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: 1394663
Sex: F
Age: 22
State: OK

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/13/2021
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: Systemic: Confusion-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: PT FAINTED AFTER GETTIN THE SHOOT AND SHE TOLD DIDN'T EAT THE WHOL DAY AND SHE HAD COVID.

Other Meds:

Current Illness:

ID: 1394664
Sex: M
Age: 77
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 06/13/2021
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: Moderna COVID-19 Vaccine First injection: 01/22/2021 ( left Deltoid ) ; Second injection: 02/19/2021 ( right Deltoid ) Pain remaining in both injection sites continuously after injections beginning three days after innoculation. More pronounced in right arm and extends to antecubital fossa area. Pressing on injection sites causes increased pain. No improvement since innoculations.

Other Meds: Metoprolol Zetia Aspirin Montelukast Pantoprazole Atorvastatin

Current Illness: None

ID: 1394665
Sex: M
Age: 61
State: NC

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)

Other Meds:

Current Illness:

ID: 1394666
Sex: F
Age: 32
State: VA

Vax Date: 06/07/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
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: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Chest Tightness / Heaviness / Pain-Mild, Additional Details: Hives on arms, back of neck and chest tightness one hour after FIRST PFIZER Covid Vaccine .Patient took Benedryl at home and shortly after the symptoms resolved.

Other Meds:

Current Illness:

ID: 1394667
Sex: F
Age: 23
State: TX

Vax Date: 05/22/2021
Onset Date: 05/24/2021
Rec V Date: 06/13/2021
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: Systemic: Allergic: Difficulty Breathing-Medium, Additional Details: Patient had COVID in January & had dyspnea that required rescue inhaler. 2 days after 1st shot, patient had dyspnea that required rescue inhaler use once & dyspnea never happened again. Doesn't sound like a true allergic reaction since nothing else happened & dysnpea didn't return. Patient didn't see MD.

Other Meds:

Current Illness:

ID: 1394668
Sex: F
Age: 24
State: GA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Red rash with swelling at injection site. issue did resolve

Other Meds:

Current Illness:

ID: 1394669
Sex: F
Age: 37
State: IN

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/13/2021
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: Pyrexia, White blood cell count decreased

Symptoms: My arm is swollen, my throat hurts, I have a painful lump under my arm, nose stopped up, body aches, feeling fatigued on going headache

Other Meds: N/A

Current Illness: N/A

ID: 1394670
Sex: F
Age: 47
State: OR

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: Cats

Symptom List: Pharyngeal swelling

Symptoms: Heart inflammation, racing heartbeat, chest tightness, chest pain, breathing trouble, left leg swelling, aches pains, chills, extreme tireness

Other Meds: Lisinopril, albuterol I have other medications and otc that I take but not right before on the day of vaccine

Current Illness: High blood pressure and asthma

ID: 1394671
Sex: F
Age: 39
State: IN

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

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

Lab Data:

Allergies: Codeine, erythromycin, walnuts, melons

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Body aches - resolved after 36 hours Fever (100.5) - resolved after 24 hours Chills - resolved after 24 hours Loss of appetite - resolved after 36 hours Headache - resolved after 36 hours

Other Meds: Gabapentin 300mg, multivitamin, prebiotic

Current Illness: None

ID: 1394672
Sex: F
Age: 68
State: GA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 06/13/2021
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: itchy red rash with swelling at injection site. issue did resolve

Other Meds:

Current Illness:

ID: 1394673
Sex: F
Age: 54
State: SC

Vax Date: 04/01/2021
Onset Date: 04/16/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Melons, and mangos

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

Symptoms: Throat began to become scratchy, and tongue felt swollen. Difficulty breathing. Chills, and severe shaking.

Other Meds: Birth Control, Vit B12, D. C Potassium, Calcium Benedryl

Current Illness: N/A

ID: 1394674
Sex: F
Age: 42
State: GA

Vax Date: 02/19/2021
Onset Date: 05/18/2021
Rec V Date: 06/13/2021
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: First dose received 1/22/2021 (lot 026L20A). 2nd dose received 2/19/2021. Become pregnant between doses 1 and 2. Pregnancy was confirmed 4/1/2021 and viable with due date of 11/14/2021. On 5/18/2021, pregnancy was confirmed as missed miscarriage (at approx 8wks 4 days). All DNA tests came back negative for genetic abnormalities up to that point.

Other Meds: None

Current Illness: None

ID: 1394675
Sex: F
Age: 20
State: IN

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/13/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Extreme chills, fever, throwing up, headache

Other Meds: No

Current Illness: Upper respiratory infection two weeks prior

ID: 1394676
Sex: M
Age: 58
State: IL

Vax Date: 01/29/2021
Onset Date: 05/03/2021
Rec V Date: 06/13/2021
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: none

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

Symptoms: Pericarditis Chest discomfort/pain and left shoulder pain began on 5/3/21. Went to emergency room on 5/5/21 and EKG showed that this was thought to be Pericarditis. I was admitted for one night.

Other Meds: Metoprolol ER Succinate 50mg (1x day), Flecainide 50 mg (2x day), Pantoprazole 40 mg (1x day)

Current Illness:

ID: 1394677
Sex: F
Age: 26
State: GA

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
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: NKDA

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

Symptoms: Patient came into the store with her mother to get her firs Covid 19 vaccination. At we carry Pfizer brand. She received the vaccination and was walking around the store she passed out and hit her lip on way to floor. Upon seeing the patient on the floor I came over to the mom to provide assistance. She was awake, however, very lethargic. I was very concerned that the patient was not coming out of the syncope fast enough. Therefore, I called 911. The fire dept. was first to arrive. They checked her vitals and asked her many questions. All vitals were in normal limits and she correctly answered their questions. The EMTs arrived and re checked vitals. All vitals still showing normal limits. They are to put her in the ambulance and take her to hospital. The patient refused and the EMTS walked the patient to her car and I returned to the pharmacy. I called patient at 6:00pm that night and mom informs me that did go the ER later because of a rash all over body. Mom states that is feeling better after hospital visit.

Other Meds: I don't know

Current Illness: patient suffers from anxiety

ID: 1394678
Sex: F
Age: 45
State: NJ

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/13/2021
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: Upon immediate injection. I started to shudder, tremble and was freezing cold and my BP spiked to 177/104 at highest. Took a full 12 hours to normalize BP. HR was totally normal. But BP was still in 160?s after 2 hours.

Other Meds: Daily vitamin, nexium 20 MG, and Claritin

Current Illness: No

ID: 1394679
Sex: M
Age: 71
State: KY

Vax Date: 03/15/2021
Onset Date: 03/30/2021
Rec V Date: 06/13/2021
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: Developed itching and ringing in both ears that has continued with periodic headaches. I have gone to an ENT specialist. 5/11/2021

Other Meds: Lost tan, atrovastaten

Current Illness: High blood pressure

ID: 1394680
Sex: F
Age: 49
State: IN

Vax Date: 06/10/2021
Onset Date: 06/11/2021
Rec V Date: 06/13/2021
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: Dizziness, lost of balance, lightheaded, vomiting , sweats onset around 11:30 am went to ER diagnosis was Vertigo,

Other Meds: None

Current Illness: None

ID: 1394681
Sex: M
Age: 58
State: NC

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills, nausea, dry heaving, sweats

Other Meds: Diclonfenac sodium Albuperol Statin Monkelukast

Current Illness: None

ID: 1394682
Sex: F
Age: 40
State: CA

Vax Date: 05/03/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: Benzene, shrimp

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

Symptoms: 1st menstrual cycle following vaccine came early, about twice the bloodflow as normal, lasted longer and horrible cramping. It made the sore arm and body aches from the vaccine seem like child's play. Now starting 2nd menstrual cycle early again, 3 days early, already increased bloodflow. I will submit another report if this cycle is as horrible as the first. Why aren't women warned of this?

Other Meds: Taken daily in the am: Daily multivitamin, vitamin d, vitamin b, 200mg caffeine, fish oil. Taken daily at night: costco sleep aid.

Current Illness: None

ID: 1394683
Sex: M
Age: 57
State:

Vax Date: 05/01/2021
Onset Date: 06/03/2021
Rec V Date: 06/13/2021
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: Nothing

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

Symptoms: Severe itching behind right and left knee and left arm. Swelling of the left ankle and left arm. Skin erythema left arm and left and right calves Time for 7 days

Other Meds: Nothing

Current Illness: Nothing

ID: 1394684
Sex: M
Age: 14
State: MA

Vax Date: 06/05/2021
Onset Date: 06/10/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: On the 5th day patient woke with nausea and extreme exhaustion and weakness in legs. After a few hours nausea subsided but limb weakness persisted. Patient had a hard time walking unassisted. Visited Dr office in early afternoon where neurological assessment occurred. Patient limb strength was normal while seated. All other tests passed. Patient tested negative for covid in pcr exam that day. Symptoms increasingly improved over next few days and symptoms are non existent 1 week following second vaccination on June 5th

Other Meds: Sertraline, montelukast, deplin, loratidine, omeprazole, vitamin d, dha

Current Illness: None

Date Died: 05/13/2021

ID: 1394685
Sex: M
Age: 68
State: IA

Vax Date: 04/16/2021
Onset Date: 05/13/2021
Rec V Date: 06/13/2021
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: NO Known Allergies

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

Symptoms: He died suddenly on May 13th. Had just had thorough physical prior to vaccines. Perfect health, weight perfect. No prior health concerns. Heart attack or stroke in his yard. After his first dose on March 16, 2021 he ceased his several mile walk each day stating he was tired and lethargic. He was a military man that rose each day of his life to that walk. His second dose was 04/16/21 he still did not continue the walks and on May 13, 2021 died suddenly of heart attack or stroke.

Other Meds:

Current Illness: Felt very Lethargic the month prior after recieving the first dose on 3/16/21

ID: 1394686
Sex: F
Age: 70
State: MA

Vax Date: 03/16/2021
Onset Date: 04/18/2021
Rec V Date: 06/13/2021
Hospital: Y

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

Lab Data:

Allergies: slfates

Symptom List: Injection site pain, Pain

Symptoms: ~ 30 days after vaccine, Pt developed increasing dyspnea. Treated with PO prednisone taper x 8 days with some improvement, however symptoms worsened off prednisone and she presented to ED on 5/3/21. Found to have multifocal PNA with significant peripheral eosinophilia. Treated with PO Abx and steroids again. Repeat CT in 6/21 shows worsening multifocal PNA with peripheral eosinophilia again. Admitted to hospital, bronchoscopy performed with results c/w chronic eosinophilic PNA. Started on IV steroids - > PO with significant improvement in parencyhmal lung disease.

Other Meds: albuterol (ACCUNEB) 0.63 mg/3 mL nebulizer solution 1 ampule, Nebulization, Every 6 hours PRN albuterol 90 mcg/actuation inhaler TAKE 2 PUFFS BY MOUTH EVERY 6 HOURS AS NEEDED FOR WHEEZE cetirizine (ZYRTEC) 10 MG tablet 10 mg, Oral, Daily fl

Current Illness: asthma

ID: 1394687
Sex: F
Age: 35
State: ID

Vax Date: 05/20/2021
Onset Date: 05/22/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Morbilliform rash 48 hours after injection across my upper body, sparing my face. Started at injection site and spread. Injection site red, itchy, hot, and swollen.

Other Meds: None

Current Illness: None

ID: 1394688
Sex: M
Age: 37
State: IN

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 06/13/2021
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: Ibuprofen, Cyclobenzeprene.

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

Symptoms: Headache, aches, chills, shortness of breath, fatigue. Felt worse than all, but 2 days that I actually had COVID back in December for 17 days.

Other Meds: Prozac, multi-vitamin, generic Allegra.

Current Illness: None

ID: 1394689
Sex: F
Age: 54
State: NC

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/13/2021
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: Arm redness/bumps "COVID arm" (duration 5 days); myalgia (duration 3 days); low fever (99.9F); tiredness; skin tenderness result of fever (duration 2 days).

Other Meds: N/A

Current Illness: N/A

ID: 1394690
Sex: F
Age: 40
State: ME

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: not known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient's wife called 6/12/2021 stating patient had a really swollen, painful area underneath her left arm. It started the day after receiving the shot, 6/10/2021. It was recommended she be seen by a healthcare professional that day, which would probably be the Emergency department.

Other Meds: baclofen 10 mg, atenolol 25 mg, levothyroxine 100 mcg, omeprazole 40 mg

Current Illness: unknown

ID: 1394691
Sex: M
Age: 15
State: OR

Vax Date: 06/10/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
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: Penicillin

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

Symptoms: Patient presented the emergency department with chest pain radiating to left arm on 6/12. Studies indicate myocarditis. Patient will be transferred to specialty hospital for cardiology.

Other Meds: None

Current Illness: None

ID: 1394692
Sex: M
Age: 46
State: MI

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

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

Lab Data:

Allergies: No

Symptom List: Nausea

Symptoms: Peripheral neuropathy on right Indra finger and right elbow

Other Meds: No

Current Illness: No

ID: 1394693
Sex: F
Age: 28
State:

Vax Date: 03/01/2021
Onset Date: 04/01/2021
Rec V Date: 06/13/2021
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: Since completing the vaccine shots (Moderna), I have experienced amenorrhea (missed menstrual cycles). Also, I have experienced irregular menstrual cycles.

Other Meds: None

Current Illness: None

ID: 1394694
Sex: M
Age: 38
State: NY

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Shingles. Took Valtrex Tylenol, symptoms subsided in 10 days

Other Meds: One-a-Day Male Pro Edge Vitamin

Current Illness: None

ID: 1394695
Sex: F
Age: 47
State: IN

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/13/2021
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: Severe body aches, fever, loss of energy, loss of appetite. Symptoms persisted for 24 hours.

Other Meds: Lisinopril, Metoprolol, Atorvastatin, sertraline, multivitamin

Current Illness:

ID: 1394696
Sex: F
Age: 36
State: KY

Vax Date: 06/10/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
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: Latex sensitivity

Symptom List: Tremor

Symptoms: Herpes outbreak on lips and inside mouth. Began two days after vaccine and continues to worsen today, three days after vaccine.

Other Meds: None

Current Illness: None

ID: 1394697
Sex: M
Age: 44
State: NC

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 06/13/2021
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: Demerol, Bactrim

Symptom List: Erythema, Pruritus

Symptoms: 1) Initially -30 mins after vaccine administered - "Electrical-like" tingling started in chest and face. then cascaded throughout entire body. 2) Following - Hives and rashes would appear randomly on neck, chest, inner thigh, inner forearm, and feet/ankles. Occurred nightly for about 2 weeks and was resolved by Benadryl, followed by having them every other night or so for several weeks. Reactions gradually reduced in frequency after about 6 weeks. 3) Currently, very infrequently, will experience random tingling/itchiness in different spots of body. Benadryl/Zyrtec will resolve.

Other Meds: Prevacid

Current Illness:

ID: 1394698
Sex: F
Age: 14
State: IN

Vax Date: 06/09/2021
Onset Date: 06/11/2021
Rec V Date: 06/13/2021
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: Appendicitis

Other Meds: None

Current Illness: None

ID: 1394699
Sex: F
Age: 52
State:

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Anxious clammy skin, arms tingling - prolonged symptoms x35 minutes - Benadryl dosed @20 minutes post vaccine.

Other Meds:

Current Illness:

ID: 1394700
Sex: F
Age: 34
State:

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/13/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Felt hot, lightheaded, diaphoretic, felt faint, peripheral vision darkness..

Other Meds:

Current Illness:

ID: 1394701
Sex: M
Age: 18
State: NJ

Vax Date: 06/06/2021
Onset Date: 06/07/2021
Rec V Date: 06/13/2021
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: penicillin

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

Symptoms: headache, sore arm could not lift arm very high, tired

Other Meds: none

Current Illness: none

ID: 1394702
Sex: F
Age: 68
State: MO

Vax Date: 03/23/2021
Onset Date: 05/01/2021
Rec V Date: 06/13/2021
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: biaxin omnicef sulfa iodine

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

Symptoms: I decided to go to the bone and joint clinic (where I have gone in the past for other ailments) because a few weeks after my last covid shot, I experienced pain at the injection site that would not go away. Upon examination, (assistant to Dr. stated that I had an enduration at the injection site. He also indicated that he has seen a dozen or so patients that have experienced joint type pain several weeks after the covid injection. I was given an oral steroid and plan to do physical therapy hoping that will help. I think it is beneficial to let you know this is happening as the CDC probably doesn't reach out to doctors in offices when patients come in with lingering issues relating to the covid vaccine. Thought it might be helpful to let you know.

Other Meds: simvastatin Ventolin inhaler as needed nasacort nose spray as needed

Current Illness: none

ID: 1394703
Sex: F
Age: 77
State:

Vax Date: 06/07/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: Red wine, perfume, gasoline smell,

Symptom List: Pain in extremity

Symptoms: Large read area at the vaccination site (4" in dia.) , it also itches

Other Meds: Daily: 500mg Vitamin C, 25mg Vitamin D3, one capsule of Vitalux with Omega 3, one tablet of Centrum for 50+ women, 150mg Magnesium Citrate, Every two days: One gel of Webber Naturals Omega-3 & CoQ10, 500mg Glucosamine Sulfate, 400mg

Current Illness:

ID: 1394704
Sex: M
Age: 56
State: MI

Vax Date: 04/06/2021
Onset Date: 04/17/2021
Rec V Date: 06/13/2021
Hospital: Y

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: Broke out in Blisters over his whole body including his mouth. His whole body swollen.

Other Meds: None

Current Illness: None

ID: 1394705
Sex: F
Age: 15
State: IN

Vax Date: 06/11/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Fever chills fatigue achiness

Other Meds: N/A

Current Illness: N/A

ID: 1394706
Sex: M
Age: 61
State: OH

Vax Date: 06/02/2021
Onset Date: 06/13/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: Bell's Palsy

Other Meds: none

Current Illness: none

ID: 1394707
Sex: F
Age: 15
State: CA

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/13/2021
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: 2nd Dose given at 830 am on June 5th. At 5pm sameday pt. Was having weak legs,dizzy, slight headache trouble standing . By 9 pm pt. Was very weak, chills and she felt as if she had fever but temp was 97.3 , by 10pm she could not get out of bed because she felt so weak and achy,, her arm was so sore I couldn?t even touch it & she couldn?t lift it , had severe chills but also started to run a fever of 101.3. She could not sleep and was quite scared. I slept in her room with her to make sure she didn?t stop breathing. Gave sips of Gatorade and at 1130 gave her 1 pill tylenol rapid gel release for pain/fever sips of Gatorade through the night

Other Meds:

Current Illness:

ID: 1394708
Sex: F
Age: 36
State: DE

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
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: latex

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: about 5-10 minutes after administration patient stated they had a rapid heart beat felt dizzy and felt like they could not breathe at which point benadryl was given and i was on standby with an epipen. paramedics were called and she was taken to hospital. Followed up with patient later that afternoon she was discharged and okay.

Other Meds: no maintenance medications

Current Illness: n/a

ID: 1394709
Sex: M
Age: 42
State: VA

Vax Date: 03/24/2021
Onset Date: 06/04/2021
Rec V Date: 06/13/2021
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: Dairy

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

Symptoms: I had an acute anaphylactic reaction to a yellow jacket sting. Within 20 minutes of the sting, my whole body was swollen and airways began to constrict. I received epinephrine, type 1 and 2 antihistamines, and steroids, and the symptoms resolved. I am reporting this because I was stung by a yellow jacket in the same location a year earlier (pre-vaccine) and had no reaction. I had never had an anaphylactic reaction. Clearly, other factors could have caused the new response to what appears to be the same stimulus, but receiving an MRNA vaccine designed to stimulate immune response seems like a suspect worth investigating.

Other Meds: None

Current Illness: None

ID: 1394710
Sex: F
Age: 62
State: PA

Vax Date: 06/11/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: MILD MUSCLE SORENESS AT INJECTION SITE, MILD FATIGUE, IMPROVED WITHIN 12 HOURS

Other Meds:

Current Illness:

ID: 1394711
Sex: F
Age: 19
State: AL

Vax Date: 06/11/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: Benzoyl peroxide, codeine, amoxicillin

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

Symptoms: Late night on the 12th after feeling bad due to an elevated temperature, I noticed my forehead was sore like it was bruised. When I looked in a mirror, I noticed a red splotch on my forehead that felt slightly raised like it was swollen. Sunday morning I checked and it was mostly gone. It?s now a very pale red almost normal skin color and less sore but still is to touch.

Other Meds: Concerta (methylphenidate), birth control, and vitamin b-12

Current Illness:

ID: 1394712
Sex: F
Age: 25
State: IN

Vax Date: 06/11/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
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: Ceclor; penicillin; peanuts; walnuts; pecans

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

Symptoms: Chills, fever, headache, shortness of breath, dizziness, fatigue

Other Meds: Propranolol; norethindrone

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm