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: 1362420
Sex: M
Age: 18
State: CO

Vax Date: 05/31/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
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: milk and nuts

Symptom List: Dysphagia, Epiglottitis

Symptoms: 18 y/o male received J&J vaccine. Five minutes after being vaccinated, pt complained of nausea. Patient presented with pale skin, diaphoretic, and incontinence of bladder in the observation area. Pt lost consciousness for 15 seconds in the car. After 15 sec, pt regained consciousness and was able to walk and talk. EMT brought the patient into the observation tent to lay on the cot. EMT obtained 4 sets of vitals and completed orthostatic vitals. Last set of vitals are: 10:15am: BP 103/60, Pulse: 74, Respiration 18 and O2 98% on room air. Blood Glucose level was 106. Pt returned back to normal state after 15 minutes in observation. Pt was no longer diaphoretic, pale, or nauseous. Pt is stable, alert, and oriented x4. Pt is walking and talking independently. No EMS services needed. Pt was instructed to follow up with the nearest ER, if symptoms return or worsen. Pt left with his mother, who is the driver.

Other Meds: NA

Current Illness: NA

ID: 1362421
Sex: F
Age: 22
State: MD

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/31/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: The day following my vaccination, I woke up to cramps and some spotting. I don?t typically bleed or have periods on my birth control, so this was out of the ordinary. It lasted for the day.

Other Meds: Oral contraceptives

Current Illness: None

ID: 1362422
Sex: M
Age: 51
State: CT

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 05/31/2021
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: Erythromycin.

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

Symptoms: on the day of the 2nd injection i had pain from the injection site up to the left side of my head. had chills and a slight fever that went away by the next day. however the shooting pain in my arm and in my left side of my neck has returned and there seems to be no way to relieve it.

Other Meds: Uloric 80mg 1x/day, 5mg lisinopril 1x/day.

Current Illness: none.

ID: 1362423
Sex: F
Age: 89
State: DC

Vax Date: 05/21/2021
Onset Date: 05/01/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received the second dose of Moderna series too early. The first dose was administered on 4/30/2021. No adverse reaction/event noted during the immediate 15 minute post vaccination observation period.

Other Meds:

Current Illness:

ID: 1362424
Sex: F
Age: 52
State: PA

Vax Date: 05/02/2021
Onset Date: 05/03/2021
Rec V Date: 05/31/2021
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: After normal 45 min walk sat down got up 20 minutes later and it felt like rocks were in my right foot. I couldn?t walk normally. Bottom of foot was swollen. Next day the same thing happened a few times but I was able to walk. Then bottom of right foot turned purple and white kinda like Reynard

Other Meds: Zinc Vit D3

Current Illness:

ID: 1362425
Sex: M
Age: 47
State: WA

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/31/2021
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: 12 hours after shot and a period at least 36 hours had fever between 99.5 and 100.3, chills, headache, muscle and joint pain, fatigue, and diarrhea.

Other Meds:

Current Illness:

ID: 1362426
Sex: F
Age: 30
State: CO

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/31/2021
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: loss of sensation/numbness of lower left and right of face, including cheeks, upper and bottom lip, chin, and along the jaw for first 72 hours after vaccine. After that, feeling returned to cheeks with only occasional numbness for the following 48 hours, while the nose/lip/chin remained numb until 5/28/2021.

Other Meds: none

Current Illness: none

ID: 1362427
Sex: F
Age: 64
State: CA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/31/2021
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: I am allergic to penicillin.

Symptom List: Pharyngeal swelling

Symptoms: Right after receiving the vaccine my thumb started to swell. I took a picture of it because I couldn't believe the size. For the next three mornings I woke up with a headache. I took Tylenol and it helped get rid of the headaches. I started to see unexplained bruising on my arms and legs a week after the vaccination. To this day, I still have bruising, but it is going away. I noticed that I was getting Petechiae (tiny red, flat spots that appear on the skin). I noticed a bruise on my breast ( I am a breast cancer survivor and have had reconstructive surgery on my breasts.) After the bruise started to disappear, my skin was already thin from radiation, but the skin started to open up and expose my silicone inside my breast. I had to go to the surgeon and my implant had to be removed. Now I am flat chested on that side. This is going to take several weeks of recovery to get through this. The surgery for the removal of the silicone was 9PM PST, Emergency Surgery.

Other Meds: I was taking tumeric, ashwagandha, vitamin D, magnesium and probiotics.

Current Illness: I did not have any other illnesses.

ID: 1362428
Sex: F
Age: 40
State: PA

Vax Date: 04/12/2021
Onset Date: 05/28/2021
Rec V Date: 05/31/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: On 5/28/2021 I started to develop shortness of breath. It continued to worsen and I went to the hospital on 5/30/2021 and it was discovered that I had a pulmonary embolism and after additional ultrasounds 3 DVT blood clots in my right leg.

Other Meds: Metformin, Tylenol,

Current Illness: Seasonal allergies

ID: 1362429
Sex: F
Age: 60
State: NC

Vax Date: 04/19/2021
Onset Date: 04/23/2021
Rec V Date: 05/31/2021
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: Codine, milk, silicone, Allegra, sulphate drugs

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Server abdominal pain around incision area. Cat scan revealed nothing wrong. Gabapentin prescribed for the pain. Systems disappeared 4 weeks later

Other Meds: Theophylline, anastrozal, amalodopine, vitamin c , multivitamin, stool softener, mirlax

Current Illness: Had hernia repair, gallbladder removed and ostomy take down 2/15/2021

ID: 1362430
Sex: M
Age: 18
State: TN

Vax Date: 05/31/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: No allergies

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

Symptoms: 01: 47 PM Pfizer Covid-19 Vaccine administered in left deltoid- mother and sister also in room. Patient left room ambulatory without any issues or distress to go sit in waiting room. 01: 52 PM Sister stated patient didnt feel well and alerted PCT . Mother present and witnessed patient have syncopal episode. He was lowered to floor but was arousable after 10-15 seconds. Patient sat upright and drank few sips of water. Patient was noted to be pale and sweating. He reports he has had similar episodes when receiving flu vaccine in the past. Mother and PCT remained with patient in lobby. 2:00 PM Patient did vomit x 1 in trash can and reports he is feeling some better 2:20 PM Patient remained in lobby with mother until feeling much better. He left ambulatory in no apparent distress.

Other Meds: None

Current Illness: None

ID: 1362431
Sex: M
Age: 51
State: GA

Vax Date: 05/18/2021
Onset Date: 05/22/2021
Rec V Date: 05/31/2021
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: N/A

Symptom List: Rash, Urticaria

Symptoms: Neurological: dexterity in fingers/arms impaired, balance affected, sensation in nasal bone area. Feeling off, mild headache.

Other Meds: Finasteride

Current Illness: None

ID: 1362432
Sex: F
Age: 75
State: MN

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: Latex, codeine

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

Symptoms: Sore arm, extreme fatigue, sore muscles throughout upper body, intermittent shooting pains

Other Meds: Levothyroxine, 50 mcg; Lisinopril, 5 Mg; Rosavustation, 10 Mg; Escitalopram,10 Mg; Lidocaine ointment 5% as needed

Current Illness:

ID: 1362433
Sex: F
Age: 34
State: MD

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 05/31/2021
Hospital: Y

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: N/A

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

Symptoms: 3/29: Heart palpitations, difficulty swallowing, tingling (face, shoulder, neck, arm), numbness in lips. April to Present: Heart palpitations, shortness of breath, chest pain, dizzy, nausea, lightheadedness.

Other Meds: N/A

Current Illness: N/A

ID: 1362434
Sex: M
Age: 39
State: OH

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 05/31/2021
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: shellfish bee stings

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

Symptoms: I had difficulty swallowing with pain in my neck. I had a severe headache and was extremely fatigued. It started Jan 8 2021 and it continued until I sought medical help from multiple physicians. I had a headache for over 90 straight days. I had a nogol in my neck, it ended up being diagnosed as acute thyroiditis. I am in a lull right now after I was able to stop the medicine. My thyroid is functioning again, but we are waiting for it to go into the hyper thyroid stage.

Other Meds: lipitor - 1xday/10mg

Current Illness:

ID: 1362435
Sex: M
Age: 11
State: WA

Vax Date: 05/30/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
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: NONE

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

Symptoms: Patient's actual birthday is date but his mom lied to us and intentionally provided incorrect birth date in vaccine consent form to make patient's age 12 just to get a vaccine for her son. When I asked for if he has insurance, she again lied and said no he does not have an insurance. I also overheard them that they were leaving town soon to visit may be location. So his mom had an intentional plan to provide wrong birthday and do not disclose insurance just to get vaccine. Patient will be 12 years soon. I called thrice to patient's mom to verify DOB when found real DOB different with central patient search . First call she hung up on me, second call she did not answer and with third call, she said she was under impression of age limit is 9 for Pfizer vaccine, then why she need to provide wrong DOB in vaccine consent form? Also she asked me to make correction in a system of DOB and let it go. I refused it and told her I will use birthday you provided in vaccine consent form which is date

Other Meds: NONE

Current Illness: NONE

ID: 1362436
Sex: F
Age: 53
State: OR

Vax Date: 04/30/2021
Onset Date: 05/05/2021
Rec V Date: 05/31/2021
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: codeine, hydrocodone, vancomycin, nickle

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

Symptoms: I had my second shot on April 30th, and on the morning of May 5th I experienced pain in my chest, irregular heart rhythms, and a general feeling of not being able to catch my breath. For a short time I felt light-headedness and a tingling in my feet/lower legs, and told my husband I might pass out. I was in the car as a passenger. So I went to an urgent care in that area. By the time I saw a DR the symptoms were abating and the ekg did not show any issues.

Other Meds: Daily multivitamin, turmeric

Current Illness: none

ID: 1362437
Sex: M
Age: 47
State: CA

Vax Date: 05/30/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
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: Blurred and cloudy vision with large halls around lihhts

Other Meds: Ibuprofen

Current Illness: None

ID: 1362438
Sex: F
Age: 61
State: NJ

Vax Date: 04/20/2021
Onset Date: 04/29/2021
Rec V Date: 05/31/2021
Hospital: Y

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

Lab Data:

Allergies: Animal saliva

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Tachycardia, high blood pressure, elevated levels of troponin. I was hospitalized with these conditions

Other Meds: None

Current Illness: None

ID: 1362439
Sex: M
Age: 24
State: MN

Vax Date: 05/31/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: none known

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

Symptoms: Patient received the vaccine around 9:38 AM and was placed in a chair for observation. Within 3 minutes the patient had fallen onto the floor on his side out of the chair. The pharmacist on duty at the time myself ran over and asked patient if he was ok and touched his shoulder. The patient regained consciousness and was moved to the vaccination room and put feet up for evaluation. The patient loss consciousness for 10 more seconds. Vitals were taken immediately (see below) and patient was interviewed for adr's. Patient had extreme diaphoresis, said he had no diplopia but did have blurred vision . Patient said his head hurt and was given 500 mg apap for one dose. He said his ears were hot. Patient said he had no pain other than his head hurting. Patient had no uticaria or redness . Patient appeared pale. He was given extensive amounts of water and a snack. He said that sounds were slightly muted. He said he had senstivity to lights.

Other Meds: none known

Current Illness: none known

ID: 1362440
Sex: M
Age: 72
State: IL

Vax Date: 02/08/2021
Onset Date: 02/22/2021
Rec V Date: 05/31/2021
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: None

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

Symptoms: Red vesicles throughout the body starting from the head/scalp then progressively moving down the back, front torso, groin area, down to the legs. Itching, burning sensation. Starting roughly two weeks after the first vaccine dose. Treatment so far received - betamethasone diproprionate cream USP 15 g apply twice daily to affected area, hydrocortisone cream USP 2.5% apply to affected area twice daily, mupirocin oinment USP 2% apply externally to the affected area twice daily; cephalexin 500 mg take one capsule three times daily then switched ciprofloxacin 500 mg tablet take 1 tablet by mouth twice daily for 10 days.

Other Meds: Precose 50 mg three times per day, Kirkland multi vitamins, Carbidopa/levodopa 25-100mg, B1 vitamin, Hydralazine hcl 100 mg 3 times per day, rosuvastatin calcium 5 mg, Ezetimibe 10 mg, Ranolazine ER 500 mg twice per day, Effient 10 mg, Phen

Current Illness: None

ID: 1362441
Sex: F
Age: 30
State: CA

Vax Date: 05/31/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Unevaluable event

Symptoms: Dizziness while sitting in observation room. Hx of Anxiety. Symptoms improved after eating snack and laying down. Left ambulatory in steady gait with husband

Other Meds: Citalopram

Current Illness: None

ID: 1362443
Sex: M
Age: 84
State: NV

Vax Date: 05/17/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
Hospital: Y

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: Active COVID infection, hospitalization

Other Meds:

Current Illness:

ID: 1362444
Sex: M
Age: 46
State: NY

Vax Date: 03/29/2021
Onset Date: 05/09/2021
Rec V Date: 05/31/2021
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: Visited the neurologist on 5/25/2021. She stated that I am suffering from facial spasms. I don't need to take any medications but need observation for more than one month.

Other Meds: N/A

Current Illness: N/A

ID: 1362445
Sex: F
Age: 41
State: CA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to shell fish.

Symptom List: Injection site pain, Menorrhagia

Symptoms: I had chest pains a few days after receiving the vaccine and went to see my Doctor who referred to the ER to check to see if I had a blood clot.

Other Meds: No

Current Illness: I have had Asthma since I was young.

ID: 1362446
Sex: F
Age: 68
State: TN

Vax Date: 03/06/2021
Onset Date: 04/01/2021
Rec V Date: 05/31/2021
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: DISCOVERED SWOLLEN LYMPH NODES IN RIGHT NECK; PAIN AND DISCOMFORT BELOW AND ABOVE COLLAR BONE ON RIGHT SIDE; EXTREME FATIGUE. SAW NP AT PCP OFFICE ON APRIL 9, 2021. STILL EXPERIENCING DISCOMFORT IN ABOVE STATED AREA. FATIGUE, UNBEARABLE AT TIMES, COMES AND GOES.

Other Meds: MEDS FOR DIABETES AND HIGH BLOOD PRESSURE; TAMOXIFEN

Current Illness: 4 YEARS INTO BREAST CANCER TREATMENT

ID: 1362447
Sex: F
Age: 41
State: TX

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 05/31/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: 4/18-23 heart palpitations and shortness of breath; 4/19 high BP, 5/17-29: heart palpitations and SOB (severe and constant 5/26-27), lightheaded on 5/23,

Other Meds:

Current Illness:

ID: 1362448
Sex: M
Age: 64
State: TX

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: 2nd hand cigarette smoke, dust, pollen

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The symptoms started 3 hours after the 2nd dose of COVID. I felt pain in my left arm ( the same arm where I was injected ), chills and fever across my body, sweating, numbness and electric tingling in head, dizziness and vertigo with sensation of wanting to vomit, a lot of pain in my joints, watery eyes and pain in my eyeballs, lack of equilibrium and orientation, and other symptoms.

Other Meds: Ibuprofen (600mg), Atenolol (100mg), Rosuvastatin Calcium 20mg

Current Illness: high blood pressure, diabetes, cholesterol, asthmatic bronchi-

ID: 1362449
Sex: M
Age: 58
State: CA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 05/31/2021
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: peanut, dog, cat, dust mite

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

Symptoms: Persistent high blood glucws values without change in diet or exercise. Fasting >120 consistently. Last AIC 6.8 Feb 2021 Increased short acting insulin from 35 to 60 units per day. Increase is managing BG

Other Meds: metformin, humalog, pioglitozone, ozempinc, lisinopril, vytorin 10/40, montelukast, citalapram, zyrtec, testosterone, xiidra, coq 10, MSM, glucosamine, omega 3 fatty acid, vitamin e, vitamin d, multivitamin

Current Illness:

ID: 1362450
Sex: F
Age: 49
State: KY

Vax Date: 01/06/2021
Onset Date: 01/12/2021
Rec V Date: 05/31/2021
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: It felt weird from the get go. I felt it go into my arm. That night I could barely move my left arm. It got better, but in the days that followed I got a pain in my neck and shoulder. I thought maybe I slept wrong. I ended up going to a physical therapist, a massage therapist, and a chiropractor to get some relief. I had some numbness and tingling down the left side of my arm with my ring finger and my pinky. I got no relief from that. I went to my doctor and he found a knot under my arm. I thought the swelling from that might have hit a nerve. My PCP sent me to another doctor, who is a surgeon. He ordered an ultrasound. When that came back, it came back as a swollen lymph node. I went and had a biopsy done. When it came back everything looked good. Last week, I was taking off my dress and I was like "oh that hurts!". The lump under my arm was bigger and was hurting. I am having another ultrasound done Friday. It is still swollen and it has been like this since a few days after Jan 6 2021.

Other Meds: zoloft - 1xday/50mg

Current Illness:

ID: 1362451
Sex: F
Age: 45
State: VA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: penicillin and amoxicillin (causes vomit)

Symptom List: Injection site pain

Symptoms: Heavy period started 2-3 weeks early

Other Meds: probiotics, elderberry gummies, fish oil/Vit. D pill

Current Illness: N/A

ID: 1362452
Sex: F
Age: 57
State: UT

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 05/31/2021
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: Hello, I received my 2nd Moderna vaccine injection on April 1, 2021 at Pharmacy. Since I received 1st Covid 19 vaccination from the same Pharmacist, I figured the first few days of pain were expected. Eight weeks later, the pain is still present in addition to streaks of pain with certain movements. I have been to my primary physician, a rheumatologist, an orthopedic specialist, and an Orthopedic Surgeon, and they all have different speculations. Though I have medical insurance, I still incur expenses and limitations. I fear I could be permanently damaged. I have received a stack of forms,, and I am trying to fill them out

Other Meds: levothyroxine, zolpidem, multi vitamin, fish oil

Current Illness: none

ID: 1362453
Sex: F
Age: 45
State: CA

Vax Date: 05/14/2021
Onset Date: 05/25/2021
Rec V Date: 05/31/2021
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: Medications: Muscle relaxers (in general) Food: None. Lactose intolerant Other: Allergic to band aids glue (not to latex)

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

Symptoms: Janssen COVID-19 Vaccine EUA NO PAIN, just a weird sensation, can only describe as "bubbles" in both my legs: behind the knee and calf. Started the night of May 25th and I didn't think any of it cause I have always had "jumpy" legs when I'm falling asleep. But Then the sensation was getting more intense the night of May 26th so the morning of May 27th I went to the ER.

Other Meds: Prescriptions: Blisovi Fe1/20 Dietary Supplements: Nutrilite Daily MultiVitamin Multi mineral Nutrilite Vit D Nutrilite Vit B complex Nutrilite Cholesterol Health Nutrilite Vit C

Current Illness: None

ID: 1362454
Sex: F
Age: 48
State: WA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 05/31/2021
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, Doxycycline, Keflex, Vicodin, Almonds, Chestnuts, Hazelnuts, Pecans, Walnuts Apricots, Bananas, Cantaloupe, Coconut, Honey, Honeydew, Pineapple Latex

Symptom List: Tremor

Symptoms: Fatigue, Diarrhea, Headache with head pressure, Numbness on left side of face, Chest pressure, Abnormal heart rhythm, Loss of peripheral vision on left eye

Other Meds: Losartan Potassium Hctz 50-12.5 mg tab, Tizanidine Hcl 2 mg tab

Current Illness: Possible Long Covid

ID: 1362455
Sex: F
Age: 62
State: ID

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/31/2021
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: Medications: Azithromycin, amoxicillin, naproxen, natural thyroid. Food: Gluten, tree nuts, eggs, cow dairy. Skin: Exima dermatitis. Environmental: seasonal hay fever

Symptom List: Erythema, Pruritus

Symptoms: Approximately 5 hours following the 2nd dose, I began to experience total body aches. Pain became acute from head to toe, with onset of chills with fever (6 degrees above normal), racing heart, congestion, migraine from aching jaw, delirious all night. Ringing in my ears and nausea. I was very well hydrated before/after vaccine. By morning, BP was back down to 113/61, but I could still hear/feel my heartbeat in my throat. Most symptoms resolved after 24 hours, other than temperature and jaw ache.

Other Meds: Align probiotic, Phyto Multi vitamin, Selenium (200 mcg), Calcium (800 mg), Magnesium Citrate (420 mg), Lomatium root (1 tsp).

Current Illness: frontal fibrosing alopecia, leaky gut

ID: 1362456
Sex: F
Age: 38
State: CA

Vax Date: 05/27/2021
Onset Date: 05/30/2021
Rec V Date: 05/31/2021
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: N/A

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

Symptoms: Starting on 5/30 my legs have become extremely itchy. I have not changed soaps or any personal care items. Today my arms have become itchy as well.

Other Meds: 10 mg of Celexa daily

Current Illness: N/A

ID: 1362457
Sex: F
Age: 58
State:

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/31/2021
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: R arm pain, R sided facial pain, after second shot, R sided leg pain/parasthesia. Unable to walk.

Other Meds:

Current Illness:

ID: 1362458
Sex: M
Age: 62
State: DE

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/31/2021
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: red dye.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: first dose. Muscle soreness first 2 days joint pain next two days. Dose recieved 4/28/21 Second dose. Upset stomach then loss of appetite the first day. Got better on second day. Very tired on the second day Third day: Hacking cough and sore throat. Could eat, but when drinking caused me to cough. Then started to lose my voice. 6th day. Coughing better but still there voice still weak. Fluids do not make me cough anymore. 2nd vaccine date 5/26/21

Other Meds: Dye free Benadryl 25mg CoQ10 200mg Simvastatin 10mg

Current Illness: a slight cold a week prior.

ID: 1362459
Sex: F
Age:
State: CA

Vax Date: 05/18/1921
Onset Date: 05/19/2021
Rec V Date: 05/31/2021
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: none

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

Symptoms: Extreme dizziness, weakness, numbness/tingling in arms and legs especially right leg and foot. Bed rest and lots of fluids. As of today May 31, symptoms are clearing but still some numbness in right leg and foot.

Other Meds: none

Current Illness: none

ID: 1362460
Sex: M
Age: 53
State: TX

Vax Date: 03/20/2021
Onset Date: 03/23/2021
Rec V Date: 05/31/2021
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: Penicillin and latex

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

Symptoms: From the 3/23 onwards heart palitations. The doctor From the 5/20 to 5/30 i was unable to sleep due to the heart palpitations. The doctor at urgent care said it was mycoclonus and prescribed clonazepam and referred me to a cardiologist.

Other Meds: Duloxitine.

Current Illness: Thorasic spine disk herination

ID: 1362461
Sex: F
Age: 20
State:

Vax Date: 05/03/2021
Onset Date: 05/08/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: tree nuts, penicillin

Symptom List: Pain in extremity

Symptoms: period lasting 2 weeks after vaccine. i have the mirena iud implant and haven?t gotten a period at all in 3 years until i got the vaccine. painful cramps.

Other Meds: vitamin D supplement

Current Illness:

ID: 1362462
Sex: F
Age: 56
State: HI

Vax Date: 05/04/2021
Onset Date: 05/27/2021
Rec V Date: 05/31/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: left arm itches alot, tingling, abdominal uncomfortable, feels like my respiratory isn't the same, tiredness, headaches everyday

Other Meds: Singular, zolpedium, estrogen

Current Illness: none

ID: 1362463
Sex: M
Age: 1
State: CO

Vax Date: 04/28/2021
Onset Date: 05/16/2021
Rec V Date: 05/31/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: 103+ fever for three days, no relief with Tylenol or ibuprofen. Minimal appetite. After fever broke, developed full body rash with much discomfort. Appetite stayed minimal and rash lasted 3-4 days.

Other Meds: None

Current Illness: None

ID: 1362464
Sex: F
Age: 61
State: OR

Vax Date: 04/24/2021
Onset Date: 05/27/2021
Rec V Date: 05/31/2021
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: NONE

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

Symptoms: 3 DAYS CONTINUED HEADACHE, JOINT/MUSCLE PAIN ON BOTH LEGS

Other Meds: VIT D

Current Illness: NONE

Date Died: 05/29/2021

ID: 1362465
Sex: F
Age: 74
State: PA

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/31/2021
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: nil

Symptom List: Vomiting

Symptoms: chest pain, fatigue, death

Other Meds: metformin

Current Illness: nil

ID: 1362466
Sex: F
Age: 55
State:

Vax Date: 05/09/2021
Onset Date: 05/09/2021
Rec V Date: 05/31/2021
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: Penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Shortness of breath, feeling faint, heart racing, very tired

Other Meds: Ramipril 2.5 mg

Current Illness: none

ID: 1362467
Sex: F
Age: 74
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 05/31/2021
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: Laytex Environmental allergies

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

Symptoms: Flu like symptoms on March 13 & 14. Dizzy, fatigue, lightheaded started March 15. I went to the Emergency Room on March 15 and told them I was having a reaction to the vaccine. I waited for over an hour and no one helped me but they helped everyone else who came after me, and with Covid so I left. I called Dr and went to his office that day. I had a hyperbaric oxygen chamber treatment and he put me on glutathione, multiple vitamin, zinc, Vitamin C, minerals. I continued seeing Dr and continued with the oxygen chamber treatments until I left New York to return home to Cape May, NJ. on May 3. I then rented a Hyperbaric Oxygen Chamber on May 4 that I continue to use daily to this day, as I continue with fatigue, dizziness, lightheadedness , although it is lessening.

Other Meds: baby asprin Multiple Vitamin allegra Vitamin C Vitamin D

Current Illness: none

ID: 1362468
Sex: F
Age: 26
State: NV

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/31/2021
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: penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient is an employee, after getting her shot, she returned to the sales floor and was talking to a customer (in front of aisle 10&11, pharmacy is in front of aisle 16). patient passed-out and fell backwards from standing position and have hit her head on her fall. Patient regained consciousness, when was helped up but again passed-out. Front end managers brought the patient to the covid waiting area room and was supported on a sitting position. Pharmacist administer ammonia inhalant and patient regained consciousness and was responsive. Patients BP was 108/70mmHg. Patient was transferred on the floor to raise legs, while waiting for 911 response. Patient was transported by fire department to ER for testing.

Other Meds:

Current Illness:

ID: 1362469
Sex: M
Age: 0
State: CT

Vax Date: 05/31/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient experiencing redness, inflammation, and heat on the same arm as the injection. Redness is the size of the upper arm on the outside of the arm from the deltoid to the elbow.

Other Meds:

Current Illness:

ID: 1362470
Sex: M
Age: 14
State: NC

Vax Date: 05/31/2021
Onset Date: 05/31/2021
Rec V Date: 05/31/2021
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: The patient became very dizzy after administration of the vaccine and appeared to almost faint.

Other Meds: N/A

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm