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: 1399387
Sex: M
Age: 76
State: OH

Vax Date: 01/12/2021
Onset Date: 04/27/2021
Rec V Date: 06/15/2021
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: Resident received 2 doses of Pfizer COVID vaccine on 1/12/21 and 2/2/21. Resident also received 2 doses of Moderna vaccine on 4/1/21 and 4/29/21. No apparent issues,

Other Meds:

Current Illness:

ID: 1399394
Sex: F
Age: 78
State: FL

Vax Date: 01/07/2021
Onset Date: 01/10/2021
Rec V Date: 06/15/2021
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: Mastitis in left breast. PCP prescribed 10 days of Doxycycl HYC Tab. 100 mg. PCP doubted that the mastitis had anything to do with the vaccination.

Other Meds: Atenolol 25 mg, Citracal, Vit. C, Red Rice Yeast + Co-Q10

Current Illness: none

ID: 1399402
Sex: F
Age: 38
State:

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 06/15/2021
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: Headache, UrticariaPruritus & NauseaVomiting Narrative: Pt took diphenhydramine and hives resolved

Other Meds:

Current Illness:

ID: 1399406
Sex: F
Age: 31
State: CO

Vax Date: 05/18/2021
Onset Date: 06/02/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: Cashews

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: When I got the first vaccine I was in my 36th week of pregnancy. I started to get a tingling sensation 06/3/2021 on my right pelvic area and extended up to my back. I developed a rash on 06/05/2021 and it felt like a burning sensation if I touched it. I went to the Urgent Care two days later because the rash was spreading. They took a swap and it was positive for Shingles. I had the Chicken Pox as a child and I had the Chicken Pox vaccine as well. I was given Acyclovir5Xdaily for 7 days. The rash dried up and it is starting to get better. Due Date: 06/28/2021 Pregnancy: First

Other Meds: Prenatal Vitamins Iron

Current Illness:

ID: 1399407
Sex: F
Age: 59
State: AL

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

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

Lab Data:

Allergies: macradantin

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

Symptoms: sore arm, unable to lift arm it has been 2 months now. Heat in arm. Painful especially when turning arm, wakes me up at night. No strength in arm.

Other Meds: Losartan, Maxzide,Gabapentin, Prozac, Centrum silver, vitamin D, Baclofen, hydrocodone, Magnesium, Potassium

Current Illness: COPD

ID: 1399408
Sex: M
Age: 39
State: OH

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

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: allergic to peanuts

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

Symptoms: The headache, chills, nausea were initial symptoms. Within a week I became disoriented, forgetful, and had terrible headaches that led me to the Emergency Department. I was diagnosed with a Glioblastoma, clogged rear brain ventricles, and encephaly within 3 weeks of receiving the vaccine.

Other Meds: no

Current Illness: no

ID: 1399409
Sex: F
Age: 52
State: GA

Vax Date: 06/12/2021
Onset Date: 06/13/2021
Rec V Date: 06/15/2021
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: i tasted the shot when it kicked in around midnight on 6/13/21. after that i began feeling nausious and extremely tired and my head, neck, and lower back began to really hurt. I was at work when this occurred. I got off work at 7:30 am and went home and went through hot and cold flashes, throwing up, migraines, body ached all over, and it felt like i had phlemph stuck in my throat. i still am not feeling well and the headaches are coming and going and hot and cold flashes. I am keeping down water at this point. the body aches are mostly occurring at night now.

Other Meds: none

Current Illness: none

ID: 1399410
Sex: F
Age: 34
State: TX

Vax Date: 04/26/2021
Onset Date: 05/18/2021
Rec V Date: 06/15/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: Carotid Artery Dissection; suspected it started on 5/18/21 with further tearing on 5/21/21. Additionally, on 5/25/21, my ability to swallow and speak was greatly diminished. It was later determined on 6/3/21 that I had a carotid artery dissection and the dissection pushed on the nerves that controlled my voice box.

Other Meds: Nuvaring

Current Illness: None

ID: 1399411
Sex: M
Age: 42
State: OK

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/15/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient was known to have fainting spells due to seeing blood in the past while in his doctor office. Shortly after immunization took place he fainted. We laid him down on the ground and propped his feet up. After a few moments he came to. He confirmed he was able to leave after another 15 minutes of monitoring.

Other Meds: none

Current Illness: none

ID: 1399412
Sex: F
Age: 45
State: AZ

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/15/2021
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: Vicoden

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Hesitant about getting the vaccination to begin with. Decided to do it anyway. At 11:00am I got the dose on my left arm. I waited the full 30 minutes after dose one of the Pfizer vaccination. Everything was good. I left and returned to my house. I felt out of it when I got home kind of a stoned feeling. As the day progressed I started to get amped up like I had a lot of coffee. I was extremely hungry too. Which was rare as I only eat 2 meals a day. Anyway, I tried going to bed around 7pm . Eight hours after I received the vax. As I laid in bed my skin felt like it was burning and became extremely itchy. This went on all night and I had massive insomnia and could not sleep. The following morning I woke up to a red rash all over my face on my arms and it would heat up go away heat up go away. The skin was still burning and massively itchy. These were the only reactions I had to the shot. I did not have a fever, or joint pain, or any of the other symptoms people described after the first dose. That I decided to go to my Dr.

Other Meds: None

Current Illness: None

Date Died: 05/29/2021

ID: 1399413
Sex: F
Age: 34
State: CA

Vax Date: 05/13/2021
Onset Date: 05/28/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: No Allergies

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

Symptoms: began with a fever, and slowly starting having nausea and diarrhea. we could not bring down fever with antibiotics

Other Meds: No Perscriptions

Current Illness: None

ID: 1399414
Sex: M
Age: 58
State: WI

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/15/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Given too soon, 21 days after the first dose.

Other Meds:

Current Illness:

ID: 1399415
Sex: F
Age: 80
State:

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine expired 18 hours previously

Other Meds:

Current Illness:

ID: 1399417
Sex: F
Age: 48
State: NC

Vax Date: 04/02/2021
Onset Date: 04/08/2021
Rec V Date: 06/15/2021
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: nka

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

Symptoms: Pt reported to me on 6-14-21 that she has been experiencing numbness and pain on the side of her body. Started 6 days after the vaccination. she saw a specialist 1 and 1/2 weeks after the vaccination. Specialist told her he thinks she might have had a stroke and wanted her to contact us to let you know of this.

Other Meds: -

Current Illness: unknown

ID: 1399418
Sex: F
Age: 55
State: WA

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 06/15/2021
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: EVERY PART OF MY BODY HURT ESPECIALLY MY HIPS, KNEES, NECK, HEAD, INJECTION SITE & NAUSEA BEGINNING DAY AFTER INJECTION & LASTED 3 DAYS. SORE THROAT AND CHEST TIGHTNESS, PALPITATIONS, FATIGUE, INABILITY TO CATCH BREATH AND UNABLE TO CLEAR MY THROAT HAS NOT GONE AWAY!!!!!!

Other Meds: SPIRONOLACTONE

Current Illness: NONE

ID: 1399420
Sex: F
Age: 51
State: CA

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 06/15/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin

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

Symptoms: while waiting the 30 minutes after the injection. i started feeling sharp pain in the heart area and asked the nurse if this was normal. they took my pressure and vitals and had me sit longer to see how i felt. The sharp pain went away but i felt pressure on the left chest area. I thought i was fine since the shooting pain was gone. The nurse said to go to the ER if the sympotms persisted. I felt tired the following 2 days with pressure on the chest. Monday 4/5 i felt more pressure and pain on the left neck and left upper back shoulder and called the triage nurse and said go to the E.R not urgent care.

Other Meds: none

Current Illness: none

ID: 1399421
Sex: M
Age: 61
State: PA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 06/15/2021
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

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

Symptoms: Immediately after the vaccination nothing, but 2 hours later I became aware of a ringing sensation in both of my ears. This is still ongoing to this day. I let a week go by and it was still there, I reported it to my doctor through a video chat. My doctor suggested to let it go and see what happens and contact him after I had my second vaccine and 2 weeks after that. I got back in touch with him and told him it hadn't gone away. He examined me and referred me to an audiologist. Audiologist had seen similar symptoms in other patients. It wasn't affecting the way I hold my conversations, I can watch TV, it does not get in the way. The audiologist stated there was a possibility it could disappear or never go away.

Other Meds: Humalin, Victosa, Metformin, Gabapentin, Enalapril, Heorvastatin, Protonix

Current Illness: no

ID: 1399422
Sex: F
Age: 51
State: KY

Vax Date: 02/25/2021
Onset Date: 03/17/2021
Rec V Date: 06/15/2021
Hospital: Y

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

Lab Data:

Allergies: Unknown

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 02/25/2021: Patient received 1st dose of Moderna 03/17 ? 3/19: 20 days after 1st dose, c/o progressively worsening bilateral lower extremity weakness of several weeks? duration. Patient had also suffered from recurrent falls over the preceding several days prior to admission. subsequent CT scan of the abdomen and pelvis revealed severe hepatic steatosis and a CT angiogram of the chest revealed bilateral pulmonary emboli. She subsequently had a duplex ultrasound of the lower extremities that revealed a right lower extremity DVT. MRI of the lumbar spine was performed for further evaluation of her bilateral lower extremity weakness that revealed some moderate bilateral neuroforaminal narrowing with mild spinal stenosis at L3-L4 and moderate spinal stenosis at L4-L5 with some degenerative endplate changes at similar levels. Dx: Pulmonary embolism - discharged home on Xarelto for complete treatment of her DVT/PE. 3/25: 2nd dose of Moderna given at Primary care - referred to ER for complaints. 3/25: ER encounter - She has been experiencing heavy vaginal bleeding, passing large clots at times, for the past six days. She reports that she usually has regular menstrual cycles, regulated on oral contraceptive pills. Dx: Menorrhagia with regular cycle, Anticoagulated ? treated and discharged on TXA 3/28 ? 4/4: 3 days after 2nd dose. presents with ongoing vaginal bleeding complicated by lightheadedness with standing, generalized weakness and fatigue, and dyspnea on exertion. Patient states she has been bleeding for almost 2 weeks vaginally. Dx: severe symptomatic anemia due to dysfunctional uterine bleeding / Menorrhagia and need for anticoagulation, Folate deficiency anemia, Venous stasis. Rx: Transfused 3 units, Provera, Due to recent VTE in stable hemoglobin cautiously started heparin, Oral contraceptives stopped, resumed Xarelto, folic acid supplement.

Other Meds: Multiple

Current Illness:

ID: 1399423
Sex: F
Age: 30
State: OK

Vax Date: 03/26/2021
Onset Date: 05/08/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: Cipro, Latuda, Bactrim, Flagyl, Percocet, Lortab, Trileptal

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: venous thrombosis

Other Meds:

Current Illness: none

ID: 1399424
Sex: F
Age: 39
State: OR

Vax Date: 06/12/2021
Onset Date: 06/14/2021
Rec V Date: 06/15/2021
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: Full body hives the third morning after the vaccine-advice nurse said go to the ER within the hour, they gave me a steroid shot and said was an allergic reaction. I don?t have any known allergies and never had hives before. I also had diarrhea, chills, fever, right lymph node swollen and painful, and exhaustion the second day after the vaccine.

Other Meds: None

Current Illness: None

ID: 1399425
Sex: F
Age: 61
State: OH

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 06/15/2021
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:

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

Symptoms: Patient called stating that starting 1 day following vaccine, she experienced arm, neck and shoulder blade pain sustaining to this day. Patient followed up with doctor and was prescribed a course of steroids but wanted to notify the pharmacy.

Other Meds:

Current Illness:

ID: 1399426
Sex: F
Age: 22
State: MN

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: Wheat: upset stomache/numbness in the face Latex gloves: Hands felt like they were buring

Symptom List: Unevaluable event

Symptoms: Patient stated that she felt a "lump and tightness" after 15 minutes of injection in her throat after receiving her first Pfizer covid vaccine. Vital signs taken o2 97%, HR 102, temp 98.4 orally, BP 126/88. Patient seen by PA who stated no swelling in mouth seen, vitals normal. Patient waited an additional 15 minutes. Patient felt better when she left clinic.

Other Meds: Fluocinonide 0.05 % Solution Continue Ketoconazole 2 % Shampoo Start Ketoconazole 2 % Cream Start Triamcinolone Acetonide 0.1 %

Current Illness: unknown

ID: 1399427
Sex: M
Age: 35
State: CA

Vax Date: 04/21/2021
Onset Date: 05/26/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Heart palpitations. Frequency fluctuates and is much more noticeable after a heavy/fatty meal and more pronounced when lying down or in the reclining position. I don't remember the exact time it started, but it was soon after my second dose. It became more pronounced after I had a meal with deep fried foods.

Other Meds: Biotin 10,000mcg once every other day 3x drops of Lugol's solution 2% with water every other day alternating with Biotin Zinc 25mcg every day 1/2 tablet vitamin B-complex 1/2 tablet vitamin C 1 capsule omega-3,6,9

Current Illness: none

ID: 1399428
Sex: M
Age: 28
State: IL

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/15/2021
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: codeine, Tylenol, tree nuts

Symptom List: Injection site pain, Pain

Symptoms: Pt. presented to nurse with complaints of dizziness and scratchy throat. Nurse contacted on-site medics immediately. On-site medics assessed patient. Per patient's request, pt. was transferred to the ER via ambulance.

Other Meds: Allergy medications

Current Illness: Seasonal allergies

ID: 1399429
Sex: F
Age: 64
State: CO

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 06/15/2021
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: Pt reports feeling significant chest pain the night of his first vaccination. Pain has now been intermittently bothersome and he has had multiple workups since that point.

Other Meds:

Current Illness:

ID: 1399430
Sex: M
Age: 21
State:

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/15/2021
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:

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

Symptoms: vaccine had expired 18 hours previously

Other Meds:

Current Illness:

ID: 1399431
Sex: F
Age: 65
State: CA

Vax Date: 06/12/2021
Onset Date: 06/14/2021
Rec V Date: 06/15/2021
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: Pineapple, papaya, kiwi

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: bicep swollen, hot to touch, red

Other Meds: HCTZ, Propranolol, Lisinopril, Estradiol

Current Illness:

ID: 1399432
Sex: F
Age: 35
State:

Vax Date: 05/30/2021
Onset Date: 06/03/2021
Rec V Date: 06/15/2021
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

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Extreme diziness, left arm numb and tingly, bad brain fog, dizziness has not stopped since 4 days after vaccine, every day. Cannot complete simple tasks at work as fast, hard to concentrate, pressure in ears, balance feels off. Hard to manage day to day routine with my kids, dizzy all the time, This is affecting my work, my lifestyle and every day concentration

Other Meds: none

Current Illness: none

ID: 1399433
Sex: M
Age: 29
State: TX

Vax Date: 04/26/2021
Onset Date: 05/26/2021
Rec V Date: 06/15/2021
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: Allergies to pollen, and almonds

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

Symptoms: Severe vertigo, nausea, light headedness at night. Lasts 30 mins. Room spins, etc

Other Meds: None

Current Illness: None

ID: 1399434
Sex: F
Age: 19
State:

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/15/2021
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: vaccine had expired 18 hours previously

Other Meds:

Current Illness:

ID: 1399435
Sex: F
Age: 35
State: TX

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: Sensitivity to Corticosteroids, Allergic to purple food coloring and agave.

Symptom List: Injection site pain

Symptoms: Within three hours after vaccination period type cramping outside of regular period. Twenty-four hours after the following symptoms began. Muscle pain. Chills. Fever. Shortness of breath. Fluid buildup in lungs. Cough. Hives all over body.

Other Meds: none

Current Illness: None

ID: 1399436
Sex: F
Age: 85
State: OH

Vax Date: 01/12/2021
Onset Date: 04/29/2021
Rec V Date: 06/15/2021
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: Resident received 2 doses of Pfizer COVID vaccine 1/12/21 and 2/2/21 and then 2 doses of Moderna vaccine 4/1/21 and 4/29/21.No adverse events noted.

Other Meds:

Current Illness:

ID: 1399437
Sex: F
Age: 13
State: CA

Vax Date: 04/16/2019
Onset Date: 11/01/2019
Rec V Date: 06/15/2021
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: 6 months after receiving Gardasil 9 vaccine my daughter stopped having periods. Two years later the problem has not been resolved.

Other Meds: None

Current Illness: None

ID: 1399438
Sex: M
Age: 39
State:

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/15/2021
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: Tremor

Symptoms: vaccine expired 18 hours previously

Other Meds:

Current Illness:

ID: 1399439
Sex: F
Age: 21
State: OR

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: I was at my apartment and started aching all over and then I was cold sweating the whole night and woke up still aching everywhere.

Other Meds: Keppra

Current Illness:

ID: 1399440
Sex: F
Age: 65
State: CA

Vax Date: 03/10/2021
Onset Date: 05/28/2021
Rec V Date: 06/15/2021
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: Penicillin

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

Symptoms: Moderna shots given at a vaccine facility on 2/6/21 and 3/10/21. She has had a gradual onset of shortness of breath. Seen by me on June 1. Dx cardiomyopathy, Class 3 CHF. Hospitalized at local Medical Center. Currently still being treated by cardiology team.

Other Meds: Estrogen, Eszopiclone, Hydrochlorothiazide, Meloxicam, Vyvanse (for at least 5 years), D3, Magnesium,

Current Illness: None

ID: 1399441
Sex: F
Age: 26
State:

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 06/15/2021
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: H/A, Dizzy, Faint

Other Meds:

Current Illness:

ID: 1399442
Sex: F
Age: 20
State: TX

Vax Date: 03/29/2021
Onset Date: 04/03/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: Sulfa based meds

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: About a week after the first dose, she went to sleep. She woke up to a burning sensation in her left arm in the forearm. It was more painful towards the wrist, but went up to the elbow. She could not go back to sleep. Woke up boyfriend to take her to urgent care. They drew blood, gave her pregnancy test. Gave her an inflammatory (Toradol). Gave her a prescription to take at home. Then sent her home. She had to miss 2 days of work. After 24 Hours pain dissolved and has not returned.

Other Meds: Melatonin gummies- 500mg @night Vyvanse 20mg 1x daily Topiramate 50mg 2x daily Lexapro 10mg 1xdaily

Current Illness:

ID: 1399443
Sex: F
Age: 59
State: NC

Vax Date: 03/11/2021
Onset Date: 04/02/2021
Rec V Date: 06/15/2021
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: It started in my right thumb in the joint it started swelling and I could bend it. The pad part of my hand was very tender. My doctor said that it may be trigger thumb caused by Tendonitis. About two weeks ago I began to have the same pain in the left hand and the same symptoms. I was offer the same treatment but I didn't take it because the first shot hurt so bad. The doctor said that if it is unusual to have the same thing in both hands. He don't think it is related to the Pfizer vaccine but I do. (Participant) I am still having trouble with both hands hurting.

Other Meds:

Current Illness:

ID: 1399444
Sex: M
Age: 86
State: NM

Vax Date: 02/18/2021
Onset Date: 02/20/2021
Rec V Date: 06/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Shoulder was sore after shot. Hands were cold (freezing) within a day, Joints at hands are swollen and can barely use; joints at shoulders ache; Hips and knee joints ache; oxycotin prescribed for pain but patient did not like side effects

Other Meds: Lansoprazole 30mg, Xarelta 20 mg, Sinvastatin 10 mg, Lisinopril 20 mg

Current Illness:

ID: 1399445
Sex: M
Age: 63
State: WV

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Pain in extremity

Symptoms: THE Night of the injection a fever developed. Severe fatugue and feeling sick. After two days this subsided but had impacted my immue system enough to cause a relapse of Babesia to the point where I had encephalitis. The encephalitis caused confusion and reduced mental ablity to the point where I had to leave work and go on short term disablity which am on still. The people administering the vacine asked me if I was immune compromized and I told them YES. They asked why and I told them Lyme Disease. They administered the Vaccine any way.

Other Meds: ambien, xanax , azithromycin, coartem, anabuse

Current Illness: Lyme Disease, Babesia

ID: 1399446
Sex: F
Age: 58
State: NC

Vax Date: 05/10/2021
Onset Date: 05/13/2021
Rec V Date: 06/15/2021
Hospital:

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

Lab Data:

Allergies: A lot

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

Symptoms: Pain in left arm. Knot on left arm in place shot was given. No taste or smell.

Other Meds: N/A

Current Illness: Pain in left arm, knot in left arm, no appetite, bad taste, no smell

ID: 1399447
Sex: F
Age: 46
State: WA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 06/15/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: "on 4/30 i left to go get my 2nd covid shot at a clinic. afterwards my arm was pretty sore. then over the next few days it continued to be really sore and developed a hard round lump, red and then the numbness started to kick in and became tingly. On wednesday my arm was still numb and tingly and the lump was even bigger. I left work and went to the hospital. thats when they monitored me and advised me to rest and gave me benedryl and a lidocaine patch,. advised to ice and heat. I am back at work today 5/8 and my arm is still numb and tingly and still hurts."

Other Meds:

Current Illness:

ID: 1399448
Sex: F
Age: 64
State: GA

Vax Date: 02/04/2021
Onset Date: 04/04/2021
Rec V Date: 06/15/2021
Hospital: Y

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Pt was in her usual state of health until January, when she had mild symptoms of covid 19. She quarantined for two weeks, then received the first dose of covid 19 vaccine. Following the vaccine, husband noticed gradual decline. Started with trouble walking and gait instability, slurred speech, swelling in feet and legs, dizziness, and SOB. She went to neurologist, had MRI that read "patchy white matter disease" with EEG consistent with encephalopathy. She also went to physical therapy to help with her strength and gait. She would be tired after but could still move joints with assistance. In the last 6 weeks, pt seems to have gotten even worse. She does not even move her joint, barely moves fingers and toes, has intermittent slurred speech and episodes of gibberish. She 24 hour care. She was discharged from PT due to inability to progress more. She is currently being treated at Hospital

Other Meds: lisinopril (PRINIVIL,ZESTRIL) 2.5 MG tablet lovastatin (MEVACOR) 10 MG tablet meclizine (ANTIVERT) 25 mg tablet

Current Illness: COVID-19 diagnosis in January

ID: 1399449
Sex: M
Age: 16
State: MA

Vax Date: 06/15/2021
Onset Date:
Rec V Date: 06/15/2021
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: NKA

Symptom List: Vomiting

Symptoms: 2nd Moderna vaccine given. Aware of age <18 YO prior to administration. CDC guidelines followed to give 2nd Moderna off label shot of series for 16 YO. PCP notified of off label use Moderna for 16 YO and OK for 2nd shot. No adverse events reported from first Moderna vaccine. Well tolerated.

Other Meds: NA

Current Illness: cold symptoms 2 weeks after first Moderna vaccination 5/18/21, no complaints offered

ID: 1399450
Sex: M
Age: 43
State: FL

Vax Date: 06/13/2021
Onset Date: 06/14/2021
Rec V Date: 06/15/2021
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: Shellfish

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Nausea, vomiting, strong headache, muscle pain, fever, chills, high blood pressure (154/87), no high blood pressure history

Other Meds: None

Current Illness:

ID: 1399451
Sex: F
Age: 43
State: NH

Vax Date: 06/02/2021
Onset Date: 06/04/2021
Rec V Date: 06/15/2021
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: i lost my sense of taste for 5 days after the vaccine

Other Meds:

Current Illness:

ID: 1399452
Sex: M
Age: 51
State: CA

Vax Date: 02/13/2021
Onset Date: 04/16/2021
Rec V Date: 06/15/2021
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: The patient develop herpes zoster in the left V1 distribution.

Other Meds: Atorvastatin, Aspirin, Lisinopril, Bisoprolol, Tadalafil

Current Illness: None

ID: 1399453
Sex: M
Age: 25
State: IL

Vax Date: 06/11/2021
Onset Date: 06/14/2021
Rec V Date: 06/15/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Vaccinated on Friday AM. Typical fever chills of vaccine about 10 hours later. Pt was taking NSAIDS, and symptoms continued Sat and Sun getting worse Sunday Night. Woke up Monday AM with severe CP 8/10. Came to ER. Found to have Trop HS of 222, EKG changes with diffuse ST elevation, and preserved EF. diagnosis of perimyocarditis and actively recovering. Treated with anti inflammatory medications.

Other Meds:

Current Illness:

ID: 1399454
Sex: F
Age: 41
State: VA

Vax Date: 06/11/2021
Onset Date: 06/13/2021
Rec V Date: 06/15/2021
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: nabumetone, olanzpine, quetiapine, ziprasidone, and penicillin

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

Symptoms: Left arm swelling, redness, warmth, and tenderness to the injection site. Generalized bodyaches, headache, nausea, & fatigue.

Other Meds: atorvastatin, buspirone, clonidine, loratadine, melatonin, omeprazole, oxcarbazepine

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm