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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1424193
Sex: F
Age: 43
State: OH

Vax Date: 06/19/2021
Onset Date: 06/20/2021
Rec V Date: 06/24/2021
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: Erythromycin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chills, body aches and headache. The headache lasted from late Saturday night/ early Sunday morning until late morning on Thursday, 6/24.

Other Meds: Synthroid, D3, B-12, Turmeric, Probiotics

Current Illness: None

ID: 1424194
Sex: F
Age: 87
State:

Vax Date: 02/19/2021
Onset Date: 03/07/2021
Rec V Date: 06/24/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination for new onset atrial fibrillation.

Other Meds:

Current Illness:

ID: 1424195
Sex: F
Age: 62
State: WA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 06/24/2021
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: Walnuts, hazelnuts, filberts, baclofen, Carbamazepine, Echinacea, latex, Lisinopril, Acetaminophen, Tramadol, Kiwi, turmeric, ibuprofen, meloxicam, proximate, NSAIDS, Imitation Root Beer, fentanyl patches.

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

Symptoms: Extreme respiratory distress, Steroids and injectable Benadryl, outcome: reduction in respiratory distress start time Time lapse: 11:30 AM - 6:10 PM

Other Meds: Benadryl, Claritin D, Multi vitamin, Calcium, vitamin D3 & B12 OXcarbazepine, oxyCODONE, predniSONE, tiZANidine, gabapentin, albuterol, amLODIPine, desipramine, fluticasone-salmeterol, Advair Diskus, metoprolol succinate, omeprazole, ondan

Current Illness: Asthma, atypical trigeminal neuralgia, Intractable facial neuralgia, glossopharyngeal

ID: 1424196
Sex: M
Age: 73
State: MN

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: patient had a third dose of the Moderna vaccine by mistake. he received his first dose at another clinic - unknown to us - in January of 2021. Pt then received a 2nd dose at our clinic on 5/27/2021 and then another dose today 6/24/2021 - we thought this was his 2nd dose but when we went to enter his vaccine in the state vaccine registry saw that he had already had two doses.

Other Meds:

Current Illness:

ID: 1424197
Sex: F
Age: 20
State: WA

Vax Date: 06/06/2021
Onset Date: 06/10/2021
Rec V Date: 06/24/2021
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: chest pain, dyspnea, dizziness, possible myocarditis found during ER visit

Other Meds: none

Current Illness: none

ID: 1424198
Sex: F
Age: 84
State: PA

Vax Date: 03/16/2021
Onset Date: 06/10/2021
Rec V Date: 06/24/2021
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: Polyethylene Glycol 3350Syncope Floxacillin Ibuprofen CiprofloxacinDiarrhea CodeineDizziness / Lightheaded Macrobid [Nitrofurantoin Monohyd/m-cryst]Fever

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

Symptoms: ASYMPTOMATIC

Other Meds: acetaminophen (TYLENOL) 500 mg tablet amlodipine-olmesartan (AZOR) 5-20 mg per tablet antiox.mv no.10/omeg3s/lut/zea (I-CAPS ORAL) aspirin 81 mg chewable tablet bethanechol (URECHOLINE) 50 mg tablet bisacodyL (DULCOLAX) 10 mg suppository bi

Current Illness:

ID: 1424199
Sex: F
Age: 39
State: CA

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/24/2021
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: Patient received Moderna Vaccine instead of Pfizer for her second shot. She only reported a sore arm and otherwise is doing fine.

Other Meds:

Current Illness:

ID: 1424200
Sex: F
Age: 65
State: AZ

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: Second shot was given 61 days after first shot

Other Meds:

Current Illness:

ID: 1424201
Sex: M
Age: 18
State: OK

Vax Date: 06/03/2021
Onset Date: 06/15/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Alpha Gal Syndrome (red meat)

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Allergy to red meat became prevalent again. Since becoming allergic to red meat in the summer of 2020, I had gained a tolerance to red meat to the point where I could consume as much as I wanted. This lasted between August 2020 and the date listed in this report. On that date I consumed red meat and had an allergic reaction to it. The reaction was a swelling of the fingers, hives on the arms and knees and wrist. As I didn?t have any reactions to red meat in the previous 10 months I didn?t make the connection that I was allergic to red meat again. The following Monday I consumed more red meat. That night I was very drowsy and went to bed at 1900. At around 0100 Tuesday morning I woke up with a terrible stomach ache and could feel my hands itching. I tried to go back to sleep. At around 0430 I woke up again with completely swollen hands to the point where I couldn?t bend any joint in them, hives on my wrists, knees, elbows, neck, forehead, back, and back of thighs. I went to the hospital for a severe allergic reaction. This is the exact same allergic reaction that I would have when I consumed red meat in June 2020 at the height of my allergy, but I had never had a reaction like it since then. Now I am sensitive to red meat again and I can?t think of any reason except that I received the vaccine. I have not consumed red meat since.

Other Meds:

Current Illness:

ID: 1424202
Sex: F
Age: 38
State:

Vax Date: 03/01/2021
Onset Date: 04/01/2021
Rec V Date: 06/24/2021
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: Nil

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Extreme heavy bleeding during periods. Periods also become unregular. Extreme bleeding has occurred for 3 periods since first vaccine and shows no sign of returning to normal flow as yet.

Other Meds: Nil

Current Illness: Nil

ID: 1424203
Sex: M
Age: 28
State: NJ

Vax Date: 04/17/2021
Onset Date: 05/11/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: On May 11 2021, I went to the gym to workout my back muscles in after work (around 3pm). After completing a heavy set of rack pulls I got light headed. After removing the weight to put it away, I accidentally dropped 25 pounds weight which was abnormal because I lost grip while light headed. I tried to walk off the pain by walking to the other side of the gym and within the next 10 minutes my face started turning pale and my lips dark blue/purple. I was sitting down as I progressively grew more light headed and started blacking out. My brother called over several people to help me maintain consciousness and an employee noted my lip and face color, low pulse and high rate of breathing. I fainted for a couple minutes then took a sip of gatorade and bounced back. I felt like that was a near death experience. Possibly related to some heart issue. A few weeks after I got a physical checkup at my doctor's office and the bloodwork came back clean. I have nothing to show why this episode occurred and feel like I should have some heart tests as a follow up. Before this incident I have been going to the gym without ever having experienced this kind of issue. What was notably odd though is I started having some chest pains not too long after my 2nd vaccination that I originally attributed to a bad sleeping position (I sleep on my side). I would have tightness that at times were consistent. Overtime the pain got weaker as I stopped doing intensive workouts. I thought it could've been a muscle tear but a tear would've healed by now. I still experience a bit of tightness when I do heavy chest exercise or if I compress my chest muscles and squeeze in the middle. I'm submitting this report because its been recently identified myocarditis is a possible side affect of the vaccine.

Other Meds: Supplements : Multivitamins, Iron

Current Illness: None

ID: 1424204
Sex: F
Age: 34
State: TN

Vax Date: 05/01/2021
Onset Date: 05/03/2021
Rec V Date: 06/24/2021
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: Most antibiotics; sulfa drugs; doxycycline; azithromycin; lidocaine

Symptom List: Rash, Urticaria

Symptoms: It started on the third, 5:30AM, it woke me up, my heart racing so quick that I was so dizzy, I was trying to gather myself and I called an ambulance but then found out that the hospital was only 8 minutes away so I drove there myself. They said that they did not know for sure if it was pertaining to the vaccine or not. A few weeks later I went to another HCF. They said my potassium is low, which has never been a problem. I eat like two bananas every day I love bananas. They gave me potassium and sent me on my way. But the first time I went to the hospital I got labs and they came back good. I mean, I have frequent episodes of this and there is nothing to blame it on except the vaccine since it began right after that. I have an EKG scheduled for the 8th of July 2021 and I guess that's about it.

Other Meds: Claritin; Protonix

Current Illness: Symptoms from first vaccination dizziness; feeling of popcorn popping under my skin

ID: 1424205
Sex: F
Age: 45
State: VA

Vax Date: 03/25/2021
Onset Date: 04/19/2021
Rec V Date: 06/24/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Developed two symmetrical indentations across both calves. Have seen 4 different specialists, none have found cause or cure.

Other Meds: Pantoprozole Doxylamine succinate (forsleep)

Current Illness:

ID: 1424206
Sex: F
Age: 68
State: NJ

Vax Date: 03/29/2021
Onset Date: 04/29/2021
Rec V Date: 06/24/2021
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: Low grade fever Tmax 100.7F, fatigue, myalgia, recurrent UTI approximately 1 month after second dose of vaccine and persistent

Other Meds:

Current Illness:

ID: 1424207
Sex: F
Age: 79
State: GA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 06/24/2021
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: Most codeine products, some statins high blood pressure pills.

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

Symptoms: The next day 03/14/2021 I started having soreness and achiness in the morning. About a 3 months later (June) I started having problems with my heart but it wasn't directly after I had my vaccine. . I did see a Doctor about my heart and they put my on a heart monitor and I haven't gotten any results from it yet. I did have a-fib one night. I have appointment with cardio tomorrow 06/25/2021. I thought it was odd because I never had a-fib before and now all of a sudden I do.

Other Meds: Hormone replacement, thyroid vitamins.

Current Illness: None.

ID: 1424208
Sex: M
Age: 34
State:

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: Expired vaccine was administered to patient. Expiration date: 02/21/2021. Date given: 06/24/2021

Other Meds:

Current Illness:

ID: 1424209
Sex: F
Age: 11
State: IL

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/24/2021
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: NKDA

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

Symptoms: Pt is not of age indicated to receive Pfizer Covid vaccination

Other Meds: n/a

Current Illness: N/A

ID: 1424211
Sex: F
Age: 80
State: FL

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Lost weight, fatigue, no cough, fever, no energy, pain and aches, headaches.

Other Meds: None

Current Illness:

ID: 1424212
Sex: M
Age: 16
State: CA

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: After receiving his second dose of the Pfizer vaccine, this patient lost consciousness while sitting in the chair. The staff slowly assisted patient into a lying position onto the ground. Patient visibly pale. Oxygen then applied at 2L via NP and vital signs were taken and stable. Approximately 30 seconds later, patient regained consciousness. Patient was able to identify name and date of birth. Patient verbalized no pain, nausea nor dizziness at this time. Water and ice pack provided for patient. Patient then slowly transferred into sitting position and was placed in observation area. Patients mother declining further transfer to urgent care. Staff encouraged further evaluation. 911 called around 12:15. Paramedics arrived shortly after and performed an EKG and blood sugar check. Patient verbalizing feeling better at this time. Patient then left clinic walking independently accompanied by his mother and siblings.

Other Meds:

Current Illness:

ID: 1424213
Sex: M
Age: 0
State: VA

Vax Date: 04/09/2020
Onset Date: 04/09/2020
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Lactose intolerance, hives when he takes amoxicillin ( both discovered after a year old)

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

Symptoms: Screamed for 4 hours straight, went from drink 2 oz every 2 hours to only 3 bottles, was able to hold head up before vaccine, wasn?t able to hold steady, was babbling , making noises, no longer make any noises or cops for about 2 months, before vaccine he was picking up toys, touching hands together and being toys to mouth, after vaccine was no longer able to pick up toys. No longer made any eye contact.

Other Meds: Nothing

Current Illness: 0

ID: 1424214
Sex: M
Age: 43
State: NH

Vax Date: 05/10/2021
Onset Date: 06/04/2021
Rec V Date: 06/24/2021
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: none

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

Symptoms: On 6/4/21 at 11:30 am, I went deaf in my right ear suddenly. It started with tinnitus and I went deaf over the course of a few minutes. 6/4/21 Urgent care visit: no sound detected in right ear 6/4/21 Emergency room visit: Oral steroid prescribed. 6/7/21 ENT specialist visit: Hearing test for baseline, diagnosed sudden onset hearing loss and additional oral Steroids prescribed. 6/14/21 ENT specialist visit: Hearing test shows no significant improvement: Steroid injections into ear prescribed and done in office 6/21/21 ENT specialist visit: 2nd steroid injection into ear done. 6/22/21 MRI of head done: (results not in yet) Future 6/25/21: ENT specialist visit: 3rd steroid injection into ear scheduled.

Other Meds: Famotadine 40mg

Current Illness: none

ID: 1424215
Sex: F
Age: 91
State: TX

Vax Date: 02/05/2021
Onset Date: 03/06/2021
Rec V Date: 06/24/2021
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: Fatigue, edema (blood clot)

Other Meds: atorvastatin Bystolic CoQ-10 Eliquis Fish Oil Lasix Lexapro risperidone

Current Illness: None

ID: 1424216
Sex: F
Age: 39
State: CO

Vax Date: 05/01/2021
Onset Date: 05/05/2021
Rec V Date: 06/24/2021
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: Soy, Wheat, Vicodin, Lexapro

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

Symptoms: Short-term: flu-like symptoms including chills, nausea, muscle aches, weakness, headache. Long term effects: delayed menstruation & insomnia, but fewer migraines.

Other Meds: Butrans 7mcg Patch Aimovig 140 Auto Injection Levothyronine Levothyroxine

Current Illness: Unknown severe flu-like virus in mid April, 2021 (flu shot in January 2021, negative for Covid 19 in 2 tests)

ID: 1424217
Sex: F
Age: 51
State: CA

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 06/24/2021
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: n/a

Symptom List: Injection site pain, Pain

Symptoms: Back of heel on left leg hurting the same night as of shot, next morning it was very painful. Never had any pain let that.

Other Meds: n/a

Current Illness: n/a

ID: 1424218
Sex: M
Age: 67
State: NJ

Vax Date: 03/21/2021
Onset Date: 04/05/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Minor allergic reaction to sulfa drugs

Symptom List: Injection site pain, Menorrhagia

Symptoms: mild, increasing to SEVERE Vertigo with related anxiety, elevated BP and heart rate

Other Meds: Avoristatin, Lorazepam, Sertraline, Lamotragine, Atenolol

Current Illness: No

ID: 1424219
Sex: M
Age: 1
State: NC

Vax Date: 06/10/2021
Onset Date: 06/21/2021
Rec V Date: 06/24/2021
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: Rash present. Comments: Papulovesicular rash located diffusely on body but concentrated on LEs with one large vesicle on L calf

Other Meds:

Current Illness:

ID: 1424220
Sex: M
Age: 34
State: TX

Vax Date: 05/29/2021
Onset Date: 06/17/2021
Rec V Date: 06/24/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: on 6/17 patient developed L shoulder pain with progressive cough, SOB, and inspiratory chest pain. ER admission discovered large pericardial effusion, low grade fever, elevated ERS, CRP, WBC.

Other Meds: bupoprion XL 150mg po qd Sertraline HCL 25mg po QD

Current Illness: none

ID: 1424221
Sex: F
Age: 62
State: PA

Vax Date: 04/07/2021
Onset Date: 06/19/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: AtorvastatinMyalgia / Muscle Pain Sulfa (Sulfonamide Antibiotics)Hives / Urticaria Sulfamethoxazole-trimethoprimHives / Urticaria Mold Other Byetta [Exenatide]Other (document details in comments) Cat DanderSneezing FluvoxamineOther (document details in comments) Invokana [Canagliflozin]Other (document details in comments) MetforminOther (document details in comments) OxycodoneItching

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: #Asymptomatic COVID-19 Infection -Patient has been COVID-19 positive since 12/2020 but denies any fever/chills, cough, shortness of breath, and does not require any oxygen supplementation

Other Meds: albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution(Expired) albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler aspirin tablet baclofen (LIORESAL) 20 mg tablet bisacodyL (DULCOLAX, BISACODYL,) 10 mg suppository blood sugar diagnost

Current Illness:

ID: 1424223
Sex: F
Age: 31
State: CO

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/24/2021
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: N/A

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

Symptoms: Pt states sever headaches, vision blurred. Dr. visit 06/24/2021 told to contact CDC/VAERS to report.

Other Meds: N/A

Current Illness: N/A

ID: 1424224
Sex: F
Age: 23
State: OR

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Patient arrived at our vaccine event. Filled out the Moderna Screening form and answered NO to having received a covid-19 vaccine previously. Staff did a 2 person verification on her screening and felt it was safe to proceed and she met all of the guidelines. Once the patient left the facility and when we were placing the vaccine into our state Alert system is when it was made clear she had already received a Pfizer vaccine on 5/24/21. She was within the except able window to receive her 2nd dose but she got it with another vaccine.

Other Meds: none reported

Current Illness: none reported

ID: 1424225
Sex: F
Age: 61
State: AZ

Vax Date: 01/14/2021
Onset Date: 05/06/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: PCN Sulfa Lamisil

Symptom List: Injection site pain

Symptoms: Sudden loss of taste 3 months after 2nd vaccine dose. I had started a new supplement (GI Revive) at that time. Stopped taking it and loss of taste persists to this day.

Other Meds: Calcium, Magnesium, vit D, vit B12, vit C, turmeric, adrenal cortex, Duloxetine, low dose naltrexone

Current Illness:

ID: 1424226
Sex: F
Age: 63
State: TN

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: When tested for environmental allergens (trees, pollen, grass, etc) at the allergist had a severe reaction that required epinephrine. She had mumps and then received a vaccine for it and had an anaphylactic reaction. Patient reported allergy to codeine and Percocet and her reaction was euphoria ( which is a side effect).

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

Symptoms: The patient and I went over her past medical history in detail and her reactions to allergy testing and previous vaccines. She wanted to proceed with vaccination. I agreed and recommended a 30 minute minimum wait for observation. I administered the vaccine and within five to ten minute she began to feel like she was having an out of body experience, her face became red and itchy, and she was dizzy. She sat in the lobby for close to 15 minutes. I checked in with her and she was not feeling any better so I administered 50mg of liquid diphenhydramine to the patient and gave her a bottle of water. She stayed in the lobby for a total of an hour and a half from start of vaccination to finish. I called her primary care provider after I had administered the diphenhydramine and related all the details of what happened to her. She agreed that the course of action taken was appropriate and to tell the patient to rest and if she was no better to come in and be seen the following day. The patient had an epipen at home and she was instructed to use it if her lips or throat began to swell and call 911. The patient and her primary care provider are going to assess if a second dose is safe following this occurrence. While she was in our care she did not have and issues with her breathing or swelling of the lips or throat.

Other Meds: Levothyroxine 125mcg, Fluticasone 50mcg nasal spray, lisinopril 30mg, vitamin d3 400IU, cetirizine 10mg, Atenolol 50mg, Clonazepam 0.5mg is what is listed in her patient profile at the pharmacy.

Current Illness: None reported

ID: 1424227
Sex: F
Age: 61
State: PA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 06/24/2021
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: Allergy to Sulfa drugs Paradoxical reaction to Opiods

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

Symptoms: After the first shot on 03242021 I experienced overall fatigue. Though I drove the 30 minutes to the first shot, I could not drive the same distance to the second due to fatigue. After the second shot, the fatigue worsened. Pain in my joints and muscles increased. My inability to walk beyond a few steps resulted in my using a cane at all times. My grip worsened and I dropped most objects I picked up. The pain had continued to increase throughout my body. I could not sleep, I became depressed. My thought processes became confused and my memory cloudy. I spoke to the Rheumatologist on June 3 out of concern and he scheduled Xrays. By 06232021 the confusion symptom started to wane.

Other Meds: Escitalopram 20mg daily Hydrochlorothiazide 12,5mg daily Olmesartan Medoxomil 20mg daily Xanax .125mg daily ( one half of .25 tablet) B12 vitamin

Current Illness: none

ID: 1424228
Sex: M
Age: 16
State: CA

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: N/A

Symptom List: Tremor

Symptoms: Pt stated that he was feeling lightheaded and dizzy while sitting in post-vac after receiving Pfizer (EW0196) vaccine. Pt became pale and clammy to touch and sat down on floor. Pt's mother stated "he gets like this when he gets shots." Pt denies any SOB, itching, pain, or other discomfort. Pt has no orofacial swelling or visible hives/rash. Pt was given juice to drink and stated that he felt better afterward. Pt's skin returned to normal and he sat up in a chair. Pt was released at 12:40 into care of mother. Pt stated he was no long symptomatic and felt "back to normal." Pt left clinic with mother, walking with steady gait, and in no apparent distress.

Other Meds: N/A

Current Illness: N/A

ID: 1424229
Sex: M
Age: 44
State: FL

Vax Date: 02/19/2021
Onset Date: 02/21/2021
Rec V Date: 06/24/2021
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: Small, hard mass started 2 days after the 2nd vaccine shot in left breast and turned into a mass the size of a golf ball after 3-4 weeks, that is painful and has not gone down in size.

Other Meds: multivitamins

Current Illness: none

ID: 1424230
Sex: F
Age: 15
State: TX

Vax Date: 06/23/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: unk

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

Symptoms: Severe stomach pain/cramps 7/10, Nausea, general malaise, headache, weakness

Other Meds: None

Current Illness: none known

ID: 1424231
Sex: F
Age: 14
State:

Vax Date: 06/03/2021
Onset Date: 06/17/2021
Rec V Date: 06/24/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Patient presented ~2 weeks after 2nd pfizer vaccine with chest pain and tachycardia diagnosed with myopericarditis course complicated by pericardial effusion and hypotension which improved prior to discharge.

Other Meds: none

Current Illness: none known

ID: 1424232
Sex: M
Age: 77
State: WA

Vax Date: 02/20/2021
Onset Date: 05/10/2021
Rec V Date: 06/24/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: RASHES ON FACE, ARMS, LEGS, SCALP & SCALP HAS LARGE SPOTS WHERE THERE IS NO PIGMENT. THE DR. HAS PRESCRIBED TOPICAL MEDICATION WHICH IS HELPING

Other Meds: TELMISARTIAN HCTZ 40/12 PRAVASTATIN SODIUM 20MG HYDROXYCHLOROQUINE 200MG AMLODIPINE BESTLATE 2.5MG

Current Illness: NONE

ID: 1424233
Sex: M
Age: 43
State: KY

Vax Date: 03/20/2021
Onset Date: 04/09/2021
Rec V Date: 06/24/2021
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: Peanuts

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

Symptoms: Was admitted to the hospital with anemia in mid April don?t think related to vaccine

Other Meds: Lisinopril

Current Illness: None

ID: 1424235
Sex: M
Age: 59
State: MA

Vax Date: 05/25/2021
Onset Date: 06/15/2021
Rec V Date: 06/24/2021
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: None

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

Symptoms: Patient first displayed hives in a localized area just above the beltline. Within 6 hours, the hives spread across the patient's entire body from head to foot. Hives were itchy, burning and painful. Hives were evaluated by healthcare professionals and determined not to be shingles or some other known condition. The hives have waned through several courses of treatment, but still remain present.

Other Meds: Androgel 1.62

Current Illness: None

ID: 1424236
Sex: F
Age: 83
State: VA

Vax Date: 02/05/2021
Onset Date: 03/05/2021
Rec V Date: 06/24/2021
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 at time of vaccines

Symptom List: Pain in extremity

Symptoms: 6-10 days after 2nd vaccine rash started on arms, legs, feet. Rash varies with raised dime sized welts to larger flat rashes. Very itchy, esp. closer to joints. Rash has increased with time and has not resolved

Other Meds: Lisinopril, simvastatin, isosorbide, ASA 81mg, Zyrtec 10mg

Current Illness: None

ID: 1424237
Sex: F
Age: 66
State: CA

Vax Date: 02/01/2021
Onset Date:
Rec V Date: 06/24/2021
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: PAIN IN MY RIGHT ARM.FROM SHOULDER TO ELBOW.TILL AT THIS TIME

Other Meds:

Current Illness: at the 2nd dose of the covid -19 shot .on 3/16/21..i started having pain in my right arm..

ID: 1424238
Sex: F
Age: 51
State: WI

Vax Date: 06/09/2021
Onset Date: 06/20/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: On 6/20/21, I woke up with a severe bloody nose, running out both my nose and my mouth. I bled profusely for over an hour. Spent time at the ER at 4:30am and then again at a different ER again at 8:00am. Finally got it stopped. I have never had a bloody nose before. Currently, I am still extremely achy.

Other Meds: None

Current Illness: None

ID: 1424239
Sex: F
Age: 74
State: PA

Vax Date: 04/10/2021
Onset Date: 06/07/2021
Rec V Date: 06/24/2021
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: NKA

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

Symptoms: Asymptomatic

Other Meds: atorvastatin (LIPITOR) 20 mg tablet donepeziL (ARICEPT) 10 mg tablet fluticasone propionate (FLONASE) 50 mcg/actuation nasal spray lisinopriL (ZESTRIL) 5 mg tablet LORazepam (ATIVAN) 1 mg tablet nitrofurantoin, macrocrystal-monohydrate, (MA

Current Illness:

ID: 1424240
Sex: F
Age: 14
State: IL

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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:

Symptom List: Vomiting

Symptoms: pt stated that she felt dizzy shortly after covid 19 Pfizer vaccine. Patient has been drinking Gatorade and symptoms did not resolve after about 30 minutes. Asked mother to see if she wanted us to call 911. Mother requested us to call then paramedics came. Paramedics checked blood pressure, oxygen and glucose levels and everything came back within normal limits. Paramedics advised mom to either keep an eye on her at home or take her to emergency room. Mom said she will take the patient to ER. Paramedics helped the patient leave the store.

Other Meds:

Current Illness:

ID: 1424241
Sex: F
Age: 44
State: PA

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 06/24/2021
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: Onset of fever, chills, body ache, and general malaise within approximately 7 hours after receiving the second dose. This lasted for a full 20 hours, with a maintained temperature between 100 F and 101 F despite regular doses of ibuprofen.

Other Meds:

Current Illness: None

ID: 1424242
Sex: M
Age: 23
State: CA

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: Fainted with vaccine. lasted about 30seconds to minute. was fine after that

Other Meds:

Current Illness:

ID: 1424243
Sex: F
Age: 48
State: FL

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: No

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Employee repots dizziness, lightheaded and nausea. The employee went home and reports vomiting

Other Meds: No

Current Illness: No

ID: 1424244
Sex: F
Age: 26
State: WA

Vax Date: 05/24/2021
Onset Date: 05/30/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Noticeable fluttering heart beat, stronger than normal, causes a tightness and some pain in the chest. Occurs on and off all through out the day, every day

Other Meds: Methylphenidate 10mg ER B-Complex Probiotic

Current Illness: N/A

ID: 1424245
Sex: M
Age: 18
State: NY

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/24/2021
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: None on file

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

Symptoms: Patient walked from pharmacy to front of store and promptly collapsed at the front registers. He was given slight fluids by bystanders before the ambulance was called, after ambulance was called the responder on the phone informed us to stop the patients intake of fluids.

Other Meds: None on file

Current Illness: None on file

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm