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: 1391842
Sex: M
Age: 16
State: WI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 06/11/2021
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: n/a

Symptom List: Dysphagia, Epiglottitis

Symptoms: No adverse event. Vaccine was given to a minor. J&J vaccine has not yet been approved for minors. Error was realized after event happened. Parent still signed consent, in addition to EAU given that stated must be 18yrs or older and signs posted. Health Dept. did call family after event, but family did not return the voicemail.

Other Meds: n/a

Current Illness: n/a

ID: 1391843
Sex: M
Age: 46
State: MD

Vax Date: 05/06/2021
Onset Date: 05/14/2021
Rec V Date: 06/11/2021
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: Initially started of as pain in lower abdomen. Went to the family dr after about a week, since pain was still lingering. I was diagnosed with a mild case of Shingles by the Dr. The shingles started to crust by the time I went to the Dr office. No other major symptoms.

Other Meds: None

Current Illness: None

ID: 1391844
Sex: F
Age: 49
State: CA

Vax Date: 06/10/2021
Onset Date: 06/11/2021
Rec V Date: 06/11/2021
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: HA, low grade fever, muscle aches, site injection pain, palpitations. morning after receiving second vaccine. Pt treating at home. ER precautions given. Denies chest pain, SOB.

Other Meds:

Current Illness:

ID: 1391845
Sex: F
Age: 66
State: ND

Vax Date: 02/05/2021
Onset Date: 03/18/2021
Rec V Date: 06/11/2021
Hospital: Y

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

Lab Data:

Allergies: none known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient was hospitalized for 3 days. 2nd dose of vaccine was 2/26/2021***

Other Meds: unknown

Current Illness: unknown

ID: 1391846
Sex: F
Age: 75
State: IL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: SULFA

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

Symptoms: TONGE FEELING THICK 25 MG BENADRYL ORAL GIVEN DECREASED SYMPTOMS

Other Meds:

Current Illness:

ID: 1391847
Sex: M
Age: 71
State: CA

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 06/11/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: NO SYMPTOMS OR PAIN AFTER FIRST SHOT (MODERNA 027A21A 3/5/21) EXCEPT FOR SORE ARM. HOWEVER, 48 HOURS AFTER 2ND INJECTION (MODERNA 027B21A% 04/02/21), BOTH KNEES STARTING HURTING. DIFFICULTY WALKING AND SLEEPING. TO DATE 6/11/21, (69 DAYS) PAIN CONTINUES. SOME OSTEOARTHRITIS HAS BEEN DETECTED IN BOTH KNEES (6/10/21). THEORY IS THAT THE 2ND VACCINE OVERSTIMULATED IMMUNE RESPONSE AND HAS CAUSED ARTHRITIS FLARE UP IN BOTH KNEES. NOTHING HAS RELIEVED PAIN TO DATE.

Other Meds: Multi Vitamin, Low dose aspirin, Vitamin D, Olmesartan, (Benicar), Atorvastatin (Lipitor)

Current Illness: none

ID: 1391848
Sex: F
Age: 26
State: MN

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: A couple day after vaccination I started experiencing vertigo. I felt as if the room was spinning. The intensity came and went. It was continuous through February 2nd-3rd. Dr. Put me on me sea-sickness meds that I took a couple time was not helpful.

Other Meds: hormonal IUD

Current Illness: no

ID: 1391849
Sex: F
Age: 41
State: LA

Vax Date: 03/16/2021
Onset Date: 04/17/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Pharyngeal swelling

Symptoms: I developed high blood pressure about a month after the vaccine...historically, my blood pressure has been low. I have stage 3 kidney disease so having high blood pressure can lead to kidney damage and/or kidney failure. At the end of April 2021, I was prescribed and reluctant to take medicine for high blood pressure, specifically Carvedilol (Coreg). Around the same time, I began having hot flashes and premenopause symptoms. I went to my gynecologist and my bloodwork revealed that my ovaries were barely functioning and I was in perimenoupause at the age of 42 years old!! Therefore, my doctor informed me that my chances of pregnancy and birthing a child were extremely slim. This was devastating news.

Other Meds: Klonopin, Buspar, Lamictal, Oxybutin, Calcitriol, Loestrin, Levoxyl, Effexor XR, Calcium, Magnesium,

Current Illness: January 2021 - Bronchitis

ID: 1391850
Sex: M
Age: 30
State:

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/11/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt c/o of lightheadedness during his observation. He initially did not want to come to the triage area as he verbalized that he gets lightheadedness occasionally. Pt mentioned that he had a hx of passing out in the past when he was in hs. No C/P, SOB, DIB, N/V, speaks in full sentences, mentating well. NP, monitored pt. VS stable; BP 119/79, HR 60, R 18, O2 99% on RA. Pt released from vaccination site in a stable condition. ED precautions discussed. Pt expressed understanding.

Other Meds:

Current Illness:

ID: 1391851
Sex: F
Age: 55
State: TX

Vax Date: 01/23/2021
Onset Date: 02/06/2021
Rec V Date: 06/11/2021
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: I am allergic to adhesive tape allergy

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I had a sinus infection sort of like I did with the last vaccine , which consist of runny nose and congestion

Other Meds: Zinc 25 mg; Estradiol .05mg; Metformin HCL ER 750mg twice a day triamterne-HCTZ 75-50mg; Amlodipine Besylate-Valsaratan 10-160mg Rosuvastatin Chloride ER 10 mg ER; Potassium Chloride ER 10 meq Litothyronine Sodium 25 MCG; Xyzal 5mg; Synthro

Current Illness: None.

ID: 1391852
Sex: F
Age: 28
State: TX

Vax Date: 05/01/2021
Onset Date: 06/08/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: Polyethylene

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

Symptoms: Swollen itchy Rash on Left arm elbow has had for 3 days When bitten by mosquito. When scrated by my cat Large red rash appeared on both hands and wrist. Rash was there for less than a day

Other Meds: Symbicort, Clonazepam, Wellbutrin XL

Current Illness:

ID: 1391853
Sex: M
Age: 16
State: ME

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: none at this time, 06/11/21, 11:00AM

Other Meds: none

Current Illness: none

ID: 1391854
Sex: F
Age: 11
State: WI

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Client and mother lied about client's age reporting they were 12. Client was 11 so dose was given while client was ineligible.

Other Meds:

Current Illness:

ID: 1391855
Sex: F
Age: 81
State: NJ

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 06/11/2021
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: Propulsid

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

Symptoms: inflammation ot eye progressing to ma ocular degeneration in left eye. Possible radiated right breast complications

Other Meds: lisinopril 20mg.qd,asa81,faslodex I'm qmonth.,vita 1qd,,fosamax dc in

Current Illness: 0

ID: 1391856
Sex: F
Age: 45
State: FL

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/11/2021
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: Patient was given a dose that was drawn up the previous day between 5:30 - 6:00PM. Dose was administered at ~11:00AM

Other Meds: Unknown - nothing on file

Current Illness: N/A

ID: 1391857
Sex: F
Age: 19
State: PA

Vax Date: 06/07/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Chest pain with elevated high sensitivity troponin level. Echocardiogram with normal LV function. LV longitudinal strain was -19.6, which is low normal. Cardiac MRI with no Myocarditis, but pericardial fluid. Findings were consistent with pericarditis. Patient was discharged to home.

Other Meds: none

Current Illness: none

ID: 1391858
Sex: M
Age: 42
State: MA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 06/11/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: Patient presented for second vaccine -- vaccine card indicated he received Moderna for his first dose (on 4/27/21) however administering clinician documented in COLOR system he received Pfizer vaccine (for first dose). Staff on site at second visit (5/27) did some review and initially concluded that Moderna was not administered that day. and subsequently decided to administer Pfizer second dose based on COLOR system documentation. However, further review revealed that SLE had administered 7 doses of Moderna (brought by as left over from mobile vaccine unit) and likely this patient was one of the receipients of the Moderna vaccine (high likelihood considering the administering clinician was the one selected to administer both Moderna and Pfizer--safe system put in place however, it's likely he failed to select the drop down feature in Color system and change from Pfizer to moderna from a documentation perspective. Employee no longer works at facility thus unable to review event with him. Patient contacted today and informed of the likelihood that he received both Moderna and Pfizer vaccines. COLOR system contacted to change the documentation to reflect he received Moderna 1st dose--new card made and sent to patient reflecting this.

Other Meds:

Current Illness:

ID: 1391859
Sex: F
Age: 30
State:

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt reported hot flashes that started 24 hours after receiving second dose and continued for 24 hours.

Other Meds:

Current Illness:

ID: 1391860
Sex: F
Age: 88
State: MI

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

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

Lab Data:

Allergies: Aleve [Naproxen Sodium] Hives ? Ivp Dye [Iodinated Diagnostic Agents] Hives ? Nsaids Hives ? Vioxx Hives and Other

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient got her vaccine then the next day developed weakness and knee pain. Later the daughter admitted that she had had increased weaknesss and confusion for a few weeks. She was seen in her PCP's office and diagnosed with a UTI and gout. The x-ray of her knee later showed a fracture of her proximal tibia. A few days later she was brought to the emergency department with a wide complex tachycardia and acute coronary syndrome. She had an 11 day stay complicated with congestive heart failure, hypoxia, aspiration pneumonia and metabolic encpehalopathy. Her daughter thinks that this was brought on by the vaccine, and asked us to fill out a vaers.

Other Meds: betamethasone dipropionate (DIPROSONE) 0.05 % EXTERNAL Lotion apply to affected area twice daily. Taking LORazepam (ATIVAN) 1 MG PO Tab TAKE 1 TABLET BY MOUTH TWICE A DAY Taking

Current Illness:

ID: 1391861
Sex: M
Age: 89
State: GA

Vax Date: 01/25/2021
Onset Date: 06/05/2021
Rec V Date: 06/11/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient hospitalized after testing positive for COVID-19. Patient is fully vaccinated.

Other Meds:

Current Illness:

ID: 1391862
Sex: F
Age: 24
State: KY

Vax Date: 02/19/2021
Onset Date: 04/02/2021
Rec V Date: 06/11/2021
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: I woke up that morning before work and left eye was swollen and hurting really bad.

Other Meds: Celexa 20mg

Current Illness: None

ID: 1391863
Sex: F
Age: 17
State:

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Severe Headache, fever, lethargic, dry throat.

Other Meds:

Current Illness:

Date Died: 05/13/2021

ID: 1391864
Sex: M
Age: 48
State: MN

Vax Date: 04/23/2021
Onset Date: 05/13/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: About 14 days after the first vaccine dose ( Pfizer) patient presented to the ER with severe chest pain. He was sent home after labs, EKG and CT chest were reported as normal. He was told that he had a hiatal hernia. One week later he was found by his wife expired in his bedroom late morning. Patient had no medical problems such as hypertension and never smoked. He was very active and played sports such as pickle ball.

Other Meds: none

Current Illness: none

ID: 1391865
Sex: F
Age: 64
State: FL

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 06/11/2021
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: Beef, green leafy vegetables

Symptom List: Injection site pain, Pain

Symptoms: Within hours of first dose, low grade headache that never went away. 2 1/2 weeks after first injection a severe migraine headache that lasted 24 hours. I rarely have regular headaches. And never had a migraine headache in my life. Headaches continued. 2nd Dose within hours severe headache and fever of 100 + degrees, chills aches & pains. Daily headaches continued. 2 1/2 weeks after 2nd dose, another severe migraine lasting 24 hours. Headaches & intermittent incapacitating migraines have continued to present. Loss of appetite and nausea from pain has resulted in a loss of 5 pounds from 115 to 105 in last 3 weeks.

Other Meds: OTC Claritin, OTC Zyrtec

Current Illness: None

ID: 1391866
Sex: F
Age: 74
State: WI

Vax Date: 02/01/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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

Symptom List: Injection site pain, Menorrhagia

Symptoms: Reporting as patient has completed Moderna vaccine series and was admitted to the hospital with diagnosis of "pneumonia due to COVID-19 virus"

Other Meds:

Current Illness: Fever, recent history of aspiration pneumonia

ID: 1391867
Sex: M
Age: 26
State: NY

Vax Date: 05/24/2021
Onset Date: 05/27/2021
Rec V Date: 06/11/2021
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: NKA

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

Symptoms: Chest pain upon inspiration and slight light headedness when doing physical activity

Other Meds: None

Current Illness: None

ID: 1391868
Sex: M
Age: 53
State: VA

Vax Date: 03/22/2021
Onset Date: 04/01/2021
Rec V Date: 06/11/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Random itching in various distinct places with flare ups of hives that get bad if scratched then last several hours then disappear, unless breaking the skin then they persist looking like bug bites, but they are not. dousing with cold water sometimes breaks the cycle. First the left wrist on top, then right ankle, then belt line or side of abdomen, then right knuckles, then under arm, then left forearm, left leg, right forearm, etc

Other Meds: Vitamin B12,, vitamin C, vitamin D, omega 3

Current Illness: N/A

ID: 1391869
Sex: F
Age: 53
State:

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/11/2021
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: local swelling, redness, itchiness, warmth of L deltoid injection site starting same day of injection (6/8). 3 days later (6/11) pt reports reaction as getting smaller and less itchy over time. pt reported resolution of other side effects such as fever, body aches which also started day of injection (6/8). denies chest pain, SOB, dyspnea, dysphagia, or other signs of systemic allergic reactions. site assessed for signs of infection by nursing and PCP. advised to take OTC benadryl and/or tylenol and continue to ice

Other Meds:

Current Illness:

ID: 1391870
Sex: F
Age: 27
State: MN

Vax Date: 01/19/2021
Onset Date: 03/10/2021
Rec V Date: 06/11/2021
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: cats

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

Symptoms: It started off with a small patch on my back. That I thought it was ring warms. Then it slowly got bigger and was itchy. Then there were 3 or 4 more patches near the other patch. Then about 2 weeks later, my whole back was covered with these patches. I used ring warm medicine and it was not helping. I went to the doctor about it. She diagnosed me with Pityriasis.

Other Meds: birth control, 1xday

Current Illness:

ID: 1391871
Sex: M
Age: 91
State: NJ

Vax Date: 01/16/2021
Onset Date: 02/06/2021
Rec V Date: 06/11/2021
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: Nausea

Symptoms: 91yrs old male was admitted to the hospital for dyspnea and lower extremity edema. Patient was found to have acute on chronic systolic heart failure. Patient was treated with intravenous diuresis. Patient tested positive for Covid-19 pneumonia and was placed on isolation. He was transfer to rehabilitation center for rehab.

Other Meds:

Current Illness:

ID: 1391872
Sex: F
Age: 79
State: AZ

Vax Date: 05/05/2021
Onset Date: 05/08/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: headache which started 3 days after and has increased in severity, associated with increase in blood pressure

Other Meds: isorsobide, torsemide, lisinopril, metoprolol, metformin, hydrochlorothiazide

Current Illness: none

ID: 1391873
Sex: F
Age: 12
State: IN

Vax Date: 06/05/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever and gastrointestinal symptoms started on Wednesday. Gastrointestinal symptoms include strong cramps nausea and diarrhea. These are worsening to the present date.

Other Meds:

Current Illness:

ID: 1391874
Sex: M
Age: 50
State: FL

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/11/2021
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: Unknown

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

Symptoms: Patient was given a vial that had been drawn up previous night (5:30-6:00PM) at approx. 11:00 AM the following day.

Other Meds: Sulfameth/Trimethorprim 800/160mg tb

Current Illness: N/A

ID: 1391875
Sex: F
Age: 46
State: AL

Vax Date: 01/12/2021
Onset Date: 02/01/2021
Rec V Date: 06/11/2021
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: Keflex

Symptom List: Tremor

Symptoms: Symptoms after 2nd shot done 2/9 : of fatigue , increased pain to joints and intense (femur)bone pain x 2 days . Fevers started 2/15/21. Bronchitis diagnosed 2/17and treated with zpack Fevers continue from 100.3-102.1 documented since this 2/15/21 Average at least 2-4 days per week Overall Increased pain /fatigue - worse than prior to shots

Other Meds: Methotrexate,folic acid, Plaquenil,Lexapro Avinza,Rinvoq,Telmisartin

Current Illness: No acute illness at time of shots 1/12 or 2/9

ID: 1391876
Sex: F
Age: 21
State: IN

Vax Date: 06/01/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
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: Chills starting about 7 hours after injection of vaccine until the end of next day, fever, body ache, injected arm sore, pain behind eyes

Other Meds:

Current Illness:

ID: 1391894
Sex: F
Age: 17
State: WI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 06/11/2021
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: No adverse event. Client was given J&J at 17 yrs, when J&J was not approved for 17 yrs at the time. Despite EAU information being given and signs posted that it was for ages 18 years and older. PHN did attempt to contact patient via phone and left message, but did not receive a phone call back.

Other Meds: n/a

Current Illness: n/a

ID: 1391895
Sex: F
Age: 55
State: IL

Vax Date: 05/16/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Allergen Reactions ? Codeine ? Lisinopril Cough ? Losartan Cough ? Lovenox [Enoxaparin] ? Nsaids ? Penicillins

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

Symptoms: 55 y.o. female with a lifetime history of insulin-dependent diabetes that presented to the emergency room just a few hours after she started having a left-sided neurologic deficit. The patient reports that she had a stroke several years ago but for some reason was told to not take aspirin and was not started on Plavix. Irregardless, the patient came in with a very significant left-sided neurologic deficit. She states that she could not speak, she had left facial droop, left arm weakness, and left leg weakness. She initially had an NIH stroke scale in the emergency room of 11. Initial CT of the head showed nothing acute. Consultation with neurology was obtained and the patient was sent for a CTA of the head and neck. No large vessel occlusion was identified and shortly after this the patient's NIH stroke scale reduced to 2 and shortly after this the neurologic deficit completely resolved and stroke scale return to 0. At that point, the patient was diagnosed with a TIA and admitted to the hospital for observation. This morning she states she feels fine. She has no neurologic deficit whatsoever. She denies any sensory or strength deficits this morning at all. The patient sugars have been a little bit high, but otherwise she had an uneventful evening

Other Meds: Current Outpatient Medications: ? buPROPion (WELLBUTRIN) 75 MG tablet, Take 1 tablet (75 mg) by mouth 2 times daily, Disp: 60 tablet, Rfl: 5 ? furosemide (LASIX) 40 MG tablet, TAKE 1 & 1/2 (ONE & ONE-HALF) TABLETS BY MOUTH TWICE DAILY AS

Current Illness:

ID: 1391896
Sex: F
Age: 60
State: OR

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 06/11/2021
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: Sulfa, shellfish, seasonal allergies, cats

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 4/14/21 12 hours post shot extreme dyspnea lasting 7 weeks now. Dizzy light headed.Emergency room visit 4/17/21 blood work indicated increase troponin and potential blood clot in lung. Heart attack 4- 27-21. Second ER visit 5/8/21 which showed additional increase in troponin levels. Second heart attack on 5/22/21. Intense back pain between shoulder blades over shoulders and on chest. Additional squeezing in chest and neck pain.

Other Meds: None

Current Illness: None

ID: 1391897
Sex: F
Age: 38
State: TX

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 06/11/2021
Hospital: Y

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: I called off work on 01/08/2021 and I woke up that morning around 2 am with a headache and fever of 102.7. The headaches never went away and they were very persistent and pulsating. I made an appointment with my PCP on 01/18/2021 at 11 AM and at this point I was getting very dizzy and nauseous. I made another appointment with my psych Doctor to make sure it wasn't an interaction with the medication I was taking. He said it shouldn't cause interaction. PCP wanted me to see Neurology and schedule for an MRI. I continued to work and was taking Motrin and Tylenol. The Headaches were still persistent. By February I seen an Opthomologist because I was having blurred vision and still had pulsating on the left side of head. He said I had increased intracranial pressure and he asked about any history of glaucoma. He had me on these eye drops to decrease eye pressure on 02/08/2021. I had a F/U on 02/16/2021 with my other psych Doctor because I still felt the same. I had another follow up with PCP on 02/23/2021. I seen the neurologist on 03/12/2021 and the the pressure was getting worse and worse by this point and people were noticing at work that I was not myself. I had vision changes and blurred vision. The Neurologist stated that he does believe the vaccine plays apart in this. He said I have intracranial hypertension and would need spinal tap. On the 02/13/2021 I was at work I threw up because I was so dizzy. I went to ER and they could not do a spinal tap so they ended up doing a spinal tap on the 02/14/2021 and they removed fluid and I had instant relief from that. I was discharged on 02/17/2021and pretty much once they removed that fluid I felt better. I still have subtle headaches but something did happen to me where I had increased intracranial pressure. I had a follow-up on the 02/23/2021 and follow up 03/31/2021 with Dr. and things were starting to resolve and get better. Neuro has me on medication for fluid on brain (diuretic) and Topamax for the headaches. MRI was done on 03/01/2021.

Other Meds: Viibryd 20 mg, Protanix 40 mg.

Current Illness: None.

ID: 1391898
Sex: F
Age: 27
State:

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/11/2021
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:

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

Symptoms: Pt w/ hx of Asthma. Pt c/o left sided headache and dizziness. BP 128/73, HR 72, RR 18. Pt given Tylenol 500mg PO. Pt stable and released from the vaccination site.

Other Meds:

Current Illness:

ID: 1391899
Sex: M
Age: 55
State: NC

Vax Date: 06/06/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
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: The patient started experiencing joint pain in both of his knees starting on 6/9. The pain is worse in the morning. They have tried taking acetaminophen and ibuprofen with no significant relief. Recommended trying diclofenac gel and rest, ice, and elevation. If no significant relief in a few days, recommended going to urgent care as patient does not have a primary doctor.

Other Meds: n/a

Current Illness: n/a

ID: 1391900
Sex: F
Age: 60
State: OR

Vax Date: 05/05/2021
Onset Date: 05/08/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Day one thru three pain at injection site and swelling. Painful arm and shoulder and could not sleep on that side for two nights. After pain and swelling subsided, had heart palpitations, and some shortness of breath on evening of night four. Event lasted about 15 minutes. Was sitting up in chair so stayed put until breathing normalized and palpitations diminished and heartbeat normalized. No history of heart palpitations before.

Other Meds:

Current Illness:

ID: 1391901
Sex: F
Age: 52
State: OH

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 06/11/2021
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: Sulfa

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

Symptoms: I had the vaccine and about 12 hours later I woke up with shacking chills, fatigue, body aches and runny nose. About 10 days after I was cleaning the kitchen and I was feeling okay but that night I woke up with shortness of breath and I had an asthma attack, I called my primary doctor and she said if I was not getting better to go to the ER. She told me to do 3 nebulizers over an hour and I felt better and she ordered prednisone and my husband picked it the next day.

Other Meds: Zyrtec, Accolade Asthma, Cortisone 45 mg, Oral contraceptive, Inhalers Symbicort, Vitamin D, fish oil, multi vitamin, Herbal supplement antioxidant vitamin

Current Illness: None

ID: 1391902
Sex: F
Age: 39
State: KY

Vax Date: 12/01/2020
Onset Date: 02/16/2021
Rec V Date: 06/11/2021
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: PCN, Bactrim

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

Symptoms: Swollen lymph node in the arm that injection was given. Experiencing extreme fatigue about 6 weeks after vaccination.

Other Meds: Levothyroxine Calcium

Current Illness: None

ID: 1391903
Sex: F
Age: 13
State: NC

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/11/2021
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: RECIEVED 2ND DOSE OF VACCINE AND THEN HAD A FAINTING SPELL A FEW MINUTES LATER DURING THE OBSERVATION WINDOW. NO HISTORY OF PREVIOUS REACTION, NO SOB, NO RASH/HIVES, EMS CHECKED HER OUT AND BP WAS FINE. SAID FAINTING WAS PROBABLY FROM ANXIETY AND NERVOUSNESS. NO ISSUES WITH 1ST DOSE OF COVID

Other Meds:

Current Illness:

ID: 1391904
Sex: F
Age: 35
State: NY

Vax Date: 01/19/2021
Onset Date: 01/29/2021
Rec V Date: 06/11/2021
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: no

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: After the shot, the second day my arm was sore. That got better but after 10-12, I couldn't hold water in my mouth. After a few hours in the evening it got worse. I woke up the next morning thinking something was wrong with my teeth, I went to the dentist but nothing was wrong according to dentist. I then went to the ER and stayed overnight while they ran tests. I did not have a stroke, they said it was bells palsy. I took medication for the nerve pain. I was doing psychical therapy and acupuncture to treat bells palsy.

Other Meds:

Current Illness: seasonal allergies

ID: 1391905
Sex: F
Age: 36
State: NH

Vax Date: 05/25/2021
Onset Date: 05/28/2021
Rec V Date: 06/11/2021
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: Started with mild muscle soreness in rib cage area, then two bumps appeared. The bumps formed small blisters on top. A third bump appeared with some tiredness. Suspected shingles, but knew it was uncommon for my age. Went to Urgent Care on Memorial Day and shingles was confirmed. Started antiviral and other supportive supplements. The two days after diagnosis felt unwell, very tired, but it resolved rather quickly. It's been about two weeks since I first noticed the bumps and its mostly resolved aside from the scabs from the bumps.

Other Meds: Progesterone cream, digestive enzyme, iron supplement, lithium orotate, 5htp, probiotic, vitamin D, phosphatidylserine, liposomal neurocalm,

Current Illness: none

ID: 1391906
Sex: M
Age: 31
State: NY

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 06/11/2021
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: Mold Sulfa drugs Limital Compazine Geodion Seroquel Zyprexa Amitriptyline Aimovig Emgality Albutrol Ceclor

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Dose 1 - I had increased body wide nerve pain. At that time, they thought I had fibromyalgia and the shot caused a flare up. Dose 2 - I had very severe body wide nerve pain, vertigo, terrible migraines, vision issues, confusion, short term memory loss and grasping for words and increased muscle weakness. It kind of mirrored a stroke. The pain was a 10/10. It was basically like all of my symptoms were getting progressively worse over the weeks. It's gotten better, but the symptoms are definitely still there. My neurologist increased the dosage of a few of my meds. At this time, they're basically managing my symptoms, but we do not have a definite source for the issue. However, the vaccine definitely caused the flare up because nothing else in my life has changed.

Other Meds: Topamax Vitamin B2 Reglan Irbesartan Dicyclomine Montelukast Symbicort Eletriptan (abortive) Baclofen Gabapentin Omeprazole

Current Illness: Undiagnosed, but currently being treated for a neurological condition Migraines

ID: 1391907
Sex: F
Age: 62
State: OR

Vax Date: 05/01/2021
Onset Date: 05/22/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: Cipro, sulfa drugs, avocado. Cat dander. Grass pollens.

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

Symptoms: Chronic nonstop dizziness, burning head, brain fog, inability to walk any distance without feeling of drugged drunkenness. Off-balance. Onset three weeks after second vaccine, has been steady 24/7 since then.

Other Meds: Levothyroxine, liothyronine. Estradiol cream. Progesterone cream. Magnesium citrate, vitamin D, coenzymated B-complex, trace minerals. Flonase.

Current Illness: Vestibular migraine.

ID: 1391908
Sex: F
Age: 15
State:

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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:

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

Symptoms: Called to where 16 yr old pt sat in observation area with her father. Pt was alert but pale. According to Pt father Pt lost consciousness for a second in chair. PT states she's afraid of needles but she did not faint from first dose of COVID-19 vaccine. PT states she felt lightheaded but did not mention any other symptom. PT father states PT does not have any medical history.Pt states she only had a very small breakfast and no lunch. Assisted PT lay on yoga mat with legs elevated. First set of vital signs were taken at 1:40: BP 109/74; P 72; Res 18; O2 Sat 100%. Second set of VS taken at 1:50 with BP 104/65, P67; Res 18 and O2 Sat 100%. PT states she felt better; her skin color turned normal. Assisted PT sitting up on the yoga mat for a few minutes then back to her chair. Water and snack provided to PT. However, around 2PM PT felt lightheaded again while in chair, she lay herself down on the ground. At this time she felt periodic nausea. Her VS at 2PM BP 108/64; P67;resp 18. Her skin color was normal. Cold towel was placed on forehead with some comfort. 7-UP given to relieve nausea. PT rested on the ground until 2:30 then went back to her chair. Her symptom finally subsided and she left observation area with her father around 2:45PM.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm