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: 1407698
Sex: M
Age: 31
State: TX

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/17/2021
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: Patient received first dose Pfizer in January 2021, second dose Moderna on 6/13/2021. Troubleshooting: pt checked Pfizer in the computer as 1st dose. Scribe and vaccinator did not look at card to see what was given prior; first vaccine out of state, so no clear record. Counseled by staff that he had received two doses of mRNA vaccine and advised to check with his doctor whether additional vaccine is needed, since the first vaccine was given so far outside the recommended 42 days between the 2 doses. Vaccinator and scribe both counseled.

Other Meds:

Current Illness:

ID: 1407699
Sex: M
Age: 21
State: FL

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 06/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient presented to ED with c/o body aches, cold sweats, night sweats, coughing, weight loss, and fevers that have worsened since onset around 2 weeks ago. Patient states his symptoms started after receiving the second Pfizer COVID-19 vaccination on 5/22/2021. Presents with fever of 101.4. Patient was transferred to the hospital for a higher level of care. ED Diagnosis : Leukemia, acute

Other Meds: N/A

Current Illness: None documented

ID: 1407700
Sex: F
Age: 16
State: MA

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/17/2021
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: Aspirin, ibuprofen, environmental

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

Symptoms: PT is a 16-year-old female with a history of dysmenorrhea and dyslexia who is otherwise healthy, and is presenting after various neurologic symptoms after second Covid vaccine on 6/9/21. PT was in her usual state of health until she had her second Covid vaccine on June 9 around 2:30 PM. She reported that initially about 10 to 15 minutes after the vaccine she began experiencing a headache and blurry vision. However this resolved after 10 to 15 minutes of resting, and patient did not think much of it at the time. She thought it was likely either due to dizziness or to anxiety around the shot. For the rest of the day she felt like her typical self. On June 10 she woke up feeling normal and went to school. Around 1:30 PM she began experiencing a severe headache that she described as pounding. She did feel like this was the worst headache of her life and rated it about a 7 out of 10. This headache continued and she began experiencing also some numbness and tingling in her right thumb that then spread to her hand. During the symptoms she suddenly had an episode of abnormal speech. She was attempting to talk to friends when she began and having difficulties forming words. She remembers being able to think logically and could think about what sentence she wanted to say, but when she tried to speak the words came out as nonsensical sounds. Eve was confused and scared by this and immediately went to the school nurse. This lasted for about 2 minutes where she was having complete aphasia. The school nurse monitored her and suspected she was having a panic attack. After 2 minutes she began being able to form words properly but was still having difficulty forming sentences that were sense of call in finding words. This lasted for about 10 minutes, and then patient returned back to baseline. School nurse called mom and mom picked patient up and immediately took her to the pediatrician. Pediatrician saw her about an hour after this episode and by the time they examined her she was completely back to her baseline. Pediatrician then referred her to neurology. Since this episode on June 10 pt has experienced intermittent symptoms including: Periodic headaches, numbness and tingling of right forearm and thumb, muscle cramping and pain. She has not had any further events of blurry vision or aphasia. She has not had any weakness or clumsiness. She has been able to engage in normal life activities. However her intermittent symptoms have persisted and have been concerning to family. She was seen by neurology outpatient on June 11 who evaluated her and at that time suspected that her vaccine may have triggered a hemiplegic migraine. They recommended brain MRI to rule out other intracranial abnormalities. Family was waiting for this MRI but her symptoms were continuing and were concerning to family. Today on June 14, Eve was experiencing muscle cramping in bilateral lower extremities and upper extremities and continuing to experiencing numbness and tingling of bilateral forearms and thumbs intermittently. The pain from cramping was more severe today than prior days, and because of this family felt more comfortable presenting to the ED for further evaluation and not waiting for outpatient MR. PT has never had a blood clot or bleeding disorder that family is aware of. She does take OCPs. There is no family history of blood clots or strokes. She otherwise has been well. She has been afebrile emesis, diarrhea, URI symptoms, abdominal pain. Briefly, 16yoF otherwise generally healthy who p/w persistent HA and paraesthesias following 2nd COVID vaccine. Initially evaluated on Monday this week by Neuro who recommended outpt brain imaging, but presented tonight due to persistence of symptoms. Has been neurologically intact here, asymptomatic aside from mild HA that resolved with tylenol. Labs wnl. Neuro consulted in the ED, ddx cerebral venous sinus thrombosis vs. post-vaccine GBS vs. COVID vaccine-associated neuropathy. MRI/MRV brain w/ contrast and MRI entire spine w/ contrast revealed "Punctate principally bifrontal T2/FLAIR hyperintensities, of indeterminate significance at this point in time. This could relate to demyelination, migraine, or be nonspecific. Follow-up MRI may clarify as clinically desired. No evidence of prior or acute ischemic insult. Unremarkable intracranial MRV. No cerebral venous thrombosis. No significant abnormality seen of the spine." Per Neurology, these lesions are not in a pattern that would be consistent w/ MS, and more likely represent an incidental finding with no correlate on neurologic exam. They recommend follow-up MRI in 6 mos to 1 yr to evaluate for any interval change. They will also continue to follow her for headache management as needed. Discussed this plan with patient and family and they expressed understanding and agreement with this plan for discharge and follow-up. Patient was discharged to home in stable condition.

Other Meds: cetirizine, Lo Loestrin Fe, EpiPen 0.3 mg

Current Illness: None noted

ID: 1407701
Sex: M
Age: 51
State: NH

Vax Date: 05/04/2021
Onset Date: 05/27/2021
Rec V Date: 06/17/2021
Hospital: Y

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

Lab Data:

Allergies: amlodipine, hydrochlorothiazide -- > reactions unknown

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Vertebral and basilar artery thrombosis

Other Meds: aspirin 81mg qD omeprazole 20mg qD valsartan 320mg qD atorvastatin 20mg qD

Current Illness: None known

ID: 1407702
Sex: M
Age: 44
State: TX

Vax Date: 04/21/2021
Onset Date: 05/16/2021
Rec V Date: 06/17/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Bells Palsey on right side of face

Other Meds: Atorvastatin

Current Illness:

ID: 1407703
Sex: F
Age: 29
State: FL

Vax Date: 06/16/2021
Onset Date: 06/17/2021
Rec V Date: 06/17/2021
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 came to pharmacy with rashes all over her body. I noticed the redness on her arms and neck. I gave her 8 ml of liquid Benadryl.

Other Meds:

Current Illness: ASTHMA, ANEMIA

ID: 1407704
Sex: M
Age: 18
State: WA

Vax Date: 04/10/2021
Onset Date: 06/04/2021
Rec V Date: 06/17/2021
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: Bee pollen

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: When he got up to use restroom his symptoms were very mild, though when he woke up the symptoms persisted for ~ 1 week. Does not recall any illnesses, but mother felt that patient seemed a little more fatigued ~ 1 week prior. Went to ER 6/4/21 with tightness in his chest worse with deep breathing, cough, laughing, worse laying down and better sitting upright. Got Pfizer COVID19 vaccine 4/10/21, which is ~ 8 weeks prior to symptoms starting. ECG showing diffuse ST elevation concerning for pericarditis. Troponin was negative, chest x-ray was negative. He was given the instructions to take ibuprofen for 1-2 weeks and just stopped the ibuprofen yesterday. His symptoms resolved after 4 days of using ibuprofen.

Other Meds: Clindamycin lotion, adapalene-benzoyl peroxide

Current Illness: None

ID: 1407705
Sex: F
Age: 44
State: OR

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: nitrates

Symptom List: Pharyngeal swelling

Symptoms: One day following the second injection, reports onset of feelig tired with headache and cough. This symptom complex lasted five days. This was accompanied by itching "like I want to come out of my skin." Took Zyrtec during the day and Benadryl at night. By day six, itching mostly subsided, and headache subsiding to some extent.

Other Meds: Carvedilol,sporonolactone,lisinopril,Lasix,digoxin,statin,metf

Current Illness: migraine with aura

ID: 1407706
Sex: M
Age: 93
State: MD

Vax Date: 04/10/2021
Onset Date: 04/17/2021
Rec V Date: 06/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt was admitted to hospital from ED for acute cholecystitis on 4/17/21, 7 days after getting the second dose of the COVID vaccine. Per guidelines, all hospitalizations' are to be reported

Other Meds:

Current Illness:

ID: 1407707
Sex: M
Age: 70
State: CA

Vax Date: 03/15/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Guillain Barre Syndrome (GBS) and paroxysmal atrial fibrillation (PAF)

Other Meds: Fosinopril, Simvastatin, Verapamil, Riluzole

Current Illness: HTN, DM, Glaucoma, Prostate cancer, spinocerebellar ataxia 6

ID: 1407708
Sex: F
Age: 17
State: MA

Vax Date: 06/15/2021
Onset Date: 06/16/2021
Rec V Date: 06/17/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Large (3 cm) painful supraclavicular lymph node x 1 on the same side as vaccine sight. The patient also has headache and neck discomfort. Temp to 100.5.

Other Meds:

Current Illness:

ID: 1407709
Sex: M
Age: 60
State: IN

Vax Date: 05/15/2021
Onset Date: 06/02/2021
Rec V Date: 06/17/2021
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: ibuprofen

Symptom List: Rash, Urticaria

Symptoms: Patient developed Unilateral (Left)numbness and tingle 3 weeks post 2nd vaccination. Symptoms have not improved. Patient says his left side is very sensitive to hot and cold now. Its his entire left side from left side of face to his foot. Describes it like a line down center of body. No prior episodes of anything like this in teh past. Says it was sudden onset . went to bed fine and woke up with it.

Other Meds: note reported

Current Illness: none reported

ID: 1407711
Sex: F
Age: 41
State: NJ

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Shellfish penicillin

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

Symptoms: I went in for my appointment and I requested Pfizer. They gave me the shot and reported it as Pfizer, but when I want back to get my second vaccine on 6/16/21, the system flagged me as not having received Pfizer last time. The vaccine they think I was given is Moderna Lot # 007B21A, but they aren't sure because things could have gotten crossed on the table.

Other Meds: Over the counter inhaler (Primatene)

Current Illness: None

ID: 1407712
Sex: M
Age: 80
State: CA

Vax Date: 01/28/2021
Onset Date: 02/02/2021
Rec V Date: 06/17/2021
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: I am allergic to Dulcolax.

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

Symptoms: I was weak and dizzy and I fell. I was taken to the hospital and monitored for 6 hours.

Other Meds: I am taking Calcium, Vitamin D3, 81mg Aspirin, Levothyroxine.

Current Illness: No illnesses at the time of vaccination.

ID: 1407713
Sex: M
Age: 22
State:

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/17/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Pt recived Pfizer 24 days ago, and received Janssen today. Instructed to file VAERS report due to admin error and Pt received shot within 28 day window.

Other Meds:

Current Illness:

ID: 1407714
Sex: M
Age: 36
State: WA

Vax Date: 05/03/2021
Onset Date: 06/11/2021
Rec V Date: 06/17/2021
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: In early May my 2nd Moderna vaccine shot caused a typical flu like symptom for 48 hours and then back to normal. About a month has passed and on June 11th I have started to feel like I had a sore throat, then the next day and since then I have an intense pain around my thyroid area when swallowing and it feels sore to the touch. My doctors office has taken swabs for flu and bacteria which have come up negative, and I am waiting on a Covid test which I presume will also be negative. Currently they diagnosed me with Pharyngitis, and I believe that it is subacute thyroiditis as a reaction from the vaccine. I have not been sick or come in contact with any sick people, and have worn a mask everywhere out of my home.

Other Meds: Dessicated Thyroid Hormone (Armour Thyroid)

Current Illness: None

ID: 1407715
Sex: F
Age: 47
State: CA

Vax Date: 05/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/17/2021
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: Cipro

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

Symptoms: June 5 - Trigeminal Neuralgia like pain in left lower jaw June 10 - Sores developed on lower left gum - started regimen for Shingles

Other Meds: 40mg Cymbalta

Current Illness: NA

ID: 1407716
Sex: M
Age: 72
State: OH

Vax Date: 02/14/2021
Onset Date: 03/01/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Development of PolyMyalgia Rheumatica Diagnosis delayed as first thought to complication of Lipitor. When persistent was diagnosed

Other Meds: None

Current Illness:

ID: 1407717
Sex: M
Age: 18
State: TX

Vax Date: 04/03/2021
Onset Date: 06/10/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: On the location of the shot a big bump has popped up feels like its getting bigger, and theres a slight pain when i put pressure on it. Its been almost 3 months since i got the vaccine and i didnt notice the bump till this month.

Other Meds:

Current Illness:

ID: 1407718
Sex: F
Age: 14
State: MA

Vax Date: 06/05/2021
Onset Date: 06/06/2021
Rec V Date: 06/17/2021
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: Large (3 cm) painful supraclavicular lymph node on the left side. Same side as vaccine given.

Other Meds: no

Current Illness: viral illness a few days after symptoms presented.

ID: 1407719
Sex: F
Age: 47
State: UT

Vax Date: 03/05/2021
Onset Date: 03/19/2021
Rec V Date: 06/17/2021
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: After the first shot, I did get very sick during the wee hours of the morning (shot was in the afternoon). I had chills, severe nausea and vomiting. It ceased about six hours later, though I was extremely tired the next couple of days. ***What I'm most interested in reporting*** is that my fingertips started tingling/numb/little "electric shocks" a couple or so weeks after the first shot, and are ***more intense and frequent after the second dose,***& which was given 04/02/21 (same location as first). My toes also tingled a bit after the first shot (several times a day), but that stopped and didn't happen after the second dose. I had no vomiting , chills, nausea or other traditional effects after the second dose. My fingertips tingle/are numb nearly all the time. The little shocks are several times a day (5-10+). It's not painful, per se, but is disconcerting and I'm concerned the effect is permanent.

Other Meds:

Current Illness:

ID: 1407721
Sex: M
Age: 57
State: NE

Vax Date: 05/03/2021
Onset Date: 06/14/2021
Rec V Date: 06/17/2021
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 known allergies

Symptom List: Unevaluable event

Symptoms: Patient reported to Hospital ED on 6/14/21 and 6/17/21 with left sided face dropping. Patient was told of diagnosis on 6/17/21 of COVID-19 vaccination associated Bell's Palsey after multiple tests performed on both visits. Patient was alert when coming to pharmacy and had clear signs of face dropping on left side. He was told to report to pharmacy by ED to submit a VAARS.

Other Meds: none on file, or listed

Current Illness: exposure to somebody that had tested positive to covid within 14 days prior to vaccination

ID: 1407722
Sex: F
Age: 59
State: MS

Vax Date: 01/21/2021
Onset Date: 02/06/2021
Rec V Date: 06/17/2021
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: Codeine

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

Symptoms: Headache, Nausea, Vomiting, Bleeding Gums, Fever Blisters, Oral Lesions. Metal Taste in Mouth. Only Able to eat soft foods. Jan-May. Took 3 rounds of antiviral. Also went to dentist because of oral pain.

Other Meds: Vitamin C, Zinc, Vitamin D

Current Illness: None

ID: 1407723
Sex: F
Age: 67
State: CO

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 06/17/2021
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: Penicillin , sulfur, iodine

Symptom List: Injection site pain, Pain

Symptoms: Benadryl depression

Other Meds: prescriptions

Current Illness: None

ID: 1407724
Sex: M
Age: 15
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: PATIENT PASSED OUT, AND WOULD NOT COME TO WHEN NAME WAS CALLED OR WHEN HE WAS SHAKEN. CALLED 911, ADMINISTERED EPIPEN, AND PREPARED TO PERFORM CPR (DID NOT NEED TO AS THE PATIENT CAME TO WITH THE EPIPEN)

Other Meds:

Current Illness:

ID: 1407725
Sex: F
Age: 32
State: CA

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

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

Lab Data:

Allergies: NONE

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

Symptoms: PATIENT HAS FEAR OF NEEDLE AND HAD AN ANXIETY ATTACK WITH SYNCOPE. NEEDED TO LIE DOWN 10 MINUTES TO RECOVER.

Other Meds: N/A

Current Illness: NONE

ID: 1407726
Sex: M
Age: 60
State: KS

Vax Date: 05/20/2021
Onset Date: 06/16/2021
Rec V Date: 06/17/2021
Hospital: Y

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

Lab Data:

Allergies: Codeine (GI upset)

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Covid vaccine received on 5/20/2021. Patient went to another state over weekend and reported spending most of Sunday, June 13, 2021 in a vehicle. Patient presented to cardiology outpatient appointment with dyspnea on 6/16/2021. Later that same day was loading hay in very hot weather (around 100 degrees Fahrenheit) and became dizzy. Later, that same day the dizziness remained and new symptoms of chest pain and shortness of breath. Patient presented to ER that evening, and was admitted to the hospital for bilateral pulmonary emboli extending into all lobes of the lungs.

Other Meds: Aspirin 81 mg daily, atorvastatin 40 mg daily, isosorbide mononitrate 30 mg daily, lisinopril 10 mg daily, metolazone 2.5 mg dialy, metoprolol succinate 12.5 mg daily, naproxen 500 mg twice daily, omeprazole 20 mg daily

Current Illness: none

ID: 1407727
Sex: M
Age: 31
State: NY

Vax Date: 03/16/2021
Onset Date: 04/01/2021
Rec V Date: 06/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sickle cell pain crisis with acute chest syndrome; 4 separate episodes since dose #2 of the vaccine

Other Meds:

Current Illness:

ID: 1407728
Sex: F
Age: 57
State: MI

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 06/17/2021
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: NKA

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

Symptoms: She received her first dose of the Pfizer COVID vaccine about one month ago. Starting one day after, she has had intermittent new issues with her hands. She describes intermittent difficulty moving (extending) digits 4+5 in both hands and digit 3 on the left and digit 1 on the right. She has had some new numbness of the left hand digit 3. She has had worsening of her chronic Raynaud's. She has also had intermittent difficulty swallowing solids and her tongue felt weak. This lasted just about 1 week after the vaccine. Her chronic diplopia also worsened since the vaccine. She has had proximal weakness in the arms and legs.

Other Meds: Prednisone gabapentin Norvasc Estrace Celebrex

Current Illness: None known

ID: 1407729
Sex: F
Age: 63
State: TX

Vax Date: 04/10/2021
Onset Date: 04/17/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Morphine, penicillin, sulfa

Symptom List: Nausea

Symptoms: Patient complained of burning sensation immediately after receiving vaccine and progressively worsening arm pain over the course of a few day after vaccine administration. Patient states arm pain did not resolve and was seen at provider's office 6/17/21 stating she has decreased range of motion to left arm and continues with left deltoid pain. X-ray of left shoulder and humerus were ordered along with physical therapy.

Other Meds: Acyclovir, amlodipine, aspirin, zyrtec, breo ellipta, gabapentin, hydrochlorothiazide, lamotrigine, meloxicam, metformin, fish oil, pravastatin, effexor.

Current Illness: laryngitis

ID: 1407730
Sex: M
Age: 31
State: IA

Vax Date: 05/20/2021
Onset Date: 06/01/2021
Rec V Date: 06/17/2021
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: Injection site pain

Symptoms: Received the J&J vaccine in May 20. Started experiencing leg muscle and back pain June 1, 2021. Progressively got worse over the following weeks. On June 15 I woke up with a new pain in my leg. Went to urgent care and had a D-Dimer test that came out very high. I was sent to ER where they discovered one clot in each leg and two in my lungs via ultra sound and ct scan. I was immediately hooked up to herapin blood thinner through an IV. I was released the following afternoon with Eliquis blood thinner tablets.

Other Meds: None

Current Illness: None

ID: 1407731
Sex: M
Age: 70
State: OH

Vax Date: 03/10/2021
Onset Date: 05/01/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Sensitive to mold B & dust

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

Symptoms: I experienced dizziness when laying down and turning my head to the left. Dr. diagnosed Benign Paroxysmal Positional Vertigo. Doctor related this is usually due to a calcium crystal that comes loose in the left inner ear. (This may or may not have been related to a trip & fall I had about 3 days prior to the first instance of the dizziness.)

Other Meds: Valsartan/HCTZ 80/2.5 mg 1x/day; Metoprolol Tartrate 25 mg 2x/day; Simvastatin 10 mg 1x/day; Albuterol inhaler 90 mcg, as needed; Testosterone Cypionate 200mg/ml, 1 ml injection every 2 weeks; Tadalafil 20 mg as needed; Fish Oil 1200 mg 2x/

Current Illness: None

ID: 1407732
Sex: F
Age: 41
State: ND

Vax Date: 04/20/2021
Onset Date: 05/09/2021
Rec V Date: 06/17/2021
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: Diagnosed with severe case of shingles 2 1/2 weeks after second dose of Moderna.

Other Meds: Multivitamin

Current Illness: None

ID: 1407733
Sex: F
Age: 69
State: WI

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 06/17/2021
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, med forum

Symptom List: Tremor

Symptoms: I started feeling fatigue later that afternoon, and I was so tired I stayed in bed. I felt bad for weeks.

Other Meds: Thyroid medication, blood pressure medication

Current Illness: No

ID: 1407734
Sex: F
Age: 73
State: CA

Vax Date: 03/09/2021
Onset Date: 04/25/2021
Rec V Date: 06/17/2021
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: compezine

Symptom List: Erythema, Pruritus

Symptoms: Tingling and tightness in scalp. Fullness feeling in head. Had acupuncture and helped for 2 weeks. Fullness and tingling comes and goes. Some days none then repeats. Saw doctor she recommended over the counter Lipoic Acid. I am taking 240 mg Life Extension super R-Lipoic Acid 2 x day. Does not seem to help. Used for 2 weeks and will continue and increase to 3x day.

Other Meds:

Current Illness: none

ID: 1407735
Sex: F
Age: 45
State: NY

Vax Date: 04/26/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: N/A

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

Symptoms: I received my last Pfizer vaccine on April 26th. After the first shot, I was tired, my arm hurt and I noticed that I my hips were aching when walked up the stairs. Not a big deal. The second shot however was a different story. Probably about a week and a half after my second shot, these painful lumps started forming in my arm pits. They were huge and pointy. I can still see the bruises from where they were poking out of my skin. The doctor said they were a side effect from the vaccine and it would take time. I was sluggish and in pain for over a month. Memorial Day was on May 31st and I could't play corn hole because throwing the bean bag was painful and my skin was raw because I had to put bandaids over the lumps when cycling reduce the friction. I finally feel like I am back to normal and I don't know how I feel about getting the vaccine again.

Other Meds: Effexor, vitamin d, ameperazole, zyrtec

Current Illness: no

ID: 1407736
Sex: M
Age: 41
State: IL

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/17/2021
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: Denies

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

Symptoms: SOB; dizziness; warmness, tingling on left arm (started before vaccination per patient)

Other Meds: Denies

Current Illness:

ID: 1407737
Sex: M
Age: 59
State:

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/17/2021
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: Minimum interval between doses not met.

Other Meds:

Current Illness:

ID: 1407738
Sex: F
Age: 69
State: CA

Vax Date: 03/01/2021
Onset Date: 04/03/2021
Rec V Date: 06/17/2021
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: Eggs, Sulfites, Sulfa

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

Symptoms: On April 3rd I woke up with a fast heart beat. I have one of the meters that give oxygen and beats per minute and it was registering at 41 and then it wasn't registering at all. After an hour I was dizzy and light headed. I was wasn't feeling right. I went to ER and my heart was beating at 240 beats per minute. They give me diltiazem. They though it was Atrial fibrillation. At 9:15 my heart went into a normal rhythm. They put me on diltiazem and put me on Eliquis to prevent strokes until I could get to a doctor later on in the week. When I left the hospital it was at normal heart beats at 72 beats per minute. I went to Dr. on April 12th. He thought it was SVT or Atrial fibrillation for sure. He referred me to an electro physiologist. I went in for an ablations on May 4th. They suspected I had Atrial fibrillation and SVT before the vaccine.

Other Meds: Methotrexate 7.5mg , 1xweek, Folic Acid 1mg, 1xday, Calcium Citrate 500mg, 2xday, Vitamin D 1000units

Current Illness:

ID: 1407739
Sex: F
Age: 27
State:

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/17/2021
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: AFTER THE SECOND DOSE OF THE COVID-19 VACCINE (MODERNA) HAD BEEN ADMINISTERED, THE PATIENT FAINTED WITHIN 15 MINUTES OF OBSERVATION OF THE VACCINE. PATIENT IS APPROXIMATELY 6 MONTHS PREGNANT

Other Meds:

Current Illness:

ID: 1407740
Sex: M
Age: 19
State: ID

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/17/2021
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: Patient received shot and 5 mins later started having a seizure. I went out and held his head while 911 was called. Seizure lasted 15 seconds. 5 mins later he had another seizure that lasted 30 seconds

Other Meds: None

Current Illness: none

ID: 1407741
Sex: F
Age: 14
State: IL

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

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

Lab Data:

Allergies: none

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

Symptoms: Patient was given Moderna vaccine but should have been given Pfizer vaccine based on patient age of 14.

Other Meds: None

Current Illness: none

ID: 1407742
Sex: F
Age: 38
State: AZ

Vax Date: 05/02/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Continued Dizziness/lightheadedness accompanied by nausea. Exhaustion. The night after receiving the shot no symptoms, not even a sore arm. The next morning woke at 8 am feeling like I had been hit by a bus. Severe dizziness, lightheaded feeling, nauseous, left arm pain at injection site along with redness and itching. No appetite. These symptoms continued for over 5 days. Now a month later still suffer daily from dizziness and nausea.

Other Meds: Costco Probiotic

Current Illness: None

ID: 1407743
Sex: F
Age: 43
State: CO

Vax Date: 06/03/2021
Onset Date: 06/04/2021
Rec V Date: 06/17/2021
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 Latex Perfumes Non-hypoalergenic laundry detergent Fabric softener

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

Symptoms: After shot I became very weak. All my joints hurt, even the joints in my fingers. I had a fever of 101 for 2 days. As those symptoms reduced, I came down with walking pneumonia &a rash has broken out on my stomach (rash is still active 2 weeks after shot)

Other Meds: Elderberry

Current Illness: None

ID: 1407745
Sex: F
Age: 41
State: MO

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/17/2021
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: After patient was immunized, realized that the vaccine was opened the day before. So the vaccine had been held in the refrigerator for about 19 1/2 hours before patient was vaccinated. Patient had no side effects or events.

Other Meds: None know at this time

Current Illness: None

ID: 1407747
Sex: M
Age: 45
State: NH

Vax Date: 01/29/2021
Onset Date: 02/15/2021
Rec V Date: 06/17/2021
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: Benzoyl Peroxide

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: February 15, 2021 started around 10:00am short runs of SVT. Intermitten throughout the day. Worsening in the evening - feeling nauseated, chest pain, palipations and anxiety. Presented to the ER around 9pm.

Other Meds: Januvia, Glyburide, Trulicity, Valcyclavir, Woman's Multivitamin, Calcium, Biotin, Nexium, Vitamin D, Cranberry Supplement, Probiotic

Current Illness: None

ID: 1407748
Sex: F
Age: 35
State: CA

Vax Date: 12/17/2020
Onset Date: 12/24/2020
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Head fog, difficulty concentrating, difficulty completing daily tasks

Other Meds: None

Current Illness: None

ID: 1407749
Sex: M
Age: 29
State: NJ

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

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: Severe Peanut and Soy Allergy

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Adverse Events: Severe Loss of Breath; Numbness in Extremities; Chest Pain; Heart Palpitations; Fainting; Dizziness Treated with Oxygen and High Dose of Benadryl at hospital. Returned home roughly 4 to 5 hours after treatment.

Other Meds: None

Current Illness: None

ID: 1407750
Sex: F
Age: 68
State: WA

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Terramyacin, nuts, pet dander, tree pollen, grasses, molds and dust

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

Symptoms: Reddening of skin around shot site.. became very itchy.. treated with Hydrocortisone cream around the red area which grew in size of a half dollar coin by bedtime on the 14th. Upon waking on the 15th it was still red and itchy so continued with cream as needed all that day. On Wednesday the 16th the redness started to diminish and so did the itchiness. By the 17th the color has returned to normal and the itchiness has gone. It was suggested I should have taken a Benadryl the first day to minimize the reaction.

Other Meds: Metformin, Furosemide, Levothyroxine, Metoprolol, Potassium, lisinopril, Atorvastatin, Stool softner, vitamin d3, Iron, b-12, multivitamin, vitamin c, benefiber, 81 low dose asprin and tylenol

Current Illness: none

ID: 1407751
Sex: M
Age: 52
State: MD

Vax Date: 04/01/2021
Onset Date: 04/16/2021
Rec V Date: 06/17/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pt was admitted to hospital from ED for chest pains on 4/16/21, 15 days after getting first dose of vaccine on 4/1/21. Per guidelines, all hospitalizations should be reported.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm