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: 1415332
Sex: M
Age: 49
State: NY

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 06/21/2021
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: Side effects within first 3 days included extreme sore arm (muscle), temperature, aching, headache, heart palpitations, dizziness, fatigue and difficulty concentrating. However, 5 weeks later I am still experiencing extreme fatigue, tiredness, as well as heaviness in chest.

Other Meds: Tylenol

Current Illness:

ID: 1415333
Sex: M
Age: 22
State: CO

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/21/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt c/o feeling light-headed... stated that he didn't eat breakfast today. Pt admin OJ & monitored for an additional 15 mins. BP-130/70, P-86, R-24, O2 Sat-96, @ 11:35a... Pt feeling better, advised to call PCP is anything changes. Pt left in stable condition. BP-128/70, P-78, R-16, O2 Sat 98, @ 1150a...

Other Meds:

Current Illness:

ID: 1415334
Sex: M
Age: 21
State: IN

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/21/2021
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: patient felt lightheaded then fainted for a few seconds. ice packs used and drank water, came back to consciousness.

Other Meds:

Current Illness:

ID: 1415335
Sex: M
Age: 67
State: CO

Vax Date: 03/11/2021
Onset Date: 05/12/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to gabapentin and flexural.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I went to my doctor's office and she was concerned about the size of my stomach and how hard it was; therefore, she immediately sent me to the ER. She could see that I was in quite a bit of pain and discomfort. Emergency room personnel examined me and the ER doctor prescribed a stool softener to clear the contents of my stomach.

Other Meds: Tola statin 40mg, Lisinopril 2.5 mg, Tamsulosin 4 mg, Chantix 5 mg, and over the counter medications aspirin .81 mg, multivitamin and vitamin D-3.

Current Illness: No

ID: 1415336
Sex: F
Age: 73
State: CA

Vax Date: 03/04/2021
Onset Date: 05/17/2021
Rec V Date: 06/21/2021
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: metal; Vicodin - makes me really ill . I have just now (after vaccine) found out that I am allergic to Mangoes - I got "mango mouth" when I ate one recently.

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

Symptoms: I had the red swollen arm (injection site) - it was a little bit later - about 10 days after the vaccine. It kept getting bigger. It looked like a really bad mosquito bite that got huge. It was itchy Body aches and fatigue and headaches showed up about that time, too. Those symptoms lasted to the end of March and early April. March 17 I blew out my knee - my right knee. I ended up getting x-rays before I came to him. He called and said to go see an orthopedic surgeon and that wasn't until later on. I did see the Orthopedic Surgeon on April 8th. He injected my knee with steroids that day and took x-rays at his location. He also gave me Tylenol. Before I got to see him, March 30th - I had a TIA - Stroke. I was home alone and I called my husband and doctor (but he didn't call back right away so it was about 4 hours) and he said I needed to go to ER - Hospital ER. The treatment was cholesterol medication and referrals to cardiologists or neurologist and also an Ophthalmologist. I did see orthopedic surgeon again, again and again. I went back to Primary care doctor, too. I saw cardiologist first - April 22, 2021. I was sent to Nutritionist - on Friday, May 28th - no treatment - she said I was doing well with diet and nutrition and she would see me in 6 months. Eye exam - on June 1st - going through more tests for that - something to do with the back of the eye. June 2nd - I saw the neurologist - that was for a consultation to go over all the results from the other tests. He said there was that had happened and that nothing was very conclusive and said I should just go on with my life. In the hospital when I was admitted for my TIA - stroke - they saw that I had a thyroid issue - and so I went to thyroid doctor June 2nd. - they added - Atorvastatin and Amlodipine. I had surgery for the loop monitor for my chest on June 9th. Also there is a New nodule on my thyroid - big enough to Biopsy - on my Thyroid. On June 15th - I got the Shingrix vaccine - same arm as COVID vaccine - wild reaction from that within 24 hours that did go away the 2nd day. It was a full body flare - similar to COVID vaccine reactions but it went away quicker. I started a new medication for me called Rinvoq - for the Rheumatoid Arthritis - this replaces the Xeljanz that I had been taking. My balance is off still and I'm using a cane and I wasn't doing that before - possibly for my knee being weak. I'm getting ready for a knee replacement eventually. Since 10 years ago, I'm compromised on the right side - that is my Lymphedema side - hence all my vaccines, etc are on the left side. Otherwise, I'm feeling well now at this point.

Other Meds: Low dose aspirin; folic acid; vit C; multivitamin with no iron; Vit D; Tums; glucosamine Chondroitin with MSM; Diclosenac; Levothyroxine; Amitriptyline; Fish Oil; Alendronate; Vit B12; Ventolin inhaler; Lisinopril; Omeprazole; Xeljanz

Current Illness: no

ID: 1415337
Sex: M
Age: 34
State: NY

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 06/21/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1415338
Sex: F
Age: 79
State: UT

Vax Date: 02/24/2021
Onset Date:
Rec V Date: 06/21/2021
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: Adhesive tape

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After I received the Pfizer Dose 2, I had extreme fatigue and lot of body aches. All during the time after I had the vaccine but the symptoms got a lot worse April 25th. I had to go twice for 2 COVID-19 TEST. I had my test at facility. I tested positive twice for COVID-19 on the week of April 25, I was really sick till like May 11th. I lost my sense of smell and taste, and extremely fatigue, and body aches everywhere, terrible cough, headache, hard time breathing, I had an oxygen monitor, but I did not get a high fever. May 10, 2021, and the Dr. diagnosed me with a sinus infection and prescribed cefdinir 300 mg, 1 capsule a day for 10 day.

Other Meds: Celecoxib; fluoxetine HCl; irbesartan; metformin; atorvastatin; warfarin; vitamin D

Current Illness: No

ID: 1415339
Sex: M
Age: 40
State: NV

Vax Date: 04/28/2021
Onset Date: 05/26/2021
Rec V Date: 06/21/2021
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: Pharyngeal swelling

Symptoms: Medication error. 1st dose was Moderna. 2nd dose should have been Moderna, but was given Pfizer.

Other Meds:

Current Illness:

ID: 1415340
Sex: F
Age: 31
State: OR

Vax Date: 05/21/2021
Onset Date: 06/02/2021
Rec V Date: 06/21/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Bell's Palsy - right side facial paralysis, on day 20, still no improvements

Other Meds: AllerClear (Loratadine)

Current Illness:

ID: 1415341
Sex: U
Age: 22
State: NY

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1415342
Sex: F
Age: 36
State: PA

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/21/2021
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: PATIENT RETURNED TO PHARMACY APPROX 3 HOURS AFTER RECEIVING 2ND DOSE OF MODERNA VACCINE. ( SHE IS AN ASSOCITAE WITHIN OUR STORE) AND COMPLAINED OF ITCH AND ARM SORENESS, NO SWELLING OF LIPS OR TONGUE UPON EXAMINING HER, SHE STATED SHE FELT A BIT ANXIOUS AND WARM , I RECOMMENDED TRYING AN ANTIHISTAMINE FOR ITCH , EXPALINED TO HER THAT MAYBE SHE SHOULD SHOULD CONTACT STORE MANAGER AND POSSIBLY LEAVE FOR DAY. ASSISATANT MANAGER WAS NOTIFIED AND DISCUSSED OPTIONS.

Other Meds:

Current Illness:

ID: 1415343
Sex: F
Age: 39
State: GA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 06/21/2021
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: Penicilljn

Symptom List: Rash, Urticaria

Symptoms: Started feeling energized within a few hours of the shot. By 7pm that evening, the energized feeling became very uncomfortable and I was sensitive to noises. The energized feeling has continued since that time, although it is not currently as strong as it was during the first 4-5 weeks after the shot. At times, the feeling was extremely uncomfortable. This energized feeling has affected my sleep, making it difficult to fall or stay asleep.

Other Meds: Omeprezole, vitamin b12, Xanax, temazapam, quazapam

Current Illness: None

ID: 1415344
Sex: F
Age: 16
State: OH

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/21/2021
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: The patient has a history of fainting after shots. She became warm and faint after receiving the injection. She was very weak and put her head on the table for about 10-15 minutes until she was feeling better.

Other Meds:

Current Illness:

ID: 1415345
Sex: M
Age: 41
State: WI

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/21/2021
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:

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

Symptoms: Should/arm/deltoid is sore, there is a red slightly inflamed spot about 3 inches long and 1 in wide. Patient did see their provider and said it is nothing to worry about and should go away.

Other Meds:

Current Illness:

ID: 1415346
Sex: F
Age: 82
State: WY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 06/21/2021
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: unknown

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

Symptoms: Client stated that night after receiving the vaccine she became dizzy, had chills, had vision issues where her eyes could not focus, and her vision was blurry. Client stated that she felt like she was doomed, and maybe having a stroke. Said her symptoms lasted about 2-3 days.

Other Meds: unknown

Current Illness: unknown

ID: 1415348
Sex: M
Age: 23
State: IL

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 06/21/2021
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: PATIENT COMPLAINED OF FEELING DIZZY AND WARM. TINGLING IN RIGHT HAND AND BACK OF THROAT. RED AND BLOTCHY AROUND NECK. FEELING NAUSEA. BENADRYL 50MG IM GIVEN RT DELTOID.

Other Meds:

Current Illness:

ID: 1415349
Sex: F
Age: 39
State: CT

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 06/21/2021
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: Site: Pain at Injection Site-Medium, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.), Additional Details: District leadder called and informed of this complaint. Patient is experiencing arm pain since vaccination

Other Meds:

Current Illness:

ID: 1415350
Sex: M
Age: 63
State: TX

Vax Date: 03/04/2021
Onset Date: 03/18/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: Iodine contrast, Amoxicillin, Crestor

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Initially IBD type symptoms. Now sour stomach

Other Meds: Hydrocortisone, Unithroid, 81mg aspirin, Prasugrel, Rapatha. Multivitamin, zinc, magnesium, vitamin D3

Current Illness: Adrenal insufficiency

ID: 1415351
Sex: M
Age: 67
State: OR

Vax Date: 05/27/2021
Onset Date: 06/04/2021
Rec V Date: 06/21/2021
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: Palsey type hand shaking, unsteady walking gate,Pain in both knees

Other Meds: ateenol,bp med,pottasium garlic gingerroot vit c vit B-12

Current Illness:

ID: 1415352
Sex: F
Age: 46
State: NY

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 06/21/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1415353
Sex: M
Age: 14
State: NV

Vax Date: 06/11/2021
Onset Date: 06/12/2021
Rec V Date: 06/21/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: Patient developed chest pain with rising troponin. Required 3 days of hospitalization. No cardiac dysfunction by echocardiogram

Other Meds: None

Current Illness: None

ID: 1415354
Sex: F
Age: 31
State: FL

Vax Date: 05/22/2021
Onset Date: 05/29/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Exactly 1 week after receiving the first dose of the Moderna Vaccine, I started getting a red rash at the injection site. It started approx. 2 inches wide & 2 inches high and over the next few days, the rash grew larger until it was about 4 inches high and 3 inches wide at the largest. I googled it and it seems that it was probably a rare reaction known as "Covid Arm". It faded away fully within 5 days to a week.

Other Meds: Sertraline 50 Mg. 1 tablet per day Sprintec Birth Control Pill Plexus Bio Cleanse 2 tablets per day Plexus ProBio 5 1 tablet before bed

Current Illness: None

ID: 1415355
Sex: F
Age: 35
State:

Vax Date: 06/06/2021
Onset Date: 06/19/2021
Rec V Date: 06/21/2021
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: Herpes Zoster on left side of neck

Other Meds: Imuran Plaquenil Eutirox 88

Current Illness:

ID: 1415356
Sex: M
Age: 24
State: OH

Vax Date: 06/10/2021
Onset Date: 06/11/2021
Rec V Date: 06/21/2021
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: Chills-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fever-Medium

Other Meds:

Current Illness:

ID: 1415357
Sex: F
Age: 34
State: WA

Vax Date: 06/17/2021
Onset Date: 06/19/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: PROTON PUMP INHIBITORS/OMEPRAZOLE 10 MG., MEPERIDINE RELATED/MEPERIDINE HCL

Symptom List: Injection site pain, Menorrhagia

Symptoms: Cough, Dry non productive, lasts throughout the day, has been constant since 2 days after vaccine

Other Meds:

Current Illness:

ID: 1415358
Sex: F
Age: 20
State: IL

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/21/2021
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 reported history of fainting before/after vaccination in the past. Reported Phobia of needles. Patient was fine after vaccination and was let into the lobby to wait 15 minutes for observation. After about 10 minutes, patient had fainted. Patient was in chair and supported to not fall out of the chair. Patient was given water and vomited about 5 minutes later. Gave icepack and observed for another 30 minutes with no incident.

Other Meds: Clindamycin lotion, tretinoin cream

Current Illness: None

ID: 1415359
Sex: F
Age: 68
State: NY

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 06/21/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: My lower back started to hurt, 102 fever, body aches, and chills. The next morning I was weak no appetite and very light headed and couldn't concentrate. I go days with muscles weakness in my body since the shot.

Other Meds: None

Current Illness: None

ID: 1415360
Sex: F
Age: 70
State: MD

Vax Date: 02/21/2021
Onset Date: 02/28/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: sulfa ointment for eyes, amoxicillin, dust mites, honeydew

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: chronic autoimmune urticaria restarted. had not had hives since about 2017. usually lasts several years before subsiding. have had them since 1975

Other Meds: alendronate, atorvastatin, aspirin 25mg , vit b complex about 1/14 of a pill, 2 drops vit d,hypochlor, dmannose, 1 systane areds, theracran, cholestoff plus, fish oil, elidil

Current Illness: none

ID: 1415361
Sex: F
Age: 58
State: SC

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 06/21/2021
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: I am allergic to sulfa drugs; Ibuprofen; Iodine; Meloxicam; Codeine; Oxycodone; Trazodone; Cipro; Latex; Tramadol; and Tylox.

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

Symptoms: After the vaccine I waited a couple of minutes when I got up I felt dizzy. After this I had to get taken back to a room and waiting a couple more minutes and was able to go home.

Other Meds: I take prescribed medications for my heart; blood pressure; depression; thyroid; and bipolar.

Current Illness: None.

ID: 1415362
Sex: M
Age: 64
State: WY

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Nausea

Symptoms: Client stated that his arm, that had the injection in, has been extremely sore off and on for a month. Client stated that he could not lay on the arm for about 3 weeks.

Other Meds: unknown

Current Illness: unknown

ID: 1415363
Sex: F
Age: 40
State: FL

Vax Date: 04/29/2021
Onset Date: 06/07/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: Nuts, alcohol, mango

Symptom List: Injection site pain

Symptoms: DVT in right calf, treating with blood thinners

Other Meds: Lexapro & hydroxizine

Current Illness: None

ID: 1415364
Sex: F
Age: 50
State: AR

Vax Date: 06/01/2021
Onset Date: 06/03/2021
Rec V Date: 06/21/2021
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: Patient had syncopal episode and had c/o severe pain from head to toe. Facility staff called 911 and she was taken to local ED.

Other Meds:

Current Illness:

ID: 1415365
Sex: M
Age: 48
State: CO

Vax Date: 06/16/2021
Onset Date: 06/19/2021
Rec V Date: 06/21/2021
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: developed rash on my right side one inch above my waste line and is about one inch in size; rash contains individual pustules.

Other Meds: men's multi vitamin

Current Illness: none

ID: 1415366
Sex: F
Age: 46
State: NY

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 06/21/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1415367
Sex: F
Age: 15
State: CO

Vax Date: 06/08/2021
Onset Date: 06/15/2021
Rec V Date: 06/21/2021
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: Erythema, Pruritus

Symptoms: achy- fainted when outside in the sun. We called PCP, said no reason to worry and hydrate. BUT her sister was admitted with myocarditis and her brother also passed out the same day! Feels like a HUGE coincidence.

Other Meds: None

Current Illness: None

Date Died: 05/28/2021

ID: 1415368
Sex: M
Age: 69
State: PA

Vax Date: 03/30/2021
Onset Date: 05/28/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Patient died of a sudden heart attack at age 70, just 2 months after receiving his 2nd dose of the vaccine. His parents lived well into their mid-eighties and patient spent the last 17 years of his working years as a door to door, getting lots of cardio exercise every day. At the time of his death he was a very low stress person and taking good care of himself.

Other Meds: None.

Current Illness: None

ID: 1415369
Sex: M
Age: 38
State: NY

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/21/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1415370
Sex: M
Age: 53
State: AL

Vax Date: 03/17/2021
Onset Date: 04/15/2021
Rec V Date: 06/21/2021
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: I had vertigo and it occurred when I looked down or laid down. My PCP referred me to and ENT Dr. I had to have therapy for the vertigo. I did therapy for awhile. They released me because I started to get better. The ENT I saw is actually doing a study due to seeing more people having vertigo after the COVID-19 vaccine.

Other Meds:

Current Illness:

ID: 1415371
Sex: F
Age: 29
State: CA

Vax Date: 06/11/2021
Onset Date: 06/20/2021
Rec V Date: 06/21/2021
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: Sulfa, shrooms

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

Symptoms: Yesterday evening I experienced three episodes of hearing loss/ringing in my left ear. The longest episode lasted for probably about a minute (which is way longer than I've ever experienced before). After the hearing loss, I noticed my eyes became a little more sensitive to light and I felt dizzy and a pressure/tickle sensation in my head which then became more focused towards the back of my left eyeball and a little of the back of my left upper arm & left wrist (very strange). No pain or numbness. I wouldn't describe it as tingle as it was more of tickle. Hearing has not gone out again since last night but I have some constant ringing/tinnitus and still feel tickle sensation in my left arm and behind left eye. I couldn?t find much about the tickle online but came across a user who had COVID who literally described a ?ticklish pressure? in their ear, so I know I can?t be the only one to have noticed this!!!

Other Meds: Wellbutrin

Current Illness: N/A

ID: 1415372
Sex: F
Age: 27
State: IL

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 06/21/2021
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: PATIENT STARTED FEELING DIZZY, FAINT, NAUSEA, PALE, AND CLAMMY. PATIENT LAID DOWN ON COT. OBSERVED

Other Meds:

Current Illness:

ID: 1415373
Sex: M
Age: 12
State: GA

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: nada

Symptom List: Pain in extremity

Symptoms: pt given shot on 6/16/21, this was his second dose of covid vaccine. that night he had some chest pain, but mild, the next day pt called mother from day camp saying he had chest pain. went to hospital ER. did ekg was wnl. still had some pain Friday, then over the weekend getting a little better. on Monday (today) pt reports he still feels the pain but not as much.

Other Meds: none

Current Illness: none

ID: 1415374
Sex: F
Age: 33
State: VT

Vax Date: 01/15/2021
Onset Date: 02/04/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and all penicillin drugs

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

Symptoms: I had some numbness and tingling while I was at work, and I almost fainted on 2/4/2021. My blood pressure was extremely high. I was referred to a neurologist.

Other Meds: No

Current Illness: No

ID: 1415375
Sex: F
Age: 31
State: FL

Vax Date: 06/19/2021
Onset Date: 06/20/2021
Rec V Date: 06/21/2021
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: Swollen and very tender lymph nodes on left side of the neck. Still dealing with this adverse event.

Other Meds: Sertraline 50 mg. 1 tablet per day Sprintec Birth Control Pill Plexus Bio Cleanse 2 tablets per day Plexus Pro Bio 5 1 tablet before bed

Current Illness: N/A

ID: 1415376
Sex: U
Age: 31
State: NY

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/21/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1415377
Sex: M
Age: 18
State: WY

Vax Date: 03/31/2021
Onset Date: 05/04/2021
Rec V Date: 06/21/2021
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: COVID arm - Client stated that his arm became red swollen, hot to the touch, in the arm that received the injection. Client stated that it lasted about a week.

Other Meds: unknown

Current Illness: V

ID: 1415378
Sex: M
Age: 29
State: IL

Vax Date: 06/02/2021
Onset Date: 06/08/2021
Rec V Date: 06/21/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The day of the vaccine, I had fever dreams. About 6-7 days after the vaccine, I noticed sediment in my urine. I made an appt with my doctor 6/15/2021. I got a urine dipstick test which showed positive for proteins. I came in the blood test the next day-which came back normal. The blood test for lipase came back elevated possible pancreatic. I am waiting CT scan results. I was prescribed a non fat diet and low carb diet to avoid inflaming the pancreas.

Other Meds: Viagra

Current Illness: None

ID: 1415379
Sex: F
Age: 58
State: CA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 06/21/2021
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: Not at the time; now I know that I am allergic to polysorbate 80

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

Symptoms: Right away after having the vaccine I felt dizzy and I told the staff that I was not feeling that well and they took my blood pressure and it was high and they kept taking it every 10 minutes or so and it kept increasing. After 45 minutes it began to level down and they sent me home but even before getting to the parking lot I started shaking and I was out of breath. They gave me epinephrine and they called 911. They took me to the hospital, and they told me I have an arrhythmia. They did an EKG. They let me go my home. Since that day my blood pressure has been high and my doctor put me on blood pressure medication. The day before having the vaccine I had a physical done and my blood pressure has been always on the low side but now it is still high. Now I am being treated for new symptoms, which are chest pressure accompanied with shortness of breath and dizziness. The dizziness its scary because sometimes I drive and I feel like a drunk person driving which is not right and not safe.

Other Meds: None

Current Illness: None

ID: 1415380
Sex: M
Age: 76
State: IL

Vax Date: 05/01/2021
Onset Date: 06/03/2021
Rec V Date: 06/21/2021
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: Started getting congested about 10 days ago. It's getting worse.

Other Meds: None

Current Illness: None

ID: 1415381
Sex: F
Age: 18
State: NY

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 06/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1415382
Sex: F
Age: 62
State: NJ

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 06/21/2021
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: penicillin, cephalosporins, bees

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

Symptoms: After first vaccine administered on April 30, 2021, patient developed severe headaches, photophobia, stiff neck, fever and chills that lasted 3 days. Second vaccine was administered 3 weeks later on May 21, 2021, fever, chills, rigors, photophobia, stiff neck, severe headache continued for 2 weeks. Patient went to an urgent care center and requested COVID rapid and PCR tests. During the visit, a flu test and Lyme Disease test were done. Tests were negative. Patient continued to be symptomatic and sought medical care at medical center on June 8, 2021. Patient received care in the ER and was admitted with a r/o diagnosis of meningitis. Empirical meningitis protocol was started. Spinal tap, blood cultures, urine cultures, tic borne infections were all negative. Patient improved with prednisone therapy. Patient discharged from hospital on June 11, 2021. Negative tic and bacterial tests and rheumatoid panel were discussed during the post discharge visit on June 21, 2021. It appears that the patient exhibited a severe adverse event reaction to the Pfizer Covid second vaccine dose.

Other Meds: losartan 100mg daily

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm