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: 1441134
Sex: M
Age: 32
State: WA

Vax Date: 05/26/2021
Onset Date: 05/29/2021
Rec V Date: 07/01/2021
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: Peanuts and cephalexin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chest pain presented 3 days after vaccination and worsened for 2 days before slowly diminishing.

Other Meds: Multivitamin

Current Illness: None

ID: 1441135
Sex: F
Age: 20
State: TX

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 07/01/2021
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: I have complete hearing loss in my left ear and I was given 3 steroid shots in my ear and the hearing has came back partially now but have complete hearing loss in high frequency.

Other Meds: I was taking birth control medication.

Current Illness: None

ID: 1441136
Sex: F
Age:
State: OR

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 07/01/2021
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: Mushrooms, Melon

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

Symptoms: Chills, body aches, felt tired, migraine, COVID arm after dose.

Other Meds: No

Current Illness: No

ID: 1441137
Sex: M
Age: 73
State: CA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 07/01/2021
Hospital: Y

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

Lab Data:

Allergies: No known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The wife called us and stated after the vaccine at some unknown point the patient passed out and has been hospitalized. The patient waited for 15 minutes in the store and was talking like normal. He walked out of the store on his own. The wife states she found out today he may have had multiple mini strokes.

Other Meds: No known

Current Illness: Per the wife she thought he had early onset of dementia.

ID: 1441138
Sex: F
Age: 67
State:

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/01/2021
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, latex, penicillin

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

Symptoms: pain at vaccine site on left arm, radiating to shoulder and neck

Other Meds: goldenseal, vit D, magnesium

Current Illness:

ID: 1441305
Sex: F
Age: 57
State: KS

Vax Date: 06/24/2021
Onset Date: 06/25/2021
Rec V Date: 07/01/2021
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: penicillin

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

Symptoms: Patient called 7 day post Moderna Covid vaccination #1 saying that she had been experiencing some muscle soreness on both sides of her neck as well as some redness/swelling around the injection site. Told her the injection site reaction was quite common and should subside over time and is ok to use with OTC pain relievers (ibuprofen, naproxen, acetminophen). The muscle soreness was a noted adverse event in trials and told her if it did not appear to get better or progressed, she should notify her physician. She did not seem real concerned, just thought we should know and she still planned on getting her second shot in approximately 3 weeks.

Other Meds: Pravachol, acyclovir, pantoprazole, bupropion, hydrochlorothiazide, clonazepam, lisinopril

Current Illness: N/A

ID: 1441306
Sex: F
Age: 33
State: IL

Vax Date: 03/13/2021
Onset Date: 04/20/2021
Rec V Date: 07/01/2021
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: birth control

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: A month after receiving my vaccine my menstrual cycle has not been the same. In April it was very light and I didnt have any breast tenderness and cramping that I normally get. And my cycle only lasted for 4 days instead of the normal 7. In May I still didn't get any of the normal breast tenderness. I did experience mild cramping throughout the month of May. My period was also late it came at the end of the month. My May period was also short it was 5 days. For the Month of June I didn't have a period at all. I had mild cramping that lasted for 2 weeks. The cramping started in the middle of June then stopped. And it came back at the end of June and then stopped.

Other Meds: none

Current Illness: none

ID: 1441308
Sex: F
Age: 39
State: NY

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: bactrim

Symptom List: Pharyngeal swelling

Symptoms: developed sensations of heat from head to toe initially. in the evening developed twitching in limbs and numbness in the face for about 2 weeks. the third week developed tendonitis in feet with pain shooting up wards of left leg calf and arm

Other Meds: none

Current Illness: no

ID: 1441309
Sex: F
Age: 17
State: TX

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: On 7/1/2021, received information from pharmacy regarding vaccination placed on 17 yo patient. On Tuesday, 6/8/2021, patient received the Moderna vaccination placed by RN working in the COVID -19 vaccination clinic. Patient is 17 years of age. On Thursday, 7/1/2021, Father informed daughter received Moderna vaccine which is indicated for 18 years of age and older and I was calling to find out how his daughter was doing. Father states, "she's fine". Then he called out to his daughter how she did after the vaccination, any symptoms. Daughter reported headaches and the father stated, "you always have headaches." Father denies any further questions or symptoms. 7/1/2021 1810 Called father back to further review symptoms needing medical attention or if severe symptoms needing ER visit, such as SOB, HA, abdominal pain, N/V, father verbalized understanding.

Other Meds:

Current Illness:

ID: 1441310
Sex: F
Age: 64
State: WA

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/01/2021
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: unknown

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient came in for her second Moderna vaccine after 28 days and was accidentally given Pfizer vaccine instead . patient is in good spirits and feels ok. No reaction to getting mixed vaccine . doctor assured her safety of situation

Other Meds: Unknown

Current Illness: unknown

ID: 1441311
Sex: F
Age: 61
State: NJ

Vax Date: 06/11/2021
Onset Date: 06/15/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Alvolax Allegra Bioxine

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

Symptoms: Patient stated that she got Technis shot for a job. Arm stayed red. Patient states that arm still aches

Other Meds: Omegazoile 40mg

Current Illness:

ID: 1441312
Sex: F
Age: 28
State: IL

Vax Date: 06/26/2021
Onset Date: 06/27/2021
Rec V Date: 07/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Fever of 102 -104F (36hr) Body aches, shakes, and chills (36hr) Headaches (began 06/28/2021) headaches encompass the whole head with pain at the base of the skull/neck

Other Meds: Birth Control Anti Depressant Allergy Pill

Current Illness: None

ID: 1441313
Sex: F
Age: 55
State: CA

Vax Date: 06/26/2021
Onset Date: 06/27/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfa medications such as Bactrim.

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

Symptoms: From the second injection on June 26, 2021, a swollen, very hard, round, red, bumpy patch on right arm at the injection site that spread and grew in size in diameter, was itchy, and very warm to the touch which lasted for 5 days. Stomach upset lasting 5 days-loose stool. The first injection site on left arm did the same, but spread even wider and left a very dark quarter-sized odd-shaped mark on the left arm that has not gone away since the first injection on May 29, 2021. Mouth sores inside my mouth on my gums--three of them, painful, gum swelling, VERY raw roof of my mouth making it near impossible to drink or eat or gargle. The mouth issues are currently ongoing today, 7/1/21. The roof of my mouth is still VERY raw from behind my front two teeth to the middle of the roof of my mouth. My gums are swollen.

Other Meds: Vitamin D and a multi-vitamin

Current Illness: None at the time and none prior.

ID: 1441314
Sex: M
Age: 64
State: PA

Vax Date: 06/28/2021
Onset Date: 06/28/2021
Rec V Date: 07/01/2021
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: patient was given covid vaccine in error. patient wanted to receive shingles vaccine.

Other Meds: atorvastatin

Current Illness: none

ID: 1441315
Sex: M
Age: 64
State: PR

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 07/01/2021
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: ASPIRIN

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

Symptoms: SWELLING OF TESTICLES AND PENIS THAT LASTED ABOUT 4 DAYS AFTER FIRST DOSE OF VACCINATION.

Other Meds: TYLENOL OR PANADOL AS NEEDED , VASOTEC 20MG PO DAILY, HCTZ 25MG PO DAILY, SIMVASTATIN 20MG PO DAILY, SINGULAIR 10MG DAILY, ALBUTEROL HFA 2 INHALATIONS DAILY, OMEPRAZOLE 20MG DAILY.

Current Illness:

ID: 1441316
Sex: M
Age: 72
State: GA

Vax Date: 03/27/2021
Onset Date: 05/08/2021
Rec V Date: 07/01/2021
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: Five weeks after the second dose on 05/08/2021 I woke up in the morning with a lump on my left leg near my shin that was the size of a golf ball. I had a Telehealth visit and I monitored it. I went to the Urgent Care on 06/08/2021 because it was getting worse. I had started to have some swelling, pain and discomfort in my legs and ankles. It was confirmed that I had Deep Vein Thrombosis in my left leg. They did not check the other leg because the medication would take care of any DVT in that leg. I also had heart palpitations at that time. I was prescribed injections of Lovonox and now I take Pradaxa. I still have pain and discomfort but no swelling in my left leg. I went to my doctor and a Hematologist with a Cardiology appointment scheduled.

Other Meds: Baby Aspirin

Current Illness:

ID: 1441317
Sex: F
Age: 61
State: CA

Vax Date: 11/16/2020
Onset Date: 11/23/2020
Rec V Date: 07/01/2021
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: penicillin

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

Symptoms: I got 4 shingles on my stomach each about 1 1/2 inches. Hurt for two weeks eventually started to heal. Felt like sandpaper on my stomach when healing and completely healed within a month.

Other Meds: Synthroid

Current Illness:

ID: 1441318
Sex: F
Age: 27
State: MI

Vax Date: 05/14/2021
Onset Date: 06/18/2021
Rec V Date: 07/01/2021
Hospital: Y

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

Lab Data:

Allergies: Keflex - hive, rash Bactrim - hive, rash Grass, Hay, Dust, Pollen

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Roughly 5 weeks after the second dose of the Pfizer\BioNTech vaccine, patient caught Covid. During the first few (3-4) days symptoms were mild and limited to shortness of breath and being easily tired. After a number of days with symptoms, patient continued feeling worse and worse. Around the 4th day of symptoms patient's face (eyes, lips, lymph nodes, throat) began to swell which prompted a visit to the ER. Once admitted, patient spent 9 days in the hospital as she moved towards a stable condition. Upon further investigation and visits with multiple specialists, a dermatologist concluded this was a case of Stevens-Johnson syndrome which may have been brought on due to vaccine (and suggested contacting CDC about this case as to his knowledge this has yet to be documented).

Other Meds: None

Current Illness: None

ID: 1441319
Sex: F
Age: 39
State: PA

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Hydrocodone-severe itching

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt developed dizziness, face pain, and scratchy throat immediately after vaccine. Pt had slight elevated blood pressure (160/100 which came down to 139/102 over the next 3-4 readings over 30-45 min). Pt remained in IMZ room with ice pack and legs elevated for ~ one hour. Pt's symptoms did not progress any further and the throat issue seemed to go away according to Pt so she went home with her sister.

Other Meds: ferrous sulfate 325mg bupropion er/sr 150mg

Current Illness: unknown

ID: 1441320
Sex: F
Age: 73
State: NY

Vax Date: 03/14/2021
Onset Date: 05/16/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Latex, benedryl, neomycin, triple antibiotic cream, propolis

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

Symptoms: Severe Vertigo due to middle ear infection

Other Meds: None

Current Illness: none

ID: 1441321
Sex: M
Age: 58
State: FL

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/01/2021
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:

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

Symptoms: PATIENT HAS SOME REDNESS ON THE ARM, SLIGHT RAISED AREA AT THE INJECTION SITE & COMPLAINS OF ITCHINESS.

Other Meds:

Current Illness:

ID: 1441323
Sex: M
Age: 52
State: OR

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
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: No adverse events noted. After administration of 2nd Moderna COVID-19 vaccine. data entry staff noted that patient received Janssen COVID vaccine prior to starting Moderna series. Janssen vaccine given 4.27. 1st Moderna administered 4.29. 2nd Moderna administered 7/1. Janssen vaccine was not disclosed prior to Moderna administration, and given by another health center. Report submitted for record keeping only.

Other Meds:

Current Illness:

ID: 1441324
Sex: F
Age: 36
State: CA

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Moderna vaccine was administered to patient past the 12 hour beyond use time. No adverse reactions occurred or have been reported by the vaccinated individual. Moderna manufacturer was contacted and we are awaiting a return call from a vaccination expert. No Adverse reactions were observed by pharmacist within 15 minutes after vaccination. Patient did not contact us as of 6 hours after vaccination to report adverse reactions.

Other Meds:

Current Illness:

ID: 1441325
Sex: F
Age: 51
State: WV

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/01/2021
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: Blackberries, codeine, gluten, NSAIDs, onion, strawberries, sulfa drugs, tomatoes

Symptom List: Injection site pain, Pain

Symptoms: Hot, erythematous, painful area left upper arm

Other Meds: Vitamin C, Astelin, vitamin D, vitamin B12, Allegra, Prozac, Flonase, folic acid, Cozaar

Current Illness: ?

ID: 1441326
Sex: F
Age: 28
State: OK

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Onion Severe seasonal allergies.

Symptom List: Injection site pain, Menorrhagia

Symptoms: The pharmacist, injected it in my left arm. I could still move despite the painful arm. I got up after sleeping and it was 7pm. I had a little bit of fatigue and muscle joint pain but nothing like the first dose. In the car at 11pm, I could tell that my body felt achy and I got chills. After we got home which was around midnight I was having severe muscle and joint pain and the fever ran 101. I felt like this was a serious reaction but it is possible that my body hurt due to the fever. I took ibuprofen and got a cold rag to then went to bed and slept 13 hours consecutively. On the 25th, I was so itchy on my whole body everywhere and then I started noticing a rash all over my body like hives. My hand had a few red spots. Everything was itchy. This happened all day on Friday. My fever fluctuated to 99. Saturday, I woke up with a hive on my back and my mom suggested Benadryl cause I was super uncomfortable. The itching and fever made me feel uncomfortable. By Sunday morning, I had a very severe allergic reaction which I went to urgent care at 7am on Saturday. They gave me steroids ( Prednisone 10mg 2xday for 5 days) and take Benadryl around the clock. They seemed to help with the rash and I could tell I was getting itchy again when I would take a break. I have experienced abdominal pain for both doses. I woke up Thursday morning with severe cramps.

Other Meds: Singulair, 10mg, 1xday Albuterol inhaler Amitriptyline, 10mg, 1xday for migraine Ocella birth control, 1 xday Nature's Sunshine (Herbal supplements) 1histablock, 1 sinusupport, 1 magnesium complex.

Current Illness: None.

ID: 1441327
Sex: F
Age: 64
State: PA

Vax Date: 06/28/2021
Onset Date: 06/28/2021
Rec V Date: 07/01/2021
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: lidocaine

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

Symptoms: patient got covid vaccine in error. patient wanted to receive shingles vaccine.

Other Meds: warfarin, metoprolol, rosuvastatin

Current Illness: none

ID: 1441328
Sex: F
Age: 43
State: CA

Vax Date: 06/23/2021
Onset Date: 06/24/2021
Rec V Date: 07/01/2021
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: Antacid meds

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 14 hours after the shot, woke up in the middle of the night with some chills, followed by difficulty breathing. Throat felt narrowed. Lasted for about 2 hours. The next 8 days chest feels heavy and have to catch a breath here and there. Today is day 8

Other Meds: Steroid drops for eyes

Current Illness: No

ID: 1441329
Sex: F
Age: 51
State: FL

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: constant itching on scalp dryness of mouth

Other Meds: allergy medication

Current Illness: none

ID: 1441330
Sex: F
Age: 61
State: WA

Vax Date: 04/08/2021
Onset Date: 04/27/2021
Rec V Date: 07/01/2021
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: none

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

Symptoms: statin induced rhabdomyolysis

Other Meds: aspirin, albuterol, metformin, Januvia, glimepiride, lisinopril. atorvastatin, gabapentin, dulera

Current Illness: covid

ID: 1441331
Sex: F
Age: 51
State: MI

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Codeine related products, beees .

Symptom List: Nausea

Symptoms: Patient received her second vaccine ( Covid-Pfizer) the 5 minutes later, she started feeling her tongue and lips swell and started coughing. 911 was called and Epinephrine was administered, 3 - 4 minutes later she started breathing better and EMS showed up.

Other Meds: N/A

Current Illness:

ID: 1441332
Sex: M
Age: 60
State: DE

Vax Date: 03/27/2021
Onset Date: 05/03/2021
Rec V Date: 07/01/2021
Hospital: Y

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: I had no symptoms up until May 3rd. I had high blood pressure - it was through the roof. - It was 193/101. I was experiencing dizziness and wobbly - not sure on my feet. ER. Changed dosage to - higher dosage - Lisinopril and Amlodipine. Primary care doctor decided to give me Prednisone - I did the series of it and I no longer take it. Blood pressure is still high and racing with the heart issues and working with the doctor to still get it under control and taking the meds. They did issue me Meclizine - in case I have a vertigo feeling. May 26th - I told her I am not going to use her services anymore and so I'm seeing Dr. now. Remicade infusion every 8 weeks. I still go to work right now.

Other Meds: Indomethacin; Omeprazole; Remicade infusion; Locinaprol; Amlodipine; Multi-Vitamin - Centrum Silver; Dietary supplements -made by Sculpt nation - Turmeric black and green's - Green Superfood Powder; PM Burn - by Sulpt nation

Current Illness: Sinus pressure and saw an ENT about that

ID: 1441333
Sex: F
Age: 26
State: MO

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: patient slumped sideways in chair a few minutes after receiving covid vaccine due to fear of needles. she was only out 15-20 seconds. no injuries.

Other Meds:

Current Illness:

ID: 1441334
Sex: F
Age: 62
State: NC

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 07/01/2021
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:

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

Symptoms: Pure and absolute exhaustion, Almost fainted due to the exhaustion, Stayed in bed for three days, After the third day, I started feeling fine and went back to work.

Other Meds: Ibuprofen, Coreg 12.5mg Twice a day, Aspirin 80 mg Twice a day, Plavix 75mg , Atorvastatin 40 mg, Zestril 10 mg

Current Illness: Sinus infection two weeks before receiving the 2nd dose

ID: 1441335
Sex: F
Age: 62
State: CA

Vax Date: 04/22/2021
Onset Date: 04/29/2021
Rec V Date: 07/01/2021
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: penicillin

Symptom List: Tremor

Symptoms: My left arm hurt a little bit just like the 1st treatment on 3/23/2021 but a week later my arm started hurting a lot more, and I have a lump or swelled up where I got my shot. It still hurts and often difficult to raise my arm to put on shirts.

Other Meds: Synthroid

Current Illness:

ID: 1441336
Sex: M
Age: 48
State: MN

Vax Date: 04/16/2021
Onset Date: 04/18/2021
Rec V Date: 07/01/2021
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 known

Symptom List: Erythema, Pruritus

Symptoms: shoulder pain started about 24 hours after administration and is still an issue. The only treatment that has been tried is acetaminophen 100mg at bedtime, which does seem to help. Pain is only an issue during the evening. The pain seems to be very slowly getting better

Other Meds: daily statin for cholesterol

Current Illness: none known

ID: 1441337
Sex: F
Age: 73
State: KY

Vax Date: 03/26/2021
Onset Date: 05/10/2021
Rec V Date: 07/01/2021
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: Niaspan

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

Symptoms: On the 27th of March, the day after my second dose, I had a slight fever (99 degrees). It was mostly tiredness and a low grade fever. I had another event later on May 1st that I do not think was related to COVID 19 vaccine. I had a bought of diverticulitis. My doctor gave me antibiotics and I was fine after that.

Other Meds: Dexolant, Toprol XL, Rosuvastatin, Estring vaginal insert, Claritin, Flonase, Vitamin C, Co-Q 10, Vitamin D, B complex, Calcium-magnesium-zinc

Current Illness: No

ID: 1441338
Sex: F
Age: 41
State: AL

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/01/2021
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: Sulfa Lavender Wheat

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

Symptoms: Dizziness about 30 minutes after. Approximately 6 hours after the injection site turned red, very swollen, very painful, difficult to lift and move arm and very sore to touch or apply pressure. Approximately 10 hours after the injection began having COVID symptoms with fever of 102.1, all over body aches, headache, nausea, very fatigued, dry mouth, itchy eyes and eye drainage, neck pain and tenderness on the left side and pain and swelling running up left arm into shoulders and neck. Also, my right arm was very sore and tender in the exact same spot as my left arm injection site. Pain in left jaw and teeth and right groin area. As of 26 hours later I have the same symptoms as listed above and my head feels very heavy like I can?t hold it up.

Other Meds: B12 Omega-3 Vitamin C Vyvanse Fetzima Plaquinil Mycaphenolate Metoprolol Pepcid Protonix Ibuprofen Lamotrogine

Current Illness: One month prior: kidney stones and bladder infection

ID: 1441339
Sex: M
Age: 71
State: NY

Vax Date: 05/29/2021
Onset Date: 06/01/2021
Rec V Date: 07/01/2021
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: Clindamyacin for Sinus Infections 2 yrs. ago

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient had an adverse reaction from the second shot on n 5/29/21 He began to shake violently as if having a seizure. Extremely cold and extremely weak. We did a tremendous amount of prayer worldwide and also treated appropriately with fluids and blankets. On 6/14/21, my husband suffered a massive heart attack and coded for 3-4 minutes in the ER. He was then hospitalized in the ICU/COVID Unit (that's right, they said he was COVID positive). No way! He also had COVID in April as well as myself (wife). He was administered many many tests over and over and they put two stents in his right artery totheheart.

Other Meds: Flomax (nightly for shy bladder) Monthly Testosterone Shots

Current Illness: None

ID: 1441340
Sex: M
Age: 44
State: MA

Vax Date: 03/08/2021
Onset Date: 03/22/2021
Rec V Date: 07/01/2021
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: pollen

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

Symptoms: Stomach , chest, side kidney, breathing . After 2nd shot continued feeling bad .

Other Meds: atrovent inhaler , vaclofen 10mg, budesonide nasal drops, buprenorphine, clonidine, docusate sodium, estitalopram, fishoil,hydroxyzine,25mg multi vitamin, nicotine gum, quetiapine 300mg, tansulosin,

Current Illness: none

ID: 1441341
Sex: M
Age: 30
State:

Vax Date: 01/26/2021
Onset Date: 06/07/2021
Rec V Date: 07/01/2021
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: NKDA

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

Symptoms: Pt reported swollen lymph node above his R clavicle last November. He had received his 1st COVID vax on 1/26/21 (MODERNA). In February 2021 he developed a swollen/tender R axillary node. Patient had undergone his 2nd COVID vax on 3/1/2021. Diagnosis: Nodular sclerosing classical Hodgkin Lymphoma, Stage II Bulky (Unfavorable) ? 6/7/2021

Other Meds:

Current Illness: N/A

ID: 1441342
Sex: M
Age: 16
State: NV

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pain in extremity

Symptoms: After the patient got the first dose of covid shot, patient started to feel light headed and sweating. Patient also stated that he started can't see thing or heard thing. But after he drink some water and sitting down waiting for ambulant he was feeling ok. EMT came and checked him out and he was ok

Other Meds: none

Current Illness: none

ID: 1441343
Sex: M
Age: 26
State: CA

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
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: Moderna vaccine was administered to patient past the 12 hour beyond use time. No Adverse reactions were observed by the pharmacist within 15 minutes after vaccination. Patient did not contact us as of 6 hours after vaccination to report adverse reactions. Moderna manufacturer was contacted and we are awaiting a return call from a vaccination expert.

Other Meds:

Current Illness:

ID: 1441344
Sex: F
Age: 29
State: MI

Vax Date: 06/30/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: The site of my injection in my right arm has been extremely sore to the point where I can barely lift it. My entire body hurts/aches as well. My shoulders, back, arms, and legs have been extremely sore all day to the point that it is hard to stand or turn my neck.

Other Meds: None

Current Illness: None

ID: 1441345
Sex: F
Age: 42
State: TX

Vax Date: 01/27/2021
Onset Date: 05/12/2021
Rec V Date: 07/01/2021
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: 20 days after the first dose I experienced dizziness every time I stand from my seat, haven?t experienced this so often, still happens but not every time now. Since May 12 I am experiencing a very strong pain on the top of my right foot that started waking me up in the middle of the night for 3 days in a row, after that I?ve been feelin so much pressure in my right leg, I believe is related to blood circulation, and I even felt a strong pressure at the back of my neck. On May 14 I bought Diosmin Hesperidin over the counter, and children aspirin, I?ve been taking that since that date, it has improved very little, I can?t tell any difference. I have never experienced anything like this before, and I am very concern of a stroke or blood clog.

Other Meds: None

Current Illness: None

ID: 1441346
Sex: F
Age: 33
State: NC

Vax Date: 05/29/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
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: Wasps

Symptom List: Vomiting

Symptoms: Random bouts of dizziness and feeling of lost balance.

Other Meds: Venlafaxine 75mg

Current Illness: Strep in early june

ID: 1441347
Sex: M
Age: 64
State: WA

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/01/2021
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: unknown

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt standing in post observation awaiting allotted time in post vaccination. Pt complaining to family members that the "room is spinning ". 1709 RN called and assessed alert man complaining of headache, denies breathing difficulty, lightheadedness, and nausea. EMTS called and arrived at 1710 Pt seated and BP 142/84 HR60 O2sat 97RA. Pt given H20 and resting in chair and monitored my EMTs. Pts symptom of dizziness is resolved and discharged at 1720.

Other Meds: unknown

Current Illness: unknown

ID: 1441349
Sex: F
Age: 49
State: CA

Vax Date: 04/24/2021
Onset Date: 04/26/2021
Rec V Date: 07/01/2021
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: NKA

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

Symptoms: Hot flashes04/26/2021, cold sweat04/26/2021, joint pain04/26/2021, migraine 04/30/2021

Other Meds: aspirin, insulin, Lipitor, ferrous sulfate, Metoprolol, Pantoprazole, famotidine, pentoxifylline, C, Glyburide, Lisinopril

Current Illness: none

ID: 1441350
Sex: F
Age: 43
State: CO

Vax Date: 02/26/2021
Onset Date: 03/16/2021
Rec V Date: 07/01/2021
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: sulfa drugs, latex

Symptom List: Injection site swelling, Limb discomfort

Symptoms: My period has been irregular since receiving the COVID19 vaccines and very heavy

Other Meds: Levothyroxin, iron supplements, multivitamin, omperazole

Current Illness:

ID: 1441351
Sex: F
Age: 12
State: NJ

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: PATIENT REPORTED NO ALLERIGES

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

Symptoms: PATIENT, WAS GIVEN THE 1ST DOSE OF PFIZER VACCINE. FEW MINUTES AFTER THE VACCINE PATIENT REPORTED FEELING DIZZY, PATIENT STATED SHE DID NOT FEEL VERY WELL, AND PATIENT HAS REPORTED HISTORY OF FAINTING AFTER VACCINATION. PATIENT WAS ADVISED TO LAY ON THE GROUND FOR WHILE SHE FELT LITTLE BETTER. HOWEVER SHE STATED SHE FEELING DIZZY, HAS HEADACHE AND REPORTED TINGLE /NUMBNESS IN HER LEGS. AMBULANCE WAS CALLED AND TOOK THE PATIENT. I FOLLOWED UP WITH THE PATIENT,. PATIENT WAS IN OKAY CONDITION, I SPOKE TO THE PATIENTS FAMILY MEMBER THEY STATED THAT THE DOCTOR SAID PATIENT FELT DIZZY DUE TO VASOVAGAL SYNCOPE. NO OTHER SIDE EFFECT WAS REPORTED.

Other Meds: N/A

Current Illness: PATIENT REPORTED NO ILLNESS

ID: 1441352
Sex: M
Age: 42
State: MA

Vax Date: 03/04/2021
Onset Date: 04/01/2021
Rec V Date: 07/01/2021
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: Penicillin; amoxicillin; cipro; oxacillin; Bactrim; Levaquin; 6mp

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

Symptoms: A month after I received the vaccine, I started having symptoms of forgetfulness, became foggy, had severe exhaustion, intense headaches, loss of appetite, issues with balance, vivid dreams and apparent hallucinations. My PCP had me see a neurologist and a rheumatologist. I had blood work drawn, tested for COVID and x-rays done. I have a CT scan in the next three weeks. We are going to come up with a plan after my CT scan.

Other Meds: Lisinopril; alopurinol; colchicine; nortriptyline; tizanidine; Symbicort; Pro air; naproxen; butalb-acetaminophen; alprazolam; fluoxetine; bupropion; omeprazole; famotidine; Remicade; buprenorphine

Current Illness: I had my chronic and long standing health conditions.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm