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: 1483835
Sex: F
Age: 41
State: IL

Vax Date: 06/28/2021
Onset Date: 07/05/2021
Rec V Date: 07/18/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: I have experienced swelling in both ankles and feet. There is pain in the left inner ankle but not the right. It hurts to touch and with movement, but I can twist/move it freely. There has been no injury to neither foot/ankle. The swelling reduces with rest and elevation but has not gone completely away since it began.

Other Meds: None

Current Illness: None

ID: 1483836
Sex: F
Age: 12
State: NJ

Vax Date: 07/13/2021
Onset Date: 07/15/2021
Rec V Date: 07/18/2021
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: Patient received her TDAP booster on Tuesday July 13th 2021. The next day she had a mild fever and didn't feel great, she had bad pain at injection site. We gave her Advil for the mild fever and arm pain. Wednesday her fever was gone and pain at injection site was better. No Advil was administered. On Thursday July 15th at 1:30 pm. she started getting hives all over her face, neck and injection site of left arm 2. We gave her Benadryl as suggested by her pediatrician over the phone. Since then, the hives have been returning every day. It's now been 4 days. She's been continuasly getting hives since Thursday the 15th of July. We've been treating her with over the counter Benadryl twice a day. They go away and return just as bad after medication wears off. She has no other symptoms aside from the hives.

Other Meds: None

Current Illness: None

ID: 1483837
Sex: F
Age: 49
State: CA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 07/18/2021
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: NKDA

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

Symptoms: Pain radiated down to left hand with severe sharp left upper arm pain at left arm injection site. Pain improved but still have left shoulder movement difficulty. Left side over shoulder movement such as take off clothes is challenging.

Other Meds: multiple vitamin, fish oil

Current Illness: none

ID: 1483838
Sex: M
Age: 58
State: MN

Vax Date: 05/20/2021
Onset Date: 05/22/2021
Rec V Date: 07/18/2021
Hospital:

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: Mature adipose tissue consistent with Lipoma, Arm Left, mass excision 1.5 x 0.5 Treatment, Surgical Removal.

Other Meds: Spring Valley C, Supplement, Zinc , D3 , Cinnamon , Co Q 10, Garlic . Bayer Men's One-A-Day complete multi-vitamin. Methimazole 1/2 tablet every other day.

Current Illness: None!

ID: 1483839
Sex: F
Age: 56
State: TX

Vax Date: 01/25/2021
Onset Date: 01/30/2021
Rec V Date: 07/18/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: After I got the injection, I was fine until that night. My arm was feeling sore and I developed a bump on the site. It was terrible on the second night. On the fourth night, I felt run down. On the fifth night, I had a whole ache and felt like I was in a car accident. I started having nausea, fatigue, headache, leg cramps and I wanted to sit down. This is when the blood pressure went off the charts. I was very high on my blood pressure. I almost fainted and the ambulance checked me and said it was 110/104. I took a sublingual pill under my tongue and did it 3 times. That calmed down my blood pressure. They gave me a temporary blood pressure and this happened on the 7th day. After time had passed, everything started subsiding. I had insomnia and I was very fatigued but I could not sleep or rest. I also experienced runny stool for 2 days which was on the 5th and 6th day along with stomach pains and was very uncomfortable.

Other Meds: Lipitor, 80mg, 1xday Tricor, 145mg, 1xday Toprol XL, 100mg, 1xday Isosorbide XR cap, 30mg, 1xday Lasix, 40mg, 1xday Citalopram, 10mg, 1xday Aspirin, 325mg, 1xday Vitamin D3, 2000iu, 1xday Pepcid, 20mg, 1xday Tums, chewable, 1xday occasional

Current Illness: None.

ID: 1483840
Sex: F
Age: 48
State: NJ

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 07/18/2021
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: beta blockers

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

Symptoms: Weakness started after 1st shot on 2/12 but it was not bad. Doctors thought initially maybe myasthenia graves, especially given closing of right eye. After 2nd shot, woken in middle of night with terrible sensation up and down spine, and trouble breathing. trouble getting out of bed and terrible weakness in legs.

Other Meds: Synthroid IVIG - Calcium, magnesium, fish oils, Vitamin D

Current Illness:

ID: 1483841
Sex: F
Age: 40
State: DC

Vax Date: 07/17/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Patient came in and said she made an appointment for a Moderna shot and she was getting her second shot. She already noted that she received the first shot on 3/29/21 and put it on the consent form. She made no mention of getting Janssen vaccine. However, her insurance reported she got the Janssen vaccine back in March and not Moderna. She has no adverse events.

Other Meds:

Current Illness:

ID: 1483842
Sex: M
Age: 61
State: WA

Vax Date: 07/01/2021
Onset Date: 07/11/2021
Rec V Date: 07/18/2021
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: Cerebral venous sinus thrombosis Symptoms - daily headache that started around 7/11/21 which is about 10 days after first dose of the vaccination

Other Meds:

Current Illness: None

ID: 1483843
Sex: F
Age: 56
State:

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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: when pharmacist administer vaccine to the patient arm, most of the dose leaked out due to the faulty syringe so per CDC COVID 19 vaccine administration errors and deviations protocol another authorized dose was administered to the patient immediately. Also patient reported dry mouth feeling after the vaccination

Other Meds:

Current Illness:

ID: 1483844
Sex: M
Age: 35
State: FL

Vax Date: 05/07/2021
Onset Date: 07/03/2021
Rec V Date: 07/18/2021
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: Rash appeared two months later. Appears to be shingles.

Other Meds:

Current Illness:

ID: 1483845
Sex: M
Age: 42
State: DC

Vax Date: 04/01/2021
Onset Date: 06/28/2021
Rec V Date: 07/18/2021
Hospital: Y

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: About 2 months after the second dose of the Pfizer COVID-19 vaccine series, the patient developed fevers and headache around late June 2021. The fevers and headache have remained persistent. One week after the fevers, he developed bilateral lower extremity weakness and decreased sensation around July 14, 2021. Due to sudden acute weakness, he was admitted to the Hospital for evaluation on July 14th, 2021. The weakness was ascending and also began to include his bilateral arms.

Other Meds:

Current Illness: Rectal chlamydia was diagnosed in June 2021.

ID: 1483846
Sex: F
Age: 68
State: IN

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 07/18/2021
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: Antibiotics that end in CIN, Diflucan, IVP dye, Tapes

Symptom List: Rash, Urticaria

Symptoms: Palpitations. Started 45 minutes after injection and lasted for 7 hours. Rested for the entire time. Was just going to the ER when the palpitations stopped. 3 months and 3 days later I had palpitations again but lasted only an hour.

Other Meds: Cardizem ER 180mg dly, Losartan 50mg dly, Vitamin D 1000 IU 3xwk, Vitamin E 400 IU 5xwk

Current Illness: None

ID: 1483848
Sex: F
Age: 58
State: OR

Vax Date: 04/20/2021
Onset Date: 04/23/2021
Rec V Date: 07/18/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: The rash that I reported earlier is still with me, however, I have been experiencing leg cramps and extreme fatigue.

Other Meds: Beet Root Sup Vitamins D, C

Current Illness: None

ID: 1483849
Sex: F
Age: 64
State: FL

Vax Date: 07/14/2021
Onset Date: 07/16/2021
Rec V Date: 07/18/2021
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: Inflamation on site of vaccination, hot to contact, red coloration, fever.

Other Meds:

Current Illness:

ID: 1483850
Sex: F
Age: 35
State: TX

Vax Date: 01/01/2021
Onset Date: 02/01/2021
Rec V Date: 07/18/2021
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: First herpes outbreak from latent infection. Was likely infected 10 plus years ago

Other Meds: Fluoxetine

Current Illness:

ID: 1483851
Sex: M
Age: 17
State: MO

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1483852
Sex: F
Age: 13
State: TX

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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: Systemic: Fainting / Unresponsive-Medium, Additional Details: about 2 minutes after administration of vaccine, patient fell out of her chair. quickly woke up, fully alert, able to speak, no pain, no anaphylaxis. fell on vaccine curtain but did not hit head, no injuries, bruises,or scratched noted or reported. mom mentioned patient was fasting prior to administration. patient reported no pain, no confusion. abulance came and escorted patient out. case number: 2021089124 sheriff's office

Other Meds:

Current Illness:

ID: 1483853
Sex: M
Age: 44
State: CA

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/18/2021
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: Site: Pain at Injection Site-Medium, Additional Details: When administering dose the vanishpoint syringe clicked and it appears the needle shot backwards in barrel in the middle of the shot instead of the end resulting in vaccine spurting out. I removed the barrel for destruction. I drew up another dose and was able to administer this successfully. Patient did report pain afterwards to which I gave him an ice pack but he returned a week later saying pain had improved 40%.

Other Meds:

Current Illness:

ID: 1483854
Sex: F
Age: 51
State: MD

Vax Date: 07/17/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs, Cipro, yellow jacket wasps, lanolin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever 100.2, body aches, prickly skin, headache, sore throat, swollen glands.

Other Meds: Prozac 40 mg/daily Buspirone 20 mg/daily Lamictal 400 mg/daily AdderallXR 20 mg/daily Adderall 10 mg/daily Propanolol 10-20 mg as needed for anxiety Lo-estradiol? (Birth Control pill) Vitamin D 5,000 IU daily Mulitivitamin, daily Vitamin B

Current Illness: none

ID: 1483855
Sex: F
Age: 48
State: NY

Vax Date: 06/28/2021
Onset Date: 06/01/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies: Tylenol with Codeine

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

Symptoms: High Blood pressure

Other Meds:

Current Illness: None

ID: 1483856
Sex: M
Age: 54
State: MA

Vax Date: 05/28/2021
Onset Date: 06/11/2021
Rec V Date: 07/18/2021
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: Quinolone Sulfa drugs Strawberries

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

Symptoms: Pericarditis. ICU Anti inflammatory, aspirin

Other Meds: Metformin Candestartin Ambien

Current Illness: None

ID: 1483857
Sex: F
Age: 47
State: MA

Vax Date: 07/17/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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: PATIENT HAD PREVIOUSLY RECEIVED A JANSSEN COVID-19 VACCINE ON 07/02/2021

Other Meds:

Current Illness:

ID: 1483858
Sex: M
Age: 34
State: PA

Vax Date: 01/01/2021
Onset Date: 02/07/2021
Rec V Date: 07/18/2021
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: Hair loss

Other Meds: None

Current Illness: None

Date Died: 05/14/2021

ID: 1483859
Sex: F
Age: 92
State: IN

Vax Date: 01/14/2021
Onset Date: 04/14/2021
Rec V Date: 07/18/2021
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: Sulpha drugs

Symptom List: Injection site pain, Pain

Symptoms: Mom was feeling fine before she had the Moderna vaccines. A few weeks later, she became extremely ill. She died on May 14, 2021.

Other Meds: Metropolol Anti-depressant Cholosterol med.

Current Illness: None

ID: 1483860
Sex: M
Age: 12
State: TX

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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: Injection site pain, Menorrhagia

Symptoms: The patient felt fine right after getting the vaccine. He and his family went to go walk around the store and were about to leave when the mother reported that he "couldn't see" (approximately 15 minutes after the vaccination). The family sat him down and we got the patient a bottle of water to drink. He felt fine afterwards within a few minutes.

Other Meds:

Current Illness:

ID: 1483861
Sex: M
Age: 28
State: TX

Vax Date: 07/12/2021
Onset Date: 07/14/2021
Rec V Date: 07/18/2021
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: Mild nut allergy

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

Symptoms: Dizziness, Lightheaded, Brain fog

Other Meds: n/a

Current Illness: N/a

ID: 1483862
Sex: F
Age: 35
State:

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Began Menstrual spotting (which normally doesn?t happen with my implant) a few days after shot and has continued until today nearly 30 days later.

Other Meds: Nexplanon

Current Illness:

ID: 1483863
Sex: F
Age: 23
State: GA

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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: Patient received a COVID vaccine. A couple minutes after administration. Patient stated that she was feeling a headache and dizzy. Pharmacist provided a cool compress to the patient's head, neck, and wrists. Patient was also provided water and Gatorade. By the end of her 15 minute waiting period, patient stated that she felt better and left with her family but remained in the store.

Other Meds:

Current Illness:

ID: 1483864
Sex: M
Age: 29
State: IL

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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 reported

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

Symptoms: Patient had an episode of syncope resulting in him hitting his head immediately following the vaccination. EMS was dispatched and the patient was cleared after being monitored. Patient stated that he has passed out in the past after giving blood. The patient had said no to having any history on this on his vaccination consent form. EMS cleared the patient to go home.

Other Meds: none reported

Current Illness: none reported

ID: 1483865
Sex: F
Age: 45
State: UT

Vax Date: 07/09/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies: Malignant Hyperthermia

Symptom List: Nausea

Symptoms: No noticeable reaction to vaccine other than, I noticed nine days after the injection a hot, hard, red swollen painful lump (dime size) developed at the injection site. I put on ice and it feels better. I've never had a reaction to a vaccine before. Did not contact my doctor. I still plan on getting my booster shot on July 30th in the other arm.

Other Meds: Sertraline, Omeprazole, Zolpidem, Clonidine (taken twice during vaccination period)

Current Illness:

ID: 1483866
Sex: F
Age: 50
State: NC

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies: Known allergies to specific foods (basil, pine nuts)

Symptom List: Injection site pain

Symptoms: 1) Headache: severe; required treatment with NSAIDs; resolved within 3-4 days without sequelae 2) Fatigue: severe; required bed rest for 3 consecutive days; resolved within 4-5 days without sequelae

Other Meds: None

Current Illness: None

ID: 1483868
Sex: M
Age: 50
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 07/18/2021
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: Frozen Shoulder

Other Meds: None

Current Illness: None

ID: 1483869
Sex: F
Age: 41
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: I experienced many adverse side effects from the 1st Moderna dose, but the most serious and long-lasting was the aggravation of my long-term cardiac symptoms that I developed after my COVID infection in April 2020. However, I will list all relevant symptoms and their duration. 1. Intensely sore arm; arm had to be immobilized (onset: 5h after shot; duration: 48 hours) 2. Nausea and loss of appetite (onset: 8h after shot; duration: 48 hours) 3. Fatigue requiring bed rest (onset: 8h after shot; duration: 72 hours) 4. Fever ranging from 99F to 102F (onset: 10h after shot; duration: 48 hours) 5. Violent chills, preventing normal movement and activities (onset: 11.5h after shot; duration 6h) 6. Pounding headache (onset: 12h after shot; duration: 72 hours) 7. Dizziness and loss of balance (onset: 20h after shot; duration: 5 days) 8. Mild fatigue requiring reduction in daily activities (onset: 72h after shot; duration: 10 days) 7. Tachycardia and heart palpitations (onset: 24h after shot; duration: still continuing 3 months later) Specifically, my heart symptoms are characteristic of POTS: my heart pounds whenever I lie down or stand up, with the abnormal sensation continuing for many minutes at a time (sometimes preventing sleep). My heart also races abnormally during exercise or stress. Furthermore, I occasionally feel irregular palpitations and chest pain. I first developed this dysautonomic pattern shortly after contracting COVID-19 (confirmed by 2 PCR tests) on April 13, 2020. At that time, my cardiac symptoms persisted for about 8 months, until November 2020, at which point they seemed to fully resolve. The 1st Moderna shot in April 2020 made all my cardiac symptoms reappear and persist. For that reason, I declined the second shot. I wish to note that I have never had any prior cardiac problems, nor have I ever been diagnosed with anxiety or other mental health conditions. Prior to contracting COVID, I was a completely healthy marathon runner and triathlete.

Other Meds: Prenatal multivitamin with DHA (OTC) Topical salicylic acid for plantar wart removal (OTC)

Current Illness: None

ID: 1483870
Sex: M
Age: 15
State:

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/18/2021
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: Patient seemed fine at the time of injection, upon leaving his seat and walking into the store he became light headed, pupils dilated, and fainted on the floor. This was approximately 3 to 4 minutes after injection. He seemed almost immediately fine, vision fine, and was able to talk and drink water. Monitored for 30 minutes after and no other signs / symptoms during this time.

Other Meds:

Current Illness: NONE

ID: 1483871
Sex: F
Age: 35
State: MD

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 07/18/2021
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: Swelling and pain to both hands.

Other Meds: over-the-counter medications, dietary supplements and herbal remedies

Current Illness:

ID: 1483872
Sex: F
Age: 20
State: MA

Vax Date: 07/09/2021
Onset Date: 07/15/2021
Rec V Date: 07/18/2021
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:

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

Symptoms: Redness, itching and hard bump in injection site

Other Meds: N/a

Current Illness:

ID: 1483873
Sex: M
Age: 69
State: NC

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 07/18/2021
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: Continuous and ongoing muscle spasms of lower extremities began about two hours after injection, and have been going on now for over six months without letup.

Other Meds: Cimetidine Levothyroxine

Current Illness: None

ID: 1483874
Sex: M
Age: 57
State: NC

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 07/18/2021
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 known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: On audit, patient has received multiple COVID vaccines -- Janssen x 3; Pfizer x 1. Contacted client to advise. Patient reported no ill effects.

Other Meds:

Current Illness:

ID: 1483875
Sex: M
Age: 72
State: NC

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 07/18/2021
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: Upon audit, found that client had received prior doses -- 2/24/2021 and 5/20/2021

Other Meds:

Current Illness:

ID: 1483876
Sex: F
Age: 54
State: NY

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 07/18/2021
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: na

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

Symptoms: Day after the vaccine she had a seizure or mini stroke that lasted between 35 minutes and 1 hour. She is currently being tested. This was her second seizure if it was a seizure. The other one occurred almost a month previously. She saw a Dr. who said it could possibly be a side effect of the vaccine.

Other Meds: Aspirin 81mg, Levetiracetem 500mg, rosuvastatin 20mg, lisinopril/hctz 20/25mg, carvedilol 25mg

Current Illness: Had a seizure on 5/15 that lasted 5 to 10 minutes. After that no other seizures. Had the vaccine on 6/11/21 and had either a seizure or mini stroke the following day. It lasted 35 minutes to 1 hour. On imaging they found a lesion on her brain where seizures are activated. She's going through testing - wearing a heart monitor and EEG

ID: 1483877
Sex: F
Age: 66
State: CA

Vax Date: 07/07/2021
Onset Date: 07/16/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillins, Claritin,

Symptom List: Pain in extremity

Symptoms: A bruise at injection site the size of a silver dollar appeared 8 days after injection. . No severe pain, just light discomfort when pressed on . Nothing else

Other Meds: Vitamin D, Ocuvite, Lostartin

Current Illness: None

ID: 1483878
Sex: F
Age: 16
State: MI

Vax Date: 06/01/2006
Onset Date: 01/01/2017
Rec V Date: 07/18/2021
Hospital: Y

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

Lab Data:

Allergies: Erithromycin, Keflex

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

Symptoms: My Pap smear results returned abnormal months after receiving this vaccine. Then In 2017 I began losing ability to control nervous system. This began with my legs and moved to my arms after sometime.

Other Meds: No

Current Illness: No

ID: 1483879
Sex: F
Age: 48
State: NJ

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 07/18/2021
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: left arm muscle tender/sore/pain since dose #2 received. Unable to maintain strength in left arm. unable to do normal activities that I was able to do without pain prior to receiving the vaccine.

Other Meds:

Current Illness:

ID: 1483880
Sex: F
Age: 49
State: IA

Vax Date: 07/13/2021
Onset Date: 07/15/2021
Rec V Date: 07/18/2021
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: penicillin, codeine

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

Symptoms: The patient developed mild swelling and redness developing over 2 days extending from below the injection site down approximately 4-6 inches. She went to urgent care for evaluation. The provider ruled out allergic-type reaction, recommended topical Benadryl cream and redness and swelling went down within 24 hours.

Other Meds: none

Current Illness: none known

ID: 1483881
Sex: F
Age: 21
State: GA

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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:

Symptom List: Vomiting

Symptoms: No symptoms

Other Meds:

Current Illness:

ID: 1483882
Sex: M
Age: 54
State: OH

Vax Date: 05/24/2021
Onset Date: 06/08/2021
Rec V Date: 07/18/2021
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: Extreme fatigue set in about 8-10 days after the second dose of Moderna. A very healthy (exercise 6 days a week and carefully watch diet) man who is known for his endless energy suddenly struggled to get out of bed. Fatigue continually got worse from June 8th until July 1st. On July 1st my heart went into arrythmia with bpm reaching 140 at rest. Normal rest is 66 bpm. The arrythmia continued to persist sporadically until I went to the Emergency Room on July 5th. It had progressed to the point that my heart would not stop racing and I thought I was in big trouble. At the ER I learned that my blood pressure had ballooned to 185/125 and my glucose was 152. No previous tests had ever shown any blood work problems in any area. And I have never felt like this in my life. Now my blood pressure is back to normal and eating very low carb to bring the glucose down. But still having an episode of depression and lack of desire to do anything. Totally unlike me at any point in my entire life. Possible delusional thoughts now as well.

Other Meds: Allopurinol

Current Illness: None

ID: 1483883
Sex: M
Age: 23
State: TX

Vax Date: 07/15/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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: Patient lied to pharmacist to obtain his first Pfizer Covid Vaccine. He was given a Janssen Covid Vaccine at a different location on 5/30/2021.

Other Meds: unknown

Current Illness: unknown

ID: 1483884
Sex: M
Age: 49
State: SC

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 07/18/2021
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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient passed out after receiving the vaccine. Patient was moved to the floor and observed closely and regained consciousness quickly. There were no signs of difficulty breathing, redness, or flushing, EMS arrived shortly and examined patient. Patient was cleared to drive home. Patient passed out once after getting a vaccine when he was kid but felt he had grown out of it. He has given blood several times

Other Meds: None

Current Illness: None

ID: 1483885
Sex: F
Age: 36
State:

Vax Date: 07/07/2021
Onset Date: 07/13/2021
Rec V Date: 07/18/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Re'cd covid vaccine in 1/2021. Became covid positive 7/16/21

Other Meds:

Current Illness:

ID: 1483886
Sex: F
Age: 46
State: SD

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 07/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin; Darvocet; Percocet; Codeine; Seasonal; Dust mites; Grass

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

Symptoms: I was lethargic the day after with a bad headache. I slept for about 3 hours. A few days later, I developed one large spot of shingles in the center of my back. I took a picture of it and sent it to my doctor. She agreed that it looked like shingles, so I came in for an appointment. She started me on some medicine for the shingles. I applied calamine lotion and some hydrocortisone to the lesion as needed for pain. I took Acetaminophen for pain. The lesion improved after a couple of weeks and it did not spread. It reoccurred again 8 weeks later with more lesions. I took another picture for my doctor and she prescribed the same medicine. I basically repeated what I did the first time. She told me to come in if it got any worse. It took about 3-4 weeks for them to go away. I got swelling at the injection site. I had a swollen lymph node on the right side of my arm. It was very painful.

Other Meds: Metformin; Lantos Insulin; Lispro Insulin; Zyrtec; Celebrex; Ezetimibe; Copeptin Supplements; Fish oil; probiotic; Vitamin C; Multivitamin; Digestive Enzymes; Levothyroxine; Flonase

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm