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: 1463542
Sex: F
Age: 45
State: OR

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 07/11/2021
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: hydrocodone, oxycodone, dairy and oil

Symptom List: Dysphagia, Epiglottitis

Symptoms: I noticed Tinnitus since the day after the vaccine. As I had several adverse reactions the first few weeks, I did not make note of it originally. Now it's the only one still around. I wanted to make sure to report that it started with the vaccine shot 2 and that it has not gone away since. The tinnitus is worst when it's quiet as it rings quite loudly, but I can block it out with other sounds of music, etc. It is awful that I can now no longer enjoy quiet.

Other Meds: none prior.

Current Illness: none

ID: 1463543
Sex: M
Age: 43
State: MA

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 07/11/2021
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 had normal muscle soreness in my left arm (arm I received the vaccine). When that soreness subsided, I started having pain in the inside of my elbow? at the bone/joint. It feels like throbbing arthritis. I have not yet sought any treatment for this, but plan to see an orthopedic

Other Meds: I take no prescriptions or OTC medication. I had the normal muscle soreness in the arm I received the vaccine (left arm). The soreness in the muscle eventually went away, but I noticed my elbow joint (inside of the elbow starting to hurt

Current Illness: None

ID: 1463544
Sex: F
Age: 37
State: NM

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 07/11/2021
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 allergy

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

Symptoms: About 5 minutes after vaccine administration (Moderna COVID 19) patient felt light headed and tongue was swelling. Gave patient Benadryl and water. About 45 minutes after she felt well again.

Other Meds:

Current Illness:

ID: 1463545
Sex: M
Age: 42
State: MI

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies: Compazine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Stomach pain, nausea, loss of appetite, weight loss. I day after and ongoing for 2 months

Other Meds: Bystolic 10mg daily

Current Illness: None

ID: 1463546
Sex: M
Age: 63
State: CA

Vax Date: 03/03/2021
Onset Date: 03/22/2021
Rec V Date: 07/11/2021
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: None

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

Symptoms: Developed blood clots, pulmonary embolism, extreme bloating.

Other Meds: Daily vitamins.

Current Illness: None

ID: 1463547
Sex: M
Age: 32
State: TX

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 07/11/2021
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: n/a

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

Symptoms: Patient received the vaccine and felt fine. Within a minute patient began to have a seizure which lasted roughly 30 seconds. Patient stated had not had a history of seizures before receiving vaccination. Also, patient stated no medical conditions to date.

Other Meds: Pre workout

Current Illness: n/a

ID: 1463548
Sex: F
Age: 15
State: AL

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies: na

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: patient fainted briefly after receiving the vaccine. i think she fainted from nerves. me and her mom sat with her for a few minutes and she recovered completely

Other Meds: na

Current Illness: na

ID: 1463549
Sex: F
Age: 29
State: MO

Vax Date: 07/09/2021
Onset Date: 07/09/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Around 9:45I started to feel like I was about to puke, then I got the chills, then a fever, then really bad body aches. I felt tired but couldn't sleep because my body hurt so bad. I had also felt numb and tingling in my hands, feels, and face. I also had cramps being to happen. They all ended up fading with 48 hours.

Other Meds:

Current Illness:

ID: 1463550
Sex: M
Age: 17
State: WA

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 07/11/2021
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: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463551
Sex: M
Age: 47
State: MA

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 07/11/2021
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: penicillin: Anaphylaxis - Criticality High - ampicillin: Anaphylaxis-Streptomycin - Criticality High - sumatriptan: Rash - Criticality High -

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient c/o dry cough, left sided headache, since returing in may. was seen in ER on 5/17. COVID test neg. symptoms improved and patient received I dose of COVID vaccine on 6/4 21. since then c/o constant left sided headache, left eye pain, on/off blurring of vision, severe dry cough. c/o loss of vision in left eye, headaches and feeling "a lot of pressure" for about 3 weeks since receiving the vaccine, sees 2 spots in the left eye that got larger than before. Had 4 episodes of vision in left eye only going black for several seconds, then when vision comes back it is "no good" for 20-30 minutes, last occurrence was 10 days ago. Pt also felt dizzy. patient has a history of stroke. After multiple provider and specialist visits patient was diagnosed with iritis and transient vision loss. Patient received second dose of vaccine on 06/27/21 (both at pharmacy) and reported return of symptoms which resolved as reported on their 06/30/21 follow up with PCP and vision specialist.

Other Meds: Albuterol (Eqv-ProAir HFA) 90 mcg/inh aerosol Start atorvastatin 10 mg tablet Taking Fioricet 300 mg-50 mg-40 mg capsule G Tussin AC 10 mg-100 mg/5 mL syrup

Current Illness: headache and dry cough since 05/2021

ID: 1463552
Sex: F
Age: 63
State: VA

Vax Date: 03/25/2021
Onset Date: 03/27/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies: tylox, daypro, anaprox, imipramine

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

Symptoms: I have had trouble with my back and neck from whiplash from car accidents. After my second injection, my back became twisted up with muscle spasms. A friend who is a physical therapist spent about an hour working on loosening up muscles and moving small joints along my spine back into place. It took several weeks for the pain to begin to ease off and my spine to begin to straighten up.

Other Meds: flexeril, baclofen, propanalol, calcium, vitamin B12, flaxseed oil, singulair, chlorpheniramine maleate, vitamin D, folic acid

Current Illness: none

ID: 1463553
Sex: M
Age: 17
State: WA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 07/11/2021
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: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463554
Sex: F
Age: 67
State: FL

Vax Date: 04/22/2021
Onset Date: 04/29/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies: Pollen

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

Symptoms: Shortness of breath

Other Meds: QUEtiapine, 200mg Claratin Sudafed

Current Illness: Bronchitis

ID: 1463555
Sex: F
Age: 17
State: WA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463556
Sex: M
Age: 17
State: WA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 07/11/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463557
Sex: F
Age: 15
State: OR

Vax Date: 07/05/2021
Onset Date: 07/06/2021
Rec V Date: 07/11/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Palpitations and chest pain Seen in ER on 7/8/21 and admitted overnight with rising troponin levels, improved by next day. Diagnosis of myocarditis related to COVID19 vaccine

Other Meds: guanfacine

Current Illness: none

ID: 1463558
Sex: F
Age: 17
State: WA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 07/11/2021
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: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463559
Sex: M
Age: 36
State: TN

Vax Date: 07/10/2021
Onset Date: 07/10/2021
Rec V Date: 07/11/2021
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: Felt pain in my whole body. Especially in both my arms. Extreme nausea and some vomiting last night. Can?t do anything. Have a fever. Thought I would be getting better but just laying in bed having awful pains.

Other Meds: None

Current Illness: None

ID: 1463560
Sex: M
Age: 54
State: AZ

Vax Date: 04/03/2021
Onset Date: 04/05/2021
Rec V Date: 07/11/2021
Hospital: Y

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: Heart attack. 2 stents installed.

Other Meds: None

Current Illness: None

ID: 1463561
Sex: F
Age: 61
State: OK

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

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

Lab Data:

Allergies: Tetnus, morphine

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

Symptoms: Pain and muscle weakness in opposite arm from 2nd vaccination until now

Other Meds: Several, took all for years before vaccination

Current Illness: No

ID: 1463562
Sex: F
Age: 28
State: IL

Vax Date: 06/20/2021
Onset Date: 06/27/2021
Rec V Date: 07/11/2021
Hospital: Y

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: Sulfa drugs Oseltamivir Grapefruit Lemon Citrus

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

Symptoms: Patient received the J and J vaccine June 20. For the next 4-5 days, patient had vomiting, fevers, chills. After that patient developed full body aches, cramps. Patient states that the initial pain was in the level of her spine and radiating down to her legs. She then states that she has and numbness difficulty with walking. She had walking difficulty especially when climbing up steps and initially later needed having help with ambulation. She also has reports that after initial symptoms 7 days after she started having some abdominal discomfort. Most recently she started having some urinary retention issues and was seen evaluated outlying hospital ER on 5th of July. Patient also states that on July 9 she presented a.m. to ER for facial numbness, right side of the mouth . She also has noticed some left-sided finger tingling because of were deficits patient present to ER. Neurology Consultation Note from 7/10/21. Pt is currently admitted to our facility currently. Right facial weakness new Paresthesias weakness Demyelinating process MRI brain with t2 flair hyperintensity differential ADEM vs CIS vs MS vs NMO spectrum disorder Left side ptosis hearing impairment chronic secondary to acoustic neuroma Low suspicion of GBS good distal strength 5/5 ankle bilaterally and knee except for left knee extension 3/5 intact distal reflexes ankle and patellar -Time of onset of symptoms was: Patient has had a progressive course of multiple neurologic complaints from June 20, 2021 when was reported that she received at a intake COVID vaccine -Had symptoms of: Initially had flu like symptoms, followed by bilateral lower extremity weakness, numbness, progressive to have urinary retention, facial weakness on the right side MRI brain Multifocal abnormal white matter T2 hyperintensities, most pronounced involving the subcortical white matter, left greater than right Abnormal signal within the upper cervical spinal cord. Diffusely low marrow signal on T1 imaging suggesting red marrow hyperplasia. Plan: LP ordered for tomorrow AM Follow up CSF results methylprednisolone 1gm x5 days will check blood sugars q.8 hours q4h neuro checks Message Lab for myelin oligodendrocyte glycoprotein (MOG) IgG autoantibody and the aquaporin-4 (AQP4) IgG serum autoantibody Follow up to see if sent.

Other Meds: Quetiapine 200 mg PO daily at bedtime Oxcarbazepine 300 mg PO daily Oxcarbazepine 600 mg PO daily at bedtime Bupropion XL 300 mg PO daily Acyclovir 800 mg PO fives times daily Prednisolone 1% ophthalmic suspension 1 drop into both eyes twic

Current Illness: Gum inflammation/tooth pain on 6/2/21 treated with amoxicillin 875 mg PO BID x 10 days

ID: 1463563
Sex: F
Age: 17
State: WA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 07/11/2021
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: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463564
Sex: F
Age: 54
State: CA

Vax Date: 04/08/2021
Onset Date: 04/01/2021
Rec V Date: 07/11/2021
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: Morphine Clyndamiacin

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

Symptoms: The second shot had me resting had a headache and some small side effects. But the ringing in my ears I thought was from the headache. My ringing in my ears hasn?t stopped

Other Meds: Multi vitamin

Current Illness: N/A

ID: 1463565
Sex: F
Age: 17
State: WA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 07/11/2021
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: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463566
Sex: M
Age: 13
State: NY

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 07/11/2021
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 vomited starting about 5 minutes after the shot

Other Meds: none

Current Illness: none

ID: 1463567
Sex: M
Age: 16
State: WA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463568
Sex: F
Age: 55
State: MO

Vax Date: 05/12/2021
Onset Date: 05/22/2021
Rec V Date: 07/11/2021
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: Strawberry pine grass mold ragweed

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Bright red Arm swollen at injection site traveling towards elbow Dose 2 anaphylactic. Stinging lips, chest pain, both injection site pain

Other Meds: Probiotic Claritin Prozac Valium norco

Current Illness: Metal on metal hip implant with elevated metalosis

ID: 1463569
Sex: M
Age: 16
State: WA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463571
Sex: M
Age: 77
State: CT

Vax Date: 07/07/2021
Onset Date: 07/08/2021
Rec V Date: 07/11/2021
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: Angioedema (severe tongue swelling)

Other Meds: Lisinopril 5 mg, Levetiracetam 500 mg

Current Illness: none

ID: 1463572
Sex: M
Age: 15
State: WA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 07/11/2021
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: Nausea

Symptoms: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463573
Sex: F
Age:
State: AR

Vax Date:
Onset Date:
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Chest pain, fatigue, sore arm

Other Meds:

Current Illness:

ID: 1463574
Sex: F
Age: 26
State: CO

Vax Date: 06/28/2021
Onset Date: 07/09/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: My arm was mildly sore the 2 days following the shot, then I had no noticeable symptoms until 7/9, when I noticed a circular red spot around the vaccination site that often itches, and burns when I unthinkingly scratch it. I have also noticed increased fatigue in the last few days as well as random bouts of nausea/vertigo that last no more than a minute or two. I had a severe headache yesterday that I'm uncertain if it was related but it lasted several hours.

Other Meds: Lexapro, vitamin D3 (5k UI), Allegra, acidophilus all taken daily

Current Illness: N/A

ID: 1463575
Sex: F
Age: 15
State: WA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 07/11/2021
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: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463576
Sex: F
Age: 16
State: WA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 07/11/2021
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: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463578
Sex: M
Age: 16
State: WA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 07/11/2021
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: Erythema, Pruritus

Symptoms: There was no adverse reaction. This was an administration error as the patient was underage.

Other Meds:

Current Illness:

ID: 1463579
Sex: F
Age: 32
State: FL

Vax Date: 07/10/2021
Onset Date: 07/11/2021
Rec V Date: 07/11/2021
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: N/A

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

Symptoms: Sore arm right after Next day (7/11), I felt weak and tired. Very fatigued. Similar to how I felt when I first had covid 5 months ago.

Other Meds: Lutera birth control and vitamin d

Current Illness: None

ID: 1463581
Sex: F
Age: 70
State: MI

Vax Date: 04/02/2021
Onset Date: 05/11/2021
Rec V Date: 07/11/2021
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: Tobramycin, ocean perch

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

Symptoms: Rapid heart rate occurred on 05/11/2021 and again on 06/09/2021, both events requiring visit to hospital. Have been diagnosed with afib.

Other Meds: D3, Famotidine, traZoDone, Lexapro, Simvastatin, Symbicort, Omega 3 ethyl esters, Zyrtec, Preservision Areds Lutein, Centrum silver, Turmeric, Calcium, CoQ10

Current Illness: None

ID: 1463582
Sex: F
Age: 69
State: PA

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 07/11/2021
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: Diffuse, longstanding myalgis and arthralgias, hallucinations

Other Meds:

Current Illness:

ID: 1463583
Sex: F
Age: 60
State: MD

Vax Date: 05/06/2021
Onset Date: 05/12/2021
Rec V Date: 07/11/2021
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: Lupus-like butterfly rash appeared pinkish 6 day after the first shot. A black spot appeared on nose side of nose two weeks after first shot and both sides of chin began to turn pinkish/red. Six weeks later, received second shot. One week after the second shot, the black spot on the nose slowly began to spread (noticeable every other day). Two weeks after second shot, pinkish butterfly rash (both cheeks and across nose) as well as both sides of chin began to get darker and spread.

Other Meds: Cartia XT, Eliquis, vitamin D,

Current Illness: afib, stroke

ID: 1463584
Sex: F
Age: 79
State: MS

Vax Date: 07/02/2021
Onset Date: 07/11/2021
Rec V Date: 07/11/2021
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: NKA

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

Symptoms: "COVID Arm" developed 9 Days after initial dose at injection site. Hypersensitivity skin reaction.

Other Meds: N/A

Current Illness: NONE

ID: 1463585
Sex: F
Age: 23
State: MO

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies: NO

Symptom List: Pain in extremity

Symptoms: PATIENT WAS GETTING HER FIRST DOSE OF THE COVID VACCINATION AND WAS TOLD TO HAVE A SEAT FOR AT LEAST 15 MINUTES FOR POST-VACCINE SURVEILLANCE. PATIENT'S FRIEND ALERTED ME, SAYING THAT THE PATIENT WAS HAVING A REACTION. SHE REMAINED SITTING IN THE LOBBY, VISION WAS DARKENING, HANDS WERE TINGLY, AND PATIENT WAS SWEATING PROFUSELY. PATIENT NEVER FULLY LOST CONSCIOUSNESS. 911, EMS, MANAGEMENT, AND HER MOTHER WERE CALLED IMMEDIATELY. PATIENT'S EVALUATION WITH EMS WERE ALL WITHIN NORMAL LIMITS BUT HER HANDS AND FINGERS REMAINED COLD AND TINGLY. SHE REFUSED TO LEAVE WITH EMS AND HER MOTHER DROVE HER TO THE NEAREST EMERGENCY DEPT.

Other Meds: NO

Current Illness: NO

ID: 1463586
Sex: F
Age: 34
State: AZ

Vax Date: 02/19/2021
Onset Date: 02/25/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies: Relpax, maxalt, frova, pcn, iodine, eggs, soy, peanuts

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

Symptoms: Swelling and redness with slight itchiness around the injection site.

Other Meds: Wellbutrin XR, Lexapro, Singulair, Albuterol, Zyrtec

Current Illness: None

ID: 1463587
Sex: F
Age: 39
State: IN

Vax Date: 07/06/2021
Onset Date: 07/09/2021
Rec V Date: 07/11/2021
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: Keflex

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

Symptoms: Swollen armpit, burning pain.

Other Meds: Prozac, Levothyroxine, Lisinopril-HCTZ, Topamax, Singulair.

Current Illness: None

ID: 1463588
Sex: M
Age: 55
State: MD

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 07/11/2021
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: Patient returned to clinic on 7/09/2021 for the second dose of Pfizer COVID-19 vaccine but did not have the CDC card with first dose information. Upon looking patient up to verify, it was noted that they had received a full series of Moderna COVID-19 vaccine on 12/30/2020 and 01/29/2021. The patient was advised that we are unable to administer the 2nd dose of Pfizer due to newly identified information. During discussing the situation with the patient, they advised they told the registration person that this was not the 1st COVID-19 vaccine. However, we are unable to verify that information due to inability to see previous answers to screening questions.

Other Meds: Unknown

Current Illness:

ID: 1463589
Sex: F
Age: 55
State: CA

Vax Date: 02/24/2021
Onset Date: 03/01/2021
Rec V Date: 07/11/2021
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: Eggs (vomiting), alleve (blood pressure drop and I passed out. I've been advised to not take iboprofens)

Symptom List: Vomiting

Symptoms: in early March I began having pulsatile tinnitus episodes... a couple of day. Not long after I experienced heart palpitations. I didn't initially think of the vaccine. However, after my second vaccine, the pulsatile tinnitus was continuing, but the heart palpitations were most concerning at about 7 or 8 a day. This went on until late April. I went to my Doctor's office about mid-April and an ECG showed nothing wrong. and I then presented at ER on the evening of the 26th as I was concerned about their frequency. Many tests were conducted and it showed nothing wrong with my heart and we could not simulate the random heart palpitations at the time. The palpitations resolved early May and I have had only a handful of tinnitus episodes since.

Other Meds: Levothyroxine 50mcg

Current Illness: None

ID: 1463590
Sex: M
Age: 42
State: TX

Vax Date: 03/10/2021
Onset Date: 03/25/2021
Rec V Date: 07/11/2021
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: 2 weeks after the second dose I had extreme issues focusing and consitrating. These effects are ongoing today.

Other Meds:

Current Illness:

ID: 1463591
Sex: F
Age: 47
State: CO

Vax Date: 07/09/2021
Onset Date: 07/09/2021
Rec V Date: 07/11/2021
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: Sensitive to all meds. Sulfa allergy

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

Symptoms: Throat closing, nasal passages closing, tingling throat and tongue

Other Meds: Standard supplements (fish oil, vitamin D, etc)

Current Illness: None

ID: 1463592
Sex: M
Age: 43
State:

Vax Date: 07/09/2021
Onset Date: 07/10/2021
Rec V Date: 07/11/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 101 fever on 07/10 pm, "feel ran over by train", itchy, small shortness of breath.

Other Meds:

Current Illness:

ID: 1463593
Sex: F
Age: 54
State: MI

Vax Date: 01/09/2021
Onset Date: 01/11/2021
Rec V Date: 07/11/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: Petechiae on lower arms

Other Meds: None

Current Illness: None

ID: 1463594
Sex: F
Age: 72
State: LA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 07/11/2021
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: meperidine,

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

Symptoms: Profound weakness begining approx. 12 hrs post vaccination. Patient unable to get up off toilet. Improved approx. 6 hours later after sleeping. Since that time, weakness continued, gait unsteady and brain fog symptoms present. Some level of anosmia and taste aberration. Patient began PT twice weekly in late April and continues now with weekly only. Memory and brain fog symptoms intermittent Taste aberrations ongoing Lab tests on 06/02/2021 WNL, Covid test Negative

Other Meds: escitalopram, divalproex, sulfasalasine, furosemide, vitamin D

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm