meds:

Current Illness:

ID: 1360839
Sex: F
Age: 74
State: WA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Fever reached over 103 degrees

Other Meds: Thyroid Multi vitamin fir mature adults, vitamin D

Current Illness: None

ID: 1360840
Sex: F
Age: 83
State: NY

Vax Date: 01/11/2021
Onset Date: 01/14/2021
Rec V Date: 05/29/2021
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, Ceflaxotine, Sulsamethoxacole

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

Symptoms: I experienced a rash on my whole body, with extreme inflammatory, redness, rash. My skin was all red over my body, my skin got crusty, ran a fever. The rash was very bad. I felt very sick. I went to see a dermatologist who put me on steroids. The steroids calmed the rash down. And 3 weeks later, same thing happened, my dermatologist again put me on steroids again and it was the same thing that occurred. Then my rash cleared up and then it also happened two more times, but not as severe. I was unable to get my second vaccine, advised from two specialists, two allergists and internists and all advised me not to take the second vaccine. All my blood work came back normal except my IEG was off the chart. I do not have the lot # to provide.

Other Meds: 2.5mg Norvac, 25mg of Metroprolol in the evening

Current Illness:

ID: 1360841
Sex: F
Age: 60
State: NJ

Vax Date: 01/26/2021
Onset Date: 02/02/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Approximately a week after the 2nd dose I experienced extreme ringing in both ears. It has been constantly present ,sometimes worse than others..I thought it would subside and when it didn?t I made an appt to see an ear doctor. My ear doctor has confirmed there has been recent complaints re tinnitus after receiving vaccine. I will be scheduled for hearing test. Also was informed there is no current treatment. Suggested white noise to mitigate the severity of the ringing. It is very debilitating to have constant noise in my ears

Other Meds:

Current Illness:

ID: 1360842
Sex: M
Age: 54
State: MI

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/29/2021
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: Patient states he slept for 36 hours after receiving second dose moderna and is still two days later experiencing massive body aches and pains as well as mild fever.

Other Meds:

Current Illness:

ID: 1360843
Sex: F
Age: 42
State: KY

Vax Date: 04/26/2021
Onset Date: 05/01/2021
Rec V Date: 05/29/2021
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: Latex, medical tape, codeine

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

Symptoms: I hesitate to call this an adverse event. However, I contacted CDC and was told I should still submit to VAERS. I've had the skin condition Vitiligo since I was 11. I've never undergone any treatment for it, as I was able to camouflage it with makeup. About 4-5 days after my second vaccination, I noticed there appeared to be a few spots of repigmentation on my forehead. To be clear, I have never had repigmentation in this area. On the following morning, I noticed a few more spots appeared to be darker in the same area. Now, several weeks later, I have a significant level of repigmentation which matches the unaffected skin around the patches of Vitiligo. Of course, I have no way to be certain the vaccine and this event are related, but I can say with confidence the latter is unprecedented in the 31 years since I was diagnosed.

Other Meds: Zyrtec

Current Illness: None

ID: 1360844
Sex: M
Age: 51
State: FL

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: Morphine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Eye swelling and irritation and floaters

Other Meds: Levoxyl Valsartan Diclofenac Allopurinol Vitamin D Jatenzo

Current Illness: None

ID: 1360845
Sex: F
Age: 52
State: IL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to Amoxicillin, Macrobid, Bactrim, with penicillin and celexa I get a rash, lexapro, prozac, Paxil, Euspar and Benadryl. I am allergic to dairy, and gluten. I have a sensitivity to corn and citrus.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: After I received the vaccine I felt like I was going to have a panic attack while I was waiting in the chair. My anxieties were already high going in to take the vaccine because I was worried. The next day I started feeling very fatigued, but I kept jumping awake because of the anxiety. I took my temperature and it was between 99-100 degrees. I had a little itchy skin rash, but I'm not sure if it was due to my anxiety. I felt that my anxiety was much higher than normal. The following week I developed stomach issues. I requested that my doctor cut down my metformin mg. My stomach issues went away, so I increased my metformin again. I started feeling better after week 3. I cut back down to 500mg again and started taking a probiotic again. I am starting to feel like I'm having flu like symptoms this week.

Other Meds: I was taking Levothyroxine 100mcg (Mon,Wed,Fri, Sat and Sunday), Tues and Thurs I take 112mcg, Metoprolol 25mg 1/2 tab 2x per day, Lucertin Potassium 100mg, Amlodipine 2.5 mg, Metformin 500 mg 2x per day, Lorazapam .005mg, Zoloft 50mg, a Pr

Current Illness: I did not have any illnesses.

ID: 1360846
Sex: M
Age: 73
State: TN

Vax Date: 04/14/2021
Onset Date: 05/29/2021
Rec V Date: 05/29/2021
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: NKA

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

Symptoms: Acute ischemic stroke, TPA given, patient hospitalized for right sided weakness and dysarthria.

Other Meds: Plavix Meloxicam Metoprolol Spironolactone Pantoprazole Hydrocodone Furosemide Dorzolamide Acetaminophen

Current Illness: None

ID: 1360847
Sex: M
Age: 64
State: TX

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 05/29/2021
Hospital: Y

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: none

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

Symptoms: He received vaccine on 3/10 and on 3/12 was admitted to hospital with a brain bleed. his INR was 10 However he had INR done 3/2/21 and it was 2.5. Dr not sure if related to vaccine or not He underwent surgery on 3/13 and was in hospital 43 days

Other Meds: Warfarin 5mg warfarin 1mg ziac 5.6.25 atorvastatin 40mg

Current Illness: aortic valve replacement and mitral valve replacement

ID: 1360848
Sex: F
Age: 28
State: WV

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 05/29/2021
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: Patient called and stated she woke up at 4:00 am on 05/29/21 with vomitting that lasted 2 hours. She is still feeling nauseated. She also is experiencing uncontrollable sharp leg pain, restlessness, throbbing of legs. She said she cannot sit still. The patient sounded very anxious and stressed over the phone. I advised her to seek medical attention to be monitored.

Other Meds:

Current Illness:

ID: 1360849
Sex: M
Age: 63
State: MD

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 05/29/2021
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: major headach, upset stomach, nausea, fever, aches, sore arm at shot

Other Meds: symbicort 80/4.5 2 hits morn 2 hits eve, montelukast sodium 10 mg daily, levothyroxine 100 mcg daily, low dose aspirin, vitamin b12, glucosamine+chondr0itin, fish oil 1000mg twice daily, super b complex kirkland, calcium citrate magnesium a

Current Illness: none

ID: 1360850
Sex: M
Age: 29
State: NY

Vax Date: 05/01/2021
Onset Date: 05/11/2021
Rec V Date: 05/29/2021
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: n/a

Symptom List: Injection site pain, Pain

Symptoms: Received swelling and high temperatures around area of shot 10 days in the morning after injection, had also experienced side effects such as high temperature, fatigue, and sneezing as well

Other Meds: n/a

Current Illness: n/a

ID: 1360851
Sex: F
Age: 31
State: IL

Vax Date: 05/22/2021
Onset Date: 05/26/2021
Rec V Date: 05/29/2021
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: When I got the shot, I felt a severe burning sensation. I didn?t feel anything from the 1st dose, but I did get a rash. 5/22-23: 101.5 fever, chills, body aches, jaw pain 5/24-26: felt back to normal other than slight fatigue and jaw pain 5/27- severe chills, aches, fever came back and jaw pain 5/28- flu symptoms remain + and bleeding gums throughout mouth + sores 5/29- flu symptoms subside but gums are more inflamed and red

Other Meds: None

Current Illness: None

ID: 1360852
Sex: F
Age: 45
State: CA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/29/2021
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: fever, chills, loss of appetite. onset about 4 hours after shot. symptoms dramatically reduced after 36 hours.

Other Meds: none

Current Illness: none

ID: 1360853
Sex: F
Age: 21
State: IL

Vax Date: 05/17/2021
Onset Date: 05/28/2021
Rec V Date: 05/29/2021
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: Red bump developed where the second dose of Moderna vaccine was injected. Bump is about two inches long. Bump is tender; painful when pressure is applied. Bump was noticed around 12 PM on 5/28/21. Bump can be itchy.

Other Meds: None

Current Illness: Developed cough and stuffy nose/sinuses in between vaccines.

ID: 1360855
Sex: F
Age: 38
State:

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Thursday at noon felt nauseas after waking up, went to bathroom, became sweaty, hot. Woke up laying on bathroom floor, unknown how long was out for. Fainted at least twice. First faint resulted in deep laceration on chip and broken tooth due to fall.

Other Meds: none

Current Illness: none

ID: 1360856
Sex: F
Age: 62
State: FL

Vax Date: 03/26/2021
Onset Date: 03/29/2021
Rec V Date: 05/29/2021
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: After the first vaccine I started have pain in my hands and feet and inflamation, especially in the morning when I woke up and as the day wore on it got less painful. After the second vaccine the pain has spread to my knees and my neck as well. I also have wrist pain. My right hand feels numb when I hold anything in it and then it tingles.

Other Meds:

Current Illness:

ID: 1360857
Sex: F
Age: 49
State:

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: Fatigue, chills

Other Meds: vitamin D

Current Illness: none

ID: 1360858
Sex: F
Age: 46
State: NJ

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Within a few hours of receiving the shot, I experienced very very weak legs. I felt I could hardly walk or support myself whenever my feet would touch the ground. I would manage to walk, but with difficulty and a lack of coordination. It was one of the most petrifying experiences in my life! I hope it was temporary, but after a week I visited my doctor and she claimed she had not heard of this effect yet. She did some blood work and requested an ultrasound on my legs. My blood work was all good except for a mildly elevated d-dimer. I didn't have a chance to do the ultra sound yet as I had an urgent trip to attend to. My leg weakness and heaviness cannot be described as pain. It is primarily weakness, heaviness, and discomfort. I feel that I have some sort of neurological disorder after the shot, but I don't really know for sure. The problem, is that I am still facing these issues even a month later! It's less than before and I am not as terrified as I was initially, but I feel there is some sort of permanent damage that has happened. I have opted not to go for the second vaccine under any condition. I actually wish I would have taken my chances with covid as my health and lifestyle are definitely compromised as a result of this vaccine. Some answers and remedies would be really appreciated please!

Other Meds: Vitamin D Zinc Magnesium Vitamin C

Current Illness: None

ID: 1360859
Sex: M
Age: 60
State: CA

Vax Date: 04/09/2021
Onset Date: 04/17/2021
Rec V Date: 05/29/2021
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: Bad pain down leg , swollen leg, very sharp pain that move into foot . foot swells everyday since vaccine

Other Meds: None

Current Illness: None

ID: 1360860
Sex: M
Age: 9
State: VA

Vax Date: 05/24/2021
Onset Date: 05/27/2021
Rec V Date: 05/29/2021
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: 4 days after receiving vaccine, patient developed urticaria. Went to ER. Received oral prednisolone and famotidine on Day 5 and seen in the office on day 6 post vaccination. Recommended continuing treatment as directed by the ER to complete 5 days for steroid and oral antihistimines

Other Meds: Floxin otic

Current Illness: Otitis externa

ID: 1360861
Sex: M
Age: 42
State: WA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 05/29/2021
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 known

Symptom List: Tremor

Symptoms: Fever 103.4

Other Meds: Thyroid, mirilax, propantezole, senna, milk of magnesia, adult multi vitamin, Vit D

Current Illness:

ID: 1360862
Sex: M
Age: 66
State: OH

Vax Date: 05/14/2021
Onset Date: 05/24/2021
Rec V Date: 05/29/2021
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: PCN

Symptom List: Erythema, Pruritus

Symptoms: Guillain- Barre

Other Meds: lisinopril

Current Illness: none

ID: 1360863
Sex: M
Age: 22
State: MA

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 05/29/2021
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: UNKNOWN

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

Symptoms: AFTER PATIENT RECEIVED THE VACCINATION, HE SAT DOWN IN THE WAITING AREA. AFTER APPROXIMATELY 1 MINUTE THERE WAS A NOISE AND I NOTICED THAT HE WAS SLUMPED TO THE RIGHT SIDE AND STARTED TO CONVULSE. I RAN OUT TO THE PATIENT AND ENSURED THAT HE DID NOT FALL AND HELD HIM IN PLACE UNTIL HE STARTED TO COME TO. AFTER ABOUT 30 SECONDS THE PATIENT STARTED TO BECOME AWARE AND COULD HEAR ME TALKING BUT WAS STATING HE COULD NOT SEE. AFTER ABOUT 30 SECONDS HIS SIGHT RETURNED. DURING THE TIME THAT I WAS FIRST WITH THE PATIENT, THE STORE MANAGER CALLED 911 AND THE EMS WAS ON SITE AFTER APPROXIMATELY 5 MINUTES. I HAD THE CUSTOMER SIT DOWN AND GAVE HIM WATER UNTIL THE PARAMEDIC ARRIVED. THEY TOOK A HISTORY OF THE PATIENT AND AFTER A FEW MINUTES TOOK HIM BY AMBULANCE TO THE LOCAL HOSPITAL FOR ADDITIONAL OBSERVATION.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1360864
Sex: F
Age: 67
State: CA

Vax Date: 03/29/2021
Onset Date: 04/12/2021
Rec V Date: 05/29/2021
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: 1)Heart Palpitations-went to ER 3 times to check; had a ZIO patch test--waiting for results; 2)increased asthma--taking all 3 asthma medications that I have not taken in many years; 3)severe tension headaches that required an injection of Torodol;

Other Meds: Minivelle estrogen patch, famotidine, calcium

Current Illness:

ID: 1360865
Sex: M
Age: 15
State: NC

Vax Date: 05/28/2021
Onset Date:
Rec V Date: 05/29/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient came in with his family right at closing time on Friday. Normally we stop giving shots at 5pm in order to have the paperwork, waiting time, etc done before closing, but we had some doses that we didn't want to waste so we agreed to administer the shots. The checklist was reviewed for contraindications and the vaccine was administered without incident. We waited after hours for the 15 minute observation time to pass, which was also without incident. It wasn't until reviewing the paperwork the next day that we realized that this individual was only 15 years old.

Other Meds:

Current Illness:

ID: 1360866
Sex: F
Age: 80
State: AR

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 05/29/2021
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: Tetracycline, Celabrex, Coconut, Advair, Ruvert.

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

Symptoms: I was very tired and my arm was a little bit sore and I ran a 99 temperature that just made me miserable. I sat around and didn't do anything because I didn't have any energy. It lasted 3 days until 02/29/2021. I did not see my Doctor for this.

Other Meds: Tikosyn, bisoprolol, urosemide, protonix, warfan, Lipitor, potassium chloride, calcium, vitamin, melatonin, multivitamin, and mg aspirin, I promise vitamin, loperamide, Tylenol.

Current Illness: None.

ID: 1360867
Sex: M
Age: 74
State: FL

Vax Date: 05/08/2021
Onset Date: 05/10/2021
Rec V Date: 05/29/2021
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: May 10 muscle pain over all of body,,,, May 11 Fever 99 to 100.6 for 4 days,, May 12 thru May 21 nausea and sever joint pain,,,, Higher than normal blood pressure,,,May 18 extreme ankle pain could not put pressure on foot for 4 days,,, Saw Doctor on May 25 and received medication to relieve pain,,, now May 29 can walk but still joint pain in both feet and knees....

Other Meds: Lisinopril, Allopurinol, Atorvastatin, vitimins, fish oil tablets

Current Illness: gout, polyneuropathy

ID: 1360868
Sex: M
Age: 40
State:

Vax Date: 05/21/2021
Onset Date: 05/24/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: Nil

Symptom List: Pain in extremity

Symptoms: Hives on day 3 and still experiencing 9 days after

Other Meds: Nil

Current Illness: Nil

ID: 1360869
Sex: M
Age: 37
State: IN

Vax Date: 01/09/2021
Onset Date: 01/11/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: Sulfur

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

Symptoms: About 2 days after the 2nd dose random muscles will be twitching all over my body. I was saw a Nuerologist and he diagnosed with Benign Safciculation Syndrome.

Other Meds: Lexipro

Current Illness: None

ID: 1360870
Sex: M
Age: 14
State:

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/29/2021
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: AE: patient passed out post vaccine administration, however; the patient did not hit head on the hard surface or become unresponsive.

Other Meds:

Current Illness:

ID: 1360871
Sex: M
Age: 24
State: TN

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/29/2021
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: Keeled- hives reaction

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

Symptoms: Patient received vaccine at 10:16a.m., patient indicated they were feeling dizzy, while seated. He was immediately attended to prevent possible fall. Given orange juice. Patients head slumped back and had labored and guppy breathing, then went unconscious for a few seconds. His pulse was monitored, breathing monitored. He became alert and was talking. He was laid on the ground in supine position. Vitals were monitored continuously throughout the rest of the patient?s extended observation period. Vitals are as follows: Time: 10:20 Pulse: 69 RR: 24 O2 Stat: 97 Time: 10:27 Pulse: 78 RR: 22 (laying) Time: 10:31 Pulse 82 O2 stat: 98(sitting up) Time: 10:35 Pulse: 83 RR: 22 O2 Stat: 99 (laying) Time: 10:37 Pulse 66 RR: 26 O2 Stat: 98 (laying ) Sitting up from here forward Time: 10:48 Pulse 86. O2: 98 Time: 10:55. Pulse 81. O2: 98 Time: 11:01. Pulse 77. O2: 98 Time: 11:20. Pulse 75. O2: 97 BP: 132/78 Patient was instructed to have someone drive him, he was instructed not to drive OF NOTE: Patient stated he did not have breakfast.

Other Meds:

Current Illness:

ID: 1360872
Sex: F
Age: 44
State: WA

Vax Date: 05/14/2021
Onset Date: 05/24/2021
Rec V Date: 05/29/2021
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: Penicillin

Symptom List: Vomiting

Symptoms: Symptoms began 9 days after 2nd shot and lasted for 5 days. Nausea, body aches, chills, fatigue, diarrhea, gas, upset stomach for 3 days after Nausea passed. Treated with peptobismol, anti inflamitories and rest.

Other Meds:

Current Illness:

ID: 1360873
Sex: F
Age: 55
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/29/2021
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: Sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Sick six days three of which I had a severe migraine. Second and third day confusion, delirious, couldn't write and couldn't think properly.

Other Meds: If anything tylenol.

Current Illness: MS, cholesterol, thyroid, migraines, depression, anxiety, scoliosis and stomach problems ie: pain in abdomen, nauseous, cramping.

ID: 1360874
Sex: F
Age: 62
State:

Vax Date: 04/01/2021
Onset Date: 04/05/2021
Rec V Date: 05/29/2021
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: I had flu like symptoms that just intensified after getting the COVID-19 vaccine.

Other Meds: None.

Current Illness: None.

ID: 1360875
Sex: F
Age: 37
State: MA

Vax Date: 05/17/2021
Onset Date: 05/01/2021
Rec V Date: 05/29/2021
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: I think Bacterium

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I got the 1st dose of Covid-19 vaccine in left arm. I think I did experience a sore muscle and may have experience leg pain. Now this arm seems to be twitching like I have anxiety.

Other Meds:

Current Illness: N/A

ID: 1360876
Sex: F
Age: 58
State: CA

Vax Date: 01/28/2021
Onset Date: 02/02/2021
Rec V Date: 05/29/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: My arms were tired, weak, heavy. I went to urgent care they thought it was Guiganne barre, but it wasn't. I was told follow up with my PCP. No treatments were done. I did feel better with time. I feel like it was possibly happening this way due to me having had Covid.

Other Meds: synthroid

Current Illness: Covid-19 within the one month prior

ID: 1360877
Sex: M
Age: 68
State: IN

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/29/2021
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 known

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

Symptoms: I push-mowed for an hour in late morning, following shot. Over the course of the remainder of the day, seemed to having some increasing fatigue. In the night, had frequently interrupted sleep, chills, body aches, mild nausea. The following day, tired all day; last night, had chills, felt abnormally warm, had reduced appetite. Took Ibuprofin around 11:00 p.m. Felt better. In repeated thermometer readings, highest temp was 98.6, is normally in 97-range. Had some chills and sweating which interrupted sleep a bit, but slept better than the previous night. Still feeling a little tired today, but overall feeling better.

Other Meds: Zolpidem, Alprazolam, Tamsulosin, Tadalafil (small dose daily), Atorvastatin, Mucinex, Aspirin 81 mg, Famotidine, Vitamin D, multivitamin, Alendronate Sodium Tablets, USP, 70 mg (one per week)

Current Illness: Recent diagnoses of chronic parotiditis and cellulitis

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm