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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1392520
Sex: F
Age: 64
State: OH

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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: sodium gluconate starch, glycate starch, composene, hydro valine, propanool, lisinopril, atenelol, wellbutrin,

Symptom List: Dysphagia, Epiglottitis

Symptoms: rapid heart rate, tongue swelling, severe headache, stomach issues, tired, bad taste in mouth, dry mouth, throat swelling, brain fog, diarrhea

Other Meds: Synthroid, omeprazole, truliance, losartan, d2, amlodipine, viville patch, b12, biotin, vitamin d3, thiamin, folic acid, probiotic, Mylanta, miralax

Current Illness:

ID: 1392521
Sex: F
Age: 60
State: OR

Vax Date: 05/05/2021
Onset Date: 05/12/2021
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: Augmentin, PCN, Macrobid, Sulfa, Cipro, Vybrid, Brintellix Mold, dust mites, blue cheese

Symptom List: Anxiety, Dyspnoea

Symptoms: Beginning 12 May 2021, I have had a migraine with aura every day.

Other Meds: Losartan , Metoprolol, Amlodipine, Januvia, Lamictal, Zyrtec Vitamin C, Multivitamin, elderberry gummies, calcium, magnesium, and zinc

Current Illness: None

ID: 1392522
Sex: F
Age: 30
State: NY

Vax Date: 01/16/2021
Onset Date: 06/03/2021
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: No

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

Symptoms: I contracted COVID-19 and started having symptoms on June 3rd. I have a fever, no smell and taste, congestion, headache, body aches.

Other Meds: I was not taking Lexapro at the time of vaccination but I now take 5mg daily. I have Kyleena IUD.

Current Illness: No

ID: 1392523
Sex: F
Age: 63
State: OH

Vax Date: 05/28/2021
Onset Date: 05/29/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: PATIENT RECEIVED DOSE #2 OF MODERNA VACCINE ON 5/28/21 (SECOND DOSE WAS SCHEDULED FOR 6/3/21). PATIENT RECEIVED SECOND DOSE 22 DAYS AFTER FIRST DOSE (APPROPRIATE WINDOW IS 24 TO 28 DAYS AFTER FIRST DOSE), PATIENT BEGAN HAVING SYMPTOMS DAY FOLLOWING VACCINE, LOW FEVER, ONGOING HEADACHE, EXTREME VERTIGO, UNABLE TO STAND ON HER FEET FOR LONG PERIODS, UNLIKE HERSELF, OUT OF IT. PATIENT WENT TO PCP ON 6/8/21 AND TRANSMITTED VIA SQUAD TO HOSPITAL WHERE SHE IS STILL CURRENTLY INPATIENT. ALL TESTS/LABWORK/SCANS HAVE COME BACK NEGATIVE FOR PROBABLE CAUSES. MEDICAL TEAM CANNOT DETERMINE IF THIS IS FROM THE VACCINE OR FROM THE TIMING OF THE VACCINE, BUT CANNOT RULE IT OUT EITHER.

Other Meds:

Current Illness:

ID: 1392524
Sex: M
Age: 74
State: IL

Vax Date: 05/26/2021
Onset Date: 05/26/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Dose was given too soon. 1st dose of Moderna given 5/5/2021

Other Meds:

Current Illness: osteomyelitis of vertebra, thoracic region primary, Spinal stenosis, cervicothoracic region, bening prostatic hyerplasia with lower urinary tract symptoms, Difficulty in walking, Contat with and suspected exporsure to other vial communicable diseases, Type 2 diabetes, Intraspinal abcess and granuloma, Essential Hypertension.

ID: 1392525
Sex: F
Age: 82
State: AZ

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: flu vaccine (got Bells Palsey 6 yrs ago and do not take vaccine any more); codeine, adhestiove tape, hydralazine, silver cream , surgiocal super glue; augmentin, anesthesia causes urie eretention and extreme nausea and vomioting need to nmix fenegrin with anesthesia.

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

Symptoms: Sharp shooting pain in right ear Noticed mfufled like sound reception in right ear (got second vaccionation shot in right arm) This has lasted since 3/11/2021 and finally saw ENT and had CT scan to see if neuroma and/or tumor in brain or inner ear NEGATIVE FOR BOTH Had hearing test and right ear has severe hearing loss.

Other Meds: amlodipine besylate 5 mg.;toprol xl 25 mg; nexium 20 mg; levothyroxine .88 mg; baby aspirin 81 mg; premarin cream; supplements: probiotioc; cranberry extract; nattokinese 2000 blood thinner;, vitamin d-3 2000, magnesium 400 mg; vitamin b c

Current Illness: Gerd (reflux) zenkers diverculum; umbilical hernia, diverticulosis, gallstones, pacmaker and nodal abalation aug. 2008 for afib; leaky heart valves moderate but biscuspid mod to severe leakage

ID: 1392526
Sex: F
Age: 41
State: GA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt vaccinated at 10:18 am Moderna, 2nd dose. At 10:40 pt reported her tongue tingling. No distress noted. VS BP 134/76 P 73 O2 sat 99%. Upon interview, pt reported same symptoms later in the afternoon after receiving her 1ST dose of Moderna vaccine on 03/11/21 and that her tongue felt burnt when drinking water? Pt given benadryl 25 mg chewable tab at 10:42 am. Pt remained on site another 30 minutes. No worsening of symptoms and reported improvement. Pt instructed to continue benadryl 25 mg po bid or seek emergency care if worsening. Pt was discharged to home via her own car at 11:15 am. Called the next day to check on pt, no answer. F/U 04/19/21 pt reported tingling went away, only had body aches.

Other Meds: none

Current Illness: none

ID: 1392527
Sex: F
Age:
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: LA

Lab Data:

Allergies: Caregiver noted pt had a hx of seizure post Tdap in 1970's.

Symptom List: Pharyngeal swelling

Symptoms: Caregiver noted pt had a hx of seizure post Tdap in 1970's. Pt's caregiver noticed redness and swelling below pt's vaccination site on R arm at 1630 PM (12mins post vaccination). Pt transferred to the triage area. NP assessed. VS taken: BP 113/82, HR 92, SpO2 100% on RA, and resp 16. No signs of distress noted. Ice pack applied to R arm. VS retaken at 1654 PM BP 109/81, HR 63, SpO2 100% on RA. Redness and swelling improved No SOB or distress. Pt discharged from vaccination clinic in stable condition w/ redness and swelling improved. ED precautions discussed. Pt and caregiver expressed understanding.

Other Meds:

Current Illness:

ID: 1392528
Sex: F
Age: 31
State: MO

Vax Date: 01/27/2021
Onset Date: 01/29/2021
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: Aspirin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 01/29/2021- Toward the end of the day I got chills and felt feverish but had no fever, got home, around 4:30pm and my fever spiked to 102.0 scratchy throat, 1/30/2021, my throat was very sore, at the end of the day I had white patches, went to ER and I had strep.

Other Meds: Omeprazole PRN Multivitamin Vitamin D Fish oil Zyrtec

Current Illness: None

ID: 1392529
Sex: F
Age: 34
State:

Vax Date: 04/30/2021
Onset Date: 05/02/2021
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: Salmon, mackerel, sardines, anchovies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Migraine with aura. Took nurtec ODT and zofran 8mg for it. Slept. Following day dizziness then feeling off and sensitive to light for weeks. Just now starting to feel a tiny bit better.

Other Meds: OB Petite Complete

Current Illness:

ID: 1392530
Sex: M
Age: 57
State: MD

Vax Date: 06/09/2021
Onset Date: 06/09/2021
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:

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

Symptoms: fevers, chills, nausea, vomiting, abdominal pain, diarrhea 1 hour after starting medications severe enough to be admitted to the hospital.

Other Meds:

Current Illness:

ID: 1392531
Sex: F
Age: 86
State: PA

Vax Date: 04/19/2021
Onset Date: 05/24/2021
Rec V Date: 06/11/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Got second dose of Moderna 4/19/21. Was having increasing shortness of breath since 5/24/21. Admitted 6/8. Increasing lower extremity edema. Is obese. Coughing up phlegm. No fever/chills/chest pain/abdominal pain. COVID negative. Found to have a saddle pulmonary embolism and DVTs in the lower extremities . Appears unprovoked. Started on Eliquis. Still currently admitted 6/11

Other Meds: Amlodipine, atorvastatin, clopidogrel, labetalol, losartan, omeprazole

Current Illness: None

ID: 1392532
Sex: F
Age: 54
State: MO

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: I have a bad reaction to Biaxin. Other than that, I do not have any allergies.

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

Symptoms: Immediately after receiving the injection, I tasted a metallic taste in my mouth, that ended up lasting 8 weeks. It was really bad for the first 2 weeks and started to slowly go away. Also, within a couple of hours after receiving the vaccine, I started to have itchiness all over my body and red splotches were on my lower extremities. They were on my arms and legs, hands and feet. I was afraid to go to sleep because I was afraid of going into anaphylactic shock. I called my doctor and he told me that I was okay as long as I did not have swelling in my throat, tongue and lips. About 3-5 days later, the splotches and itchiness subsided. I never had any swelling.

Other Meds: I was taking Eliquis, Citalopram, Zyrtec, Flonase, a multivitamin and acetaminophen.

Current Illness: I did not have any other illnesses.

ID: 1392533
Sex: F
Age: 56
State: WI

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Dobutamine

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

Symptoms: Evening after the vaccine: "Last night, out of nowhere, I instantly got a severe headache, muscle aches, felt nauseous, had stomach pain and eventually ended up vomiting. I went and laid down because my body was shaking so much I couldn't control myself. "

Other Meds: Lantus 100 UNIT/ML vial solution lisinopril (ZESTRIL) 5 MG tablet chlorthalidone (HYGROTEN) 50 MG tablet atorvastatin (LIPITOR) 20 MG tablet traZODone (DESYREL) 50 MG tablet aspirin 81 MG EC tablet phenazopyridine (Pyridium) 200 MG tablet f

Current Illness: No acute illnesses

ID: 1392534
Sex: M
Age: 47
State: SC

Vax Date: 05/09/2021
Onset Date: 05/17/2021
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:

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

Symptoms: DVT, pulmonary embolism

Other Meds:

Current Illness:

ID: 1392535
Sex: F
Age: 58
State: CA

Vax Date: 05/26/2021
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: None known

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

Symptoms: Itching and swelling and warmth of mid-triceps area on injected arm and redness and slight swelling of left lower eyelid.

Other Meds: Cholecalciferol Multivitamin

Current Illness: None

ID: 1392536
Sex: M
Age: 12
State: FL

Vax Date: 05/15/2021
Onset Date: 05/16/2021
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: None

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

Symptoms: Swollen lymph node under left arm. This remained until he got his second shot. He also had a strong response to the first shot with fever and headache. He tested positive for covid in January of 2021.

Other Meds: Multi vitamin gummy for kids. Occasional melatonin. Allergy pills (Claritin)

Current Illness: None

ID: 1392537
Sex: F
Age: 49
State: OK

Vax Date: 01/04/2021
Onset Date: 01/11/2021
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: I started having a racing heart that lasted for days at a time . I went to my heart doctor 2 weeks after symptoms started. she put me on a heart monitor for 30 days. I briefly mentioned having had the covid vaccination at my appt, but she said it didnt have anything to do with it. I was one of the first in my community to have gotten the shot. So the racing and palpations lasted on and off for 2+ months. They have since subsided. We never did any type of ultrasound at the time because we didnt know about the correlation between shot and myocarditis. my halter monitor did show episodes of tachycardia and bradycardia.

Other Meds: claritin

Current Illness: none

ID: 1392538
Sex: F
Age: 50
State: TX

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

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

Lab Data:

Allergies: n/a

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: CHILLS, ACHES, HEADACHE FOR 2 FULL DAYS. SLIGHT HEADACHE FOR 5 DAYS

Other Meds: n/a

Current Illness: n/a

ID: 1392539
Sex: M
Age: 11
State: PA

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

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

Lab Data:

Allergies: none

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

Symptoms: Patient was 11 years and 9 months years old at time of vaccination. Must be 12+ for Pfizer

Other Meds: none known

Current Illness: none known

ID: 1392540
Sex: F
Age: 22
State: OH

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: unknown

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

Symptoms: Patient experienced a rash at the injection site. Her mom told us this after the second dose was already given.

Other Meds: unknown

Current Illness: unknown

ID: 1392541
Sex: F
Age: 34
State: OR

Vax Date: 01/13/2021
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: n/a

Symptom List: Unevaluable event

Symptoms: Covid-19 Positive on 6/10/2021

Other Meds: n/a

Current Illness: n/a

ID: 1392542
Sex: F
Age: 59
State: VA

Vax Date: 04/05/2021
Onset Date: 04/27/2021
Rec V Date: 06/11/2021
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: Clindamycin Codeine Penicillin Shellfish

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

Symptoms: Pericarditis: Chest pain, inflammatory markers were elevated. Improved with Colchicine

Other Meds: Lisinopril 20 mg daily Calcium Cinnamon FIsh Oil Ibuprofen Loratadine 10 mg tablet

Current Illness: none

ID: 1392543
Sex: M
Age: 13
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Pain

Symptoms: Patient received vaccine and stayed in pharmacy building for 15 minutes. Around that time patient's parents came back up to pharmacy to notify staff that he had broken out into a rash in the back and his hands felt swollen. I asked if he had any trouble breathing and parents stated no. We followed the Adverse Event Action Plan. We called 911. Patient's parents then stated son is starting to have some breathing issue. I came out with EpiPen and was going to administer when mom stated son's symptoms has resolved greatly and she did not want me to administer EpiPen. Shortly after EMS arrived and evaluated patient and took him to hospital for observation.

Other Meds: N/A

Current Illness: N/A

ID: 1392544
Sex: F
Age: 65
State: SC

Vax Date: 04/12/2021
Onset Date: 06/01/2021
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:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Beginning June 1st I have had vertigo every morning, it is going on 2 weeks now. I have no other symptoms that would lead to believe I have an infection of any kind.

Other Meds:

Current Illness:

ID: 1392545
Sex: M
Age: 0
State: ID

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None.

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

Symptoms: Patient developed petechial rash on neck around 6pm after receiving the vaccines. Patient had a lab draw and mom will continue to monitor.

Other Meds: Over-the-counter eczema cream.

Current Illness: None.

ID: 1392546
Sex: F
Age: 16
State: WA

Vax Date: 05/08/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 16 year old patient received Moderna vaccine due to facility error, Moderna not currently covered under EUA for anyone under the age of 18. Patient reported no adverse reaction or outcome.

Other Meds:

Current Illness:

ID: 1392547
Sex: F
Age: 14
State: GA

Vax Date: 06/01/2021
Onset Date: 06/01/2021
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: Patient was supposed to receive the Menigitis conjugate vaccine but received the meningitis B vaccine

Other Meds:

Current Illness:

ID: 1392548
Sex: F
Age: 27
State: IL

Vax Date: 05/02/2021
Onset Date: 05/23/2021
Rec V Date: 06/11/2021
Hospital: Y

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: 1st Dose Reactions-Fatigue/Tiredness: occurred two days after injection for four consecutive days & Injection Site Pain: occurred for 48hrs after injection 2nd Dose Reaction-Appendicitis: occurred four days after injection

Other Meds: Junel Fe

Current Illness: None

ID: 1392549
Sex: U
Age:
State: OH

Vax Date:
Onset Date:
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:

Symptom List: Nausea

Symptoms: Extreme fatigue that will not go away, headache

Other Meds:

Current Illness:

ID: 1392550
Sex: M
Age: 20
State: IN

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin/amoxacillin

Symptom List: Injection site pain

Symptoms: No taste morning after shot (5am) body pains and headache gradually worsened until 2pm when ibuprofen was taken, all symptoms subsided by 5pm

Other Meds: Sudafed, melatonin

Current Illness: None

ID: 1392551
Sex: F
Age: 11
State: MN

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

Symptoms: Patient received a dose of Pfizer COVID vaccine but was not 12.

Other Meds:

Current Illness:

ID: 1392552
Sex: F
Age: 46
State: CO

Vax Date: 03/28/2021
Onset Date: 04/01/2021
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: Penicillin

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

Symptoms: On 4/1 I began to experience heart palpitations. The palpitations continued Friday 4/2, when I contacted my medical provider's text a doctor feature. I have not experienced heart palpitations on a regular basis, and these were long and sustained. The doctor recommended an EKG, which I declined. The palpitations decreased and abated the following week. They resumed about a week and a half following the 2nd pfizer injection, which I had on 4/18/21, and lasted on and off for about a week. However, I still have occasional palpitations since then.

Other Meds: None

Current Illness: None

ID: 1392553
Sex: F
Age: 21
State: TX

Vax Date: 06/10/2021
Onset Date: 06/11/2021
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: N/A

Symptom List: Tremor

Symptoms: I?m having a rash on my arms and thighs, 100 fever, massive headache, and arm hurts bad where the second shot was given.

Other Meds: Robitussin and mucinex.

Current Illness: Just the reaction from the first vaccine.

ID: 1392554
Sex: F
Age: 14
State: PA

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Erythema, Pruritus

Symptoms: Pale, blue around eyes, muscles/hands contracted, unable to move hands or feet. O2 - 100%, BP 110/74, Pulse 112. Called for ambulance. By the time the ambulance arrived her hands and feet improved and she was able to move extremities. She was able to sit up.

Other Meds:

Current Illness:

ID: 1392555
Sex: M
Age: 39
State: IL

Vax Date: 05/06/2021
Onset Date: 05/28/2021
Rec V Date: 06/11/2021
Hospital: Y

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: none

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

Symptoms: I don't have the vaccine card on hand, but approximately 2.5 week after the second dose of the moderna covid 19 vaccine, my husband developed an ascending aortic dissection which required emergency open heart surgery. This is the 3rd person with this, the other 2 reported the same scenario a couple weeks after receiving the 2nd dose of moderna.

Other Meds: lisinopril 5mg

Current Illness: none

ID: 1392556
Sex: U
Age: 15
State: NY

Vax Date: 05/18/2021
Onset Date: 05/18/2021
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: None available

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

Symptoms: Chest pain, unable to sleep. Headache

Other Meds: None

Current Illness: None

ID: 1392557
Sex: M
Age: 49
State: IA

Vax Date: 05/18/2021
Onset Date: 05/26/2021
Rec V Date: 06/11/2021
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: Metformin Diarrhea

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Double pulmonary embolism, and DVT

Other Meds: LEVEMIR FLEXTOUCH 100 UNIT/ML SUBCUTANEOUS SOLUTION PEN-INJECTOR (INSULIN DETEMIR) inject 35 units once daily KRILL OIL 1000 MG ORAL CAPSULE (KRILL OIL) Take one capsule daily (OTC uses for joint health); Route: ORAL INSULIN ASPART FLEXPEN

Current Illness:

ID: 1392558
Sex: M
Age: 66
State: OR

Vax Date: 05/11/2021
Onset Date: 05/17/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: I have Celiac and cannot eat wheat, rye, barley. I am 100 percent guten free in my diet.

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

Symptoms: Received the J&J vaccine on May 11th, on May 17th I began having a migraine headache. On May 19th I began having vertigo symptoms, loss of balance, spinning room if I turned my head and when rolling over in bed. I needed to hold onto a countertop to avoid falling over. The headache subsided after six days, the vertigo (spinning room) continued to June 1st. I am still having balance issues when bending forward. I was seen by a Nurse Practitioner on May 18 at a Clinic. I told the NP I was conerned that I was experiencing headaches and vertigo with one week of receiving the J&J vaccine. I was told to review a video on Eply exercises for the vertigo. I do not know if a report was made by clinic regarding my adverse reactions.

Other Meds: No prescription medication Vitamins-B-12, D3

Current Illness: None

ID: 1392559
Sex: F
Age: 37
State: AZ

Vax Date: 01/27/2021
Onset Date: 03/24/2021
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: not applicable

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

Symptoms: have not had a normal menstrual cycle since the second injection, starting in February. I have not had a period currently since late April and am not pregnant, not a chance to be pregnant, no change in stress, diet, weight etc.

Other Meds: not applicable

Current Illness: NOT APPLICABLE

ID: 1392560
Sex: F
Age: 62
State: MI

Vax Date: 04/08/2021
Onset Date: 05/06/2021
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: LA

Lab Data:

Allergies: NKDA

Symptom List: Pain in extremity

Symptoms: 4/7/2021 patient had a normal cbc with differential. on 4/8/2021 she received the J&J vaccine. On 5/6 and 5/25 she was hospitalized with GIB secondary to AVMs. However, from a hematology perspective she has bicytopenia. Further workup as outpatient determines she has continued bleeding issues, clumped platelets, elevated platelet factor analysis. We are going to do a bone marrow biopsy.

Other Meds: no

Current Illness: high cholesterol, HTN, and hypothyroidism

ID: 1392561
Sex: F
Age: 48
State: MO

Vax Date: 02/19/2021
Onset Date: 03/19/2021
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: None.

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

Symptoms: I got an audiogram, CT to make sure that I am okay. I am taking an advil whenever I have a headache. I have been instructed to seek a neurologist and get an MRI.

Other Meds: Branch Chain amino acid, 1xday- 4-5xweek

Current Illness: None.

ID: 1392562
Sex: M
Age: 44
State: CA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
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: Crab, Macadamia Nuts, Latex, Brown Rice, Allergic to almost all antibiotics.

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

Symptoms: Tingling hands and feet started same day. Continues off and on for 6 weeks now. Chest pain upon even mild exertion like walking around the block. Lasted for a few weeks. Right arm bone pain severe lasted for about 3 weeks Spine felt swollen near coccyx/sacrum and C7-C6 pain. Feeling of Lower spine swelling and pain started less than 24 hrs. after. Lasted approx 2 weeks. Extreme tiredness lasted 2 weeks Baseball shaped raised area on chest near right arm(vaccinated arm) started perhaps a week in and lasted about a week.

Other Meds: None that I recall

Current Illness: None that I recall.

ID: 1392563
Sex: F
Age: 14
State: NY

Vax Date: 06/08/2021
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: pollen, wagweed

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

Symptoms: child reports had low grade fever (99), injection site pain/swelling, developed red/blanchable wheal like annular patches/plaques on sides of both feet of various sizes (1 cm to approx. 2 inch diameter) - describes as painful, denies itching

Other Meds: Fluoxetine

Current Illness: none known

ID: 1392564
Sex: M
Age: 12
State: NY

Vax Date: 05/13/2021
Onset Date: 05/18/2021
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: None

Symptom List: Vomiting

Symptoms: Both times after my son received his Covid-19 vaccine, we noticed that his feet swelled up a few days after and have been periodically swollen since.

Other Meds: Methylphenidate, but not taken on the day of vaccination.

Current Illness: None

ID: 1392565
Sex: F
Age: 56
State: IN

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Two days after the second dose of the vaccine I had pain pain in my lower right side. I was nauseous and in pain for two days. I went to the ER and they identified I appendicitis and I had my Appendix removed four days after the vaccine. The procedure was performed outpatient. Two months after the vaccine I also had Diverticulitis.

Other Meds:

Current Illness:

ID: 1392566
Sex: M
Age: 55
State: MD

Vax Date: 04/02/2021
Onset Date: 04/18/2021
Rec V Date: 06/11/2021
Hospital: Y

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: tramadol

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

Symptoms: NSTEMI monitored and improved on his own; no surgical intervention needed started on imdur and losartan and discharged home

Other Meds: aspirin 81 mg, nifedipine 60 mg, nicotine 21 mg patch, carvedilol 25 mg BID, gabapentin 600 mg TID PRN, famotidine 20 mg PRN, calcitriol 0.25 mcg, calcium acetate 1334 mg TIDWC, atorvastatin 80 mg

Current Illness:

ID: 1392567
Sex: F
Age: 49
State: IN

Vax Date: 04/26/2021
Onset Date: 04/26/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: chronic tinnitus - it's maddening and constant; sometimes also a dizzy feeling.

Other Meds: Vitamins

Current Illness: none

ID: 1392568
Sex: F
Age: 47
State: OH

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: penicillin

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

Symptoms: flu like feeling, chest pains, muscle pain, nauseous, tingling sensations in feet and legs, headache, shortness of breath

Other Meds: omeprazole, vitamins, oregano, biotin

Current Illness:

ID: 1392569
Sex: M
Age: 12
State: WI

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Flu vaccine

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

Symptoms: Administration of 0.5 ML dose rather than 0.3 mL

Other Meds: N/A

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm