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: 1364788
Sex: M
Age: 20
State: CA

Vax Date: 05/30/2021
Onset Date: 05/30/2021
Rec V Date: 06/01/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt was w/father who reported that pt felt dizzy & anxious. Pt reported improvement after laying down & drinking juice/water. BP 144/90; HR 72; RR 18. Pt was stable & released from vaccination site.

Other Meds:

Current Illness:

ID: 1364789
Sex: F
Age: 90
State:

Vax Date: 01/18/2021
Onset Date: 01/23/2021
Rec V Date: 06/01/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient presented to the ED and was subsequently hospitalized on 1/23/21, 3/26/21, and 4/19/21. She did receive a second dose of vaccine on 2/17/21.

Other Meds:

Current Illness:

ID: 1364790
Sex: F
Age: 17
State: TX

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 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: 1364791
Sex: F
Age: 72
State: MI

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 06/01/2021
Hospital:

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

Lab Data:

Allergies: PCN, reglan

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 24 hours after each vaccine suffered chills body aches that required bed rest.

Other Meds: Lisinopril/HCTZ, vitamin D, claritin,

Current Illness: no

ID: 1364792
Sex: F
Age: 17
State: TX

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 06/01/2021
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: 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: 1364793
Sex: M
Age: 53
State: MA

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 06/01/2021
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: NKDA

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

Symptoms: Patient states one day after receiving second dose of the Moderna Vaccine he has been having moderate fatigue and c/o increase sob with running

Other Meds:

Current Illness: none

ID: 1364794
Sex: F
Age: 50
State: GA

Vax Date: 04/23/2021
Onset Date: 05/15/2021
Rec V Date: 06/01/2021
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: May 15 %100 Sudden hearing loss in my right ear that has not returned.

Other Meds: none

Current Illness: none

ID: 1364795
Sex: M
Age: 17
State: TX

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 06/01/2021
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 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: 1364796
Sex: F
Age: 36
State: CA

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 06/01/2021
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: Mild Chest pain shortness of breath 24 hrs after shot. Went way with Tylenol and rest. Returned next day worse. Emergency room tests ruled out heart, lung issues, and blood clot. Following up with primary care.

Other Meds: Levothyroxine Lexapro

Current Illness: None

ID: 1364797
Sex: F
Age: 17
State: TX

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 06/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 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: 1364798
Sex: F
Age: 82
State:

Vax Date: 02/19/2021
Onset Date: 05/30/2021
Rec V Date: 06/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: fall

Other Meds:

Current Illness:

ID: 1364799
Sex: M
Age: 24
State: WA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 06/01/2021
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:

Symptom List: Rash, Urticaria

Symptoms: He was also given the Janssen covid vaccine on 3/31/21. He did not report this information when offered the moderna vaccine. No adverse symptoms have been reported.

Other Meds:

Current Illness:

ID: 1364800
Sex: M
Age: 20
State: TN

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 06/01/2021
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: vasovagal syncope 10 minutes after injection

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1364801
Sex: M
Age: 47
State: NY

Vax Date: 05/22/2021
Onset Date: 05/24/2021
Rec V Date: 06/01/2021
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: seasonal allergies

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

Symptoms: Two days after my second dose, I became sick for 7 days. The symptoms came on immediate, chronic coughing and sneezing, head cold symptoms, fatigue, chills with no fever. The symptoms ended immediate after seven days. I though it could be seasonal allergies; however, I have never had seasonal allergies with this strength and duration.

Other Meds: none

Current Illness: none

ID: 1364802
Sex: F
Age: 64
State:

Vax Date: 05/04/2021
Onset Date: 05/18/2021
Rec V Date: 06/01/2021
Hospital: Y

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

Symptoms: Patient hospitalized within 6 weeks of receiving COVID vaccination with endometrial cancer.

Other Meds:

Current Illness:

ID: 1364803
Sex: M
Age: 17
State: NY

Vax Date: 05/29/2021
Onset Date: 06/01/2021
Rec V Date: 06/01/2021
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: Peanuts, Pollen, Soy

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

Symptoms: Myocarditis

Other Meds: None

Current Illness: No

ID: 1364804
Sex: M
Age: 37
State: PA

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 06/01/2021
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: None

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

Symptoms: Significant lower back pain and inflammation

Other Meds: Excedrin

Current Illness: None

ID: 1364805
Sex: M
Age: 66
State: VA

Vax Date: 04/29/2021
Onset Date: 05/31/2021
Rec V Date: 06/01/2021
Hospital: Y

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

Lab Data:

Allergies: nkda

Symptom List: Ear pain, Hypoaesthesia

Symptoms: symptoms start 5/31/21. R facial droop, R blurred vision, inability to close R eye. Presented with irretractable n/v, dyspagia, and obstipation on 5/27/21.

Other Meds: lisinopril, flomax, miralax, propanolol, cymbalta, abilify, amlodipine, magnesium citrate, naloxegol, olanzapine, percocet, protonix, chloraseptic throat spray, compazine, promethazine, miralax, propanolol, cymbalta, abilify, buspar, zofran

Current Illness:

ID: 1364806
Sex: F
Age: 29
State: OR

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 06/01/2021
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: Headache, tiredness immediately on the day of. 8 days later, soreness returned in my arm at the injection site. This soreness had originally subsided within 48 hours. It came back 8 days later and lasted another ~48 hours.

Other Meds: none

Current Illness: none

ID: 1364807
Sex: F
Age: 50
State: GA

Vax Date: 04/30/2021
Onset Date: 05/05/2021
Rec V Date: 06/01/2021
Hospital:

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

Lab Data:

Allergies: Allergic to penicilin.

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

Symptoms: This is my second shot and I have a very bad rash on my breast, under my breast, and my groin. I have had it since last month of May and it keeps me up at night along with a fever at times now. I need to know what I should do?

Other Meds: Triamterine-HCTZ75-50 mg

Current Illness: none

ID: 1364808
Sex: F
Age: 32
State: PA

Vax Date: 05/05/2021
Onset Date: 05/20/2021
Rec V Date: 06/01/2021
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: Adhesive as a child.

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

Symptoms: She got her vaccine, she went home and seemed to have slept a lot with both vaccines. She also had lack of appetite and did not want to come down to the table to eat, just wanted to sleep. If her mother could get her down to eat, she would take 2 bites of food and go back to bed, which mother feels the vaccine may have lowered her threshold for seizures. About 15 days after the vaccine she came to her door and she was banging in the hallway and was hollering help me. Her mother felt that she was having a seizure which she has not had any in about 2 1/2 years, and she was into one that her mother stopped with the cannabis oil. They have been controlled with the cannabis oil for the last 2 1/2 years but she was having multiple daily seizures prior to the cannabis oil. Her mother went downstairs and got her cannabis capsules and the MCT oil which she gave sublingually and she started to subside from the screaming and then moaned for 30 minutes. She then started to have involuntary neck movements and her head would swing back as she is walking, and she has been tapping her head on items and on her mother, which her mother thinks she is trying to tell her that something is wrong. She was not doing this prior to the 2nd vaccine. Her days and nights also seemed to be out of sorts since the vaccine as well. She is very limited in communication and does not speak much, but has so more since she started the cannabis oils.

Other Meds: Women's daily vitamins (vita fusion), Cannabis infused MCT oil or coconut oil (medical marijuana).

Current Illness: None.

ID: 1364809
Sex: M
Age: 61
State: MI

Vax Date: 04/21/2021
Onset Date: 04/26/2021
Rec V Date: 06/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: Had shortness of breath and admitted to hospital for blood clot/pulmonary embolism on 4/28/21 * Hematologist suggested I should report for information purposes. Not stating this is believed to be the cause of the event - just reporting as requested

Other Meds: Lisinopril Mynocycline 81 aspirin

Current Illness: none

ID: 1364810
Sex: F
Age: 50
State: MT

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/01/2021
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: Penicillin as a small child.

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

Symptoms: fever, chills and night sweats

Other Meds: Women's Daily Probiotic blend D3 50 mcg (2000 IU) Calcium Citrate plus Magnesium (250 mg Calcium; 100 mg Magnesium) Nature's Blend Omega-3 Fish Oil (1000 mg)

Current Illness: None.

ID: 1364811
Sex: F
Age: 35
State: VT

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 06/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Itchy throat, Anxiety

Other Meds:

Current Illness:

ID: 1364812
Sex: F
Age: 45
State: MI

Vax Date: 05/13/2021
Onset Date: 05/25/2021
Rec V Date: 06/01/2021
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

Symptom List: Injection site pain, Menorrhagia

Symptoms: I went to the ER 5/25/2021 for headaches, nausea and calves, ankles, and feet swollen badly. Dr, prescribed a fluid pills and the swelling was gone after a couple of days.

Other Meds: liprotar

Current Illness: No

ID: 1364813
Sex: F
Age: 35
State: WA

Vax Date: 05/19/2021
Onset Date: 05/30/2021
Rec V Date: 06/01/2021
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: N/A

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

Symptoms: I have had a lump size of a grape in my arm since the injection but almost two weeks after the injection a second small hard lump has formed. Both are tender and really hard.

Other Meds: N/A

Current Illness: N/A

ID: 1364814
Sex: M
Age: 44
State:

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 06/01/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient presented to the ED on 5/8/21 with hypertensive emergency. Per ER provider's notes: He was at the VA today getting his 2nd Covid vaccine (Pfizer) and during the post vaccine waiting period, he developed frontal headache and transient L arm tingling. He was sent to ED in Superior and BP was as high as 219/114. He was given amlodipine and toradol and dilaudid and BP did not come down. He also had a slight elevation in troponin and had second episode of L arm tingling. Decision was made to not give ntg since he already had a headache. No chest pain or other neuro sx. Head CT neg for bleed. No chest pain. Patient presented to the ED again on 5/11/21 with similar symptoms as previous visit.

Other Meds:

Current Illness:

ID: 1364815
Sex: F
Age: 29
State: OR

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 06/01/2021
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: exhaustion/tiredness (consistently all day), mild nausea (on and off all day), headache (mild, all day) Resulted in sleeping for most of the day, eating simple foods. Symptoms were completely gone by the following morning (April 28)

Other Meds: birth control, spironolactone

Current Illness: none

ID: 1364816
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/01/2021
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: Booster shot was administered May 7th 2021

Other Meds:

Current Illness:

ID: 1364817
Sex: M
Age: 55
State: VA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 06/01/2021
Hospital:

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

Lab Data:

Allergies: Nifedipine - headaches. penicillin - diarrhea Not true allergies for adverse reactions

Symptom List: Nausea

Symptoms: tooth infection, skin papular lesions and dark circles around both eyes

Other Meds: duloxetine 20mg po qd ER

Current Illness: no

ID: 1364818
Sex: F
Age: 56
State: PA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 06/01/2021
Hospital:

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

Lab Data:

Allergies: HCTZ; Sulfa antibiotics

Symptom List: Injection site pain

Symptoms: "Severe headache, nausea, fatigue, body aches, sore injection site unrelieved by Tylenol and/or Naproxen. Headache onset within the first 12 hours after injection. Other symptoms started within 24 hours of injection and continued past 48 hours of injection.

Other Meds: Amlodipine; Armodafinil; Bupropion; Caltrate; Vitamin D; Famotidine; Losartan; Metoprolol Succinate ER; Multivitamin; Fish oil; Venlafaxine

Current Illness: None listed

ID: 1364819
Sex: M
Age: 65
State: MI

Vax Date: 05/12/2021
Onset Date: 05/28/2021
Rec V Date: 06/01/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Small red dots started appearing on both lower legs ~15 total on 5/28. Three additional dots have shown up on my right arm, and two on my left arm since then. A few more on my legs since then. Now have ~25 in total. Dots are spread out and are not in any patterns or clusters.

Other Meds: Losartin

Current Illness: N/A

ID: 1364820
Sex: M
Age: 70
State: WA

Vax Date: 03/03/2021
Onset Date: 03/10/2021
Rec V Date: 06/01/2021
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: no known food allergies.

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

Symptoms: Patient developed muscle pain in thigh/shoulders/arms/hips, started 1 week after COVID-19 Moderna Vaccine Sought medical care 4/2/2021 Started prednisone with improvement in symptoms. Treated for polymyalgia rheumatica

Other Meds: simvastatin, aspirin, timolol eye drops, xalatan eye drops, probiotic, glucosamine-chondroitin, and PRN afrin.

Current Illness: no

ID: 1364821
Sex: F
Age: 34
State: IL

Vax Date: 03/20/2021
Onset Date: 05/04/2021
Rec V Date: 06/01/2021
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: Due to the Orilissa medication, I do not experience monthly menstruation. However, about 6 weeks after my vaccine dose from J&J, I experienced menstruation spotting for the first 2 - 3 days and then it turned into an irregular period. All-in-all, my period lasted about 8 days. Additionally, I experienced extreme cramping leading up to the irregular period due to the vaccine. No treatment was needed but I did consult with a doctor and they assured me that this is a none side effect.

Other Meds: Taltz: 80 mg/monthly Orilissa 150 mg/daily Mirena IUD

Current Illness: none

ID: 1364822
Sex: F
Age: 15
State: VT

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 06/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Client felt lightheaded and faint. Presyncopal. Had not eaten that day by mid afternoon. Given juice and a snack and felt better quickly.

Other Meds:

Current Illness:

ID: 1364823
Sex: M
Age: 76
State: NJ

Vax Date: 03/17/2021
Onset Date: 03/23/2021
Rec V Date: 06/01/2021
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: no

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

Symptoms: within days the pain and weaknesses that were reported to be common became far worse and long lasting (now in my seventh week), affecting my neck, head, shoulders and legs, especially my quads. I could not turn my head left or right, I had pain shooting up the backsides of my neck into my head, had head pain, shoulder muscles pain, and severe leg pains. I initially was told by my doctor that it would go away, and it hasn't, although not as severe now in my neck or shoulders, and I have more, but limited neck turning movement. My legs are i terrible shape and cause me a LOT of pain, for which I went a couple of weeks ago to an Urgent Care place, who said I need to go to a specialist, but recommended I try taking a NASID for two weeks first regularly, to see what happens. I am nearing the end of that period, having taken ALEVE twice a day. It has helped cut down on the pain, but the basic problems still persist. I feel like I have aged 10 or more years, although I had been healthy and vigorous before taking the 2nd Moderna shot, and I am expecting that the "doctors" do not know how to handle this. I am frightened.

Other Meds: methotrexate, but intake suspended one week before and one week after shot appt. omeprazole

Current Illness: none

ID: 1364824
Sex: F
Age: 28
State: MN

Vax Date: 01/25/2021
Onset Date: 01/28/2021
Rec V Date: 06/01/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: diffuse hives for about 4 months (end of January to end of May 2021)

Other Meds: none

Current Illness: none

ID: 1364825
Sex: F
Age: 13
State: MD

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 06/01/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: fainted right away, pale, sweaty, eyes closed and then rolling back in the head. This never happened before.

Other Meds: Claritin and multivitamin

Current Illness: no

ID: 1364826
Sex: F
Age: 52
State: MA

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 06/01/2021
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: Augmentin

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

Symptoms: Shot was Friday 28May21 12:50 pm. I awoke Saturday with a sore arm, armpit and left ribcage into breast. By night fall, it became Inflamed lymph nodes in armpit with slight swelling in left breast. This lasted throught Monday night. I also had a tender right armpit on Monday. A severe ocipital headache accompined this. I did a hot soak in the bath with epsom salt on Sunday. I took ibuprofen and excederine migrane for the headache and inflamation, along with hot and cold compresses, primaraly hot. Inflamaiton is almost gone, but still tender today, Tuesday 01Jun21. I notified my Doctor today. Side note, it is possible that I had an undiagnosed case of Covid-19 last February-March 2020.

Other Meds: ic drospireno-ne-ee3-0.03mg tab

Current Illness: none

ID: 1364827
Sex: F
Age: 83
State: TX

Vax Date: 03/25/2021
Onset Date: 03/29/2021
Rec V Date: 06/01/2021
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: Plavix, Zocor, Zetia, Renexa, Mexitin Lipator, stelestro Sulfa, Eggs

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

Symptoms: Severe fatigue, muscle aches, loss of appetite, short of breath on walking

Other Meds: Repatha, Torsemide,Eplerenone,K, Cozaar,Rhymol,Nitroglycerin Patch, Lactololose,Advair, Albuterol Ambien, Acarbose, Allopurinol Levothyroxine, Climara patch, Priloscec, Biotin Fibrr One, Cranberry,

Current Illness: no

ID: 1364828
Sex: F
Age: 27
State: TX

Vax Date: 05/28/2021
Onset Date: 05/30/2021
Rec V Date: 06/01/2021
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: Pain in extremity

Symptoms: Period is late

Other Meds: N/A

Current Illness: N/A

ID: 1364829
Sex: F
Age: 34
State: PA

Vax Date: 12/26/2020
Onset Date: 05/15/2021
Rec V Date: 06/01/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Dx loss of taste ? loss of smell ? Nasal Congestion GRAVIDE PARA: G 3 P 1 1 0 2 EDD: 08/19/2021

Other Meds: cetirizine (ZyrTEC) 10 mg tablet HYDROXYprogesterone cap,ppres, (MAKENA) 250 mg/mL oil mometasone (NASONEX) 50 mcg/actuation nasal spray prenat.vits,cal,min-iron-folic tablet

Current Illness:

ID: 1364830
Sex: F
Age: 60
State: WY

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 06/01/2021
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: N/A

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

Symptoms: Got metallic taste in the mouth following shot approximately one minute after and last 30 minutes. Also when walking out having a hard time swallowing, stopped on top of the stairs and swallowed but went to car and waiting x20 minutes before leaving/ after feeling better.

Other Meds: Several medication per patient that she does not remember them all.

Current Illness: N/A

ID: 1364831
Sex: F
Age: 54
State: MA

Vax Date: 04/28/2021
Onset Date: 04/30/2021
Rec V Date: 06/01/2021
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: Penicillin

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

Symptoms: Broken blood vessel on front of eye.

Other Meds: IC Fluoxetine HCL - 80 mg a day DHEA - 200 mg a day

Current Illness: None

ID: 1364832
Sex: M
Age: 46
State: NV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 06/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: A small hive on my back that grow into multiple hives on my back. It lasted for two or three weeks. I went to see the doctor and he gave me a steroid and cream for the hives.

Other Meds:

Current Illness:

ID: 1364833
Sex: M
Age: 48
State: TN

Vax Date: 05/28/2021
Onset Date: 05/01/2021
Rec V Date: 06/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: on 05/28/2021 patient recieved a pfizer (covid 19) vaccine lot ew0180 expiration 08/2021 which was diluted with 0.8ml of the correct diluent lot 6023824 expiration 03/23 instead of 1.8ml. patient was injected 0.5 ml by IM route to left arm at 05:12pm. patient was Informed and consulted on possible systemic or local side effects. no adverse effect reported.

Other Meds:

Current Illness:

ID: 1364834
Sex: M
Age: 15
State: VT

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 06/01/2021
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: Presyncopal - laid down on stretcher. Father states that child does this after every injection. Child had played tennis in am and come without eating or drinking. Given snack and juice. Felt better and improved quickly.

Other Meds:

Current Illness:

ID: 1364835
Sex: M
Age: 73
State: FL

Vax Date: 05/01/2021
Onset Date: 05/12/2021
Rec V Date: 06/01/2021
Hospital: Y

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: none known

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 5/12/21 04:00 awoke with nosebleed, blood blisters on face and abdomen (all new) 5/12/21 afternoon arrived to hospital with gum bleeding in addition to symptoms above. Initial platelets = 2 and q6h CBCs yielded PLTs of 0. 0, 1, and 1 in first 24h. CBC & BMP otherwise WNL. Treatment for acute idiopathic thrombocytopenia was initiated by hematology/oncology. Patient refused blood products including IVIG on religious grounds. Within 24 hours, he started IV dexamethasone, oral tranexamic acid subcutaneous romiplostim (Nplate). Bleeding controlled within first 2 days but oral ulcers remained. Strict bedrest to avoid injury. Uneventful hospital course. Bone marrow biopsy on 5/25/21.

Other Meds: allopurinol, amlodipine, aspirin, liusinopril/HCTZ, multivit

Current Illness: none known

ID: 1364836
Sex: M
Age: 31
State: NJ

Vax Date: 04/03/2021
Onset Date: 05/27/2021
Rec V Date: 06/01/2021
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: Shingles

Other Meds:

Current Illness:

ID: 1364837
Sex: M
Age: 56
State: VA

Vax Date: 05/10/2021
Onset Date: 05/17/2021
Rec V Date: 06/01/2021
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: nifedipine: headache penicillin: diarrhea Not true allergies but adverse reactions

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

Symptoms: bilateral dark circles around eyes, tooth infection and skin papular lesions.

Other Meds: duloxetine ER 20mg po qd

Current Illness: Pt had similar adverse reaction after first covid vaccine: tooth infection, bilateral dark circles around eyes and papular skin lesions.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm