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: 1481547
Sex: F
Age: 52
State: OR

Vax Date: 05/01/2021
Onset Date: 05/03/2021
Rec V Date: 07/17/2021
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: PCN

Symptom List: Dysphagia, Epiglottitis

Symptoms: onset of left neck mass with adjacent rash 3 days after vaccination. Rash resolved, but now burning/paresthesias are reported around the left neck/shoulder. Ultrasound pending

Other Meds: magnesium, vitamin D3, potassium, turmeric, iodine, B-complex, fexofenadine

Current Illness: none

ID: 1481548
Sex: M
Age: 58
State: MD

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient stated he received AstraZeneca back in February

Other Meds: No medications

Current Illness: None

ID: 1481549
Sex: M
Age: 41
State: FL

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 07/17/2021
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: None

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

Symptoms: Severe shortness of breath even during non strenuous activities.

Other Meds: None

Current Illness: None

ID: 1481550
Sex: F
Age: 49
State: IL

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: itching on left arm , pt taking Benadryl

Other Meds:

Current Illness:

ID: 1481551
Sex: M
Age: 65
State: NV

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: Latex rubber gloves and any latex touching skin

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

Symptoms: Left arm broke out in a red rash that was incredibly intense, rash was also present in the right arm and across the front of chest down to waistline. The itching was felt in all areas that were not paralyzed. Over the next few days the left arm had pimple like projections with puss coming out of them. the same thing occurred on my chest and some of these bled. The reaction was a similar reaction to poison ivy or poison oak that i remembered from the past. I also tried using some Calamine lotion on the skin.

Other Meds: Methenamine Hippurate 1 GM, Vitamin C, Simvastatin 5 MG, Cyanocobalamin 500 MCG, Cholecalcif 25MCG, took Loratadine 10 mg in response to allergic response

Current Illness: none

ID: 1481552
Sex: F
Age: 74
State: GA

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 07/17/2021
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: Cefprozil

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

Symptoms: Had a headache and irregular heartbeat that lasted about 15 hours. Next day, I was back to normal.

Other Meds: Bystolic, Montelucast, Benadryl, Aspirin 51mg, vitamins C , D3, zinc, NAC, Magnesium

Current Illness: None

ID: 1481553
Sex: F
Age: 42
State: MD

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient revealed she received the AstraZeneca Vaccine back in February

Other Meds: None

Current Illness: No

ID: 1481554
Sex: F
Age: 49
State: CA

Vax Date: 07/07/2021
Onset Date: 07/15/2021
Rec V Date: 07/17/2021
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: Swollen, raised area about 3" around vaccine site, very itchy.

Other Meds: prenatal multivitamin. naturals algae dha omega 3. restorative probiotic.

Current Illness:

ID: 1481555
Sex: M
Age: 84
State: TX

Vax Date: 04/19/2021
Onset Date: 04/27/2021
Rec V Date: 07/17/2021
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: My father has hard time breathing, He needs to lay down on bed all day long to breath.

Other Meds: amlodipine; metformin hydrochloride sustained release tablets; metoprolol tartrate tablets; Estazolam tablets;

Current Illness:

ID: 1481556
Sex: F
Age: 33
State: CA

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 33-year-old female who complained of throat tightness and shortness of breath about 15 minutes after receiving her first dose of pfizer Covid-19 vaccine. Patient was given one dose 0.3 ml epinephrine to the right thigh at 12:42PM on scene and EMS was called and arrived at 12:50 PM. Patient stated that her throat swelling felt moderately improved after administration of epinephrine, but that she felt jittery with a fast heart rate after administration of the epinephrine. Vital signs remained stable throughout the event. The patient was able to speak throughout the event. No loss of consciousness. No hives or angioedema noted. The patient was evaluated by EMS and was transferred to the ED.

Other Meds:

Current Illness:

ID: 1481557
Sex: M
Age: 31
State: FL

Vax Date: 07/02/2021
Onset Date: 07/09/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Rashes/itch appear few days after second shot (chest/torso) - been ongoing for 10 days now

Other Meds:

Current Illness:

ID: 1481558
Sex: M
Age: 84
State: TX

Vax Date: 04/19/2021
Onset Date: 04/27/2021
Rec V Date: 07/17/2021
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: no

Symptom List: Rash, Urticaria

Symptoms: My father has hard time breathing; He has to lay on bed all day long to breath.

Other Meds: Amlodipine metformin hydrochloride sustained release metoprolo tartrate Estazolam

Current Illness:

ID: 1481559
Sex: F
Age: 14
State: ME

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/17/2021
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 known allergies

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

Symptoms: Immediately after administration, the patient slid off the chair and bumped her head on the trash can. She came to, but did not remember what happened. She was pale in color and started to perspire. We gave her water and was asked to lay on the floor. No medication was given and patient concentrated on breathing until she was able to get up. She layed on the floor for approximately 5 minutes until she was feeling better. We continued to monitor her until 4PM

Other Meds: none

Current Illness: no known

ID: 1481560
Sex: F
Age: 35
State: AR

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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: Latex, amoxicillin, propranolol, Naproxen

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

Symptoms: Itching all over body. Swelling of the lips and throat.

Other Meds:

Current Illness:

ID: 1481561
Sex: F
Age: 38
State: NY

Vax Date: 07/05/2021
Onset Date: 07/05/2021
Rec V Date: 07/17/2021
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: Patient mentioned when she came for her 2nd COVID vaccine that she had some pain in her inner thigh up to her groin (on the same side as her shot) that started soon after her 1st dose and lasted about 4 hours. She also started bleeding 4 hours after her shot and this lasted for about 6 hours along with some mild cramping. She did not report this after the 1st dose because she didn't really know if it was related to her vaccine or not. After receiving her 2nd dose she started having some pain in her ankle that went to her shin and lasted about 2 hours. She also had some mild cramping right after the shot. She called the pharmacy later to report that she started bleeding again 4 hours after the shot. The bleeding was off and on for the rest of the night and into the next morning. She has a Mirena IUD for birth control and hasn't had a period in years. She did contact her OBGYN after the 2nd shot and her MD had not heard of any of these reactions with any patients with the Mirena IUD.

Other Meds: Has a Mirena IUD

Current Illness:

ID: 1481562
Sex: M
Age: 27
State: WV

Vax Date: 03/05/2021
Onset Date: 03/15/2021
Rec V Date: 07/17/2021
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: NKA

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

Symptoms: Increased systems with neurological disorder, a movement disorder.

Other Meds: Doxycycline Omeprazole

Current Illness: Diagnosed: Functional Movement Disorder (FMD)

ID: 1481563
Sex: M
Age: 71
State: MD

Vax Date: 03/29/2021
Onset Date: 04/10/2021
Rec V Date: 07/17/2021
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: IV Flourescein, Brazil nuts, raw Almonds, Ambien

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

Symptoms: About 10 days after the second Covid vaccination on 29 March (first shot was on 8 March) a single skin blister appeared on my left forearm. I though is might have be poison ivy, though I had no reason to believe I had contacted poison ivy. Over the next month, additional blisters and skin eruptions appeared, notably around right ear lobe and surrounding tissue, along underside of jaw line to similar area of the left ear lobe. On 14 April my primary doctor suggested topical Hydrocortisone or similar cream as treatment giving at best very short relief from the itching. On 1 July I was seen by Dr's PA who took 2 skin biopsies and prescribed Clobetasol cream. Still only very short symptomatic relief. Spraying alcohol mixed with witch hazel works as well. Blisters start small (pin head to eraser size) may or may not grow to as large as a dime. May be singular or in clusters.

Other Meds: Medications for patient as of April 2021 Ordered by Dr. Timolol maleate 0.5% (6.8 mg/ml) for Glaucoma. One drop in each eye in AM. Travatan Z 0.004% for Glaucoma. One drop in right eye in PM. Ordered by Dr. Doxycycline for bronchitis.

Current Illness: Bronchitis since January 2021

ID: 1481564
Sex: M
Age: 70
State: MI

Vax Date: 02/17/2021
Onset Date: 02/21/2021
Rec V Date: 07/17/2021
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: Malaise, myalgia, fatigue. Began about 4 days after the 2nd Pfizer vaccine. Lasted 10 days. I presumed it to be a viral syndrome but it was atypical and felt strange. It felt like when I had COVID in Nov 2020 but milder and without the respiratory symptoms or loss of smell. It finally resolved after 10 days or so. Later, after reading about the delayed local reactions to the Moderna vaccine, I thought that a delayed SYSTEMIC reaction was also possible. In my best clinical judgement this was a DELAYED SYSTEMIC REACTION.

Other Meds: flecainide, Hytrin, Myrbetriq, curcumin, alpha lipoic acid.

Current Illness: None

ID: 1481565
Sex: F
Age: 41
State: MI

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient received the Janssen COVID-19 vaccine on 7/17/21 at roughly 4:35 pm and shortly after felt hot, sweaty, and faint. Patient was given apple juice and laid on the floor for several minutes before feeling much better. She was then able to leave on her own.

Other Meds:

Current Illness:

ID: 1481566
Sex: M
Age: 13
State: IL

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: NO KNOW ALLERGIES

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

Symptoms: NAUSEA/VOMITING

Other Meds: NOT KNOWN

Current Illness: NO

ID: 1481567
Sex: F
Age: 23
State: MO

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/17/2021
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 had a reaction to first dose and came back for second dose. Hospital said she was fine to get it and it was not a seizure but she should eat before the dose this time. Pharmacist discussed incidence with her and she agreed to wait in lobby for 30 minutes. patient received vaccine and was walked to lobby to sit. She got up a few minutes later to report feeling dizzy. She walked over to consultation window and fainted before pharmacist could reach her. She came to immediately, 911 was called and they said she had a vasovagal reaction. She declined going to hospital as she felt fine and sat for 30 more minutes before leaving.

Other Meds:

Current Illness:

ID: 1481568
Sex: M
Age: 30
State: OK

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Unevaluable event

Symptoms: Patient received his first Moderna COVID vaccination and went and sat down in front of the pharmacy. About 5 minutes after his shot, a woman walking by heard him say he felt like he was going to pass out and caught him as he was falling out of his chair. Staff member heard the commotion and immediately got my attention. I instructed him to call 911 and went out to the patient. As I got to the patient he was beginning to regain consciousness. The woman said the patient had hit his head on the shelving that was behind the chair. I gave him some water and had him stay seated until EMS arrived. EMS checked him out and released him into the care of his family.

Other Meds:

Current Illness:

ID: 1481569
Sex: M
Age: 54
State: TX

Vax Date: 07/11/2021
Onset Date: 07/12/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Got very dizzy which caused me to collapse. I then had a seizure where my eyes went up in my head and lost consciousness for a few minutes.

Other Meds: Centrum for men supplement, Pravastatin 20mg, Lisinopril 40mg

Current Illness: None

ID: 1481570
Sex: M
Age: 13
State: CA

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: History of Present Illness: 13y/o male with no significant past medical history or allergies reports nausea following receipt of first dose Pfizer vaccine today. He reports associated pre-syncopal sensation, palpitations and minimal difficulty with swallowing. He denies shortness of breath, chest pain, swelling/numbness of the lips and tongue, vomiting, injection site pain/redness or rash. Physical Exam: VS- HR ~110 VS #2: taken by paramedic reportedly within normal limits and normal sinus rhythm Inspection: no redness, swelling or pain at injection site; no rashes. No tongue/lip swelling. Heart: increased rate, regular rhythm; radial pulse strong with increased rate Lungs: clear to auscultation bilaterally without adventitious sounds Plan: Patient was also evaluated by paramedics. After ~30min, the patient reported cessation of symptoms and was feeling much better. Paramedic informed patient and mother that he can be transported by ambulance to hospital or decline services. The mother and patient elected to decline transportation via ambulance to hospital as he was feeling much better. Patient and family left the site after his symptoms resolved.

Other Meds: none

Current Illness: none

ID: 1481571
Sex: M
Age: 65
State: DC

Vax Date: 01/26/2021
Onset Date: 02/07/2021
Rec V Date: 07/17/2021
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: Global Transient Amnesia - sudden onset of memory loss and inability to form short term memory. No other medical problems. Lasted about six hours

Other Meds: Venlafaxine 37.5 mg Atorvastain 10 mg

Current Illness: none

ID: 1481572
Sex: M
Age: 64
State: RI

Vax Date: 03/20/2012
Onset Date: 03/24/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: NONE

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

Symptoms: EXTREME FATIGUE ENDED AFTER ABOUT 4 DAYS HEADACHE ENDED AFTER ABOUT 3 DAYS FATIGUE STILL CONTINUING

Other Meds: METFORMIN AVORASTATIN

Current Illness:

ID: 1481573
Sex: F
Age: 29
State: AZ

Vax Date: 01/01/2021
Onset Date: 06/01/2021
Rec V Date: 07/17/2021
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: Amoxicillin, latex

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: No adverse affects- I got covid 5 months after the vacvine

Other Meds:

Current Illness:

ID: 1481574
Sex: M
Age: 53
State: CA

Vax Date: 05/03/2021
Onset Date: 05/06/2021
Rec V Date: 07/17/2021
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: Spots on my calves that come and go. (I have pictures) sudden irregular heartbeat. I am being evaluated by my doctor.

Other Meds: Metoprolol 50 mg OD, valsartan 80mg OD, Amlodipine 10mg OD, Metformin 500mg BID, and Magnesium 100 mg OD.

Current Illness: None

ID: 1481575
Sex: F
Age: 30
State:

Vax Date: 07/14/2021
Onset Date: 07/15/2021
Rec V Date: 07/17/2021
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: Gluten

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

Symptoms: Loss of taste.

Other Meds: Sertraline.

Current Illness: No

ID: 1481576
Sex: F
Age: 27
State: CO

Vax Date: 06/10/2021
Onset Date: 06/11/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: Abilify, Augmentin, minocycline, Percocet, prochlorperazine, Septra, hormonal birth control, beer

Symptom List: Nausea

Symptoms: At approximately 12 P.M. on 6/11/21, a mental fog resulting in foggy thinking, forgetful, unable to focus, strange space-y feeling in head, and decreased ability to hear began. This resulted in being unable do to normal daily activities. The fog was still present the evening of 6/12/21, but appeared to be receding. On 6/13/21, the fog continued to reduce and I was nearly able to function normally. As of the afternoon of 6/14/21, the mental fog was completely gone and I was back to normal function.

Other Meds: Escitalopram, fish oil, fludrocortisone, gabapentin, lamotrigine, melatonin, quetiapine, tazarotene, Vitex

Current Illness: Sunburnt and dehydrated on the day of the vaccination

ID: 1481577
Sex: F
Age: 39
State: CA

Vax Date: 07/06/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: Dairy, almond sensitivity

Symptom List: Injection site pain

Symptoms: I have not had my period, should have come on the 11th-13th. I?m always regular, and not sexuality active. I have some mild pms symptoms . Also reduced sex drive.

Other Meds: Escilatopram 20mg daily

Current Illness:

ID: 1481578
Sex: M
Age: 78
State: MA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 07/17/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: CONTINUING DISCOMFORT IN THE INTERIOR OF THE LEFT SHOULDER WITH WEAKNESS OF SHOULDER WHEN STRESSED.

Other Meds: ROSUVASTATIN CALCIUM 10 MG, IC CHLOTHALIDONE 24MG, ASPIRIN, VITAMINS

Current Illness: NONE

ID: 1481579
Sex: F
Age: 64
State: WA

Vax Date: 07/12/2021
Onset Date: 07/13/2021
Rec V Date: 07/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Aspirin stomach sensitivity

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

Symptoms: A-fibalation 27 hours after vaccine. No prior history of a-fib or any heart issues. Started at hospital 7/13/21, ambulanced to other hospital twelve hours later, released 7/16/21.

Other Meds: Tramadol

Current Illness: none

ID: 1481580
Sex: M
Age: 13
State: OH

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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: No known allergies

Symptom List: Tremor

Symptoms: pt felt light headed, dizzy,nausea, headache

Other Meds: N/A

Current Illness: none

ID: 1481581
Sex: F
Age: 65
State: MA

Vax Date: 03/25/2021
Onset Date: 04/15/2021
Rec V Date: 07/17/2021
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: dairy, cows milk

Symptom List: Erythema, Pruritus

Symptoms: I had hives or dermatitis starting mid February 2021. Recieved my first covid shot on March 25, 2021 followed by a sunburn rash on face. I had my second covid shot on April 15, 2021 followed by same suburn rash on face, neck and chest. Covid shot site was a giant hive, red and swollen for days. I have been suffering with a very bad rash since.

Other Meds: probiotics, lorazepam,

Current Illness: None

ID: 1481582
Sex: F
Age: 32
State: MO

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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: no known allergies

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

Symptoms: 10:11 about 25 minutes after 2nd Moderna shot patient stated mouth, tongue, lips feel itchy, breathing is fine, no swelling, no other symptoms , gave 50mg dose of Benadryl at 10:13am , pt stated feeling better after about 15 minutes, continued to watch/monitor for an hour , pt stated feelilng fine and appeared to be fine, boyfriend was with her , so she did not leave alone.

Other Meds: unknown

Current Illness: unknown

ID: 1481583
Sex: F
Age: 57
State: TN

Vax Date: 07/16/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Excruciating headache, chills, body aches for 10 hours.

Other Meds: Pravastatin 40 mg, CoQ10 200 mg

Current Illness: None

ID: 1481584
Sex: F
Age: 53
State: CA

Vax Date: 07/08/2021
Onset Date: 07/09/2021
Rec V Date: 07/17/2021
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: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Starting the day after taking the 1st dose of the Pfizer COVID vaccine; I feel a lot of anxiety; rapid heart palpitations; prolonged exhaustion/tiredness, muscle/leg pain; arm soreness for the first 4 days.

Other Meds: Metformin Insulin Over the counter supplements; Vitamin B12, Vitamins C, Elderberry.

Current Illness: N/A

ID: 1481585
Sex: M
Age: 44
State: FL

Vax Date: 06/03/2021
Onset Date: 06/18/2021
Rec V Date: 07/17/2021
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: NO

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

Symptoms: Weakness or tingling sensations, especially in the legs or arms

Other Meds: CREATINE, PROTEINE POUNDER

Current Illness: NOTHING

ID: 1481586
Sex: F
Age: 10
State: MS

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/17/2021
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: Misinformation was given to the pre-screening nurse--given 2010 as year of birth by patient's mother. Vaccine given--later discovered that pt is 10 years old instead of reported 12.

Other Meds: unknown

Current Illness: none known

ID: 1481587
Sex: M
Age: 78
State: AZ

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 07/17/2021
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: I have had crippling tinnitus in both ears 24/7 since the covid shots. Sometimes so loud I cannot hear anything or anyone else.

Other Meds: None

Current Illness: None

ID: 1481588
Sex: F
Age: 33
State: FL

Vax Date: 07/08/2021
Onset Date: 07/09/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: NSAIDs Bactrim walnuts macadamia nuts

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

Symptoms: Low-grade fever, Aches, Chills began approximately 24 hours after vaccination. Onset was fairly quick, within hours. No treatment. Slept overnight and felt improved the next morning.

Other Meds: spironolactone elderberry women's multivitamin maca root

Current Illness: N/A

ID: 1481589
Sex: F
Age: 28
State: NY

Vax Date: 04/08/2021
Onset Date: 06/28/2021
Rec V Date: 07/17/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: In the past few weeks, starting at the end of June, when I bend over, viscous fluid pours out of my nose. It's persistent post-nasal drip that lacks the consistency of familiar snot. It isn't minuscule enough to ignore. It's like I am climbing out of a chlorinated pool. It only happens when I bend down to pick something up and whatever comes out keeps coming until it decides it is done.

Other Meds:

Current Illness:

ID: 1481590
Sex: F
Age: 40
State: CA

Vax Date: 06/01/2021
Onset Date:
Rec V Date: 07/17/2021
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: They treated me very well and I had no symptoms after the vaccine.

Other Meds: None

Current Illness: No

ID: 1481591
Sex: F
Age: 27
State: CO

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/17/2021
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: Abilify, Augmentin, minocycline, Percocet, prochlorperazine, Septra, hormonal birth control, beer

Symptom List: Vomiting

Symptoms: On 7/8/21 around 8 P.M., the mental fog I experienced from the first Moderna COVID-19 shot returned. The symptoms once again included an inability to think, focus, or remember stuff with a spaced out feeling in my head and a decreased ability to hear. I was completely unable to function normally. On 7/9/21 around 3:00 P.M., the symptoms listed above continued and I was still unable to function normally in my daily activities and work. At 7/10/21 at 2:57 P.M., the mental fog appeared to be receding, but I was still not back at normal function. On 7/11/21 at 5:25 P.M., the remainder of the mental fog manifested as being a little slow mentally as I attempted to return to normal activities and work. On 7/12/21, as of 2:37 P.M., the mental fog was completely gone. No treatment was given for this side effect or the same one one I experienced with the first Moderna shot on 6/10/21 because I did not think that anything could be done.

Other Meds: Escitalopram, fish oil, fludrocortisone, gabapentin, lamotrigine, melatonin, quetiapine, tazarotene, Vitex

Current Illness: Sunburnt starting on 6/10/21, lasted about 2 weeks

ID: 1481592
Sex: F
Age: 39
State: WI

Vax Date: 12/23/2020
Onset Date: 04/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 4/17/2021 - New onset of significant pelvic/ abdominal pain, initially thought to be severe, early, out of the ordinary menstrual cramps. Because I had an IUD, checked to ensure my IUD was in proper position on 4/26. It was. A few weeks later, had abnormal bleeding (starting 5/28) not associated with normal menstrual cycle and significant pain starting 6/4. Transvaginal ultrasound showed cystic fallopian tube vs hematosalpinx. Workup has not shown a known cause. It was not an ectopic pregnancy. There have been no signs/ symptoms/ exam findings lab work consistent with PID (which would be the main cause with an IUD). Underwent antibiotic treatment and IUD removal with continued milder intermittent pain. Will be having a repeat US coming up to determine if it has resolved.

Other Meds: None - Regularly, copper IUD in place, occasional Vitamin D and Vitamin C

Current Illness: None

ID: 1481593
Sex: F
Age: 50
State: CA

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Started experiencing itchiness/rash same day of first shot. Now have horribly painful hives/bruises all over body. Urgent care, doctor and emergency room haven?t been able to help just say I?m ?allergic? to something.

Other Meds: Triamcinolone

Current Illness: None

ID: 1481594
Sex: F
Age: 15
State: WI

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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: none reported

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient was faint a few minutes after receiving the vaccine. She was lowered to the ground and regained consciousness almost immediately. airway was stable--no other adverse events. Patient was able to sit up and drink water. When she was comfortable, she was moved to a chair to recover. She continued to drink water as needed and was monitored by staff. No medication/other interventions were needed. When patient was comfortable and feeling better she was able to leave with her father without incident.

Other Meds: not known

Current Illness: none reproted

ID: 1481595
Sex: M
Age: 17
State: AK

Vax Date: 06/03/2021
Onset Date: 06/17/2021
Rec V Date: 07/17/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin

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

Symptoms: Immediately after administration, he started taking deep breaths and holding his chest with chest pain. He then lay down on the exam table and symptoms improved in a few minutes. 14 days later, on 6/17/2021, he developed severe muscle pain and was hospitalized two days later on 6/19/2021 for rhabdomyolysis. Discharged 6/22/2021 from Medical Center. He is an active athlete, plays alot of basketball and lifts weights. This was his first episode of rhabdomyolysis.

Other Meds: none

Current Illness: none

ID: 1481596
Sex: M
Age: 29
State: TN

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Nausea, vomiting, dizziness, light headed

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm