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: 1417853
Sex: M
Age: 69
State:

Vax Date: 06/02/2021
Onset Date: 06/15/2021
Rec V Date: 06/22/2021
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: Shingles

Other Meds: Diabetes medications - insulin, herbal meds unidentified

Current Illness:

ID: 1417854
Sex: F
Age: 29
State: NY

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 06/22/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417855
Sex: M
Age: 50
State: MA

Vax Date: 03/12/2021
Onset Date: 03/18/2021
Rec V Date: 06/22/2021
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: Bump behind my left knee. From doctor visit on 3/23/2021: On exam of the left knee there is a soft ballotable nontender 4 x 4 centimeter cystic lesion in the popliteal fossa. No distal edema. Negative Homans' sign This appeared on 3/18/2021. It is not painful and is not stopping me from exercising. There is some mild swelling in my right leg.

Other Meds: none

Current Illness: none

ID: 1417856
Sex: M
Age: 19
State: NY

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 06/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417857
Sex: F
Age: 55
State: MI

Vax Date: 03/24/2021
Onset Date: 03/27/2021
Rec V Date: 06/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Heavy vaginal bleeding X 3 days beginning approx 3/27/2021, around 3 days post 1st covid vaccine. Previously no menstrual bleeding or spotting for 7 months since starting on tamoxifen. Bleeding was bright red, and significantly heavier than normal menstruation.

Other Meds: Tamoxifen, vitamin C 1000mg, vit D3 100mcg, multivitamin

Current Illness: none

ID: 1417858
Sex: M
Age: 87
State: TX

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/22/2021
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: Pt had Pfizer in Jan/Feb 2021

Other Meds:

Current Illness:

ID: 1417859
Sex: U
Age: 18
State: NY

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 06/22/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417860
Sex: F
Age: 56
State: ID

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 06/22/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Pharyngeal swelling

Symptoms: I experienced pain in my right wrist, then my left wrist started hurting. My knees and ankles started hurting and I could not walk.

Other Meds: No

Current Illness: No

ID: 1417861
Sex: F
Age: 2
State: MD

Vax Date: 06/10/2021
Onset Date: 06/14/2021
Rec V Date: 06/22/2021
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 known

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient's parents noticed the onset of hair loss starting 6/14/21, and report no other symptoms. The hair loss is on-going as of today. The patient?s father reports a history of 2 prior episodes of similar hair loss, the first occurring in July/August of 2020 (approximately 85% total hair loss) and the 2nd episode occurring in December 2020 (with approximately 40% total hair loss). During those 2 prior episodes, the patient was evaluated by her pediatrician and a pediatric dermatologist. A diagnosis of alopecia (of likely auto-immune etiology) was made and topical steroids were prescribed.

Other Meds: None

Current Illness: None

ID: 1417862
Sex: M
Age: 56
State: NV

Vax Date: 06/01/2021
Onset Date: 06/08/2021
Rec V Date: 06/22/2021
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: no

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I caught a kind of flu the middle of May and was sick for a couple of weeks. COVID test came back negative. After my second vaccination, on 6/8/2021 I started to experience gastric distress that caused pain and caused me to lose sleep. After 2 nights I checked into the ER. Thursday 6/10/2021 they determined I had an infected gallbladder and removed it immediately. I was discharged 6/11/2021.

Other Meds: Atorvastatin, Lisinopril, Nicotine patches,

Current Illness:

ID: 1417863
Sex: U
Age: 21
State: NY

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 06/22/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417864
Sex: M
Age: 14
State: CT

Vax Date: 06/20/2021
Onset Date: 06/22/2021
Rec V Date: 06/22/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Chest pain and palpitations

Other Meds: None

Current Illness: None

ID: 1417865
Sex: M
Age: 92
State: ND

Vax Date: 01/06/2021
Onset Date: 04/26/2021
Rec V Date: 06/22/2021
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: Penicillin

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

Symptoms: Case was hospitalized. 2nd vaccine was 3/29/2021

Other Meds: unknown

Current Illness: unknown

ID: 1417866
Sex: F
Age: 78
State: ID

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 06/22/2021
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: Adhesive tape/latex; alcohol (oral and injectable); amitriptyline; amlodipine; amoxicillin; anything with aspirin product; atropine; Bactrim; candida albicans; Cefaclor; ciprofloxacin; Darvocet; declomycin; Demerol; diltiazem; Effexor; epinephrine; erythromycin; Floxin; hyoscyamine; Kapidex; Keflex; Levaquin; Lortab; Mellaril; Norpramin; Novocain; penicillin; Phenergan; potassium chloride; Premarin; propoxyphene napsylate; Prozac; saline drip; sucralfate; sulfa; surgical scrub (I cannot use the iodine scrub); tobramycin dexamethasone; Toradol; tramadol; vancomycin; Vicodin; wilate (Von-Willebrand Factor); xylocaine.

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

Symptoms: The day after I received the second dose, I woke up and felt like I had the flu. I called to make an appointment with my family doctor and I couldn't get in to see someone until March 25th, 2021. I saw his PA. The reason I didn't go to the doctor right away is because the pain lasted about 2 full days and then it was gone. The PA thought that I may have had a 24 hour flu.

Other Meds: Candesartan; torsemide; estradiol; vitamin D3; vitamin B12; latanoprost; Refresh Plus eyedrops; potassium; stool softener; Tylenol; quinidine; AYR saline nasal mist.

Current Illness: I did not have any illnesses.

ID: 1417867
Sex: F
Age: 56
State: CA

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/22/2021
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: NA

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

Symptoms: PATIENT WAS GIVEN MODERNA FOR HER 2ND SHOT, HOWEVER HER 1ST SHOT WAS PFIZER

Other Meds: NA

Current Illness: NA

ID: 1417868
Sex: U
Age: 19
State: NY

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 06/22/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417869
Sex: F
Age: 0
State: OR

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/22/2021
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: None

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

Symptoms: Racing heartbeat that comes and goes, random shooting joint pain, fatigue, numbness in fingers, arms and feet. I became sick as expected from the second shot (no issues with the first one) and it took 3 days for my fever to stop but it?s been about 4 weeks and I?m still having issues as described above. None of this was an issue prior to my second vaccine. I?m extremely healthy, eat non-processed foods, exercise 5-6 times a week, don?t drink, smoke or have inflammatory foods. There is nothing other than the vaccine to indicate the onset of what I?m experiencing.

Other Meds: 50mg daily sertraline and norethindrone acetate and ethinyl estradiol 1mg/0.02mg daily

Current Illness: None

Date Died: 03/23/2021

ID: 1417870
Sex: M
Age: 87
State: TX

Vax Date: 03/08/2021
Onset Date: 03/20/2021
Rec V Date: 06/22/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Profuse rectal hemorrhaging and blood clots

Other Meds: Unknown

Current Illness: None

Date Died: 03/21/2021

ID: 1417871
Sex: F
Age: 67
State: AK

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 06/22/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Nausea, vomiting, diarrhea, muscle pain with fatigue with the first and second dose. Was reported to not be able to hold anything down with second dose and sudden death while sleeping (nap for fatigue). Found dead in bed 3/21/2021. No allergic reactions were reported. No unusual electrolyte findings suggested the cause.

Other Meds: Cyclobenzaprine, Atorvastatin, Lorsartan, Hydroxyzine and Vitamin B-12

Current Illness: None known

ID: 1417872
Sex: F
Age: 19
State: NY

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 06/22/2021
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: 1417873
Sex: F
Age: 35
State: TX

Vax Date: 03/04/2021
Onset Date: 03/16/2021
Rec V Date: 06/22/2021
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: Penicillin, eggs

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

Symptoms: No prior issues of anemia, on 16MAR my hb levels were 10.9. On 31MAR, my hb levels were 10.8. On 14APR, my hb level was at 10.5 and I was started on OTC iron supplement by my provider. On 2JUN, my hb level was at 12.3 and I was still diagnosed with iron deficient anemia.

Other Meds: multivitamin, probiotic

Current Illness: None

ID: 1417874
Sex: F
Age: 53
State: NY

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/22/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417875
Sex: F
Age: 61
State: DE

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 06/22/2021
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: plaquenil

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

Symptoms: swelling, redness, warm to the touch then itching at injection site more than 2 to 3 days post injection. Patient complained of all symptoms except itching on 6/19. Added severe itching on 6/21. on 6/22 patient said itching is less and redness and swelling subsiding

Other Meds: not known

Current Illness: Lupus

ID: 1417876
Sex: F
Age: 66
State: PA

Vax Date: 06/10/2021
Onset Date: 06/11/2021
Rec V Date: 06/22/2021
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: I have several allergies.

Symptom List: Injection site pain, Pain

Symptoms: I had several body aches, joint aches, stomach pain and nausea.

Other Meds: I was taking prescription drugs.

Current Illness: I have post COVID.

ID: 1417877
Sex: F
Age: 29
State: MA

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

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

Lab Data:

Allergies: unknown

Symptom List: Injection site pain, Menorrhagia

Symptoms: First COVID-19 vaccination given on 4/21/2021, second dose given after recommended interval. Both doses were Moderna

Other Meds: unknown

Current Illness: unknown

ID: 1417878
Sex: F
Age: 44
State: NY

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 06/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417879
Sex: M
Age: 57
State: SC

Vax Date: 03/22/2021
Onset Date: 03/24/2021
Rec V Date: 06/22/2021
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: PT STATES THAT HE HAS HAD ARM PAIN NOT JUST AT THE INJECTION SITE BUT HIS WHOLE ARM SINCE 2 DAYS AFTER BEING VACCINATED

Other Meds: NONE

Current Illness: NONE

ID: 1417880
Sex: M
Age: 50
State: NY

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 06/22/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417881
Sex: M
Age: 61
State: WA

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 06/22/2021
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: A VERY, VERY minor neck ache started the day after my 2nd Pfizer injection (4/30/21), on right side of neck, below right ear. Ache continued to get worse VERY slowly on almost a daily basis. About 2 weeks after that 2nd injection, my neck started popping/cracking when I moved it around. Pain continuing to get worse (but very slowly). On 6/10/21, (with pain continuing to slowly get worse, but at a pretty high level by now) I finally went to see a doctor. He checked for serious conditions and concluded it wasn't anything 'serious' and suggested a few sessions of physical therapy. The earliest I could get physical therapy would be almost 2 months away, so I have not had physical therapy yet. On 6/11/21 I took an Ibuprofen and played racquetball. The neck pain was completely gone for about 11 hours and then slowly came back. I have been taking 2 Ibuprofens a day since then and even if I don't take an Ibuprofen for a day the neck pain seems to be easing. It feels like it may be slowly getting better, although there is still some pain and cracking/popping when I move my neck.

Other Meds: Cytomel, 5Mcg. (for hypothyroidism ). Levothyroxine Sodium, 75Mcg. (for hypothyroidism ). Vitamin D, 2,000IU. Fiber capsules. Magneium, 400mg. Multi-vitamin, daily, for matures. Ocuvite, Adult 50+

Current Illness: None

ID: 1417882
Sex: F
Age: 60
State: FL

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 06/22/2021
Hospital:

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

Lab Data:

Allergies: penicillin, cats , grass,

Symptom List: Nausea

Symptoms: left shoulder pain pain goes down to fingers . can not apply pressure. like fire and ants at times.

Other Meds: none

Current Illness: none

ID: 1417883
Sex: M
Age: 38
State: PA

Vax Date: 05/24/2021
Onset Date: 05/27/2021
Rec V Date: 06/22/2021
Hospital:

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

Lab Data:

Allergies: Levaquin

Symptom List: Injection site pain

Symptoms: PVCs developed 3-4 days after 2nd Pfizer shot. No treatment and has not gone away. Cardiologist said they probably will never go away.

Other Meds: Pantoprazole and Finasteride

Current Illness: None

ID: 1417884
Sex: F
Age: 52
State: CA

Vax Date: 05/26/2021
Onset Date: 05/28/2021
Rec V Date: 06/22/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: After getting the second shot, like at 1 pm I started having diarrhea and it lasted 4 days. I also had extreme fatigue and my body and feet hurt a lot, it felt like I was having Covid-19 again. I still have the fatigue and pain and I wake up very tired and with pain in my feet. I cannot do a lot of things because I get very tired very soon. 2 days after having the vaccine I woke up and I noticed some red spots in my arms and there was a really big one close to my elbow. I still have those spots. The next day they became blisters, and I went to the hospital because they were very itchy. They did a Covid test, but it was negative. They said the spots were because of the vaccine but there was no problem and if the blisters popped, I should return to the hospital. However, that did not happen. They gave me an injection, but I do not remember the name of it. They did not do any medical tests they only looked at it. I still have the spots but now they are black instead of red.

Other Meds: Amlodipine 5 mg for High blood pressure

Current Illness: None

ID: 1417885
Sex: F
Age: 43
State: IL

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 06/22/2021
Hospital: Y

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: A week after the COVID vaccine, I experienced muffled ear pain and ringing in my ears. Then a week later I felt chest pain, heart rate at rest was 130's-140's. Went to the ER and Troponin levels were elevated. I was diagnosed with Myocarditis, of unknown cause since all my respiratory panels were negative, all my labs do not point to any cause except that I received the COVID vaccine.

Other Meds: Tylenol extra strength

Current Illness: none

ID: 1417886
Sex: U
Age: 23
State: NY

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 06/22/2021
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: 1417888
Sex: F
Age: 53
State: WA

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/22/2021
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: Anaphylaxis to cashew nut oil, coconut oil, diagnostic XR materials/gadolinium, nuts, iodine, iron, lidocaine, morphine, shellfish. Hives to Penicillin.

Symptom List: Erythema, Pruritus

Symptoms: 2 minutes post Moderna vaccine pt experienced acute onset of palpitations, shakiness, profuse sweating, dizziness/lightheadedness, no chest/throat/lung complaints. HR 137-150, SpO2 97% room air. in the middle of interview, pt reported sudden onset worsening palpitations, tightness in chest. abnormal lung exam. Epinephrine and Benadryl provided in urgent care, ALS transport called to ER.

Other Meds: No

Current Illness: No

ID: 1417889
Sex: F
Age: 71
State: AK

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 06/22/2021
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: no

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

Symptoms: felt like it hit bone when shot was given felt like a frozen shoulder and began taking physical therapy for it because pt favored it too long.

Other Meds: no

Current Illness: no

ID: 1417890
Sex: F
Age: 48
State: CO

Vax Date: 05/15/2021
Onset Date: 06/07/2021
Rec V Date: 06/22/2021
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: Phenergan

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

Symptoms: I had swelling in both ankles. I'm having excessive bruising all over in odd spots. Bruises just appear mostly on trunks of body but some on arms and legs. Pain in calves. I went to the doctor. The swelling is less of a problem as I'm wearing compression socks and putting. I am still having quite a bit of pain in my calves, especially later in the day and it's keeping me off my feet. The bruising is subsiding, I'm noticing a sudden appearance of spider veins, and also some of my veins on are leg (left leg) they are near the skin and they have become more visible and when I wear the compression socks those veins hurt. I realized that was the site of the pain were where those veins are so I took the compression socks off and that helped to alleviate the pain. The compression socks were kind of aggravating those veins. Leg pain is still an issue.

Other Meds: Estradiol; topiramate; Lamictal; Klonopin

Current Illness: No

ID: 1417891
Sex: F
Age: 44
State:

Vax Date: 05/07/2021
Onset Date: 05/21/2021
Rec V Date: 06/22/2021
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: Shingles infection

Other Meds:

Current Illness:

ID: 1417892
Sex: F
Age: 49
State: NY

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 06/22/2021
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: Chocolate, Bananas, Yeast, White Potatoes, Milk, Morphine, Toradol, Augmentin

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

Symptoms: I got lethargic. I tried to take a nap but I felt like I was freezing and couldn't get warm. A few hours later, I got up from a nap and had a fever of 103.2. The next day my knees and hip were killing me. It felt like my hips and knees were being ripped apart. I had pain in my knee and hip joints. I had a little bit of a headache. On Monday my fever went down. On Tuesday my symptoms went away and I felt back to normal. About a month later I had the headache, fever, joint pain, and a rash. The doctors said it could of been a tick born illness but test was negative. My white blood cell count and iron was low.

Other Meds: Multi Vitamin, Levoxyl, Zyrtec, Vitamin D, Calcium, Magnesium, Zinc, Potassium, ALA, Probiotic, Enzyme

Current Illness:

ID: 1417893
Sex: M
Age: 62
State: NY

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/22/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417894
Sex: M
Age: 43
State: NJ

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 06/22/2021
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: After 2nd dose following events occur deteriorating overall health. I don't have any preexisting health conditions. 1. On May 24th at around 12.15 am, I started experiencing 100 degree fever followed by chills. The blood pressure shot up to 165-95 and heart rate was around 140. Was feeling breathless and sweaty and was being rushed to ER . 2. On 30th May again experienced BP at 165-90 and pulse was at 150 and rushed to ER 3.Again on May 31st, BP shoot up to 170-90 and pulse 145 and ER visit. 4. Consulted cardiologist and on Metoprolol medicine 5. Always feeling dizzy and lightheaded with unprovoked rise in BP and pulse. 6.Unable to resume regular day to day activities including office work. 7. Daily fluctuation in BP and pulse observed till now since 2nd dose of vaccine.

Other Meds: NONE

Current Illness: NONE

ID: 1417895
Sex: F
Age: 24
State: NM

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 06/22/2021
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: After I got the vaccine, I was feeling a lot of pain in my hands, especially my thumbs. My fingers felt numb and tingly. I have pain in both of my hands, but more so in my left hand and arm. My left leg is also sore. Went to the doctor. They gave me some antiflammatory med.

Other Meds: prenatal vitamins

Current Illness: none

ID: 1417896
Sex: M
Age: 72
State: IN

Vax Date: 06/01/2021
Onset Date: 06/07/2021
Rec V Date: 06/22/2021
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: No

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

Symptoms: 72 hours after second vaccine injection, all ,my joints were on fire. Tremendous pain in joints and weakness in legs, hands and back.

Other Meds: Prednisone 5mg Fish oil, calcium, D3, Zn,Mg, Tumeric,

Current Illness: No

ID: 1417897
Sex: F
Age: 33
State: NY

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/22/2021
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: 1417898
Sex: F
Age: 13
State: NM

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

Symptom List: Vomiting

Symptoms: fainted, grey color, cool/clammy skin, thready pulse, not responsive. EMS on site who attended her. She become responsive while the assessed her. Their dx was vasal vagal and advised her mom to take daughter to urgent care. Mother's name is.

Other Meds: unknown

Current Illness: unknown

ID: 1417899
Sex: M
Age: 78
State: LA

Vax Date: 05/25/2021
Onset Date: 05/29/2021
Rec V Date: 06/22/2021
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: Sulfonamides, quinine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: states had no symptoms for first 24 hours, then developed expected side effects including headache, body aches, fatigue. then on day 4 or day 5, states he developed problems with his equilibrium(falling into walls) but catches self and has not actually fallen to floor/ground. states no really "dizziness, just problems with balance". has not seen doctor or had any follow up. states afraid of vaccine and will not receive dose 2.

Other Meds: Albuterol Inhaler prn cough Vitamin C 500 mg 1 po daily Pramipexole Dihydrochloride 0.25 mg 1 tab po hs B Complex vitamins 1 daily Meclizine 0.25 mg 1 po daily Amlodopine Besylate 10 mg po once daily Buspirone HCL 7.5 mg 1 tab bid Potassi

Current Illness: denies

ID: 1417900
Sex: U
Age: 20
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1417901
Sex: M
Age: 53
State: NV

Vax Date: 06/18/2021
Onset Date: 06/20/2021
Rec V Date: 06/22/2021
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: I had my injection on June 18. I started experiencing chills, body aches, fatigue on June 20. Yesterday morning (June 21) I felt even worse and knew I was running a fever. I went to see a doctor. My fever turned out to be high - 100.4 (oral) and I tested positive for Covid. I wish I didn?t take the vaccine

Other Meds: Multivitamins, zinc

Current Illness: Tooth infection. Prescribed antibiotics which I finished 2 days before the vaccine

ID: 1417902
Sex: F
Age: 42
State: FL

Vax Date: 03/19/2021
Onset Date: 04/13/2021
Rec V Date: 06/22/2021
Hospital:

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

Lab Data:

Allergies: Augmentin; Metformin

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

Symptoms: In April I fell in the dollar store and I thought I cleared the shelf and fell. After that I had the balancing issues, after that I had eye pain. I did a CT SCAN and it was normal. I went to a eye doctor he thought the trulicity is what was making my eyes hurt. I called my PCP and told me to not to take it anymore. So, basically I was told it takes 3 weeks for it to get out of my system and it's been over a month and I'm still having the issues.

Other Meds: Januvia, Buspirone, Fluoxetine , Lisinopril-HCTZ, Trulicity, Alprazolam

Current Illness: None

ID: 1417903
Sex: M
Age: 30
State: WA

Vax Date: 04/01/2021
Onset Date: 05/15/2021
Rec V Date: 06/22/2021
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: 31-year-old gentleman with history of no known chronic medical problems who presented with acute chest pain. Lab evaluation revealed significantly elevated troponin EKG revealed ST elevations reciprocal ST depressions. Echo findings show LV dysfunction with an EF between 35 to 40%. with the most likely cause of non-ischemic cardiomyopathy, specifically noted Takotsubo CM (stress induced) although he did receive his second dose of mRNA vaccine 2 days prior to the event.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm