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: 1429603
Sex: F
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 06/26/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Several days after my second dose I developed double vision. My right eye has moved upward and to the side (strabysmus) and I can?t see without. Patch on that eye. I am seeking care from a neuro-ophthalmologist, hoping to be treated with a newly approved drug, Tepezza.

Other Meds: Thyroid replacement; metoprolol 50 mg, amitryptilene 50 mg,

Current Illness: Hypothyroid

ID: 1429604
Sex: M
Age: 49
State: KS

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 06/26/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Migrating numbness and tingling in both arms and legs, (4 months, still present). Insomnia (4 months, still present). Muscle twitching all around my body. (4 months, still present). Fasciculations especially in both calves, constant (3 months, still present). Acid reflux (without heartburn, but reflux in my esophagus, 1 month, still present). Difficulty swallowing (1 month). Cramping or discoordination in hands (4 months, still present). Anxiety (4 months, still present).

Other Meds: None

Current Illness: None

ID: 1429605
Sex: F
Age: 72
State: RI

Vax Date: 03/18/2021
Onset Date: 05/20/2021
Rec V Date: 06/26/2021
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: Sulfa drugs Penicillins Lisinopril

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

Symptoms: Had left breast biopsy based on mammography image

Other Meds: Amlodipine Pravastatin Escitalopram Calcium + d Multi vitamin

Current Illness: None

ID: 1429606
Sex: M
Age: 23
State: MO

Vax Date: 06/22/2021
Onset Date: 06/23/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Diffuse urticarial, pruritic rash

Other Meds: None

Current Illness: None

ID: 1429607
Sex: M
Age: 24
State: FL

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

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

Lab Data:

Allergies: NKA

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

Symptoms: PT REPORTED FEELING DIZZY AND WEAK KEPT PT WAS KEPT IN OBERSEVATION FOR ADDITIONAL 45MINS UNTIL HE FELT BETTER

Other Meds: PER PT NONE

Current Illness: PER PT NONE

ID: 1429608
Sex: M
Age: 60
State: TX

Vax Date: 03/23/2021
Onset Date: 04/15/2021
Rec V Date: 06/26/2021
Hospital: Y

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: NKA

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

Symptoms: Diagnosis: Aplastic Anemia Patient is still in treatment as of 6/26/2021

Other Meds: Losartan for high blood pressure

Current Illness: None

ID: 1429609
Sex: F
Age: 21
State: FL

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/26/2021
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: Red Dye #40

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Arm has rash and hard bump at injection site. This is still persistent after 2 days, it started a few hours after receiving the vaccine and hasn't gone away yet. I only got a little bump after my first dose immediately after, but this is far worse after my second dose. There is a lot of pain in general and it becomes even worse when my arm touches even fabric.

Other Meds: None.

Current Illness: None.

ID: 1429610
Sex: F
Age: 32
State: WA

Vax Date: 05/20/2021
Onset Date: 06/01/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Pharyngeal swelling

Symptoms: I started experiencing heart palpitations that lasted for days at a time at the end of May 2021/beginning of June 2021. After several weeks where the palpitations continued, I sought treatment where they diagnosed this and saw that my heart is prematurely beating and then pausing to reset itself. On 6/24/2021 I went to the ER on advice from my doctor. From what they say, there is not really a treatment for these symptoms and I will just have to wait and see if they go away. At this reporting time, they are still ongoing. I'm to follow up with my family medicine doctor.

Other Meds: Larissa Oral contraceptive Levothyroxine 25 mg NP Thyroid 32 mg Spironolactone 50 mg

Current Illness:

ID: 1429611
Sex: M
Age: 30
State: WI

Vax Date: 04/20/2021
Onset Date: 04/29/2021
Rec V Date: 06/26/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: ~a week and a half after Vaccine, I experienced 'room spinning' vertigo and dizziness at around 1am. I was sick for the next few hours, vomited for around the first hour after. Symptoms of dizziness for the next two days, then Vertigo/dizziness/vomiting again the following night. After around 3 more days, the symptoms subsided. I had my 2nd Moderna shot on 5/18/2021 (Lot 036C21A) and on 6/10/2021 the symptoms began again. After the first case, I saw online Urgent care and was referenced to an in-person visit to a primary care doctor. I was 'diagnosed' with BPPV, which I've never experienced symptoms of before. They ran me through several tests at the office, but by the time I got to the primary care doctor the symptoms had subsided again. I'm currently still experiencing a light dizziness 24/7 since 6/10/2021.

Other Meds: None at the time

Current Illness: None

ID: 1429612
Sex: M
Age: 64
State: TN

Vax Date: 05/30/2021
Onset Date: 05/30/2021
Rec V Date: 06/26/2021
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: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: numbness and tingling to right arm x 1 month. Prescribed Diclofenac topical. Referred to Ortho.

Other Meds: Amlodipine

Current Illness: none known

ID: 1429613
Sex: F
Age: 14
State: ND

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

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

Lab Data:

Allergies: N/a

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

Symptoms: Became pale, diaphoretic, nauseous and had an emesis. B/P and pulse were stable. She was given water and a granola bar. She was also leaned back and feet were put up in the chair to raise them above her heart.

Other Meds: N/a

Current Illness: Na

ID: 1429614
Sex: M
Age: 37
State: AZ

Vax Date: 06/24/2021
Onset Date: 06/25/2021
Rec V Date: 06/26/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Chills, weak, sinus pressure, extremely painful earache

Other Meds:

Current Illness:

ID: 1429616
Sex: F
Age: 75
State: NM

Vax Date: 06/24/2021
Onset Date: 06/25/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies: Ketakonazole

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

Symptoms: 24 hour dizzy, fever of 100 and aches in joints

Other Meds: Thyroid....Levothyroxine

Current Illness: none

ID: 1429617
Sex: F
Age: 37
State: FL

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/26/2021
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: NKA

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

Symptoms: PT FELT WEAK AND DIZZY WANTWED TO LAY DOWN ON FLOOR. FELT A LITTLE BETTER AFTER LAYONG ON FLOOR. KET T ON FLOOR FOR 15MIN THEN PT SAT ON FLOOR FOR ADDITIONAL 15MIN/ NO LONGER DIZZY.

Other Meds: PER PT NONE

Current Illness: PER PT NONE

ID: 1429618
Sex: F
Age: 47
State: PA

Vax Date: 05/16/2021
Onset Date: 05/17/2021
Rec V Date: 06/26/2021
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: No

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

Symptoms: My waist on the right side hurt a lot and my leg down to the bottom. I could not walk severe pain and I still have it and from that day I've had to spend money for the problem I now have.

Other Meds: None

Current Illness: No

ID: 1429619
Sex: F
Age: 60
State: FL

Vax Date: 06/05/2021
Onset Date: 06/15/2021
Rec V Date: 06/26/2021
Hospital: Y

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: Pt's husband came in today (6/26/2021) and reported that ten days after receiving the shot (6/15/21), his wife (the patient) started feeling weak and felt numbness in her legs. She is currently in the ICU being treated. They believe it may have been because of the shot. Blood clot has not been confirmed.

Other Meds:

Current Illness:

ID: 1429620
Sex: M
Age: 20
State: ND

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/26/2021
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: NA

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

Symptoms: He became dizzy and nauseous after about 10 minutes of sitting following the shot. Blood pressure and pulse were stable he was given water and a granola bar and his feet were put up. He was fine after 10 minutes and went home with his mother.

Other Meds: NA

Current Illness: NA

ID: 1429621
Sex: F
Age: 72
State: TX

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

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

Lab Data:

Allergies: morphine/coedine minocycline herbal essence body powder asp

Symptom List: Ear pain, Hypoaesthesia

Symptoms: fever, headache, nausea, muscle pain, weakness, swollen lymph node in left armpit, swelling/pain at injection site, rotating nystagmus, visual blurring

Other Meds: Extradiol 0.5 mg daily Progesterone 100 mg daily PantoprazoleSOD 40 mg daily Pimecrolimus Cream 1% Advil over the counter

Current Illness:

ID: 1429622
Sex: M
Age: 42
State: CA

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/26/2021
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: Dizziness started to occur approximately 9 hours after injection. Continued to next day.

Other Meds: lisinopril

Current Illness:

ID: 1429623
Sex: F
Age:
State: KY

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

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

Lab Data:

Allergies: Suprex,amoxicillin

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

Symptoms: A week after second shot i had a fever off and on , no appetite, also felt like I couldn?t breath at one point and started hyperventilating?about four days later I had brown spotting , then intense cramping PMS symptoms for 2 weeks straight , I was also 16 days late on my period. When receiving my period it was 7 days as it normally is and was fine after period ended I am now having chest pains on the left side .

Other Meds: None

Current Illness: None

ID: 1429624
Sex: F
Age: 82
State: CO

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 06/26/2021
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: celery

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

Symptoms: The day after the second shot i had a low grade temperature of 99.3, Severe muscle aches, and very tired. I began to have huge amounts of blood mucus, spitting it up and choking on it. Was given a sinus infection amoxicillin antibiotic and musilix and nasal sprays. 2 weeks The heavy blood mucus traveled into my eustachian tubes, imparing my hearing and making me off balance...3 weeks. Experienced sever headahce for a week and went to ER for Ct scan . No stroke or anyerism . Then the heavy bloody mucus went into my bronchi and lungs causing shortness of breath and weakness...given a pneumonia antiibiotic . I am currently on a prescription for Prednisone ( on the refill) and improving slightly but still weak and tired and shortness of breath. Still having shortness of breath (6/26/21_ and very tired. Cannot perform all my daily functions like taking a walk . I am able to prepare meals. adverse reaction still exits 2/25/21 - 6/26/21

Other Meds: levithyroxin

Current Illness: none

ID: 1429625
Sex: F
Age: 31
State: TN

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/26/2021
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: The patient was given a dose of the vaccine that was expired. The vial was from the previous day (6/24/21). No adverse events have been reported as of 6/26/21.

Other Meds:

Current Illness:

ID: 1429626
Sex: M
Age:
State:

Vax Date: 05/20/2021
Onset Date: 05/27/2021
Rec V Date: 06/26/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Had intermittent pulsentile tinnitus that turned in to traditional tinnitus ie ears ringing all the time

Other Meds: None

Current Illness: None

ID: 1429627
Sex: F
Age:
State: KY

Vax Date:
Onset Date:
Rec V Date: 06/26/2021
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: Rash pain heat on shin of both legs.

Other Meds:

Current Illness:

ID: 1429628
Sex: M
Age: 28
State: CO

Vax Date: 05/17/2021
Onset Date: 05/24/2021
Rec V Date: 06/26/2021
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: Injection site pain, Menorrhagia

Symptoms: Patient noticed a change in his moods about 6 days after the first dose. Didn't think anything about it at first but coworkers and family members noticed his moodiness and he was easily aggravated. He reached out to us to see if anyone else had reported these symptoms following their Moderna vaccine

Other Meds: none

Current Illness: none

ID: 1429629
Sex: M
Age: 60
State: GA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 06/26/2021
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: 1st dose of vaccine administered on 03/25/21 at 1:30 pm. Side effects: 03/25/21-03/28/21 ? pain on the site of injection; nausea. 03/26/21-04/04/21 ? increased tone of facial muscles; tiredness. 04/05/21-04/07/21 ? stomach pain; slight increase in body temperature up to 37.2 C; nausea; vomiting; muscle and joint pain in the belt region. 04/08/21-04/12/21 ? increased maximum body temperatures up to 37.8 C; temperature declined overnight to 36.7-37.2 in the morning and then rising again; change of voice; all other side effects are gone. 04/13/21-04/14/21 ? maximum body temperature decreased to 37.4 C; change of voice. 04/15/21-04/20/21 ? maximum body temperature decreased to 37.2 C; change of voice. 04/20/21 blood test results - inflammation: Erythrocyte Sedimentation Rate (ESR) 56 mm/hr SARS-CoV-2 Antibodies, Spike Protein 15.10 U/mL C-Reactive Protein (CRP) 1.06 mg/dL 04/21/21-05/08/21 ? maximum body temperature decreased to 36.7-37.0 C; change of voice persists; chest pain. Multiple rectal bleedings: 04/30/21, 05/01/21, 05/11/21, 05/12/21, 05/15/21, 05/16/21, 05/21/21, 05/22/21, 06/03/21, 06/04/21(small). Temperature is in the normal range since 05/09/21. 06/01/21 blood test results ? inflammation gone: Erythrocyte Sedimentation Rate (ESR) 10 mm/hr SARS-CoV-2 Antibodies, Spike Protein 10.10 U/mL C-Reactive Protein (CRP) 0.44 mg/dL Looking for suggestion to do or not to do second vaccine administration.

Other Meds: None

Current Illness: Tachycardia in isolated days.

ID: 1429630
Sex: F
Age: 16
State: PA

Vax Date: 05/01/2021
Onset Date: 06/03/2021
Rec V Date: 06/26/2021
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: Started developing paresthesias in bottom of feet 2 days after 2nd Pfizer vaccine. That progressed ascending up to legs and arms over the course of 3 weeks. She went to the hospital and was diagnosed with Gullain-Barre syndrome based on the CSF studies and MRI imaging.

Other Meds: none

Current Illness: none

ID: 1429631
Sex: F
Age: 24
State: FL

Vax Date: 06/18/2021
Onset Date: 06/25/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: About a week after the first dose of COVID-19 Moderna vaccine, I developed an itchy rash around the area where I was injected (left arm). I took an antihistamine allergy pill (50mg) to help with the swelling. It's still red, flakey, and oddly shaped currently (06/26/2021). Symptom is mild thus far, but I wanted to note it.

Other Meds: N/A

Current Illness: N/A

ID: 1429632
Sex: M
Age: 14
State: IL

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/26/2021
Hospital: Y

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: The patient received the vaccine and 4-5 minutes later he fell out of his chair, facedown. He appeared to be convulsing. He was pale, diaphoretic, and disoriented. His blood pressure was 76/36 and his pulse was 84. Radial pulse was 2+. EMT was called. His EKG appeared to have a slight elevation in his inferior leads. He and his guardian deny any significant history. Upon discharge with EMT, the patient was alert and tolerating liquids well. The patient's guardian states that he has had a similar reaction prior when he was the age of 6. She states that he also felt slightly lightheaded from the first Pfizer vaccination.

Other Meds: N/A

Current Illness: N/A

ID: 1429633
Sex: F
Age: 22
State: PA

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Nausea

Symptoms: About 15 minutes after vaccine starting having swelling of throat and tongue. It progressed to difficulty breathing.

Other Meds: Unknown

Current Illness: Unknown

ID: 1429634
Sex: F
Age: 57
State: NC

Vax Date: 06/15/2021
Onset Date: 06/18/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Shingles rash - Upper left shoulder - Treatment: Valacyclovir 1 gram tablet 3 times per day, 21 tablets. Treatment not complete. Rash still present, rash not spreading. Day of shot 6/15/2021 - slight tingling top of left hand, left foot, left side of face. Resided after 8 hours. 6/17/2021 to current (6/26/2021) - sneezing 6/18/2021 to current (6/26/2021) - mild chest congestion, wet cough, nasal inflammation (basically means, can't breath through nose), sinus congestion and drainage. Treatment: 10 mg Loratadine, over-the-counter cough and expectorant syrup, over-the-counter nasal spray.)

Other Meds: loratadine 10 mg 1 time per day

Current Illness: None

ID: 1429635
Sex: F
Age: 76
State: FL

Vax Date: 02/01/2021
Onset Date: 02/12/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Developed Atrial Fibrillation (24 hours) four days after 2nd immunization. One previous episode of this arrhythmia was2.5 years previously. On 6/8/2021, I had a cardiac ablation for the arrhythmia which began in February

Other Meds: Celebrex 200 mg. AD

Current Illness: NKA

ID: 1429636
Sex: F
Age: 71
State: CA

Vax Date: 02/18/2021
Onset Date: 03/10/2021
Rec V Date: 06/26/2021
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: About 10-15 days after receiving the second dose of the vaccine, I experienced symptoms similar to those of a panic attack. light-headedness, a fluttery sensation in the chest (heart area) and temblor in the hands.

Other Meds: Calcium and Vitamin D supplements

Current Illness: None

ID: 1429637
Sex: F
Age: 34
State: MA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/26/2021
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: Unknown

Other Meds:

Current Illness:

ID: 1429638
Sex: F
Age: 31
State: CA

Vax Date: 03/11/2021
Onset Date: 04/20/2021
Rec V Date: 06/26/2021
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: No

Symptom List: Erythema, Pruritus

Symptoms: In April 2020 I was 5 days late from starting my period with a 3 day outcome. In May 2021 I was 7 days late with a 3 day outcome. And this month June 2021 I?m currently 6 days late from starting my period. I haven?t changed my diet,weight, or stress level also I?m not diabetic.

Other Meds: Women?s multivitamin

Current Illness: No

ID: 1429639
Sex: F
Age: 12
State: CA

Vax Date: 06/05/2021
Onset Date: 06/06/2021
Rec V Date: 06/26/2021
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: Client reported she self-medicated with Motrin and symptoms resolved the next day (2 days after vaccination). Client denied having any allergies or chronic conditions and she did not follow-up with a physician regarding side-effects. Vaccine site lead provided education to client and mother on COVID-19 vaccine side-effects and encouraged to report any additional side-effects on VSAFE. Clinical coordinator was consulted and provided approval to administer 2nd dose with a 30-minute observation period.

Other Meds: None

Current Illness: None

ID: 1429640
Sex: M
Age: 41
State: MA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/26/2021
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: Unknown

Other Meds:

Current Illness:

ID: 1429641
Sex: M
Age: 69
State: MA

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/26/2021
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: dose was administered sub-q vs IM in error

Other Meds:

Current Illness:

ID: 1429642
Sex: M
Age: 32
State: MA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Unknown

Other Meds:

Current Illness:

Date Died: 02/14/2021

ID: 1429643
Sex: F
Age: 70
State: GA

Vax Date: 01/01/2021
Onset Date: 02/01/2021
Rec V Date: 06/26/2021
Hospital: Y

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: Unknown

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

Symptoms: Lethal stroke

Other Meds: She had been treated for liver cancer

Current Illness:

ID: 1429644
Sex: F
Age: 19
State: MA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Unknown

Other Meds:

Current Illness:

ID: 1429645
Sex: M
Age: 27
State: MA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/26/2021
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: Unknown

Other Meds:

Current Illness:

ID: 1429646
Sex: F
Age: 40
State: PA

Vax Date: 03/29/2021
Onset Date: 04/15/2021
Rec V Date: 06/26/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Sudden Cardiac Arrest, needed to be defibrillated twice. Life support for 2 days. No previous health issues. Hospital stay for 7 days. ICD implanted.

Other Meds: NuvaRing

Current Illness: None

ID: 1429647
Sex: F
Age: 20
State: KY

Vax Date: 06/07/2021
Onset Date: 06/22/2021
Rec V Date: 06/26/2021
Hospital: Y

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

Symptoms: 2 weeks following vaccine developed pruritus, jaundice, fatigue, headache, elevated liver enzymes and cholestasis found to have moderate acute cellular rejection on liver biopsy in addition to cholangitis/peri-cholangitis, being treated with high dose steroids and antibiotics

Other Meds: tacrolimus, mycophenolate, concerta, melatonin

Current Illness: none

ID: 1429648
Sex: F
Age: 20
State:

Vax Date: 06/25/2021
Onset Date: 06/26/2021
Rec V Date: 06/26/2021
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: pain in the arm I got the vaccine in, elevated heart rate, body aches

Other Meds: birth control

Current Illness:

ID: 1429649
Sex: M
Age: 22
State: MA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/26/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: unknown

Other Meds:

Current Illness:

ID: 1429650
Sex: F
Age: 45
State: CO

Vax Date: 06/04/2021
Onset Date: 06/05/2021
Rec V Date: 06/26/2021
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: Biaxin/bee stings

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

Symptoms: Day after 2nd dose. Temperature over 100 all day. Tylenol did not help. Bad muscle aches. Headache. Fatigue. 2nd day after totally fine. 3rd day after. Fatigue. Headache. Heart palpitations. High blood pressure. Racing heart. Day 4 after. Heart attack symptoms. Severe anxiety. Dizzy. Neck and jaw pain. Severe Chest pain. Upset stomach. High blood pressure. Racing heart.

Other Meds: None

Current Illness: None

ID: 1429651
Sex: F
Age: 12
State: MI

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/26/2021
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 known allergies

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient received her second Pfizer vaccine and approximately 15 minutes after noted that her arm that the vaccine was given in was numb. Upon assessment she was unable to lift her arm, she could not "feel" her arm and had decreased grip strength in the arm the vaccine was given. Ice applied, no change after being observed. Patient was sent to Urgent Care downstairs for further observation.

Other Meds: none

Current Illness: N/A

ID: 1429652
Sex: M
Age: 20
State: TX

Vax Date: 06/20/2021
Onset Date: 06/20/2021
Rec V Date: 06/26/2021
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: administered after expiration date but Moderna tested lot and said it provided the necessary protection and did not need to be repeated

Other Meds:

Current Illness:

ID: 1429653
Sex: M
Age: 35
State: MA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/26/2021
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:

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

Symptoms: unknown

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm