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: 1371752
Sex: M
Age: 4
State: MI

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 06/03/2021
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: Varivax was administered at physician office 11 days after MMR was administered at Health Dept. Mother informed the ordering provider that MMR was administered at Health dept on 5/17/21 during the Well Check physical exam on 5/28/21. Nursing staff arrived into patient room to administer 2 vaccines (DTaP-IPV & Varivax) on 5/28/21. Mother verbally informed staff nurse that MMR was given in the past few weeks. Nurse verbally acknowledged that the MMR date was noted in the patient chart & proceeded to administered Quadracel & Varivax as was ordered by physician. Mom is aware that MMR & Varivax are both 'live' virus vaccines & called to question the validity of the most recent Varivax administration on 5/28/21 since it was not more than 30 days apart from the MMR on 5/17/21.

Other Meds:

Current Illness:

ID: 1371753
Sex: F
Age: 60
State: AZ

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: 2nd covid shot was administered 64 days after the 1st shot.

Other Meds:

Current Illness:

ID: 1371754
Sex: M
Age: 24
State: IL

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

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

Lab Data:

Allergies: none

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

Symptoms: Patient arrived on 03JUN2021 to receive 2nd dose of Pfizer. Patient reported that following 1st dose of Pfizer and completing standard observation period of 15min, he developed onset of Hives and SOB 1 hour (10am) following administration of the Pfizer vaccine at 0900. Patient reports that he did not seek medical attention and chose to wait out the symptoms. Patient reported that his SOB resolved 30min following onset without medical intervention. Patient reported that his Hives resolved 2hours following onset without medical intervention. Patient 2nd dose of Pfizer was not given due to potential adverse reaction to 1st dose.

Other Meds: none

Current Illness:

ID: 1371755
Sex: F
Age: 24
State: NJ

Vax Date: 06/01/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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: Got the 2nd dose at 5:15pm June 1st. Woke up at 2:30am with a splitting headache and moderate nausea. Both symptoms last all day. Around 6pm, I start violently vomiting regularly (about 20-30 minutes in between) until around 11pm. Couldn?t keep anything down, including water, Tylenol, and pepto to try to ease the nausea, so there was really nothing to throw up but stomach acid. Otherwise it was dry retching for hours on end. Finally fell asleep after 11pm with mild discomfort in my stomach. Woke up the following morning (today) with just some mild stomach aches and soreness with a slight headache. I could keep down water this morning for the first time in 24 hours.

Other Meds: Xanax and Wellbutrin

Current Illness:

ID: 1371756
Sex: F
Age: 85
State: WI

Vax Date: 04/14/2021
Onset Date: 05/04/2021
Rec V Date: 06/03/2021
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:

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

Symptoms: Patient presented to the ED and was subsequently hospitalized for cryptogenic stroke within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1371757
Sex: F
Age: 66
State: FL

Vax Date: 01/17/2021
Onset Date: 01/24/2021
Rec V Date: 06/03/2021
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: benadine

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

Symptoms: Exactly a week later, my arm at the injection site felt very warm. It was red and actually looked like I had a hive (raised whelp). It was 3in in diameter. It was itchy, red, and hot. I called my Dr. and he said for now to put some Benadryl cream on it. My husband had an appointment at the doctor 2 days later and I had him look at the whelp. He told me to keep using the cream and it started helping. He told me to be careful and watch for anything odd. He was afraid that after the 2nd dose I would have a worse reaction, but I didn't have any reaction at all. Within a few days it was gone and everything was fine.

Other Meds: Rosuvastatin - 1xday/10mg Telmisartan - 1xday/40mg Questran - 1xday/4mg Omeprazole - 4xweek/20mg Bentyl - 2xday/10mg Synthroid - 1xday/112mcg Potassium Chloride - 2xday/20meq (Klorcon) Triamterene/hctz - 1xday/75/50 Women's multivitam Fish

Current Illness:

ID: 1371758
Sex: M
Age: 38
State: MO

Vax Date: 01/25/2021
Onset Date: 01/29/2021
Rec V Date: 06/03/2021
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: painful bumps on the right side, under my neck. They looked like painful zits. Went to the dermatologist and was diagnosed with shingles. It has since cleared up

Other Meds: Metformin

Current Illness: none

ID: 1371759
Sex: M
Age: 58
State: TX

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: Demerol, coconut

Symptom List: Pharyngeal swelling

Symptoms: Arm really red and hard, it was swollen and hot, extremely fatigue, headache, body aches, cough

Other Meds: N/A @ time

Current Illness: None

ID: 1371760
Sex: M
Age: 61
State: NC

Vax Date: 04/01/2021
Onset Date: 04/12/2021
Rec V Date: 06/03/2021
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: sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: on 4/12/2021 found to have severe elevated BP 180/80 range which persisted despite BP medications. On May 12, 2021 found to have elevated creatinine, potassium and decreased E GFR. Duplex ultrasound on the left kidney demonstrated renal artery stenosis to 80%+. After renal parameters were improved with fluids, left kidney artery was stented (X2) with resolution of the high BP. No clear etiology for stenosis was noted (no plaque, no clot etc)

Other Meds: none

Current Illness: none

ID: 1371761
Sex: M
Age: 39
State: FL

Vax Date: 05/18/2021
Onset Date: 05/01/2021
Rec V Date: 06/03/2021
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: I feel dizzy and lightheaded. I have the feeling that my blood pressure is high and my head feels hot and booted. I feel pretty unwell and do not feel healthy as I have headache and feel like my head heavy.

Other Meds: Biktarvy

Current Illness: Mononucleosis

ID: 1371762
Sex: M
Age: 18
State: NY

Vax Date: 05/30/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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: NKDA / No food allergies

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

Symptoms: 18 yo male with no significant PMH presented to the hospital on 6/2/2021 with c/o chest pain and SOB. Per patient and his mother at bedside, he received the second dose of Pfizer vaccine on Sunday. Day after had mild headache, aches, arm pain and abdominal pain. Last night woke up with chest pain and SOB. They called his pediatrician who recommended they come to the ER for evaluation. In ED was found to have elevated troponin and EKG changes. CTA negative for PE. EKG showed ST elevations/ PR depressions inferior/ lateral leads concerning for pericarditis. Patient was seen by cardiology and diagnosis of myo/pericarditis was made. Patient was prescribed Aspirin 325 mg TID and Protonix 40 mg QD for GI prophylaxis. Patient will follow up with the cardiologist 1 week after discharge for further management and medication adjustments.

Other Meds: Not on any prescribed medications

Current Illness: No significant PMH

ID: 1371763
Sex: F
Age: 60
State: DC

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 06/03/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: pt received pfizer at outside location. Reports day after receiving vaccine had rash for 5 days. Rash: bright red indurated splotches. Located on buttocks, truck thighs, arm. Pruritic and tender. Resolved 5 days later, except for erythematous patch on left medial thigh.

Other Meds: none

Current Illness: none

ID: 1371764
Sex: F
Age: 48
State: IN

Vax Date: 05/28/2021
Onset Date: 05/30/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin,I.V contrast dye

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

Symptoms: Rash on abdomen chest and back. Face was red and hot like sunburn

Other Meds: Clonzapam

Current Illness: No

ID: 1371765
Sex: F
Age: 79
State: NY

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: IVP dye,Iodine, nitroglycerin, aspirin/NSAIDS, Prolensa, Sulfa drugs, penicillin, Shellfish, Cats, Dogs, Horses, Pollen, Dust, Mites

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

Symptoms: Adverse event: ears "clogged up" i.e. filled with fluid. A common allergic reaction with me. Lasted several hours. Going away after a few hours.

Other Meds: Amlodopine, Diovan, Latanaprost, Cosopt take daily

Current Illness: High blood pressure,

ID: 1371766
Sex: M
Age: 12
State: TX

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: N/A

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

Symptoms: Pt stated feeling nausea, mother stated pt passed out for 15 seconds then gained consciousness. P:80 BP: 126/79 O2: 99% T: 77.5 F RR:14

Other Meds: N/A

Current Illness: N/A

ID: 1371767
Sex: M
Age: 17
State: FL

Vax Date: 05/14/2021
Onset Date: 05/19/2021
Rec V Date: 06/03/2021
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: None

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

Symptoms: Patient began with substernal chest pain 8 out of 10. Patient was taken to emergency room. At the outside hospital patient was given Motrin with improvement of pain. Patient's troponin at outside was 34.5. CK-MB was 41.6. CK was 523. CBC was unremarkable. Sed rate was 15. CRP 1.46. Patient had chest x-ray that showed no acute process. EKG at outside hospital shows sinus rhythm with occasional PVC. Mild diffuse settle ST elevation and no PR depression. Upon arrival to the floor patient had no significant pain. On telemetry patient was found to have an episode of nonsustained ventricular tachycardia. Patient denies recent cough, congestion or fevers. Patient does have 2 parents and a dog at home. Of note patient got first dose of pfizer Sars-Covid-19 vaccine on April 14. Second dose of Pfizer vaccine was given on May 14. Initial troponin i-STAT presentation was 11.03. Patient also experiencing nausea and vomiting on 5/20.

Other Meds: Bactrim and Keflex

Current Illness: abscess on right groin

ID: 1371768
Sex: F
Age: 56
State: SC

Vax Date: 03/19/2021
Onset Date: 03/21/2021
Rec V Date: 06/03/2021
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: capsaicin from cayenne pepper, adhesives

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

Symptoms: I received the first vaccine Friday March 19, 2021, I woke up Sunday, March 21, 2021 with severe vertigo. It lasted over 3 1/2 weeks. I saw a neurologist, was sent to vestibular physical therapy. It was determined I was experiencing BPPV. The extremely disabling vertigo subsided but I still felt off. I received the second vaccine Friday April 16, 2021. I was very tired and nauseated. I had occasional episodes of dizziness and nausea. On Monday April 19, 2021 I continued to deal with dizziness and nausea but it was intermittent and not as severe as the first episode of vertigo. I have experienced dizziness and nausea daily since. It comes and goes. I returned to the neurologist and the vestibular physical therapist, this is not BPPV. My eyes are displaying a down-beat movement. Nothing is relieving the dizziness and nausea at this time. A CT scan has been ordered.

Other Meds: prescriptions taken daily: levothyroxine liothyronine Adderall triamterene meloxicam potassium chloride sonata vitamin D2 progesterone over the counter: flonase glucosamine hci melatonin

Current Illness: none

ID: 1371769
Sex: F
Age: 32
State: IN

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
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: Swollen & painful arm Facial swelling Joint and muscle pain/weakness Exhaustion Fever Shortness of breath Headache Nausea Confusion Feeling more depressed

Other Meds: Effexor, Buspar, Wellbutrin, lisinapril

Current Illness: None

ID: 1371770
Sex: F
Age: 35
State: CA

Vax Date: 01/07/2021
Onset Date: 01/23/2021
Rec V Date: 06/03/2021
Hospital: Y

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

Lab Data:

Allergies: hydrocodone-acetaminophen - upset stomach

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 1/8-1/10/21: fever, nausea, bodyaches, headache, fatigue 1/23/21: cough, orthopnea, bodyaches, headache, fatigue, rhinorrhea, sore throat, chest tightness and nausea 2/11/21: edema 2/16/21: hospitalized with EF 25%

Other Meds: gabapentin 100 mg daily

Current Illness: n/a

ID: 1371771
Sex: F
Age: 14
State: OR

Vax Date: 05/29/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: small dots on skin that look a bit like Petechiae. This is on her left mid-thigh. She also had very itchy nose and ears.

Other Meds: Magnesium, Vitamin D

Current Illness:

ID: 1371772
Sex: F
Age: 60
State: TX

Vax Date: 05/18/2021
Onset Date: 05/20/2021
Rec V Date: 06/03/2021
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: I have a couple allergies to medications. The class of drugs from calcium channel blockers and penicillin.

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

Symptoms: I noticed a large lump, it started as a rush that was itchy and painful. I had some joint and muscle pain. The lump is still there and painful. I did have diarreha and fatigue.

Other Meds: I take Juiceplus tablets.

Current Illness: No.

ID: 1371773
Sex: F
Age: 61
State: NJ

Vax Date: 06/01/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, Sulfa drugs, Cipro, and Iodinated Glycerol.

Symptom List: Unevaluable event

Symptoms: At around 3:00 am on June 2, 2021, I experienced chills and an extreme headache. I took Tylenol and layed down.

Other Meds: Famotidine, Aspirin, Vitamin D

Current Illness: None

ID: 1371774
Sex: F
Age: 23
State: TX

Vax Date: 06/01/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 24 hours after the first does, broke out in a rash along legs and arms.

Other Meds: Humira injections and Norgestimate and Ethinyl Estradiol tablets

Current Illness:

ID: 1371775
Sex: M
Age: 22
State: CA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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: Pt received 2nd dose Pfizer @1330 & noted to have fainting episode @1335 in observation area. Woke up with TRN support & was transferred from chair to w/c. Brought to triage area, noted w/dizziness, cool sweat & pale complexion. Pt state he has history of fainting in past. Denied CP, SOB & other abnormal sx. BP 105/57; HR 84; O2 Sat 97%) Monitored patient for 15 min & increased hydration/fluids. Pt was stable & released from vaccination site

Other Meds:

Current Illness:

ID: 1371776
Sex: F
Age: 58
State: CA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: Sea Food Allergy

Symptom List: Injection site pain, Menorrhagia

Symptoms: In approximately 4 hours after the vaccine I started to get a headache and muscle aches. In about 6-7 hours I started itching. I didn't feel good so I went to sleep early. The next morning the symptoms worsen I had a horrible headache and body aches. I was very itchy and I notice I had a rash and some hives. I called the urgent care is my primary care. I did a phone appointment with the physician in charge at urgent care. I sent photos of my Face, Chest and Arms with the rash. I was then instructed to take Benadryl which is what I had on hand. I was given a prescription antihistamine. After taking it and taking Advil for the muscle pain. The symptoms subsided. The rash and hives disappeared. I had some redness for the day and a little bit of itching. The muscle aches and headache continued for a total of 3 days. I was advised not to take the second dose. Later my doctor prescribed an epipen and said it was up to me if I wanted to take the second dose. I chose not to take the second dose.

Other Meds: Ativan, Motrin

Current Illness: none

ID: 1371777
Sex: M
Age: 75
State: CA

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 06/03/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: 75 year old male who presents with Weakness and altered mental status after second covid vaccine. Patient with advanced dementia, at baseline ambulatory , follows some direction and able to feed himself , but since second vaccine worsening weakness, stopped walking and communicating and today was too lethargic for family to wake him up, thus 911 called. Patient had similar but less severe reaction after first vaccine, and had covid disease earlier this year . Normally cared for at home by wife and son . Patient unable to give any history , awake but not coherent.

Other Meds:

Current Illness:

ID: 1371778
Sex: F
Age: 31
State: WA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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 reported

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient experienced brief LOC approximately 5 minutes after vaccination. Vital signs stable on waking, HR 64, SpO2 99%, BP WNL. Allowed to rest with cool packs to neck and chest, given snacks and juice/water to drink. Later, case reported feeling nauseated and vomited 2 times. Called EMS as she did not have anyone who could give her a ride and we did not feel safe allowing her to drive herself home.

Other Meds: unknown

Current Illness: gastroenterologic illness (nausea and vomiting overnight) reported to us after vaccination

ID: 1371779
Sex: F
Age: 31
State: CA

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: In the morning, I started feeling body aches, headaches, nauseated, very tired as well. Due date September 16, 2021

Other Meds: Calcium, Vit D , Levothyroxine

Current Illness:

ID: 1371780
Sex: M
Age: 18
State:

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: While in observation after vaccine was given, 18 y/o male had a tension of body and fainted out of chair from sitting position. Head did hit the concreate floor. Male immediately jumped up once he hit the floor. Syncopal event occurred. HE was brought back into treatment area and placed on EKG along with vitals. Normal sinus rhythm, BP and HR stable. Small laceration to right side of temporal lobe about 1cm long, minimal depth, no stiches required, bleeding stopped immediately and ice pack placed. Neurological intact, pupils equal and reacted to light. AAOX4, No nausea, vomiting or dizziness. Male is stable condition with brother. Advised to seek further eval with x-ray of skull for precaution. He was in agreement and understood.

Other Meds: Denies

Current Illness: /none

ID: 1371781
Sex: F
Age: 38
State: CA

Vax Date: 04/08/2021
Onset Date: 04/14/2021
Rec V Date: 06/03/2021
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: chrons began to flare, after years of remission, after receiving the vaccine

Other Meds: Humira, MP6,

Current Illness: none

ID: 1371782
Sex: M
Age: 0
State: VA

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: 28 year old male presented for initial dose of Phizer-BioNtech at 1100 AM on 6/3/21. Pre-assessment form was filled out and reviewed with nursing student administering the vaccine. The client stated no known allergies to medications, food, venom, or environmental elements. He also stated no allergic reactions to previous vaccines. The client also stated that he had no known health issues. After administration the patient stated he was dizzy and then immediately became unresponsive, diaphoretic, eyes rolled back, and head hyperextended. Family was present and we asked if he had any seizure history and his family declined. At this time the patient and family informed us that after vaccines in the past he does faint but didn't inform staff before this vaccine was administered. The patient remained unresponsive for 45 seconds. Then his feet were elevated and he asked to lay down. At 11:11 AM his HR was 60 and O2 was 97% on pulse oximetry. He felt hot and was still diaphoretic and felt very fatigued. Once he started feeling better we sat him back up and his HR was 89 and O2 was 99%. We gave him 2 bottles of water and crackers. He remained in our care for 45 minutes. He then waited an additional 30 minutes in the post vaccine area. His family stated they were going to drive him home and get some food. The patient is expected to return June 24, 2021 for his second dose of the Phizer vaccine. We provided additional discharge instructions

Other Meds: None

Current Illness: None

ID: 1371783
Sex: M
Age: 69
State: WI

Vax Date: 04/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: na

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

Symptoms: Patient was diagnosed with COVID-19 on 06/01/2021

Other Meds: na

Current Illness: na

ID: 1371784
Sex: M
Age: 68
State: IA

Vax Date: 02/17/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
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: n/a

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

Symptoms: Patient rec'd 3 Moderna vaccines. He rec'd his first one on 2/17/21. He then rec'd a liver transplant on 3/21/21. His doctor told him to start the Moderna series over again. He rec'd a second vaccine on 4/29/21 and a third vaccine on 6/1/21.

Other Meds: n/a

Current Illness: liver transplant

ID: 1371785
Sex: F
Age: 63
State: GA

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 06/03/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: stroke

Other Meds: Estragon cream 0.01%, multi-vitamin, Fish oil, Calcium, Vitamin C

Current Illness: None

ID: 1371786
Sex: F
Age: 47
State: NC

Vax Date: 06/01/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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: Erythema, Pruritus

Symptoms: Moderna COVID-19 Vaccine EUA pain in injection area at 5am (6/2/21) with severe headache, joint pain and chills (took 1,000mg of acetaminophen). Chills, hot flashes and cold sweats, body aches, fever, nauseas, soft stool (took 1,000mg acetaminophen). Went to bed around 1:30pm and slept. Felt better in the evening hours with a remaining slight headache and light body aches taking 500mg of acetaminophen at 5pm.

Other Meds: fish oil 1,000; Zinc 100 mg, D3 2,000Ui, Vitamin C1,000. Osteo Bi-flex

Current Illness:

ID: 1371787
Sex: M
Age: 89
State: NY

Vax Date: 02/19/2021
Onset Date: 02/26/2021
Rec V Date: 06/03/2021
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: penicillin

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

Symptoms: rhumatoid arthritis in both hands

Other Meds: simvastatan, xarelto

Current Illness: None

ID: 1371788
Sex: M
Age: 12
State: TX

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: N/A

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

Symptoms: Pt stated feeling nausea, mother stated pt passed out for 15 seconds then gained consciousness. Pt left at 2:25 feeling better P:80 BP: 126/79 O2: 99% T: 77.5 F RR: 14

Other Meds: N/A

Current Illness: N/A

ID: 1371789
Sex: M
Age: 72
State:

Vax Date: 04/07/2021
Onset Date: 04/11/2021
Rec V Date: 06/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1371790
Sex: M
Age: 32
State:

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

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

Symptoms: This was the patient's third dose on 05/27/2021. When home visiting RN gave first dose on 04/26/2021, the patient marked 'No' to 'Have you ever received a dose of COVID-19 vaccine?'. No adverse reaction was noted to patient during 15 min post-vaccine observation. Actual first dose was given on 02/05/2021.

Other Meds:

Current Illness:

ID: 1371791
Sex: F
Age: 45
State: CA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 06/03/2021
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: NO

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

Symptoms: THE MORNING AFTER MY VACCINE MY TOES AND LEGS WERE NUMB AND TINGLY AND FELT HEAVY AND FELT WEIRD WALKING. I HAVE NEVER FELT THIS FEELING BEFORE, IT WENT AWAY PRETTY MUCH AFTER A COUPLE DAYS AND THEN CAME BACK A WEEK LATER E VEN WORSE THEN BEFORE AND STAYED FOR AT LEAST 3 DAYS SO I WENT TO URGENT CARE AND THEY SAID IT WAS NOT A BLOOD CLOT AND THEY DIDNT KNOW MUCH ABOUT THE VACCINE. NOW OVER 3 WEEKS LATER I STILL HAVE NUMBNESS IN MY TOES AND LEGS. IT COMES AND GOES, SOME DAYS ARE WORSE THAN OTHERS.

Other Meds: VITAMIN C AND BIOTIN AND OVER THE COUNTER ALLERGY MED

Current Illness: NO

ID: 1371792
Sex: F
Age: 18
State: PA

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

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

Lab Data:

Allergies: no

Symptom List: Pain in extremity

Symptoms: While administering the shot, the syringe separated from the needle, preventing proper administration

Other Meds: unknown

Current Illness: none

ID: 1371793
Sex: M
Age: 35
State: NJ

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pain in left shoulder muscle has not subsided after 3 weeks of receiving shot. Pain killers do not help.

Other Meds:

Current Illness:

ID: 1371794
Sex: F
Age: 40
State: NJ

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 06/03/2021
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: Yes, medications: quetiapine, flagyl, patrum, magnesium (heart palpitations & elevated blood pressure) zpak, biaxin and sulfa penicillin (anaphylaxis)

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

Symptoms: I woke up on the 4/13/2021 with hives all over my body I did not know what it was I had no pain at injection site I felt fine I went about my business the next day I felt like there were ants crawling under my skin by Thursday the feeling of heat kept rising in my skin i would look and it would be hives the following the bloody noses began every three days i get nose bleeds. the hives has gotten worse I am now taking 6 Benadryl's a day just to avoid itching my skin off I went to medical facility where i received 2 steroid injections. The dr does not know what to do, I had to go to the hospital to cauterize the inside of my nose they could not figure out the cause. I had a stroke back in Oct and I thought maybe something was going on but the Dr said it was not associated. Ever since I received the shot I have not been the same. Right before the hives appear, it feels like the stinging burning feeling right after someone slaps your skin. This lasts for 30 seconds. My skin is dark but my skin turns red with the hives. They gave me Zofran for the nausea, they also gave me a nose pincher thing that I use when I have nosebleeds. Also, I thought it was allergies but I have congestion that have no diagnosis. It is hard to breathe. I feel like I have Covid but I do not. The doctors say I have insomnia, I have headaches due to the congestion. I also feel tired. I have dizziness that feels like I am on a merry go round that I can't get off. Walking up stairs exhausts me which is unusual because I am a physically fit individual. I have had to take a lot of days off from work due to these side effects. Taking as many Benadryl's as I do causes drowsiness and I am a single mother of 4, I cannot be drowsy.

Other Meds: Yes, blood pressure and thyroid medications

Current Illness: None

ID: 1371795
Sex: F
Age: 28
State: IL

Vax Date: 06/01/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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: Fever to 101.9 all day on 6/2/21, red painful circular rash around injection site on 6/3/21

Other Meds: Multivitamin, omega3, probiotic

Current Illness: None

ID: 1371796
Sex: F
Age: 28
State: MI

Vax Date: 05/19/2021
Onset Date: 05/01/2021
Rec V Date: 06/03/2021
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: none

Symptom List: Vomiting

Symptoms: Patient received a dose of Covid 19 vaccine that was not concentrated enough. Diluent used to mix 6 dose vial was 0.8mL rather than 1.8mL. Pt was called and checked on for adverse reactions, patient reported no symptoms other than sore arm.

Other Meds: Sertraline

Current Illness: none

ID: 1371797
Sex: M
Age: 23
State:

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

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 21 y/o male here with brother whom he witnessed having an adverse reaction. Male moved into treatment area with brother and started to have a panic attack/vasovagal response. Became lightheaded, dizzy and diaphoretic. Placed on EKG per EMS, stable normal sinus rhythm, heart rate 71, BP 120/73. Placed in supine position, AAOx4 neurologically intact. Waited about 30 minutes, stable. No complaints or any other issues at this time. Able to walk out with brother.

Other Meds: None

Current Illness: None

ID: 1371798
Sex: M
Age: 46
State: NY

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 06/03/2021
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 received both shots in the same arm. A couple days later I started feeling pain in my left elbow that has not gone away. The pain feels as if it?s in my muscles and bones. I had no prior pain, injuries or problems prior to the shot.

Other Meds:

Current Illness: None

ID: 1371799
Sex: M
Age: 23
State: DE

Vax Date: 05/18/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Acute L thalamic ischemic stroke Initial symptoms of right sided paresthesias

Other Meds: None

Current Illness: None

ID: 1371800
Sex: F
Age: 51
State:

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 06/03/2021
Hospital: Y

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 had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1371801
Sex: F
Age: 35
State: VA

Vax Date: 05/11/2021
Onset Date: 05/16/2021
Rec V Date: 06/03/2021
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: Began at night, itching at the injection site. In the morning, it was swollen, red, hard and hot lump on my upper arm. It was also quite itchy and sore. The rash was about 3 inches in diameter and circular. It was hard to the touch and very warm. Lasted about 5 days then went away.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm