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: 1413191
Sex: F
Age: 45
State: CA

Vax Date: 04/19/2021
Onset Date: 05/06/2021
Rec V Date: 06/20/2021
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: Very heavy period with large clots of blood and cycle began 2 weeks earlier than expected. Became extremely fatigued bleeding so heavily 5 days in a row.

Other Meds:

Current Illness:

ID: 1413192
Sex: F
Age: 45
State: CA

Vax Date: 06/18/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: sinus pressure causing moderate nerve pain in teeth

Other Meds: Levothyroxine, Necon

Current Illness: N/A

ID: 1413193
Sex: F
Age: 30
State: CA

Vax Date: 06/17/2021
Onset Date: 06/18/2021
Rec V Date: 06/20/2021
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: None

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

Symptoms: Congestion, runny nose, constant sneezing

Other Meds: Mini pill Sertraline

Current Illness: None

ID: 1413194
Sex: M
Age: 24
State: AR

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

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Around an hour after receiving the injection my heart started racing and that lasted for about 1 hour. When my heart started racing I become fatigued and developed a headache. My heart has not been affected since then but I am still experiencing fatigue and headache.

Other Meds: Escitalopram

Current Illness: None

ID: 1413195
Sex: M
Age: 75
State: IN

Vax Date: 02/18/2021
Onset Date: 02/22/2021
Rec V Date: 06/20/2021
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: High temperature (100 degrees) and fatigue for 5 weeks. Temperature finally left but fatigue remains to this day. Then on May 22nd 2021 I had a severe attack of paracarditis. Had to go to emergency room. Could not breath terrible pain in head and chest and could not bend over with out feeling like I would pass out. Refered to cardiologist am now waiting on stress tests and echo cardiogram. Cardiologist not sure what's wrong or if I have heart or lung damage or if can be traced to the Covid episode with out further tests. Any suggestions?

Other Meds: Topiramate, Sertraline HCL, Buspirone, Atrovastatin, HCTZ/Lisinopril, Areds 2, B-12, Magnesium, Potassium, Vitamin D, Omega-3, 81mg Aspirin, Glucosamine Chondroitin.

Current Illness:

ID: 1413197
Sex: F
Age: 50
State: HI

Vax Date: 01/25/2021
Onset Date: 02/18/2021
Rec V Date: 06/20/2021
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: None

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

Symptoms: After 2nd COVID-19 vaccination I experienced the following: a. Abdominal pains - lasted approximately 2 mos b. Thumb and middle finger of right hand developed osteoarthritis. I presently continue to be seen by my doctor and occupational therapist.

Other Meds: Losartan, HCTZ, Simvastatin, Allegra, Celexa (medications) Ibuprofen Eurasia Diclofenac doTerra multi-vitimans Bio-Astin

Current Illness: None

ID: 1413198
Sex: F
Age: 23
State: CA

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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 that I know of

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I am having major stomach pains, it's like very painful gas and cramps. I am too nauseous to eat or move, really. My arm hurts so much it feels like if I pick anything up (like my phone, or a blanket) with my left arm, I get this shooting, tearing pain all through my upper arm. All the joints in my left arm have sharp shooting pains along with just general stiffness. I also had tingling in my fingertips & some major swelling all through my upper arm and shoulder.

Other Meds: Zoloft Wellbutrin XL Buspirone Propranolol Vitamin D supplements Vitamin B-12 supplements

Current Illness: None that I know of

ID: 1413199
Sex: M
Age: 20
State: UT

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

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

Lab Data:

Allergies: 0

Symptom List: Pharyngeal swelling

Symptoms: Covid toes. Severe sores on toes and getting infected!!!Lips feel like deep deep cuts. Severe bleeding in lips. Nausea. You should take this off the market and read the medical insert and warn people of these bad side effects.

Other Meds: 0

Current Illness: 0

ID: 1413200
Sex: F
Age: 22
State: CA

Vax Date: 05/01/2021
Onset Date: 06/10/2021
Rec V Date: 06/20/2021
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: myocarditis/pericarditis

Other Meds:

Current Illness:

ID: 1413201
Sex: F
Age: 33
State: MA

Vax Date: 06/08/2021
Onset Date: 06/18/2021
Rec V Date: 06/20/2021
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: Shell-fish containing products

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chest and left arm pain occurred the night of 6/18/21 with NSTEMI noted (elevated troponin with no acute ischemia on EKG). Thought to be from myocarditis. Patient started on aspirin and metoprolol as per Cardiology consult.

Other Meds: citalopram; dextroamphetamine-amphetamine; famotidine; ferrous sulfate; norethindrone

Current Illness:

ID: 1413202
Sex: F
Age: 64
State:

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

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

Lab Data:

Allergies: Penicillin

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

Symptoms: 100 degree fever for 24 hours , vomiting, chills, bone pain extremely intense, chest pressure , numbness of right hand, swollen lymph node in right arm pit , extreme exhaustion, dizziness

Other Meds: Sulfasalazine, Methotrexate, folic acid, synthroid

Current Illness:

ID: 1413203
Sex: M
Age: 56
State: WA

Vax Date: 05/13/2021
Onset Date: 05/15/2021
Rec V Date: 06/20/2021
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: N/A

Symptom List: Rash, Urticaria

Symptoms: Both elbows sore. Right side more Sever. I can barely hold or carry things with right arm. Joints in both feet sore(Toes). Left side a bit worse. Pain the same as of now 06/20/2021 I would add that I have no idea if this is due to vaccine. I have never had any issues with my elbows before though and for both to start hurting simultaneously is odd. I haven't seen a doctor, I do not have insurance.

Other Meds: Ground flax seed, ibuprofen, stool softener N/A

Current Illness: N/A

ID: 1413204
Sex: M
Age: 25
State: MA

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 06/20/2021
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: A shingles like rash appeared on both legs. From knees to ankles. Extremely itchy and pimply looking. Home treatments of mainly calamine lotion to stop the itch

Other Meds: None

Current Illness: None

ID: 1413205
Sex: F
Age: 16
State: IL

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Vaginal aphthous ulcers

Other Meds: Adderall

Current Illness: None

ID: 1413206
Sex: F
Age: 43
State:

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/20/2021
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: Nil

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

Symptoms: Joint pain - waking me up at night Swollen lymph nodes - groin, neck and under arms

Other Meds: Nil

Current Illness: Nil

ID: 1413207
Sex: M
Age: 24
State: CA

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: pt was sitting and than fainted 911 arrived and helped pt recover

Other Meds:

Current Illness:

ID: 1413208
Sex: M
Age: 39
State: NJ

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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:

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

Symptoms: Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Hyperventilation-Severe, Systemic: Nausea-Severe

Other Meds:

Current Illness:

ID: 1413209
Sex: M
Age: 39
State: NJ

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Hyperventilation-Severe, Systemic: Nausea-Severe

Other Meds:

Current Illness:

ID: 1413210
Sex: F
Age: 62
State: NJ

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 06/20/2021
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: Systemic: Blood Disorder (diagnosed by MD)-Medium, Additional Details: Patient reported that within 1 hour of receiving vaccine, she noticed leg pain and swelling. She went to the ER where she was diagnosis with a blod clot in the lower leg. The patient was started on a blood thinner (Eliquis) to treat DVT and prevent further clotting. Patient reported that she swelling and leg pain has gone down significantly but she still notes some swelling at the site of the clot.

Other Meds:

Current Illness:

ID: 1413211
Sex: M
Age: 73
State: FL

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 06/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site: Itching at Injection Site-Mild, Systemic: tingling-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild

Other Meds:

Current Illness:

ID: 1413212
Sex: F
Age: 46
State: FL

Vax Date: 03/04/2021
Onset Date: 04/01/2021
Rec V Date: 06/20/2021
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: NKA

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

Symptoms: About three weeks after the last vaccination which was done on March 4, 2021, I started noticing some numbness in my fingers that has progressively gotten worse and was intermittent for a week and now constant in varying degrees all the time.

Other Meds: Met Forman 500mg BID, Simvastatin 10mg QD, Escitalopram 10mg QD

Current Illness: None

ID: 1413213
Sex: F
Age: 14
State: NJ

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: face was pale---consiousness was on and off-Severe, Systemic: Nausea-Severe, Additional Details: after recieving 1 st dose of pfizer vaccine--patient was in the observation area for 15 minutes,during that time frame patient started feeling nauseous and then she felt dizzy..her skin was turning pale.. her consiousness was on and off.. she would respond one time and then another second she would freeze..at one point she lost consiousness. then we called 911 (EMS) right away...before even ems arrived patient regained consiousness. when EMS arrived patient was responsive & went to hospital.

Other Meds:

Current Illness:

ID: 1413214
Sex: F
Age: 14
State: NJ

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: face was pale---consiousness was on and off-Severe, Systemic: Nausea-Severe, Additional Details: after recieving 1 st dose of pfizer vaccine--patient was in the observation area for 15 minutes,during that time frame patient started feeling nauseous and then she felt dizzy..her skin was turning pale.. her consiousness was on and off.. she would respond one time and then another second she would freeze..at one point she lost consiousness. then we called 911 (EMS) right away...before even ems arrived patient regained consiousness. when EMS arrived patient was responsive & went to hospital.

Other Meds:

Current Illness:

ID: 1413215
Sex: F
Age: 13
State: TX

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Headache-Medium, Systemic: Hypertension-Medium, Systemic: Tachycardia-Medium, Additional Details: patient experienced syncope about 15 minutes after vaccine given...lasted around 30 minutes

Other Meds:

Current Illness:

ID: 1413216
Sex: F
Age: 53
State: PA

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 06/20/2021
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: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1413217
Sex: M
Age: 44
State: NJ

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 06/20/2021
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: Penicillin Sulfa Food sensitivities

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

Symptoms: Cognitive, behavioral, psychiatric within 1-2 hours. Adult left home and wandered for over 22 hours before being found by police in heat no phone keys etc. required filing a missing persons report. Still doing neuro work up.

Other Meds: Sodium cromolyn

Current Illness:

ID: 1413218
Sex: M
Age: 32
State: CA

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Flushed / Sweating-Severe

Other Meds:

Current Illness:

ID: 1413219
Sex: F
Age: 18
State: IL

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Systemic: Shakiness-Severe, Systemic: Weakness-Severe

Other Meds:

Current Illness:

ID: 1413220
Sex: M
Age: 13
State: AZ

Vax Date: 06/19/2021
Onset Date: 06/20/2021
Rec V Date: 06/20/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: rapid heart rate - resting heart rate 113

Other Meds: none

Current Illness: none

ID: 1413221
Sex: F
Age: 47
State: MO

Vax Date: 05/29/2021
Onset Date: 05/30/2021
Rec V Date: 06/20/2021
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: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1413222
Sex: F
Age: 44
State: MO

Vax Date: 05/29/2021
Onset Date: 05/31/2021
Rec V Date: 06/20/2021
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: Systemic: Lymph Node Swelling-Mild, Additional Details: Patient had lymph node swelling in upper left chest quadrant that started just a few days after vaccine admin and has continued all the way to the second dose on 6/19/21. Patient still wanted to get second dose.

Other Meds:

Current Illness:

ID: 1413223
Sex: F
Age: 34
State: FL

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 06/20/2021
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: I have been extremely dizzy since the day after. So dizzy sometimes I still throw up. It has been a month and I am still dizzy

Other Meds: Fluoxetine 40 mg

Current Illness: None

ID: 1413224
Sex: F
Age: 34
State: AZ

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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:

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

Symptoms: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Felt light-headed, and fell unresponsive for less then 1 minute-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: called 911, EMT/paramedics came, checked vitals (all were fine), Blood glucose 100.

Other Meds:

Current Illness:

ID: 1413225
Sex: M
Age: 25
State: FL

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Weakness-Medium, Additional Details: PATIENT STARTED FEELING WEAK AFTER A FEW MINUTES OF SITTING DOWN, HE THEN FAINTED/UNRESPONSIVE SO I LAYED THE PATIENT DOWN AND RAISED HIS LEGS, PATIENT CAME CONSCIOUS IN LESS THAN A MINUTE. I STAYED BY PATIENTS SIDE UNTIL HE WAS FEELING WELL AND CONFIDENT ABOUT LEAVING THE PHARMACY. PATIENT RECOVERED PRETTY WELL.

Other Meds:

Current Illness:

ID: 1413226
Sex: F
Age: 46
State: NJ

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 06/20/2021
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 Food sensitivities and chemical sensitivities

Symptom List: Erythema, Pruritus

Symptoms: High blood pressure spiking ~165/120 Water retention Agitation 48 hours later started an inflammatory nightmare headache, full debilitating body pain, diarrhea for days followed by several days of constipation ?. This has ignited an inflammatory firestorm for me given the MCAS and I?m still struggling to get things back in order and leveled off

Other Meds: Cromolyn sodium

Current Illness:

ID: 1413227
Sex: F
Age: 34
State: AL

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/20/2021
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: Penicillin

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

Symptoms: HEADACHES, VERTIGO, VOMITING LIQUIDS, HIGH FEVER AND DEHYDRATION. It last 30hrs. Still dealing with nausea.

Other Meds: N/A

Current Illness: N/A

ID: 1413228
Sex: M
Age: 64
State: PA

Vax Date: 03/18/2021
Onset Date: 04/08/2021
Rec V Date: 06/20/2021
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: Patient was vaccinated on 3/18/21. 1 to 2 weeks later patient reported fatigue and general malaise. Reported to PCP. PCP obtained CMP, CBC with differential. Patient was found to be hyponatremic with a serum sodium level of 110. Patient was admitted to hospital on 4.12.21. Workup showed that patient was in AKI and had DVT. Patient was treated with 3% sodium chloride infusion and was given diuretics. AKI resolved through his course of admission. Patient was treated with enoxaparin for DVT.

Other Meds: Aspirin Atorvastatin Cyanocobalamin Furosemide Levetiracetam Omeprazole Warfarin

Current Illness: Small B-Cell Lymphoma of Spleen Vitamin B 12 deficiency Anemia of unspecified origin Tobacco Abuse

ID: 1413229
Sex: F
Age: 21
State: SC

Vax Date: 06/13/2021
Onset Date: 06/14/2021
Rec V Date: 06/20/2021
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: Site: Itching at Injection Site-Severe, Site: Redness at Injection Site-Severe, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash Generalized-Severe

Other Meds:

Current Illness:

ID: 1413230
Sex: F
Age: 48
State: GA

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 06/20/2021
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: Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash Generalized-Medium

Other Meds:

Current Illness:

ID: 1413231
Sex: M
Age: 29
State: TX

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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: Systemic: Chills-Medium, Systemic: Confusion-Medium, Systemic: Diarrhea-Medium, Systemic: Dizziness / Lightheadness-Medium

Other Meds:

Current Illness:

ID: 1413232
Sex: F
Age: 15
State: TX

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/20/2021
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: Pain in extremity

Symptoms: Error: Diluent Administered Instead of Vaccine

Other Meds:

Current Illness:

ID: 1413233
Sex: F
Age: 30
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)

Other Meds:

Current Illness:

Date Died: 05/25/2021

ID: 1413234
Sex: F
Age:
State: TX

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

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

Lab Data:

Allergies: TBD

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

Symptoms: Multiple blood clots that led to death on May 25, 2021.

Other Meds: TBD

Current Illness: Stomach cancer

ID: 1413235
Sex: M
Age: 30
State: WA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 06/20/2021
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: Severe acute nerve pain, beginning from vaccination site and spreading over the course of several days to shoulders, neck and throat

Other Meds:

Current Illness:

ID: 1413236
Sex: F
Age: 41
State: NY

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 06/20/2021
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: Vicodin

Symptom List: Vomiting

Symptoms: I had my 2nd vaccine on 4/5 @ 4:30pm. I felt slightly tired afterwards and noticed that I couldn't stop yawning. After getting home, I ate dinner and went to bed at around 9pm. At around 2:30am, I woke up feeling an intense heaviness on my chest as if something was sitting on top of me and crushing my upper chest. I stood up and had to immediately crouch over due to the intensity of the pain and heaviness. My husband had to hold me up and suggested going to the hospital. I was terrified and just wanted to wait and catch my breath. It was hard to believe what was happening and I did not want to go to the hospital. After about 5 mins, the intensity of the pain subsided and I was able to breathe normally. I was able to go back to sleep with minor discomfort and woke up at around 6am without any symptoms. About 2 weeks later, I started to have chest pain, which I had never experienced before. I tried to attribute it to all sorts of things, but it didn't go away so on 5/1, I went to City MD to have an EKG and chest X Ray. Both came out normal and they told me to follow up with a cardiologist for due diligence. I followed up with a cardiologist and they also ran an EKG and X Ray with normal results. Depsite normal results, I thought it was important to report this because I am a healthy and fit 42 year old with no prior heart history and found it uncanny that I had my first "heart event" within 12 hours of my 2nd vaccine.

Other Meds: Align, Vitamin D, Alegra

Current Illness: N/A

ID: 1413237
Sex: F
Age: 42
State: IN

Vax Date: 06/18/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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: Phenergan

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Facial twitching of upper lip and right cheek for approx 20 seconds.

Other Meds: Unithroid, flonase, omeprazole, allegra, probiotic

Current Illness: None

ID: 1413238
Sex: M
Age: 51
State: MI

Vax Date: 05/18/2021
Onset Date: 06/12/2021
Rec V Date: 06/20/2021
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: Severe body wide and joint pain 1 month after the shots

Other Meds: Lamictal, Cialis

Current Illness: None

ID: 1413239
Sex: F
Age: 24
State:

Vax Date: 06/17/2021
Onset Date: 06/19/2021
Rec V Date: 06/20/2021
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: Allergic to Bactrim

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Irregular period- no period on my birth control and after my 2nd dose, I am now experiencing a heavy flow period with cramps and fatigue.

Other Meds: Zoloft and Lo Loestrin

Current Illness:

ID: 1413240
Sex: F
Age: 72
State: MD

Vax Date: 05/04/2021
Onset Date: 05/20/2021
Rec V Date: 06/20/2021
Hospital:

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

Lab Data:

Allergies: caffeine, amoxycillan, statins

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

Symptoms: About 2 weeks after vaccine I began having coughing and coughing up mucus. Until past couple of weeks, I thought it wasn't anything too unusual. But it isn't going away, and coughing a few days ago was so severe that I got dizzy and had dizzy spells for about 20 hours. I have to keep a box of tissues nearby around the house. Once I am up-and-about for a few hours, I can go out shopping for an hour or so an hold-back coughing episodes. I have started taking a minimal dose of cough medicine and aspirin in the last 3 or 4 days and that helps a little. I haven't been to see a doctor as I had just seen my cardiologist about a month prior to vaccine, and have seen other doctors for various reasons and tests in last several months -- and have had my flll of them.

Other Meds: none

Current Illness:

ID: 1413241
Sex: F
Age: 53
State: NY

Vax Date: 03/11/2021
Onset Date: 04/16/2021
Rec V Date: 06/20/2021
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: Neosporian, certain fruits and nuts

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

Symptoms: I began to experience chest pain--it felt as if I had a very tight band around my chest. It hurt to breath. I recognized this feeling because 20 years prior I had pericarditis and went to the ER. If I didn't know better, I would have been concerned that I was having a heart attack. I saw the cardiologist about a week later and a few days after that he sent me for an ultrasound of my heart. He told me to take a high does of ibuprofen round the clock for about 2 weeks or until the pain stopped. it took about 2 weeks on these meds to feel better. Now this pain comes back periodically and I take ibuprofen.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm