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: 1464670
Sex: F
Age: 28
State: FL

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/12/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: amoxicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: dizziness, disoriented , could not stand, headache, could not stand, does not remember any of time after shot. , loss function of extremities., responded to pain , does not remember anything in ER was kept in hospital 4 days , began to move extremeties after 3 days. Extreme weakness in body , did not have awareness and body movements for several days.

Other Meds: Claritin Tylenol Wellbutrin lamotrigine denztropine

Current Illness: no

ID: 1464671
Sex: F
Age: 42
State: ME

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 07/12/2021
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: Amoxicillin, Clindamycin, Morphine, bees

Symptom List: Anxiety, Dyspnoea

Symptoms: I got hives on my left arm but it was delayed, until 1 week after the injection and I took some Benadryl and Prednisone. Since then, I still have intermittent muscle pain at the injection site. Sometimes it turns like a funny reddish, purple, brown spot. I have a lot of chest pain but its not cardiac chest pain. I talked with the doctors that I worked with. It just comes and go. I just take Benadryl and try to rest and drink a lot of water. I never had it before the injection. I tried to get the J&J vaccine and the pharmacist asked if I had any other vaccines and I said yes and they told me I could not have this vaccine because of the hives I developed with the other one.

Other Meds: Multi vitamin, Zyrtec every day

Current Illness: None

ID: 1464672
Sex: F
Age: 59
State: CA

Vax Date: 07/09/2021
Onset Date: 07/10/2021
Rec V Date: 07/12/2021
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: Dust, hay fever

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

Symptoms: Hives in the left armpit. Still have the hives there. Nowhere else. Didn't itch at first; now itching a lot 48 hours after noticing the hives

Other Meds: Trazodone, Cetirizine, Gabapentin

Current Illness: None

ID: 1464673
Sex: M
Age: 70
State: MS

Vax Date: 03/18/2021
Onset Date: 04/19/2021
Rec V Date: 07/12/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Myocarditis and periocarditis

Other Meds: Vitamin D, Vitamin C , Tumeric , Hydroxychloroquin, zinc

Current Illness: none

ID: 1464674
Sex: F
Age: 66
State: IN

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 07/12/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Per patient's husband--had pain in side starting about 1 hour post first vaccine. woke up the next morning, had blurred/double vision (pain in side has subsided). Has been diagnosed with Myasthenia gravis. Per husband-doctor does not believe that it was caused by the vaccine, but may have caused her body to show the above symptoms.

Other Meds: N/A

Current Illness: N/A

ID: 1464675
Sex: F
Age: 35
State: MI

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/12/2021
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: None

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

Symptoms: None

Other Meds: Nicotine 2mg gum

Current Illness:

ID: 1464676
Sex: F
Age: 46
State: OR

Vax Date: 04/02/2021
Onset Date: 04/20/2021
Rec V Date: 07/12/2021
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: Amitriptyline, Propranolol

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Unexplained nerve pain in arms, right knee and both ankles. This came on after the second shot, but I don't know if it's related to it. After the covid vaccine, one month later, I began Mavyret, and completed it. My doctor has no explanation for it, and has me going to orthopedic doctors to dig further into what is going on. I had no related I juries or health problems and it came on suddenly. It debilitated me, and I was unable to walk. My doctor out me on Diclofenac and a muscle relaxer and it's reduced the pain greatly. Also had x-rays, they show nothing. The nerve sensation is now very faint in my lips and hands.

Other Meds: Ajovy, rizatriptan

Current Illness:

ID: 1464677
Sex: M
Age: 17
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/12/2021
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: Pharyngeal swelling

Symptoms: PT is a 17 y/o previously healthy boy who presents with 3 days of moderate-severe, substernal chest pain, dyspnea, and nausea 2 days after receiving the 2nd dose of the Pfizer COVID-19 vaccine. On Tuesday (7/6), PT received the second Pfizer COVID-19 vaccine. The following day (Wednesday 7/7) PT had "flu-like symptoms" with chills, subjective fever, and a sore arm that resolved by Thursday (7/8). He was back to his baseline state of health on Thursday (7/8) and felt fine that whole day. On Friday afternoon (7/9) when he was at work washing dishes where he had some physical exertion he began to notice at 16:30-17:00 that he developed substernal, sharp, 7/10 chest pain that did not radiate, improve/worsen with deep breaths, sitting up, laying down or with movement of his upper extremities. It worsened towards the end of the night and peaked at 8/10 by 22:00-23:00 that same evening. His sister picked him up from work per his regular routine and he went home and took a shower which improved the pain to a 5-6/10 when he went to sleep. He woke up at 3 AM on Saturday (7/10) AM and had one episode of NBNB emesis associated with the chest pain. When he woke up later that morning he felt improved until 10-12 AM he developed mild chest pain again which he took Tums for. He also tried Motrin which did not help his pain at all. On the morning of admission (7/11), he woke up at 6-7 AM with upper right back pain, dyspnea, and nausea along with the persistent chest pain which prompted him to present to MFSH. He does endorse mild sore throat but denies any fevers, recent sick contacts, known COVID-19 exposure or previous history of COVID-19. There is a family history of cardiac disease including a fatal MI in his father. His mother's family also has a history of heart disease and both sides have a history of high cholesterol. He did add Whey Protein recently to his diet to for muscle building, but he DENIES any drug, alcohol, tobacco, vaping, marijuana, THC use. He does not play any sports regularly. He also denies any recent bug/tick bites or rashes.

Other Meds: Whey Protein

Current Illness: None

ID: 1464678
Sex: M
Age: 64
State: CT

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: bee stings

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Ringing in the ears within two days of receiving the second dose. It is constant and most distracting at night time, when watching TV or reading. It has not lessened in any way since it has started. My primary care physician says there is nothing he can do. I noticed other on-line feedback about this side effect after the 2nd dose of the covid vaccine so I wish to report it.

Other Meds: Sertraline Atorvastatin Amlodipine Besylate Ramipril Aspirin

Current Illness: none

ID: 1464680
Sex: M
Age: 33
State: UT

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 07/12/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient was transferred from a county jail to Corrections facility. He requested a COVID Vaccine. He did not tell us he was previously vaccinated at his county jail. He was given a Moderna vaccine on 6/10/2021 by the Health Department. On 6/22/2021 he received a Janssen (J&J) vaccine from us, 12 days later. Health Department was notified. Our instructions were to repeat the vaccine in 28 days from his last dose, and that the Janssen on 6/22 is invalid due to it being given to soon from the initial Moderna dose on 6/10.

Other Meds: unknown

Current Illness: Denies

ID: 1464681
Sex: F
Age: 44
State: CO

Vax Date: 05/27/2021
Onset Date: 05/29/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: N/A PT DIDNT SPECIFY

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

Symptoms: PATIENT CALLED PHARMACY 7-12-21 TO REPORT HAVING "NERVE DAMAGE" FROM COVID VACCINE. PATIENT STATED SHE HAD SEEN A DOCTOR WHO ADVISED IT WOULD TAKE 8 MONTHS TO GO AWAY. PATEINT REPORTED NUMBNESS/TINGLING IN ARM. PATIENT STATES THIS HAS BEEN PERSISTENT FOR 2 MONTHS NOW AND IS NOT GOING AWAY.

Other Meds: N/A PT DIDNT SPECIFY

Current Illness: N/A PT DIDNT SPECIFY

ID: 1464682
Sex: F
Age: 48
State: CA

Vax Date: 04/12/2021
Onset Date: 04/15/2021
Rec V Date: 07/12/2021
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: Still no taste or smell

Other Meds: Levothyroxine, Naproxen, Doxycycline Hyclate, Turmeric

Current Illness: None

ID: 1464683
Sex: F
Age: 79
State: TX

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/12/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: I received the Johnson & Johnson Covid19 vaccine at 3:30 PM on June 30, 2021. At 5:30 PM I experienced muscle pain in my right lower thigh muscles right below my hip replacement scar that continued throughout the night. The next day the muscle pain was so sever I could not walk on my right leg and had to get down my walker from my surgery. The following day the pain was less severe. It has been 12 days now since the vaccination and my right thigh muscles are still sore but I can walk OK.

Other Meds: Inderal, Fosamax, ChlorTrimeton

Current Illness:

ID: 1464684
Sex: M
Age: 77
State: SC

Vax Date: 01/20/2021
Onset Date: 04/26/2021
Rec V Date: 07/12/2021
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: Shingles outbreak with numbness in right leg and top of foot, also in Aib

Other Meds: Pravacol Multi Vitamin

Current Illness: None

ID: 1464685
Sex: F
Age: 64
State: CA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 07/12/2021
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: No

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

Symptoms: Right after the vaccine, stomach, headache and I was tired. This was for about 8 hours. That was it for that. At 04:00 am, June 27th, I had a headache and this one lasted forever; it didn't stop even with Tylenol. It didn't come and go. I had a fever 99-101; I had body aches. I was very tired. Those a lasted a day. I did bedrest to treat.

Other Meds: Thyroid medicine

Current Illness: No

ID: 1464686
Sex: M
Age: 32
State: OH

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: NO KNOWN ALLERGIES

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

Symptoms: IMMEDIATELY HAD METALLIC TASTE IN HIS MOUTH AND BEGAN TO SWEAT PROFUSELY. WAS PALE AND FELT DISORIENTED. AFTER SEVERAL MINUTES OF A COLD CLOTH AND WATER HE BECAME CHILLED. HE LEFT WITH HIS WIFE AFTER 30 MINS AND NOW SAID THAT HE FEELS BACK TO NORMAL AGAIN.

Other Meds: NO MEDICATION

Current Illness: NO

ID: 1464688
Sex: F
Age: 52
State: AR

Vax Date: 04/07/2021
Onset Date: 06/21/2021
Rec V Date: 07/12/2021
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: I got a metallic taste in my mouth. I had drainage in nose, cough and was running a fever. It got so bad; I went to Urgent care. They did a Covid-19 test, which came back negative. They also did a chest X-ray, which showed bronchitis and inflammation. They give me Arborol and Prognose. I also was taking over-the-counter medicine as well. A week later, had a phone appointment because of the symptoms was getting worse. I had legions on my hands and above my lip and at my nose.

Other Meds:

Current Illness:

ID: 1464689
Sex: F
Age: 40
State:

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient was given covid -19 vaccine 6 days earlier the minimum vaccination period. pt waited after vaccination 20 mins without any complications. patient was examined by two health care providers. Providers cleared patient to go home and to go to the nearest emergency room if any symptoms present.

Other Meds:

Current Illness:

ID: 1464690
Sex: M
Age: 63
State: UT

Vax Date: 07/09/2021
Onset Date: 07/10/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: no known drug allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: He says that overnight after the vaccine his left ear now feels plugged and as a result he cannot hear well. He noticed it starting the morning after the vaccination and is still experiencing the same sensation 3 days later. It still feels plugged.

Other Meds: not reported

Current Illness: none reported

ID: 1464691
Sex: M
Age: 52
State: TX

Vax Date: 05/13/2021
Onset Date: 05/29/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: Bells Palsy - followed by Guillain Barre

Other Meds: n/a

Current Illness: n/a

ID: 1464692
Sex: M
Age: 70
State: CO

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 07/12/2021
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: CIIS was down on 4/1/21 and the record in EPIC didn't show that patient had already received 2 doses of MRNA vaccine for COVID19 We review CIIS for all people experiencing homelessness due to their mobile lifestyle. That day CIIS was not working and the record in EPIC showed that patient was due for his second dose of Moderna. Later in the day CIIS was working and we found that patient had a dose of Pfizer also: Moderna 02/04/21, Pfizer 03/20/21, Moderna 04/01/21

Other Meds:

Current Illness:

ID: 1464693
Sex: F
Age: 14
State: TX

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/12/2021
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: Unevaluable event

Symptoms: Patient received vaccine about 1415 and felt "dizzy" at about 1440pm. Pt was able to follow basic commands, appeared pale, and mother stated she "fainted." Pulse and o2 level were 70 and 97% on RA. Pt observed for 20 more minutes and was able to walk, A&O X4. Mother stated she usually feels dizzy when she gets lab work done; per mother, pt had not had anything to eat since last night.

Other Meds: Omega 3

Current Illness: None

ID: 1464694
Sex: F
Age: 41
State: WA

Vax Date: 03/31/2021
Onset Date: 04/09/2021
Rec V Date: 07/12/2021
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: Benadryl

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

Symptoms: About a week and a half after each dose, I had ankle pain so severe that I could not walk at times. It came and went at random times. It continued on and off for about six weeks following the second vaccine before clearing up. I suspect it affected my immune system and flared my rheumatoid arthritis.

Other Meds: None

Current Illness: None

ID: 1464696
Sex: F
Age: 68
State: CA

Vax Date: 02/01/2021
Onset Date: 02/20/2021
Rec V Date: 07/12/2021
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: upset stomach with Vicodin, erythromycin

Symptom List: Injection site pain, Pain

Symptoms: nephrotic syndrome (protein in urine, swollen ankles); current treatment is Lisinopril 10 mg daily and Atorvastatin 20 mg daily

Other Meds: Calcium 1000 mg B12 1000 mcg Acetyl L-Carnitine 1000 mg Alpha Lipoic Acid 1200 mg

Current Illness: peripheral neuropathy

ID: 1464697
Sex: M
Age: 15
State: OR

Vax Date: 06/17/2021
Onset Date: 06/18/2021
Rec V Date: 07/12/2021
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: chest pain, slightly more on left

Other Meds: none

Current Illness: none

ID: 1464698
Sex: F
Age: 63
State: FL

Vax Date: 06/06/2021
Onset Date: 07/09/2021
Rec V Date: 07/12/2021
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: A certain med, can't remember the name; sulfa drugs

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

Symptoms: I started sneezing and got a really runny nose. I had body aches and headaches. I have a cough. I was tested for COVID on 7/09/2021 and tested positive, and also tested positive for Influenza B.

Other Meds: Insulin via pump; centroid; medicine for Adison's disease; vitamin C; vitamin D3; vitamin biotin; calcium; colatin

Current Illness: None

ID: 1464699
Sex: F
Age: 60
State: LA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 07/12/2021
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: Fever, chills, weakness, fatigue

Other Meds: Estroven (Once a day), Calcium (200 mg, once a day), Leviteracetam (2 times a day)

Current Illness: None

ID: 1464700
Sex: M
Age: 36
State: CO

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: Pnc

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe throat problems, headache lasted over a month, muscle weakness, fatigue, fever. I?ve been on antibiotics since the vaccine.

Other Meds: Methadone

Current Illness: None

ID: 1464701
Sex: M
Age: 59
State: TX

Vax Date: 04/05/2021
Onset Date: 05/10/2021
Rec V Date: 07/12/2021
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: Left side arm and leg weakness, fatigue, weight loss,

Other Meds: None

Current Illness: None

ID: 1464703
Sex: F
Age: 66
State: LA

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: 2.5x2.5 inch circle around injection site today, 07/12/21. Inj date 07/09/21. Red, warm with no fever today. Chills and tired on Saturday but no fever ever reported. Pt treated at home with ice and Tylenol. Recommended Benadryl for reaction.

Other Meds: none

Current Illness: none

ID: 1464704
Sex: M
Age: 59
State: OH

Vax Date: 04/01/2021
Onset Date: 05/05/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Weakness and tingling in your extremities Issues maintaining body temps. Blood sugar hitting crazy numbers on 12 hour fast Tired and sore, left rear neck tingling with head aces

Other Meds: none

Current Illness: none

ID: 1464705
Sex: F
Age: 63
State: GA

Vax Date: 06/28/2021
Onset Date: 07/08/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: NSAIDS, Aspirin, Ceclor, EES, Ancef, Levaquin

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

Symptoms: Started with a red patch on injection arm midway between elbow and shoulder July 8, 2021. The red patch continued to grown until it was 6 inches long and 3 inches wide as of July 12, 2021. Started with a headache July 8, 2021 and continued until July 12, 2021, with severe ringing in my ears. I also have a lymph node behind left ear that is swollen. I?ve been tired as well since July 8th. I did take Benadryl hoping it would help with the red patch as well as medication for the headache, but it never helped. Things got progressively worse.I called the CDC and they advised seeking medical attention which I did today, July 12, 2021. When I arrived at the doctor my blood pressure was 130/100, no fever, pulse ox was 99. My doctor felt it was a reaction from the vaccine and began a course of treatment to relieve the symptoms.

Other Meds: Synthroid, Estrace, Singulair, Fioricet Vitamins C, D3, B12, Multi

Current Illness: Fluid in ear

ID: 1464706
Sex: F
Age: 54
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 07/12/2021
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: No known allergies

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

Symptoms: Patient received first dose of moderna vaccine at vaccination site and started dry heaving/vomiting and then passed out. Then she had seizure and was brought to ER.

Other Meds: None

Current Illness: No prior medical history

ID: 1464707
Sex: F
Age: 63
State: CA

Vax Date: 03/11/2021
Onset Date: 06/29/2021
Rec V Date: 07/12/2021
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: Tremor

Symptoms: Bell?s palsy left side

Other Meds: Fluoxetine 60mg/day Bupropion XL 150mg/day Levothyroxine 75 mcg/day

Current Illness: none

ID: 1464708
Sex: M
Age: 34
State:

Vax Date: 07/11/2021
Onset Date: 07/12/2021
Rec V Date: 07/12/2021
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: Metallic taste 20 hours after second dose of Pfizer vaccine. Other side effects: mild fever, some sore throat, body pain. During the first night: chills to the point of shaking and insomnia.

Other Meds:

Current Illness:

ID: 1464709
Sex: F
Age: 36
State:

Vax Date: 04/10/2021
Onset Date: 04/16/2021
Rec V Date: 07/12/2021
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: April through May: Electrical jolts in both lower legs and heaviness, tingling sensation in left arm, tingling sensation in head, tingling sensation on left side of face, numbness and tingling sensation on left side of the tongue June to present-continuing to have tingling sensation on the left side of face, numbness and tingling sensation on the left side of the tongue, occasionally tingling in the head, occasional numbness in the left calf down to the foot, occasional weakness in hands and functions, especially the left hand (unable to grip and hold objects), weakness in the left arm

Other Meds: None

Current Illness: None

ID: 1464710
Sex: M
Age: 30
State: CA

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/12/2021
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: Pt received his Covid vaccine and as was scheduling his second dose, pt stated he started to feel dizzy. patient was reclined and gavin juice and called for assistance from the LVN . Pt was pale, clammy/sweaty, and dry heaving.; call for Rapid Response. They were in the pt's room within the minute and proceeded to take vitals and treated the pt with a bag of IV fluid while having the pt be observed by an RN for an additional amount of time. After the nurse observed the pt walking on his own, she gave pt permission to leave. Patient was discharged 1601 after receiving a liter of NS IV.

Other Meds:

Current Illness:

ID: 1464711
Sex: F
Age: 45
State: IN

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/12/2021
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: NA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: WIthin 3 hours of dose administration, observed and felt non-painful muscle "twitching" in both legs. Both hands and feet became cold with pallor and Raynaud's phenomenon observed in both hands feet requiring constant rewarming. Approximately 8 hours later, experienced bilateral hand and foot "pins and needles" sensations. Sought medical treatment today 7/12 as symptoms intermittently persist in addition to lightheadedness (feeling as though fainting would occur) and brain fog experienced for 6 hours on 7/3. On 7/10, was awakened from sleep with tachycardia (peak HR 148 lasting 49 minutes as captured by Fitbit wearable device). The following am 7/11, numb sensation felt on L arm with continued "pins and needles " sensations experienced in Bilateral hands and feet. This writer was unable to work that day as a result.

Other Meds: NA

Current Illness: NA

ID: 1464713
Sex: F
Age: 21
State: WI

Vax Date: 02/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/12/2021
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: Vaccinated with Moderna on 2/6/21 and 3/6/21. Symptom onset 7/6/21 with cough, loss of smell, headache and fatigue. Tested positive for Covid-19 on 7/10 2021.

Other Meds:

Current Illness:

ID: 1464714
Sex: F
Age: 59
State: HI

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 07/12/2021
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: cats, dust, gluten, levaquin, mango, nitorfurantoin, pcn, seafood, sulfa

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

Symptoms: This 59-year-old female presents to the emergency room with itchiness throughout her body. Patient reports that at 4 PM she received her second Pfizer vaccine. While she was being observed she started to get an itchy sensation throughout her body and a scratchy feeling to the right side of her throat. Denies any difficulty swallowing, chest tightness, chest pain shortness of breath, facial swelling, lip swelling or tongue swelling. Patient reports that when she got her first Pfizer vaccine she did not have any issues. Patient reports that she has multiple allergies to the environment, states she gets very sensitive and gets itchy very fast. Pt was given famotidine, tyrtase level drawn=3.0

Other Meds: Epi-Pen for food allergies zyrtec 10 daily

Current Illness: none known

ID: 1464715
Sex: F
Age: 48
State: IL

Vax Date: 04/11/2021
Onset Date: 05/20/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: Blue and Red Dye Allergy

Symptom List: Pain in extremity

Symptoms: I had ablation completed and have been period free. the next month after the shot my periods started back up and have not stopped. I was also diagnosed with Sjogrens sydrome a month ago - not sure if it is related or not.

Other Meds: Synthroid for Thyroid

Current Illness: None

ID: 1464717
Sex: M
Age: 31
State: VA

Vax Date: 06/21/2021
Onset Date: 07/12/2021
Rec V Date: 07/12/2021
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: patient came in today 07/12/21 and mentioned since he got the vaccine on 06/21/21 he has been feeling side effects , he mentioned his hear beat feels different , numbing , some chest pain, dizziness , I mentioned to the patient to schedule a visit to his doctor , in order to do more tests , and make sure everything is ok, patient he will reach out to the Dr today

Other Meds:

Current Illness:

ID: 1464718
Sex: M
Age: 26
State: TX

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 07/12/2021
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: N/A

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

Symptoms: Chest pains. Was given morphine to help subdue pain. After being discharged from hospital, I was prescribed indomethacin and colchicine to help with chest pains

Other Meds: N/A

Current Illness: Positive for Covid-19 one month prior to vaccine

ID: 1464719
Sex: F
Age: 45
State: IN

Vax Date: 05/17/2021
Onset Date: 07/08/2021
Rec V Date: 07/12/2021
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: Mold, Dust Mites

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

Symptoms: Cyst under right arm pit, Knee/toe/back pain, right arm tingling (falling asleep) at night, red painful bumps on legs, bumps in mouth, tired. Doxycycline started on 09Jul21. X-rays and bloodwork scheduled.

Other Meds: Multi-Vitamin, Sertraline, Fish Oil, Alprazolam, Potassium, Cetirizine, Cyclobenzaprine

Current Illness: None

ID: 1464720
Sex: F
Age: 54
State: LA

Vax Date: 07/10/2021
Onset Date: 07/10/2021
Rec V Date: 07/12/2021
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: milk, flax, augmetin, bactrim, cefaclor, Cipro, Biaxin, vancomycin, erythomycin, gentamicin, penicillin, amoxicillin, codeine, tamiflu, clindamycin, soy, nuts, pineapple, sunflower seeds,

Symptom List: Vomiting

Symptoms: Received vaccine at 11:09AM on 7/10/2021. The vaccine in my arm was burning rather badly within a few minutes of it being administered. About 10PM the same day I started feeling dizzy, bad headache, muscles and joint started aching all over my body, joints were hurting, a few hives on my torso and I was experiencing chills. Went to sleep that night and was very ill the entire next day with fever, chills, aching all over, swollen lymph notes in my neck, in my left arm pit, coughing out excessive phlem, headache, sore joints, and hives on my arms, legs and torso. It is now 7/12/2021 at 4:34PM, I am still dealing with hives wheels all over my legs, several small hives on my right arm and several hives on my belly and sides. My antihistamine is helping to keep the hives in check. I am still quite sore all over and the arm I received the injection in hurts a lot.

Other Meds: Claritin

Current Illness: None

ID: 1464721
Sex: F
Age: 41
State: CA

Vax Date: 04/08/2021
Onset Date: 04/12/2021
Rec V Date: 07/12/2021
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: I experienced about 5-6 days later, numbness to both of my legs, from my calves all the way to my toes and also to my hands and face. I saw my PCP, she consulted with a neurologist and recommended that I get a MRI of the brain. MRI brain showed to be negative. At this time I only have numbness to my toes and face, slowly improving.

Other Meds:

Current Illness:

ID: 1464722
Sex: F
Age: 70
State: MA

Vax Date: 03/25/2021
Onset Date: 03/27/2021
Rec V Date: 07/12/2021
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: Penicillin, PEG, opioid analgesics

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

Symptoms: Raised red & itchy spots (hives?) on my chest and stomach which lasted for about 2 1/2 months. The severity of the rash varied throughout that time. I was mostly able to resist the urge to scratch I contacted my Dr who recommended Benadryl, but I never felt the need to take it.

Other Meds: Chlorthalidone, diltiazem, fish oil, flaxseed oil, stool softener, lo-dose aspirin, folic acid, multi- vitamin, vitamin D3, losartan potassium, over counter allergy

Current Illness: None

ID: 1464723
Sex: F
Age: 21
State: WI

Vax Date: 03/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/12/2021
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: Vaccinated with Moderna on 2/6/21 and 3/6/21. Symptom onset 7/6 with cough, loss of smell, headache and fatigue. Tested positive for Covid-19 on 7/10/21.

Other Meds:

Current Illness:

ID: 1464724
Sex: F
Age: 59
State: LA

Vax Date: 03/18/2021
Onset Date: 03/30/2021
Rec V Date: 07/12/2021
Hospital:

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

Lab Data:

Allergies: Latex, Band-Aids, Nicotine, Sulfa, Inseds, Neosporin, Suda, Dextromorphin, Statins, Sedatives, Anti-Physic, Anti-Depress, A1 Protein, Chocolate, Avocados, Bananas, Hair Dyes, Wool, Perfume, Cat, Pollen

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

Symptoms: Pt. states received 1st Phizer shot 03/18/2021 and started experiencing symptoms 04/01/2021, pain in the left shoulder(frozen shoulder), joints popping with pain, right leg going numb at night (sometimes both), over time arms and legs would both go numb. Disorientation associated with fatigue, nerves (feeling pulled), jaw pain, bottom of the feet tender (sensitivity), head jolts (electrical feeling). Difficulty chewing/ swallowing, lips and tongue go numb while eating. Trouble staying awake during the day due to lack of sleep at night time. Lapse of time with random black out periods, fatigue with activity. Anxiety due surroundings and struggling to cope with stress and agitations. PT/OT is helpful to an extent. Appetite lowered (plain yogurt/ plain rice). Peeling of the skin and lips (flakes) excessive dry skin. Temperature change sensitivity, and light sensitivity. Consulted and Neuro appt. late Sept.

Other Meds: Clonidine, Gabapentin, Thyroid medicine, Panaprezal, Xyzal, Flonase, Multi-Vitamin, Singulair

Current Illness: N/A

ID: 1464725
Sex: F
Age: 49
State:

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 07/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None.

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

Symptoms: I had a fever of 101 degrees. I had a sore throat, runny nose, body aches. All the flu symptoms. The next day, I felt better.

Other Meds: Blood Thinners; Iron Pills; Multivitamin.

Current Illness: None.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm