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: 1394966
Sex: F
Age: 28
State: MA

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Bleeding from the vagina during and after intercourse. Intercourse and after was painless, I felt no discomfort at all but experienced large amount of bright red blood. I am not on my period and should not be for another few weeks. I have experienced bleeding after sex but never to this extreme.

Other Meds:

Current Illness:

ID: 1394967
Sex: M
Age: 19
State: SC

Vax Date: 06/08/2021
Onset Date: 06/11/2021
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: Penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: Shortness of breath. Rapid heartbeat.

Other Meds: Melatonin

Current Illness: None.

ID: 1394968
Sex: F
Age: 56
State: WA

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 06/13/2021
Hospital: Y

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: NKDA

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

Symptoms: Almost immediate (next day) started having numbness in left fingers 3-5, heavy, glove like feeling in left hand, pain down left arm gradually intensifying in frequency and severity over 6-7 weeks. Cervical MRI ordered due to intense, sharp, stabbing left arm pain and numbness down ulnar side of left arm. Admitted to Medical Center on June 11, 2021 due to findings on MRI and worsening of symptoms. Drs. have narrowed down the DX to likely Acute Transverse Myelitis- pending results from a spinal tap done June 12, 2021. Currently still admitted for pain control and IV steroids to control swelling on spinal cord.

Other Meds: Levothyroxine 50mcg Lexapro 10mg Busprione 5mg Multi Vitamin OTC Vitamin D 1000mg

Current Illness: None

ID: 1394969
Sex: F
Age: 81
State: MI

Vax Date: 04/12/2021
Onset Date: 04/15/2021
Rec V Date: 06/13/2021
Hospital: Y

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

Lab Data:

Allergies: Medium: Trazodone Not Specified: Aspirin; Neurontin [Gabapentin]; Oxycodone; Propoxyphene N-apap; Ultram [Tramadol]

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Vertigo, Vision changes, Retinal vein Occlusion of left eye, weakness, tachycardia, Hypertension

Other Meds: amLODIPine 5 MG tablet Take 1 tablet by mouth daily. Commonly known as: NORVASC cholecalciferol 125 MCG (5000 UT) capsule Take 5,000 Units by mouth Daily. Commonly known as: VITAMIN D3 irbesartan 300 MG tablet Take 1 tablet by mouth dai

Current Illness: none

ID: 1394970
Sex: M
Age: 0
State: NC

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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: Patient fainted about 5 minutes after vaccination

Other Meds:

Current Illness:

ID: 1394971
Sex: M
Age: 20
State: MI

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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: Patient got his vaccine and was instructed to sit in the waiting/observation area for 15 minutes. At approximately 3:10pm, I heard a loud bang and peeked my head out of the pharmacy and saw that there was a young man on the floor. He fell into the endcap. I immediately ran out to the customer. Upon talking to him, he did not pass out or hit his head but did severely scratch the left side of his cheek to his neck above is collar bone. I checked his blood pressure and it was 119/79. He initially said he felt very hot and was sweaty, then we gave the patient orange juice as he stated he hadn't had much to eat, and felt better after drinking the juice. He denied EMS and called his grandmother to come pick him up.

Other Meds:

Current Illness:

ID: 1394972
Sex: M
Age: 22
State: PA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: The patient had received his vaccine, and and moved to the bench to wait 15 minutes post-vaccine. The patient got dizzy and went to the floor a few minutes after being seated. No other side effects or issues and the patient was fine after sitting a few minutes

Other Meds: unknown

Current Illness: unknown

ID: 1394973
Sex: F
Age: 16
State: MO

Vax Date: 06/08/2021
Onset Date: 06/12/2021
Rec V Date: 06/13/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: chest pain, nausea, myalgias

Other Meds:

Current Illness:

ID: 1394974
Sex: M
Age: 44
State: FL

Vax Date: 04/01/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Prolonged herpes zoster outbreak.

Other Meds: None

Current Illness: None

ID: 1394975
Sex: F
Age: 45
State: AZ

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No-per immunization paperwork filled out by patient

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient stopped by the pharmacy on 06/11/21 showing injection site reaction with redness and pain, which spread about 3-4 inches. Patient was concerned with pain that radiated under the armpit/breast area (lymph node area). Also, a lump had formed in-between the base of the neck and the shoulder area, near the clavicle. Skin was intact with no redness. Lump was noticeable about a nickel-size in diameter. She complained of stiffness and muscle pulling from the left of the neck when she turned her head to the right.

Other Meds: Prescription on file for Vitamin D3 1,000mg 1qd

Current Illness: unknown

ID: 1394976
Sex: F
Age: 48
State: FL

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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: N/A

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

Symptoms: Patient stated that " she felt as if her skin was reddening and she was forming a rash". No visible signs of rash or reddening. Palpated skin, skin in tact no bumps. Patient stated that she "was feeling just a bit nervous but was ok". Patient was release after 30 minutes of observation

Other Meds: N/A

Current Illness: N/A

ID: 1394978
Sex: F
Age: 65
State: NJ

Vax Date: 03/24/2021
Onset Date: 04/19/2021
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: Penicillins, Doxycyline, Sulfur

Symptom List: Rash, Urticaria

Symptoms: approx. week and a half later. My Knees and feet got worse. Knees couldn't bend, walk up stairs, kneel. Feet had crushing pains, felt hot (internally) throbbing. Ears ringing got louder then ever before. They are still in the same pain. Also receiveed the gel shots for arthritis in my knees on 4/26, 5/3, 5,10. Which has not made any difference in the pain.

Other Meds: Amlodipine 10mg, Vitamin C, Vitamin D, Naproxen

Current Illness:

ID: 1394979
Sex: M
Age: 73
State: MN

Vax Date: 03/09/2021
Onset Date: 05/16/2021
Rec V Date: 06/13/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Felt very ill for 36 hours then treated for heart racing and dehydration.

Other Meds: Staten

Current Illness: None

ID: 1394980
Sex: F
Age: 57
State: SC

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

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: Augmentin, Lipitor, rice

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

Symptoms: Subdural hematoma chronic with bleed for 3 weeks since about March 12, then acute subdural hematoma on April 2. Required EMS, had a seizure during transport, and required a craniotomy with evacuation on April 2 within hours of the second vaccine m.

Other Meds: Meyoptolol, Zetia, Hydroxyzine, muktivitamin

Current Illness: Chronic subdural hematoma estimated to have begun 3 weeks prior around March 12, 2021, the date of first Pfizer COVID-19 vaccine. Not discovered until acute subdural hematoma on April 2, 2021.

ID: 1394981
Sex: F
Age: 15
State: CA

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: NONE

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

Symptoms: PT LOST CONSCIOUSNESS 5 MINUTES AFTER VACCINE, SLOW HEART RATE, CLAMMY SKIN, NAUSEA, UNCONTROLLED BLADDER RELEASE. PT REGAINED CONSCIOUSNESS AFTER 30 SECONDS AND AMBULANCE WAS CALLED. BP NORMAL AND PT RECOVERED AFTER ABOUT 20MINUTES AND WAS ABLE TO WALK ON HER OWN.

Other Meds: NONE

Current Illness: NONE

ID: 1394982
Sex: F
Age: 32
State: NY

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

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

Symptoms: After 1 week of first dose of moderna vaccine, patient experienced breakthrough bleeding and on and off spotting through out until she received the 2nd dose 28 days after.

Other Meds: n/a

Current Illness: none

ID: 1394983
Sex: F
Age: 26
State: IL

Vax Date: 05/22/2021
Onset Date: 05/24/2021
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: no allergies

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

Symptoms: Patient had swollen ball at left wrist and pain in left forearm up until elbow. Also, had swelling and pain at same forearm the day after the second dose of covid vaccine

Other Meds: medroxyprogesterone 5mg once daily from 6/6/21 to 6/10/21, topical econazole as needed on feet, topical triamcinolone as needed on feet; otc tylenol as needed

Current Illness: no

ID: 1394984
Sex: F
Age: 55
State: MI

Vax Date: 06/08/2021
Onset Date: 06/09/2021
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: Penicillin and mold

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Itchy Rash appeared on right chest.

Other Meds: None

Current Illness: Type II Diabetes

ID: 1394985
Sex: F
Age: 16
State: IL

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 known

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: pt felt slight tightening of chest and throat- injected epinephrine- pt felt better after about 15 minutes and was released to her mother. After phone discussion on 6/13/21, mother said symptoms returned later in the day and she went to ER and received a steroid injection. Per mother on 6/13/21. pt was feeling fine

Other Meds: zolmitriptan, topiramate, fluoxetine, Seroquel, Flonase, allegra

Current Illness: none

ID: 1394986
Sex: F
Age: 36
State: NY

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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: lactose intolerant

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

Symptoms: "Janssen Covid 19 EUA" Patient received her Janssen covid 19 today, she has had a history of fainting from vaccines in the past. I administered her vaccine and moments after she reported she was feeling faint. We laid her down on the floor and applied an ice pack to her neck. She never lost consciousness. I had her wait for 30 additional minutes and the patient was feeling better when she left.

Other Meds: unknown

Current Illness: unknown

ID: 1394987
Sex: F
Age: 31
State: PA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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: NONE

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

Symptoms: pt got second pfizer covid vaccine(12:53pm) (no problems with first one), while she was during her post-vaccination wait, she looked at her arm and noticed hives (1:15pm) gave her 10mls of benadryl she waited 20 more minutes and left

Other Meds: BIRTH CONTROL

Current Illness: NONE

ID: 1394988
Sex: F
Age: 20
State: AZ

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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: Unevaluable event

Symptoms: First dose administered 4/15/21, and second dose was administered on Day 59 (approximately 17 days beyond the window set by the CDC)

Other Meds:

Current Illness:

ID: 1394989
Sex: F
Age: 71
State: MA

Vax Date: 04/02/2021
Onset Date: 04/10/2021
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: ASA, PCN, ESS, Latex, silicone, NSAIDs, bananas, avocados, chestnuts,

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

Symptoms: Abdominal pain. No bloating, or tenderness. Calcium, vitamin d and MVI stopped on day seven. Pain took eight days to resolve. Had same pain first dose of covid 19 vaccine and while on arimidex.

Other Meds: Synthroid, maxide, lanoxin, Calcium, vitamin D, MVI

Current Illness:

ID: 1394990
Sex: F
Age: 73
State:

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Injection site pain, Pain

Symptoms: Large Blisters and Redness above the treatment site

Other Meds: Unknown

Current Illness: Hypertension, Diabetes

ID: 1394992
Sex: M
Age: 13
State: TX

Vax Date: 06/11/2021
Onset Date: 06/13/2021
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: Amoxicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Chest pain, headache, dizziness, vomiting and chills. Possible myocarditis

Other Meds:

Current Illness:

ID: 1394993
Sex: F
Age: 46
State: TX

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

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

Symptoms: 2nd dose was given and my concern is my left arm (where the vaccination was given) my under armpit is swollen to the touch. It is so painful that I cannot sleep. The shot was given in my left shoulder and it is my left under armpit that appears swollen. This is concerning to me because I was feeling fine prior to receiving the vaccination and I hadn't shaved or done anything to irritate myself. No previous issues.

Other Meds: N/A

Current Illness: N/A

ID: 1394994
Sex: M
Age: 45
State: NJ

Vax Date: 05/30/2021
Onset Date: 05/31/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: On 5/31, fever, chills, achy, headache, fatigue for 3 days and on 6/4 developed sore throat and congestion on top of continued headache and extreme fatigue. Still do not feel well 14 days after second dose.

Other Meds: Multi-vitamin, vitamin C, Vitamin D, Fish Oil

Current Illness: No

ID: 1394995
Sex: M
Age: 17
State: MN

Vax Date: 06/11/2021
Onset Date: 06/13/2021
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: none that I am aware of

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: got a rash that all over my legs, thighs, arms, going up to my neck

Other Meds: anti depressants / anxiety meds

Current Illness: nope although I did have covid last year

ID: 1394996
Sex: F
Age: 30
State: WA

Vax Date: 04/16/2021
Onset Date: 05/05/2021
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: N/A

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

Symptoms: 3 weeks after first shot (05/05/21) woke up at 2:30 am with chest pressure, high heart rate, and left side pulsating feeling, and weakness on my left arm and leg. Called emergency and was taken to ER. Had similar episode while in ER at 5am. CT of lungs and heart found nothing. D-dimer slightly elevated on blood test. ECG showed nothing. Was discharged. Primary doctor did tests for viruses and enzymes. Found nothing. Cardiologist scheduled a stress test and echocardiogram. Passed out on stress test after 8 minutes. Still waiting for an echocardiogram on 18th of June. Neurologist scheduled EEG, MRI of the neck. Still waiting for them. Was in ER (06/02/21) a week after my second shot (05/27/21), with continuous left arm and leg weakness (I was limping). MRI of the brain showed nothing. Got discharged.

Other Meds: - lexapro - trazedone - contraceptive pills

Current Illness: - left side abdominal pain

ID: 1394997
Sex: F
Age: 13
State:

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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:

Symptom List: Nausea

Symptoms: After a few minutes, patient stood up to walk around, and became light headed and fell down. Became pale and sluggish

Other Meds:

Current Illness:

ID: 1394998
Sex: F
Age: 68
State: MD

Vax Date: 05/01/2021
Onset Date: 05/01/2021
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:

Symptom List: Injection site pain

Symptoms: Minor swelling/redness at injection site

Other Meds:

Current Illness:

ID: 1394999
Sex: F
Age: 10
State: NM

Vax Date: 02/11/2019
Onset Date: 02/11/2019
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Storage unit did not record temperature of vaccine. Could not verify for a period of time, vaccine may have been ineffecive; No treatment or adverse reaction.

Other Meds:

Current Illness:

ID: 1395000
Sex: M
Age: 32
State: PA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: None

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

Symptoms: Immediately had sinus tachycardia and brought to the emergency room. Developed bilateral neuropathy and left sided numbness afterwards. Imaging and lumbar puncture ultimately performed which showed multiple sclerosis. I had no symptoms prior to being vaccinated with the COVID19 vaccine.

Other Meds: Metoprolol Succinate 25mg PO daily Escitalopram 10mg PO daily

Current Illness: None

ID: 1395001
Sex: M
Age: 13
State: OH

Vax Date: 06/07/2021
Onset Date: 06/07/2021
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: peanuts

Symptom List: Tremor

Symptoms: Patient's mother called explaining that within 24 hours of receiving the vaccine, the patient had bright/flashing light in both eyes, numbness in his fingers and toes, chest pain, and stomachache. These events did resolve by June 9th when she called me however he still had a stomachache. I told her that these events would not be expected and that she needed to follow up with his primary care doctor. He received his first shot from us as well with no complaints

Other Meds: Only prescription/over the counter medication/dietary supplement/herbal remedy is his first covid 19 vaccination he received on May 17th at 3:30pm

Current Illness: no

ID: 1395002
Sex: F
Age: 25
State: IA

Vax Date: 06/09/2021
Onset Date: 06/09/2021
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: Oranges, Fish (all but cod and salmon), shellfish, corn syrup.

Symptom List: Erythema, Pruritus

Symptoms: Staring 5 hours after the vaccine a tightness in the chest started. It was difficult to breathe. By the next day it was difficult to move because of what felt like a band around my chest. It feels like I am running out of air doing my normal routine. I have started moving excessively slowly as I can't get a deep breath. It is four days after the vaccine and I am considering going to the er because it is not clearing up. I started taking Benadryl and Claritin yesterday which has greatly relieved the symptoms (not gone but brought to a manageable level), but everytime the medication wears off it comes back in full force.

Other Meds:

Current Illness: None

ID: 1395003
Sex: F
Age: 14
State: UT

Vax Date: 06/03/2021
Onset Date: 06/04/2021
Rec V Date: 06/13/2021
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: None

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

Symptoms: Longer than an 8 day menstrual cycle. At first I didn?t think this was weird but it turns out that many of my women friends are experiencing longer periods, and friends who went through menopause a long time ago are having hot flashes like menopause again. I know of about 6 people now. So that?s when I thought my daughters extra long menstrual cycle could be an adverse event.

Other Meds: None

Current Illness: None

ID: 1395004
Sex: M
Age: 61
State: CA

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

Symptoms: From the evening on 2021-06-11(Fri), of the 2nd shot of Moderna CoVid-19 vaccine, the whole body was knocked out until the late morning of 2021-06-13(Sun), with pain all over the body, headache, sore throat. Had to be in bed. The reason for this report is that the symptom is contrary to the listed side effects. The 1st shot of Moderna Covid-19 vaccine was taken on 2021-05-12(Wed). After the 1st shot, the side effect symptoms are within the listed. Injected arm was swollen and pain there lasted several days. Except the side effect on arm, other side effects were not noticed. === continued It is understood that the side effect is less after the 2nd shot. However, in my case, after the 2nd shot, the side effect symptoms are far beyond the listed, as described earlier. FYI, the 2nd shot was given a different healthcare worker(LVN?), who was a receptionist for the 1st shot. She used unprotected(disposable dry cotton piece) to clean injection spot and the disposable bandage after shot. Subject suspicion goes for overdose. Please advise.

Other Meds: N/A

Current Illness: N/A

ID: 1395005
Sex: M
Age: 34
State: LA

Vax Date: 05/17/2021
Onset Date: 05/19/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: About two days after the shot, during the flu like symptoms, I started having constant dull chest pains and my heart rate wouldn't go lower than 90 even when sleeping. Resting heart rate was around 110-120 constantly for almost 3 weeks. I just toughed it out and it ended last week, but my family and friends told me I should report it as the CDC was looking into the problem.

Other Meds: Zoloft (100 mg)

Current Illness: None

ID: 1395006
Sex: M
Age: 4
State: NM

Vax Date: 02/11/2019
Onset Date: 02/11/2019
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:

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

Symptoms: Storage unit did not record temperature of vaccine. Could not verify for a period of time, vaccine may have been ineffective; No treatment or adverse reaction.

Other Meds:

Current Illness:

ID: 1395007
Sex: F
Age: 30
State: CA

Vax Date: 06/04/2021
Onset Date: 06/13/2021
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: Penicillin

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

Symptoms: 9 days after receiving the first dose of the MODERNA vaccine, my right arm presented a rash in the area of the vaccine, which has an approximate circumference of 3 cm, it presented itching, pain, a hot and red sensation. I also had a mark, resembling a "bite" and feels like a small button.

Other Meds: Omeprazol

Current Illness:

ID: 1395008
Sex: F
Age: 62
State: CO

Vax Date: 04/24/2021
Onset Date: 05/07/2021
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: Pain in extremity

Symptoms: My reaction to the Moderna 2nd dose, was significant. I was sick with a fever and flu like symptoms, but felt better after a few days, but not 100pct. About 7 days later I had a deep pain just under my left shoulder blade, like a muscle or torn rib but more intense, about 3 days later I developed a painful and itchy rash on my right shoulder Blade. I remember feeling extraordinarily exhausted, extreme headaches and brain fog so bad that I could not focus, concentrate or remember what I was doing. I lost my temporary job because I was unable to comprehend or remember things. I was able to get into the doctor who confirmed it was Shingles. They gave me a steroid and anti viral. The rash went away, but the lethargy, weakness, and radiating pain in my back, right shoulder, neck and arm and chest is still there.

Other Meds: None

Current Illness: None

ID: 1395009
Sex: M
Age: 30
State: CT

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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: n/a

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

Symptoms: About 2 minutes after administering the vaccine to the patient, the patients fiance notice that the patient began to roll his eyes and slump over. Upon accessing the patient I notice that the patient was unresponsive to my calls, at which point I motion for my technician to call for emergency; then I proceeded to try to move the patient from the chair to the floor with the aid of his fiance. The patient became responsive a second before we go him to the floor and he seemed responsive and was breathing pretty well. The patient was unresponsive for about 35 second at which point his eyes were rolled backwards, his head was sweating profusely as well as his muscles seemed to become very rigid. Thankfully within 5 minutes emergency personal was at the scene and they took his blood pressure and heart rate with both values being on the lower end. The patient objected to going to the hospital, at which point they offered to roll him outside for him to get fresh air and observes him before leaving with his fiance

Other Meds: N/A

Current Illness: N/A

ID: 1395010
Sex: F
Age: 39
State: TX

Vax Date: 04/01/2021
Onset Date: 05/09/2021
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: None

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

Symptoms: My cycle started 6 days early and I had vaginally bleeding for 18 days straight until my physician gave me a prescription for progesterin to stop the bleeding. I am not sure if I will continue to bleed if my cycle comes on again?.now I am currently 7 days late for it to start.

Other Meds: Vitamin - liquid gold liquid vitamin (vegan)

Current Illness: None

ID: 1395011
Sex: F
Age: 44
State: IL

Vax Date: 03/02/2021
Onset Date: 04/23/2021
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:

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

Symptoms: Shingles

Other Meds:

Current Illness:

ID: 1395012
Sex: F
Age: 11
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Vaccine was given to an 11 year old, age was not verified by nurse before giving the injection

Other Meds:

Current Illness:

ID: 1395013
Sex: F
Age: 36
State: SC

Vax Date: 01/21/2021
Onset Date: 03/25/2021
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: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Autoimmune disease - lupus.

Other Meds: N/A

Current Illness: N/A

ID: 1395015
Sex: M
Age: 15
State: CA

Vax Date: 06/05/2021
Onset Date: 06/06/2021
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:

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

Symptoms: Fever, nausea for 36-48 hrs in length. Cleared. 48 hrs later no fever but severe nausea, vomiting, and diarrhea for 36 hrs appxly. Has seemingly cleared currently for past 12 hours.

Other Meds:

Current Illness:

ID: 1395016
Sex: F
Age: 34
State: MI

Vax Date: 06/13/2021
Onset Date: 06/13/2021
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: After receiving the second shot of covid vaccine (pfizer), the patient started experiencing severe pain on the right side of her head. Her eye shut closed, and she couldn't keep it open. Her eye was also watery. She then started experiencing difficulty breathing and chest tightness. She was also sweating.

Other Meds:

Current Illness:

ID: 1395017
Sex: F
Age: 51
State: CA

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: RA

Lab Data:

Allergies:

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

Symptoms: Patient called pharmacy on 06/13/2021 01:20 P.M.. She complained of swelling from her left knee to her toe since getting her first dose of the Pfizer vaccine on 06/11/2021 in her right arm. Her arms were not swollen. Just her left leg. Swelling started the night of 06/11/2021 and has not improved since then. She said she hadn't done any walking or any other movement that would cause this swelling. I told her to try putting on cold compresses and taking allergy medication to help with the swelling, and if it doesn't improve, to go see a doctor.

Other Meds:

Current Illness:

ID: 1395018
Sex: M
Age: 21
State: TN

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: none

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

Symptoms: Next morning after receiving vaccine, there was tightness in upper chest that migrated to the left side near the heart. It persisted for about 3 weeks and then I started having stomach problems. About a month after I started having headaches and started having difficulty breathing.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm