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: 1501514
Sex: F
Age: 41
State: PA

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/26/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1501515
Sex: F
Age: 24
State: OK

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Site: Pain at Injection Site-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Medium, Systemic: Weakness-Medium, Additional Details: Patient fainted after covid vaccine administered.EMS was called.She was taken to hospital.

Other Meds:

Current Illness:

ID: 1501516
Sex: F
Age: 24
State: OK

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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:

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

Symptoms: Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Weakness-Medium, Additional Details: Patient fainted after Moderna covid vaccine.EMS was called and patient was taken to hospital.

Other Meds:

Current Illness:

ID: 1501517
Sex: F
Age: 31
State: FL

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: PCN - Sulphur Drugs

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Dizzy, states feels like in a dream-like state. Assessed by paramedic. Client denies difficulty breathing. Assed by onsite paramedic. Vital signs done. Client observed for another 15 mins. Stated felt much better, requested to leave. Client instructed to seek medical attention should she experiences any further symptoms.

Other Meds: Unisom Birth Control

Current Illness: vertigo, low BP

ID: 1501518
Sex: F
Age: 16
State: KS

Vax Date: 07/24/2021
Onset Date: 07/24/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Seizure-Mild, Systemic: Shakiness-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: IMMEDIATELY AFTER VACCINE ADMINISTRATION, PT FAINTED FOR A FEW SECONDS, STARTED JERKY MOVEMENT. WHEN CAME BACK SHE DID NOT REMEMBER ANYTHING. THEN AGAIN SHE FAINTED TURNED EXTREMELY PAIL WITH EXCESSIVE SWEATING AND FEELING HOT, SHE SEEMED STUNNED GAZING TO ONE POINT NOT ABLE TO TALK OR MOVE. RPH ASKED TO CALL 911 IMM. PT TURNED BLUE WITH VERY LOW PULSE AND SHALLOW BREATHING. RPH ADMINISTERED EPIPEN TO THE UPPER OUTER RIGHT THIGH TO HELP RAISE BP AND PULSE. PUT PT IN SUPINE POS W/ ELEVATED FEET

Other Meds:

Current Illness:

ID: 1501519
Sex: M
Age: 23
State: IL

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/26/2021
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:

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

Symptoms: Site: Pain at Injection Site-Severe, Additional Details: Pain starting at injection site, expanding to include arm from elbow to sholder evening of 7/22, on 7/23 expanding to include hand and wrist, becoming more severe on 7/24. Patient visited emergency room on 7/25.

Other Meds:

Current Illness:

ID: 1501520
Sex: M
Age: 23
State: IL

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/26/2021
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: Site: Pain at Injection Site-Severe

Other Meds:

Current Illness:

ID: 1501521
Sex: F
Age: 24
State: OK

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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: Systemic: Fainting / Unresponsive-Medium, Systemic: Weakness-Medium, Additional Details: Patient fainted after receiving Moderna covid vaccine.EMS was called and patient was transported to hospital.

Other Meds:

Current Illness:

ID: 1501522
Sex: F
Age: 52
State: WI

Vax Date: 04/09/2021
Onset Date: 06/07/2021
Rec V Date: 07/26/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Sensory issues that started in legs, then went to arms and lower jaw. Tightness, burning, altered sensory. These symptoms started approximately 8 weeks post vaccination and worsened over time. Ongoing and untreated to date. No definitive diagnosis yet.

Other Meds: none

Current Illness: None

ID: 1501523
Sex: F
Age: 35
State: TX

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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: Systemic: Nausea-Severe, Systemic: Vomiting-Severe

Other Meds:

Current Illness:

ID: 1501524
Sex: M
Age: 58
State: MO

Vax Date: 07/24/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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, just seasonal allergies

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

Symptoms: Soreness at injection site, slight headache, no energy, tired and sleepy, no appetite, body aches. I am diabetic and without eating my blood sugar reading went up to a reading over 400. Still feel tired on todays date 26 Jul 21 (2 days after vaccination) Still have soreness at injection site.

Other Meds: Tulicity, Novalog, Tresiba, Metformin, Lisinopril/HCTZ, Fenofibrate, Tramadol, 81mg Aspirin, OTC Fish Oil,

Current Illness: N/A

ID: 1501525
Sex: F
Age: 15
State: CA

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1501526
Sex: M
Age: 31
State: CA

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient fainted for about 1 minute, urinated during fainiting. Paramedics checked patient vitals, everything was norma-blood pressure, heart rate. Pt has history of fainting in the past. Followed up with pt at 6 pm 7/25/21, pt is doing well with some headache. Before vaccination pt did not eat and he exercised. Pt received Pfizer Covid vaccine at 12;15 pm. Pt also said that he felt dehydrated, he only consumed caffeine in the morning.

Other Meds:

Current Illness:

ID: 1501527
Sex: M
Age: 12
State: VA

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/26/2021
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: Systemic: Dizziness / Lightheadedness-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Additional Details: Pt felt lighted & turned pale shortly after administration. Clinic had pt lay flat for a while & he recovered thereafter.

Other Meds:

Current Illness:

ID: 1501528
Sex: F
Age: 37
State: IL

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/26/2021
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: Site: Pain at Injection Site-Mild, Systemic: PAIN DOWN ADMINISTRATION ARM-Mild, Systemic: Lymph Node Swelling-Mild, Additional Details: Pt reported lymph node under armpit started swelling starting about 4 days after date of administration and continued til her 2nd dose was due 21 days later. She reported the symptoms as mild, not requiring medical treatment.

Other Meds:

Current Illness:

ID: 1501529
Sex: M
Age: 12
State: FL

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/26/2021
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: NKDA

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

Symptoms: Patient was supposed to receive Gardasil9, but was given Vaqta instead

Other Meds:

Current Illness:

ID: 1501530
Sex: F
Age: 51
State: FL

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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: Spasms to right side of neck; short term, comes and goes. Then resolved, per client. Client c/o spasms to Rt. side of neck. Onsite paramedic in attendance. Client refused to have vitals done. Client remained in observation for another 15 mins. as requested. Spasms resolved. No further issues. Client also instructed should she experience any further symptoms to seek medical attention.

Other Meds:

Current Illness:

ID: 1501531
Sex: F
Age: 53
State: AZ

Vax Date: 04/16/2021
Onset Date: 05/01/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs, vicodin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: About 2 weeks after the 2nd Pfizer dose, began experiencing neurogenic bowel disorder. Lower colon motility contractions had stopped. Sensory nerves also affected. This has continued to present, July 2021.

Other Meds: Albuterol, Advair HFA inhaler, benedryl for asthma

Current Illness: None

ID: 1501532
Sex: F
Age: 5
State: FL

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: Cephalosporins, Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Kinrix was administered Subcutaneously instead of Intramuscularly

Other Meds:

Current Illness:

ID: 1501533
Sex: F
Age: 54
State: WA

Vax Date: 03/18/2021
Onset Date: 05/01/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Vaginal bleeding and cramping began nine days after the second dose. Lasted three days the first time. Second round of bleeding for three days approximately one month later. Third round of bleeding lasting six days started July 19 until July 24, which was heavier and longer than previous two cycles. Went to primary physician approximately one week after initial bleeding.

Other Meds: levothroid, artovostatin, progesterone, dotti patch, fish oil, vitamin D, magnesium

Current Illness: none

ID: 1501534
Sex: F
Age: 31
State: MN

Vax Date: 03/25/2021
Onset Date: 06/03/2021
Rec V Date: 07/26/2021
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: Na

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

Symptoms: Mentrual cycle is significantly heavier, more painful and period is starting 7-10 days earlier than usual.

Other Meds: Na

Current Illness: Na

ID: 1501535
Sex: M
Age: 53
State: CT

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 07/26/2021
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: tired, entire body aches, and bad pain in both feet. persistent numbness in body extremities. The pain in one foot has remained until present which has slowly subsided. It has caused nerve damage in that foot.

Other Meds: none

Current Illness: none

ID: 1501536
Sex: F
Age: 32
State: VT

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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: Gluten (celiac disease) Mango

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

Symptoms: Pregnant: approximately 37 wks 3 days Due Date: August 11th Injection given. Approximately 15-30 seconds passed. Feeling that something was wrong, lasted only a second before I felt like my breathing was changing. Felt a pressure on all sides of me, heaviness. Each breath became harder to take. Called for help. Tried to stand but could not, fell to floor. Very difficult to get in air at all. Crawled into room with technician who went for emergency supplies. Could not breath. Technician tried to administer one epi-pen, which failed to work. Administered a second. Within 5-10 seconds breathing began to improve. I began to shake uncontrollably. Chest pain /pressure started in center of chest. Unable to move from side of sit up without breathing suffering. I was taken by emergency services to the nearest hospital to make sure breathing/oxygen levels were stable. Taken to Hospital. Contractions started after about 15-20 minutes in the ambulance. The ER ran tests/labwork. I'm unaware of what they are. Once I was deemed stable for transfer, with contractions continuing, I was was transferred to Medical Center to be monitored at Labor and Delivery for potential early labor. I was discharged that evening when labor did not progress.

Other Meds: Unithroid 75 mcg Omeprazole OTC dose Prenatal Vitamin (OLLY)

Current Illness: Mild cough 5 days prior, no other symptoms. Healthy at time of appointment for several days.

ID: 1501537
Sex: M
Age: 52
State: FL

Vax Date: 04/06/2021
Onset Date: 07/16/2021
Rec V Date: 07/26/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No known drug allergies

Symptom List: Injection site pain, Pain

Symptoms: 7/18/2021 Patent presemted to ED with a chief complaint of chest pain for the last 3 days associated with shortness of breath. Refers has been using ibuprofen achieving minimal relief. Received COVID 19 vaccinate in April (Johnson & Johnson). Upon initial evaluation on ED VS: stable. Laboratories revealed elevated creatinine and COVID 19 TEST Positive. EKG: Sinus rhythm, T wave abnormalities. A chest x ray: IMPRESSION: Left lower lung airspace disease. CT angio showed Acute pulmonary embolism, left lower lobe, nonocclusive. COVID-19 infection considered asymptomatic and no treatment required for this. Discharged home on 7/19/21.

Other Meds: lisinopril

Current Illness:

ID: 1501696
Sex: F
Age: 33
State: DE

Vax Date: 03/05/2021
Onset Date: 03/15/2021
Rec V Date: 07/26/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: I had a frozen embryo transfer on 8/31/2020. I received my first dose of Pfizer on 2/12/21 and my second dose on 3/5/21. I began experiencing swelling in my hands, feet, and face toward the beginning of March. I let my OB know and she decided to do blood work which I had done on 3/15/21. The blood work showed low platelets and high uric acid. My BP was elevated at this point but not overly high. I went into the hospital to be monitored on 3/17/21. My BP was elevated but not enough to be admitted. My protein in my urine was in the single digits. I had another appointment on 3/19/21 and my blood pressure was high. I was told to monitor my BP at home and if I had a reading over 160/90 or a headache to call immediately. On 3/20/21 I had a horrible headache and a high BP reading so I was again told to go to the hospital. At this point my BP was very high so I was admitted to the hospital. I was 31 weeks pregnant at this point. The goal was to get to 34 weeks. The protein in my urine continued to rise into the 10,000s. On 3/22/21, I had a horrible headache while in the hospital and my BP rose into the severe range. It was determined that I developed severe preeclampsia and I had an emergency c-section at 4:30 AM on 3/23/21. My son was born at 31 weeks 6 days and spent 37 days in the NICU. I also developed posterior reversible encephalopathy syndrome and lost some of my vision and had hallucinations. After about a month, my BP and vision were back to normal.

Other Meds: Prenatal vitamin

Current Illness: None

ID: 1501697
Sex: F
Age: 63
State: MI

Vax Date: 03/25/2021
Onset Date: 04/24/2021
Rec V Date: 07/26/2021
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: sulfa, penicillins, ceftin, clindamycin

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

Symptoms: severe leg and foot cramps/spasms. every night and sometimes during the day time. toes point downwards like a ballerina's foot, calf muscles get hard and very painful. sometimes my foot shakes when this happens

Other Meds: magnesium, D3, B12, Hydrochlorothiazide , pravastatin, baclofen, Naproxen 500,

Current Illness:

ID: 1501698
Sex: F
Age: 32
State: NY

Vax Date: 07/18/2021
Onset Date: 07/19/2021
Rec V Date: 07/26/2021
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: Numbness in both arms all the way to hands Vertigo minor Panic attack High anxiety Crying Hormonal Irritable

Other Meds:

Current Illness: Lyme disease

ID: 1501699
Sex: F
Age: 29
State: MI

Vax Date: 06/02/2021
Onset Date: 07/09/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: Nka

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Missing menstrual cycle, verified not pregnant.

Other Meds: Prozac Wellbutrin Adderall Xanax marijuana

Current Illness: Bronchitis

ID: 1501700
Sex: M
Age: 1
State: WI

Vax Date: 07/21/2021
Onset Date:
Rec V Date: 07/26/2021
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: no allergies

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

Symptoms: Patient was given DTaP and Kinrix instead of DTaP and HIB. Parent notified via provider, no adverse reaction.

Other Meds: nothing

Current Illness: none

ID: 1501701
Sex: F
Age: 49
State: VT

Vax Date: 05/20/2021
Onset Date: 05/22/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: sulfur, penicillin, dilauded, morphine

Symptom List: Nausea

Symptoms: Swelling of intestines (leading to severe diverticulitis-never had before) Swelling of ovary (5x) Swellng of liver Swelling of mesentery Spleen pain Stomach pain Heart palpitations Continued stomach and intestine issues

Other Meds: vitamin d vitamin c

Current Illness: Lyme and Bartonella

ID: 1501703
Sex: F
Age: 40
State: WI

Vax Date: 07/24/2021
Onset Date: 07/26/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: My period came early. (The last date of my menstral cycle is 7/6/2021) When I woke up this morning my menstral cycle has begun again. I also want to add on 7/24/21 I had such strong body aches that night I became rehabilitated from that night until this morning. Aches are gone but my period has now started again.

Other Meds:

Current Illness:

ID: 1501704
Sex: F
Age: 28
State: NE

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 07/26/2021
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: Chest pain, rapid heart rate (126+ BPM) at rest, heart skipping a beat/heart palpitations , extreme fatigue, numbness in extremities, fever, chills

Other Meds: Prenatal vitamin

Current Illness: 6 weeks postpartum

ID: 1501705
Sex: F
Age: 33
State: MO

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 07/26/2021
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

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

Symptoms: Allergic reaction/swollen face / puffy eyes / numbing of left side / tingling on upper and lower lips.

Other Meds: Zyrtec Duloxetine 20mg

Current Illness: None

ID: 1501706
Sex: F
Age: 32
State: ND

Vax Date: 03/01/2021
Onset Date: 04/20/2021
Rec V Date: 07/26/2021
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: My period became irregular after first dose of vaccine. Skipping March then April was very intense period. No period in May. June was very intense period and July have been regular in timing and intensity. My assumption is the side effect is (if caused by vaccine) has run its course. Didn?t impact my life much. Didn?t need to seek medical attention. Thought it would be good to share though.

Other Meds: Sertraline 50 mg daily

Current Illness: None

ID: 1501707
Sex: F
Age: 36
State: NC

Vax Date: 04/15/2021
Onset Date: 05/04/2021
Rec V Date: 07/26/2021
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: Wellbutrin-- break out in hives Promethazine-- break out in hives

Symptom List: Erythema, Pruritus

Symptoms: After the first shot, I suffered from daily migraines for a week. I took Motrin to help with the migraines. After the second shot, half my body broke out in hives the next day. My doctor prescribed a prescription antihistamine. The hives went away after a few days. A few days after my second vaccine, I got my period. My period lasted for close to a month. My doctor prescribed me Provera to stop my period. Provera finally stopped my period. Starting 12Jul2021 I got my period and now on 26Jul2021, I still have my period with horrible cramps. My period was light in the beginning, but starting 23Jul2021, my period started getting very heavy. I reached out to my doctor to see if I need another round of Provera to stop my period.

Other Meds: Adderall Zoloft HCTZ Probiotic for gut health Trazadone Tizanadine Requip

Current Illness: No

ID: 1501709
Sex: F
Age: 15
State: FL

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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: penicillin, omnicef

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

Symptoms: Client was vaccinated and waiting in the observation area when she stated she was seeing black spots. Client was taken to the reconstitution area in a wheelchair where her vitals were taken and she was asked to lay in a supine position. Parent explained that client gets like this or has similar experience if she does blood draw. Client was asked if she had a meal and she said she ate very little and had done her morning exercise. Client declined having her sugar done. Client was hydrating with water then her vitals were taken again while sitting up. Client parent stated that her BP is usually normal. Client was asked if she wanted to go to an emergency room. Client responded that she was feeling better and wanted to leave with her mother.

Other Meds: none

Current Illness: none

ID: 1501710
Sex: F
Age: 62
State: WI

Vax Date: 04/16/2021
Onset Date: 06/19/2021
Rec V Date: 07/26/2021
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: I have received a new diagnosis of high blood pressure and now receiving medication for it.

Other Meds: Fosamax; Calcium; Vitamin D.

Current Illness: None.

ID: 1501711
Sex: M
Age: 17
State: MI

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 07/26/2021
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: UNKNOWN

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: CLIENT WAS ONLY 17 YEARS OF AGE AT TIME OF VACCINATION. NO ADVERSE EFFECTS REPORTED.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1501712
Sex: M
Age: 23
State: NY

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/26/2021
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: fish, shrimp

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

Symptoms: patient complained of an itchy throat

Other Meds: benzoyl peroxide, nortriptyline, cholecalciferol

Current Illness:

ID: 1501713
Sex: F
Age: 35
State: IN

Vax Date: 07/20/2021
Onset Date: 07/22/2021
Rec V Date: 07/26/2021
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: Reoccurrence headaches and back pain

Other Meds: Collagen booster apple cider vinegar vitamins

Current Illness: Na

ID: 1501714
Sex: F
Age: 57
State: VA

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 07/26/2021
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: Vaccines were administered. Patient reports upper arm pain in the left upper arm that has been ongoing since getting her first COVID vaccine in March. She states her arm was swollen almost immediately after the first vaccine, she did not report this to anyone. Patient reports pain is worse with lying down, aching and tingling pain, constant pain like needles are sticking in her arm, and hurts when raising her arm up putting on her clothes. She reports no problems after the 2nd vaccine which was given in her right arm. She states that the arm did swell right after the injection but is not sure how long it took for swelling to go down.

Other Meds: Medrol Dosepak 4 mg tablet Symbicort 160 mcg-4.5 mcg/inh aerosol ProAir HFA 90 mcg/inh aerosol losartan 100 mg tablet polyethylene glycol 3350 - powder for reconstitution hydroCHLOROthiazide 12.5 mg tablet

Current Illness: Essential (primary) hypertension F32.9 Depression L20.9 Atopic dermatitis, unspecified type K59.00 Constipation, unspecified constipation type D64.9 Anemia J45.30 Mild persistent asthma, unspecified whether complicated M47.816 Degenerative arthritis of lumbar spine F79 Intellectual disability

ID: 1501717
Sex: F
Age: 20
State: NY

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/26/2021
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 experienced vasovagal symptoms post vaccine and was placed in trendelburg position of stretcher.

Other Meds:

Current Illness:

ID: 1501718
Sex: F
Age: 55
State: KS

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

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

Lab Data:

Allergies: None

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

Symptoms: Broke out in hives. They start at about 10pm nightly. Come on her arms, legs, thighs and sides. Itches in palm of hands. Looks like ring worms and boils . They disappear in the morning time then reappear every night around 10 pm.

Other Meds: Methazole 10mg (twice daily)(one taken at time of vaccination)

Current Illness: None

ID: 1501719
Sex: F
Age: 33
State: NY

Vax Date: 04/09/2021
Onset Date: 04/20/2021
Rec V Date: 07/26/2021
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

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

Symptoms: Menstrual cramps and bleeding. Been having bad vaccine.

Other Meds: No

Current Illness: No

ID: 1501720
Sex: M
Age: 39
State: VA

Vax Date: 03/29/2021
Onset Date: 04/11/2021
Rec V Date: 07/26/2021
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: None known

Symptom List: Vomiting

Symptoms: On 4/11/2021, i was sitting and having coffee when i started get a lot of pain on the left side of my chest which was radiating in my lower back and in my left arm. Initially i though it was acidity related so i had a cup of cold milk to reduce the symptoms. However the pain did not stop and it did not feel like the indigestion discomfort. The symptoms looked like very classic heart related issue symptoms, so my wife drove me to the ER immediately.

Other Meds: None

Current Illness: None

Date Died: 07/09/2021

ID: 1501721
Sex: F
Age: 85
State: MI

Vax Date: 06/21/2021
Onset Date: 07/09/2021
Rec V Date: 07/26/2021
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: Death after 2 1/2 weeks. Received 2nd shot on 6/21/21 and died on July 9, 2021.

Other Meds: Trazadone, BP meds,

Current Illness: Cancer

ID: 1501722
Sex: F
Age: 47
State: CO

Vax Date: 04/01/2021
Onset Date: 07/14/2021
Rec V Date: 07/26/2021
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:

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

Symptoms: Patient received J&J vaccine in April. No detail on the exact date and lot number is available in system. Patient reported developing bilateral ulnar numbness and swelling at night.

Other Meds:

Current Illness:

ID: 1501723
Sex: F
Age: 44
State: SC

Vax Date: 03/09/2021
Onset Date: 05/06/2021
Rec V Date: 07/26/2021
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: Sinus tachycardia, and pulmonary hypertension

Other Meds: Seasonique, Wellbutrin 300 mg, Cymbalta 40 mg, HCTZ 50 mg

Current Illness:

ID: 1501724
Sex: F
Age: 43
State: FL

Vax Date: 07/19/2021
Onset Date: 07/21/2021
Rec V Date: 07/26/2021
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: Severe menstruated bleeding and clotting

Other Meds:

Current Illness:

ID: 1501725
Sex: M
Age: 67
State:

Vax Date: 03/17/2021
Onset Date: 04/13/2021
Rec V Date: 07/26/2021
Hospital: Y

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: Was diagnosed with A-fib. Healthcare professional provided patient with blood thinners. Patient was hospitalized for 5 days. Was unable to walk. Has seen 3 cardiologists.

Other Meds: Amlodipine, Coreg

Current Illness: None.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm