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: 1430108
Sex: F
Age: 16
State: GA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
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: Systemic: Chills-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Hyperventilation-Medium, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Vomiting-Mild, Additional Details: Approximately 5 minutes after administration, patient fainted while seated in chair. After awakening, patient reported feeling faint and tingling in her extremities. Patient was breathing heavily. After breathing normalized, patient reported severe menstral cramps. Patient was given Midol, water, and pretzles. Shortly after, patient stated that she was still light headed so she laid on the ground. Patient eventually recovered and left pharamcy.

Other Meds:

Current Illness:

ID: 1430109
Sex: M
Age: 62
State: AL

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 06/27/2021
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: Flu type illness for 3 days followed by pnuemonia symptoms and Myocarditis.

Other Meds: none

Current Illness: diabetes

ID: 1430110
Sex: F
Age: 17
State: NC

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Mild, Additional Details: She has a history of vasovagal reaction to needles and blood draws. Provided her with water and crackers and observed for about 30 minutes.

Other Meds:

Current Illness:

ID: 1430111
Sex: F
Age: 15
State: VA

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/27/2021
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: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: tingling sensation on the arm that got the vaccine-Mild, Systemic: Headache-Mild, Systemic: Hypotension-Mild, Systemic: Weakness-Mild, Additional Details: as soon after giving vaccine, pt fainted. Woke up after 1-2 mins, pt was positioned flat on her back with legs elevated. Pt took apple juice and 25mg benadryl @7:30pm, watched pt for another 15 mins and took blood pressure before leaving. BP was low but mom states she always has low blood pressure. Followed up next day around 1pm, mom states pt has pain at the injection site, headache, no fever, and sleeping

Other Meds:

Current Illness:

ID: 1430112
Sex: M
Age: 15
State: CA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Vomiting-Mild

Other Meds:

Current Illness:

ID: 1430113
Sex: M
Age: 28
State: CA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
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: Site: Pain at Injection Site-Mild, Systemic: PT SAID HE IS VERY WARM AFTER INJECTION AND STARTED SWEATING. THEN HE SAID THINS ARE VERY BLURRY AND WE CALLED 911. THEY CAME AND CHECKED ON HIM AND THEN TOOK HIM WITH THEM.-Severe, Systemic: Flushed / Sweating-Severe

Other Meds:

Current Illness:

ID: 1430114
Sex: F
Age: 12
State: NJ

Vax Date: 06/23/2021
Onset Date: 06/24/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Heart palpitations Shortness of breath Pressure in chest

Other Meds: None

Current Illness: None

ID: 1430115
Sex: F
Age: 35
State: FL

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/27/2021
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: Pharyngeal swelling

Symptoms: My all organic face products, which haven?t changed and I?ve never had an adverse reaction to, started feeling like a chemical burn on the same night as the vaccine. It has continued to feel like that, although the severity has subsided. Within a couple of days, I started having a random feeling of swelling all along my jawline, and noticed a bright red, hot, itchy rash along the jawline and upper neck area. It wasn?t raised or bumpy. I now get random reactions like that throughout the day, and it has changed from being jawline/upper neck-specific to random areas of the neck.

Other Meds: None

Current Illness: Partial thyroidectomy May 18. Encouraged by surgeon to have first and second shot before and after surgery, respectively.

ID: 1430116
Sex: F
Age: 66
State: TN

Vax Date: 06/23/2021
Onset Date: 06/25/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: Contrast Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Covid arm: Large rash appearing two days after shot. Doesn't hurt or itch. Is hot. Today is Day 5. It's still there but decreasing.

Other Meds: NP Thyroid 60 mg Vitamin D Omega 3

Current Illness: None

ID: 1430117
Sex: F
Age: 59
State: FL

Vax Date: 03/12/2021
Onset Date: 04/01/2021
Rec V Date: 06/27/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: No adverse events at time of vaccines but within 2 weeks of the second vaccine my existing, under control, Rheumatoid Arthritis began to flare with excessive inflammation, sharp pain in almost all joints, hand swelling, headaches, etc. As of this date, 6/27/2021, Rheumatoid flare still exists with no relief. Enbrel was stopped 05/12/21, Kevzara was started 05/31/2021 in hopes that this flare was a result of medications not working. To this date, the only relief is found when using high dose Prednisone daily. Prednisone has not been needed to control the disease in several years. This is the worst flare I have felt in 20 years with this disease and there seems to be no relief.

Other Meds: Advair 500 Spiriva Respimat Enbrel Aralast

Current Illness:

ID: 1430118
Sex: F
Age: 55
State: NC

Vax Date: 04/26/2021
Onset Date: 04/29/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin (rash) IV Contrast Dye (rash)

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

Symptoms: 4/29/21 Emergency room visit-Chest pain, fluid in pleural cavity, inflammation of the covering of the heart. Discharged from the ER with Colchicine 0.6mg tablet (2x/day), indomethacin 25mg capsule (3x/day), pantoprazole 40mg (1/day). Visited primary health provider on 5/25/21 who added prednisone to help with the inflammation. Visited the ER on 6/4/21 with chest pain and atrial flutter. Admitted to hospital to control the heart rate with Eliquis 5mg(2/day), colchicine 0.6mg (2/day), digoxin 125mcg 1x/day, diltiazem 180mg 1/day, indomethacin 25mg 3xday, metoprolol 50mg 2/day, pantoprazole 40mg 1xday.

Other Meds: Lexapro 20mg/day Trazodone 50mg/day Women's Multivitamin 1/day Vagifem 10mcg 2x/week

Current Illness: Gallstones-Gallbladder removal 4/22/21

ID: 1430119
Sex: F
Age: 39
State: NY

Vax Date: 06/26/2021
Onset Date: 06/27/2021
Rec V Date: 06/27/2021
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: Banana, avocado

Symptom List: Rash, Urticaria

Symptoms: Same as first shot. 102 fever, joint aches. This time I have a headache and upset stomach

Other Meds: Hydrochlothiazide, welbutrin, levothyroxine

Current Illness: None

ID: 1430120
Sex: M
Age: 53
State: IN

Vax Date: 04/20/2021
Onset Date: 05/03/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

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

Symptoms: Severe pain and swelling in ankles and legs that lasted for more than eight weeks. Lumps appeared under the skin that were extremely painful to touch. Substantial joint pain ankles, knees, elbows, and wrist was present and varied in location and severity.

Other Meds: This is a follow-up to a previous report of adverse event. I was diagnosed with Erythema Nodosum and tested for all previously know causes. All items tested for came back negative.

Current Illness: None

ID: 1430121
Sex: F
Age: 46
State: FL

Vax Date: 05/21/2021
Onset Date: 05/29/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Chest pain. Constant headache Increased blood pressure. Swelling in the extremities.

Other Meds: None

Current Illness: None

ID: 1430122
Sex: F
Age: 61
State: IN

Vax Date: 03/30/2021
Onset Date: 04/05/2021
Rec V Date: 06/27/2021
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: penecillin

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

Symptoms: occasional vertigo, dizziness

Other Meds: paxil, lipitor, losartin, water pill

Current Illness: none

ID: 1430123
Sex: F
Age: 54
State: MA

Vax Date: 04/01/2021
Onset Date: 04/23/2021
Rec V Date: 06/27/2021
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: NA

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Pain and exhaustion that has changed my ability to live as I always have

Other Meds: Multi vitamin

Current Illness: NA

ID: 1430124
Sex: F
Age: 62
State:

Vax Date: 06/23/2021
Onset Date: 06/24/2021
Rec V Date: 06/27/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: 24 hours after administration got hives at the site. This along with intermittent pain lasted for 4 days

Other Meds:

Current Illness:

ID: 1430125
Sex: M
Age: 13
State: NY

Vax Date: 06/24/2021
Onset Date: 06/25/2021
Rec V Date: 06/27/2021
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: Chest pain (achy, severe) with radiation to the left arm, chills, sweating, subjective fever, cough. Patient is a 13 year old male with a history of a neck dislocation who currently presents with 2 days of chest pain after receiving the second COVID-19 vaccine. His first vaccine was on June 2, 2021. He tolerated that vaccine well except for some mild left arm pain where he received the vaccine. The second dose was on 6/24/2021 around 3 pm. He felt well that first day, but on 6/25/2021 he started to have achy chest pain when trying to go to sleep. The pain radiated to the left arm and severe. It was worse when lying flat. It prevented him from falling asleep at night. The following day he did okay and went about his normal day. He even was able to play basketball (mostly shooting) and had to play with only his right arm because of pain in the left arm. Last night he again started to feel the achy chest pain with radiation to the left arm thus came to the hospital for evaluation. He states that the pain is associated with chills/sweating, subjective fever, and a cough. Denies any shortness of breath, headache, lightheadedness, dizziness, changes in appetite, nausea, vomiting, diarrhea, muscle aches, or swelling of extremities/face.

Other Meds: None

Current Illness: None

ID: 1430126
Sex: F
Age: 75
State: CA

Vax Date: 03/15/2021
Onset Date: 04/30/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Brain fog, unsteadiness, disequilibrium, eyelids feel heavy, numbness in fingertips, left hand

Other Meds: Pradaxa, simvastatin, zinc, vit D, turmeric, vit C, calcium,

Current Illness: atrial fibrillation

ID: 1430127
Sex: M
Age: 74
State: MA

Vax Date: 06/01/2021
Onset Date: 06/21/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient developed a lower extremity DVT approximately 2 weeks after receiving the J&J COVID-19 Vaccine. Patient was treated and discharged from our facility on apixaban.

Other Meds: Amlodipine Melatonin Metoprolol Succinate

Current Illness:

ID: 1430128
Sex: F
Age: 46
State: IL

Vax Date: 06/27/2021
Onset Date: 06/27/2021
Rec V Date: 06/27/2021
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: itching of throat

Other Meds: None

Current Illness: None

ID: 1430129
Sex: M
Age: 56
State: VA

Vax Date: 06/22/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List: Unevaluable event

Symptoms: Just a few hours after receiving the vaccine in the late afternoon of June 22, I began having flu-like symptoms including severe soreness in the injection area, fever to 100 degrees, nausea, severe body aches especially in my legs, and headache. These slowly subsided by late on June 24. Overnight on June 27, I was awakened by my left arm twitching in the tricep area. It continues to twitch as I write this mid-morning on June 27. If it continues for the next few days, I will have to see a doctor. These adverse effects have made me decide against getting the second dose of the shingles vaccine.

Other Meds: Centrum multivitamin, garlic tablet, vitamin D

Current Illness: None

ID: 1430131
Sex: M
Age: 60
State: MN

Vax Date: 05/05/2021
Onset Date: 05/10/2021
Rec V Date: 06/27/2021
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: nuts, omeprazole, pantoprazole

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

Symptoms: Abrupt worsening of his chronic neuropathy 5 days after receiving dose 1 of COVID19 vaccine series. (He did receive dose 2 later without any change in symptoms). Workup shows axonal polyneuropathy somewhat responsive to steroids. An alternate cause of his abrupt worsening of neuropathy not found. He was taken off of his disulfiram which he had started on fall 2020. This did not seem to help. He did show some improvement with 1g IV solumedrol daily x5 days.

Other Meds: cloNIDine HCL (CATAPRES) 0.1 MG tablet TAKE 1 TABLET(0.1 MG TOTALY) BY MOUTH THREE TIMES DAILY AS NEEDED, disulfiram 500 mg Tab Take 500 mg by mouth daily, EPINEPHrine (EPIPEN/ADRENACLICK/AUVI-Q) 0.3 mg/0.3 mL injection Inject 0.3 mL (0.3 m

Current Illness: no acute illnesses

ID: 1430132
Sex: F
Age: 51
State: MA

Vax Date: 05/24/2021
Onset Date: 06/01/2021
Rec V Date: 06/27/2021
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: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: The next period following my second vaccine was unusually heavy. Within hours of starting, I had extremely heaving bleeding for 2 days.

Other Meds: None

Current Illness: None

ID: 1430133
Sex: M
Age: 41
State: CA

Vax Date: 03/12/2021
Onset Date: 03/19/2021
Rec V Date: 06/27/2021
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: Approximately seven days following second dose of Pfizer COVID vaccine, I began experiencing heart palpitations, elevated heart rate, chest pressure, difficulty breathing, shortness of breath, and dizziness. Multiple "episodes" each day would occur without warning, did not relate to physical activity, or any other stimulus - would just happen throughout the day, often multiple times per hour. Even to this day, more than 90 days following the second dose of Pfizer, there are multiple times each day when I feel chest pressure, heart palpitations, and slight shortness of breath. It is not as common, or as severe as it was early on, but some symptoms remain.

Other Meds: None

Current Illness: None

ID: 1430134
Sex: F
Age: 55
State: NC

Vax Date: 01/08/2021
Onset Date: 06/15/2021
Rec V Date: 06/27/2021
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: Between 1 and 2 weeks after the second vaccine I noticed that my heart was racing most of the time, even when lying down. I visited Dr during that time and my blood pressure, which is usually about 118/78, was instead about 154/80. I don't remember exactly, but much higher than usual. It might have been 156/90, around there. My heart would beat fast enough to make me uncomfortable even when lying down. The rapid heart beats lasted for about 2 months. My blood pressure was back to normal by April.

Other Meds: none

Current Illness: none

ID: 1430135
Sex: F
Age: 55
State: MN

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 06/27/2021
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: Reactive Rheumatoid Arthritis in Left Arm and bloodshot eyes. Severe pain in left shoulder, elbow, wrist, hand, and the whole arm. Cannot lift arm or reach with arm while flexing muscles. Constant pain, worsens and gets slightly better with Tylenol. Difficulty sleeping when arm pain is bad. Bloodshot eyes. Prescribed allergy meds for eyes. Tylenol arthritis for arm pain, only helps mildly.

Other Meds: Xarelto, daily multi-vitamin

Current Illness: None

ID: 1430136
Sex: F
Age: 14
State: IN

Vax Date: 06/27/2021
Onset Date: 06/27/2021
Rec V Date: 06/27/2021
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: Pt here for second pfizer vaccine. RN chose syringe from prefilled syringes filled by another in clinic, , RN. This RN cleansed left deltoid with alcohol wipe and inserted needle into left deltoid. At this time noticed that there was no fluid in syringe and plunger was already fully down. Needle was removed and syringe was disposed of in sharps container. Area cleaned again with alcohol swab and vaccine was administered without difficulty. Team lead, on duty was notified of the situation. Both RN and Team lead spoke to both parents and explained the situation, assuring parents that patient did not receive 2 doses of vaccine today.

Other Meds: N/A

Current Illness: N/A

ID: 1430138
Sex: F
Age: 31
State: NY

Vax Date: 06/27/2021
Onset Date: 06/27/2021
Rec V Date: 06/27/2021
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: 31 year old female with no know medical condition vaccinated on left arm, deltoid area started complaining of light headedness and decreased blurry vision, patient was lay down on the floor and while in the process faints, pateint legs were raised and patient recouperated conciousness 5 seconds after, patient recovered completely and was discharge home

Other Meds: none

Current Illness: none

ID: 1430139
Sex: F
Age: 33
State: NY

Vax Date: 06/25/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: Ciprofloxacin, doxycycline

Symptom List: Nausea

Symptoms: Mild seizure Stabbing pain in lymph nodes

Other Meds: Klonopin

Current Illness: Neuropathy

ID: 1430140
Sex: F
Age: 36
State: NV

Vax Date: 06/19/2021
Onset Date: 06/24/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies, Kiwi, some shellfish

Symptom List: Injection site pain

Symptoms: rash on upper torso an extremities of right arm and left arm breast and back Taking on the duplicate form of the hives red itchy patches raised in the middle

Other Meds: Ferrous sulfate 325mg , Ibuprofen 800, multivitamin

Current Illness: None

ID: 1430141
Sex: F
Age: 37
State: GA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: Doxycycline Makena

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

Symptoms: Extreme fatigue. Fainting. Vitamin deficiency (D, b12,) low hemoglobin, not previously low.

Other Meds: Wellbutrin Breo Albuterol

Current Illness:

ID: 1430142
Sex: M
Age: 15
State: NC

Vax Date: 06/24/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
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: Hives, mostly on arm where vaccine was given

Other Meds: none

Current Illness: none

ID: 1430143
Sex: F
Age: 29
State: IN

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/27/2021
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: Metoprolol Cephalexin

Symptom List: Tremor

Symptoms: sore throat started day of injection Severe pain starting one day after injection, especially in joints and abdomen Major headache starting day of injection Swelling and rash on injection site, starting two days after injection

Other Meds: Calcium One-a-day Zoloft

Current Illness:

ID: 1430144
Sex: F
Age: 56
State: NC

Vax Date: 06/25/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
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: woke up at 1:00 a.m with fever 101 and body aches from neck to feet. difficulty ambulating, developed wet cough. took motrin and Advil throughout the 26th. Woke last night with swollen right arm, right and tender to touch and numbness in right 4th and 5th fingers. I've been awake and numbness has not subsided. This is probably all normal side effects but after Covid Vaccine, and original Shingrix, I was just sore for a day and didn't feel this bad.

Other Meds: Cozaar, Hctz, Wellbutrin,, zyrtec

Current Illness: none

ID: 1430145
Sex: F
Age: 33
State: IN

Vax Date: 06/25/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
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: Sore Arm, fatigue, irritable

Other Meds: Metformin

Current Illness: None

ID: 1430146
Sex: M
Age: 54
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 06/27/2021
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: Sore at injection site

Other Meds:

Current Illness:

ID: 1430147
Sex: F
Age: 75
State:

Vax Date: 03/06/2021
Onset Date: 03/13/2021
Rec V Date: 06/27/2021
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: Bee stings, some metals

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Muscular pain in left arm from site of injection to elbow,tingling in fingers unable to tolerate pressure on left arm.Joint pain

Other Meds: Blood pressure meds

Current Illness: N/A

ID: 1430148
Sex: M
Age: 15
State: IN

Vax Date: 06/25/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
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: Ibuprofen, aspirin, flagyl, dogs

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

Symptoms: Swollen Lymph nodes in Axilla area . Large and tender

Other Meds: Albuterol inhaler as needed

Current Illness:

ID: 1430149
Sex: F
Age: 68
State: GA

Vax Date: 01/16/2021
Onset Date: 03/05/2021
Rec V Date: 06/27/2021
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: My left side of head buzzing, frying sound from tinnitus

Other Meds: Vitamin D Vitamin C

Current Illness: Hypertension Stenosis Cervical

ID: 1430150
Sex: M
Age: 70
State: MO

Vax Date: 02/27/2021
Onset Date: 03/05/2021
Rec V Date: 06/27/2021
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: morphine lisinopril

Symptom List: Pain in extremity

Symptoms: one week following vaccination was unable to respond, unable to move, life flighted to hospital intubated and treated for blood infection

Other Meds: fluticasone propionate, gabapentin, melatonin, milnacipran, potassium chloride, tamsulosin hcl

Current Illness: torn rotator cuff, shoulder replacement diagnosed mid February 2021

ID: 1430151
Sex: M
Age: 12
State: CA

Vax Date: 06/21/2021
Onset Date: 06/24/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: Tamiflu

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

Symptoms: Headache, Fatique, Diarrhea 4-6 times per day, Neck Stiffness and Pain (swollen lymph nodes), Low Grade Fever

Other Meds: Aptiom 600 mg, Keppra 500 mg

Current Illness: none

ID: 1430152
Sex: F
Age: 57
State: OR

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 06/27/2021
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: Amoxicillian

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

Symptoms: After 1st Dose: Day 2 - extremely tired, Day 4 - Fatigue, extreme body/muscle pain deep in muscles debilitating, Day 5- less severe pain, fatigue. January 11th, extreme pain from hiatal hernia first time for medical treatment at Urgent Care followed by PCP care and medication. After 2nd Dose: Day 2-4 tired, mild body pain, 10 days latersore throat, very tired, extreme fatigue 3 weeks after 2nd Dose diagnosed with Epstein-Barr Virus, months later dealing with fatigue

Other Meds: metoprolol succinate 25mg, Duloxetine Hydrochloride 60mg, Meloxicm 15mg, D3 1000IU, Aller-Tec, Advocare CorePlex, Caltrate 600+D3, B6 100mg,

Current Illness: Sinus Infection

ID: 1430153
Sex: M
Age: 33
State: OH

Vax Date: 04/20/2021
Onset Date: 05/10/2021
Rec V Date: 06/27/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Shortened breath and hearth discomfort

Other Meds: None

Current Illness: None

ID: 1430154
Sex: F
Age: 50
State: NE

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/27/2021
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: None

Symptom List: Vomiting

Symptoms: Within 15 minutes of receiving the vaccine, my left arm/hand was numb and tingling. Within 1 hour of receiving the vaccine, both of my legs/feet and right arm/hand also became numb and tingling, and I felt muscle weakness. On 06/17, I started taking Prednisone for 5 days, which helped reduce the numbness and tingling but did not eliminate it. After ending the Prednisone treatment, the numbness and tingling increased again. It has now been 17 days since the vaccine and I still feel numbness and tingling in both arms/hands and legs/feet. It has reduced in intensity but has not gone away.

Other Meds: Synthroid

Current Illness: None

ID: 1430155
Sex: F
Age: 13
State: CA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
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: Patient said she felt immediate, strong pain in her arm from the jab the nurse gave her. She said the needle was in her arm a lot longer than when she received her first shot. I also watched patient receive her first COVID shot from a different provider, different facility, and I was surprised by the force of the jab of this second COVID shot, and length of time the needle was in her arm. After the nurse left us in the room to wait 15 minutes, patient became more and more uncomfortable, hot, sweaty and nauseous. Within 5 minutes, she was lying down on the exam table - at which time I alerted staff at the nurse's station in hallway that patient wasn't well and we needed help. She said she would get "the provider" and be right in. When I walked back into the room, patient was curled up in a ball on the table, pale, clammy and not able to speak. I yelled down the hallway for help right away, and stepped back into the room. Patient then began to vomit. At least two nurses entered the room, and began to assess her vitals. Her blood pressure was low, but she was breathing fine. 'The provider" (I don't know his name) came in and I told him about how hard she was jabbed, and that she began to feel badly immediately afterward.

Other Meds: none

Current Illness: none

ID: 1430156
Sex: M
Age: 15
State: IN

Vax Date: 06/25/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: At 1 am, my son presented with headache, dizziness, lightheadedness, shaking, ringing in ears, shortness of breath, and pallor. Vasovagal symptoms and near syncopal episode. Was able to get him to the floor to avoid a fall. Vomited several times. Severe vasovagal symptoms began to resolve within one hour. Didn?t check heart rate during initial near syncopal episode but was tachycardic after initial stabilization. Headache and fatigue persisted and is still lingering today.

Other Meds: None

Current Illness: None

ID: 1430157
Sex: F
Age: 53
State: VA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/27/2021
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: Penecillin Anti nausea meds

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Loud buzzing/ ringing in both ears

Other Meds: Cymbalta Levoxyl Losartan Gabapentin Multivitamin

Current Illness: None

ID: 1430158
Sex: F
Age: 26
State: IN

Vax Date: 05/28/2021
Onset Date: 06/02/2021
Rec V Date: 06/27/2021
Hospital: Y

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

Lab Data:

Allergies: Alcohol (beer, cider, liquor, etc)

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

Symptoms: Woke up with burning sensation and pressure in my heart, felt like a heart attack and was treated with Myocarditis, treated with metoprolol succinate to help heal the inflammation of my heart.

Other Meds: Rosuvastatin, Estarylla, vitafusion probiotic for digestive health

Current Illness: None

ID: 1430159
Sex: F
Age: 61
State: MD

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/27/2021
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: Contact sensitivity to iodine solutions. Severe adverse reaction (1 week of malaise, generalised myalgia) following Rabies vaccination 40 years ago.

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

Symptoms: 25 June 11 pm: Entire body aching -- Up multiple times during the night, general muscle aching and fatigue, some confusion; migraine developed overnight. 26 June, 7 am: Out of bed, short walk, general myalgia, fatigue, migraine, had to lie down. 8:30 am: Slightly longer walk, felt slightly better, able to eat small amount after this. 9:30: Felt nauseated, migraine, fatigue, and myalgia worse. Noon: Brief walk outside, lay back down due to nausea, fatigue, myalgia. 2:30 pm: Nausea a bit better, ate apple, lay back down due to symptoms above. 5 pm: Migraine and nausea slightly better, fatigue and myalgia persist. 6:30 pm: Ate plain lettuce, extreme nausea, and tinnitus; vomited entire quantity; nausea improved. Remained prone rest of evening. 7:30 pm: Mild nausea persists, migraine improving, may be slight decrease in myalgia. 9 pm: To bed, slept well, definite improvement through night, some myalgia persists and occasional tinnitus. Able to drink water throughout.

Other Meds: Omega fatty acids, collagen, vitamin D, calcium, magnesium, SAM-e

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm