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: 1510271
Sex: M
Age: 22
State: ID

Vax Date: 07/26/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
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: The day after the shot, the patient experienced severe headaches, fatigue and nausea. This lasted one day. The 2nd day after the shot patient was feeling better and went to work. While there he had one episode of fainting where he was unconscious just momentarily. Pt slumped and DID NOT hit his head. Followed up with healthcare provider. Provider felt things were good and told pt to return if anything changed.

Other Meds:

Current Illness:

ID: 1510272
Sex: M
Age: 29
State: CA

Vax Date: 01/28/2021
Onset Date: 07/27/2021
Rec V Date: 07/28/2021
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: PCN

Symptom List: Anxiety, Dyspnoea

Symptoms: Covid + even though 2 doses vaccinated. One dose missing in the record. Advise to up to date at injection clinic with vaccine record

Other Meds: None

Current Illness: HIV pos

ID: 1510436
Sex: F
Age: 72
State: TN

Vax Date: 07/02/2021
Onset Date: 07/09/2021
Rec V Date: 07/28/2021
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: fragrancem cleaning products, anesthesia, tizanidine, flushot, smallpox vaccine penicillin

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

Symptoms: patient called stating she had covid arm. bright red band around arm starting 1 week after vaccination and went away in a few days.

Other Meds: synthroid 25 mcg pravastatin 10 mg valium 10 mg doxycyline hyclate 100 mg metoprolol tartrate 25 mg

Current Illness: none

ID: 1510438
Sex: F
Age: 30
State: FL

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/28/2021
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: Swollen painful arm, Headache, fever, body aches

Other Meds: None

Current Illness: None

ID: 1510439
Sex: F
Age: 59
State: TX

Vax Date: 07/26/2021
Onset Date: 07/27/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Patient reported her leg giving out causing her to fall on the day following her Covid-19 vaccination. She reported one leg giving out around 4pm, and then both legs giving out a few hours later causing her to sprain her ankle. She said there was no warning leading up to the event and that she experienced no other symptoms or adverse effects. She mentioned that doctors diagnosed these events as TIAs. Due to the proximity of these occurrences to her vaccination, she felt that it should be reported. Since then, she has had no other problems.

Other Meds: unknown

Current Illness: None reported

ID: 1510440
Sex: F
Age: 54
State:

Vax Date: 03/23/2021
Onset Date: 04/23/2021
Rec V Date: 07/28/2021
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: Headache - constant started 1 month after the vaccine

Other Meds:

Current Illness:

ID: 1510441
Sex: M
Age: 58
State: WA

Vax Date: 06/14/2021
Onset Date: 07/06/2021
Rec V Date: 07/28/2021
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: penicillin- flushing mild to moderate

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt. was administered his 2nd dose of Moderna at 22 days instead of the 28 days CDC was contacted and they did say the pt shall be okay and that he does not need to repeat the series

Other Meds: ascorbate calcium (vitamin C) 500 mg tablet prescribed on 06-15-2021, take 1 tablet by mouth daily; atorvastatin 80 mg tablet prescribed on 03-03-2021, Take 1 tablet every day by oral route for 30 days; baclofen 20 mg tablet prescribed on 0

Current Illness:

ID: 1510442
Sex: F
Age: 24
State: CA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Pharyngeal swelling

Symptoms: Pt. received her first dose of COVID - 19 vaccine Pfizer 0.3 ml IM on her Lt. deltoid at 08:39 am on 07/28/21.Pt c/o Lt upper arm tingling at 8:41 am. Nurse did massage on her Lt. arm site area. Then pt. c/o dizziness at 8:42 am. Pt looked pale & conscious. Nurses assisted pt. lay on the examination bed. BP:97/57,P:47,SPO2:96%.at 8:47 am. Pt said that she did not eat her breakfast & did exercise for 1.5 hrs. before the vaccination. BP: 101/64, P:56, SPO2:96% at 08:50 am & pt. said that she had no more dizziness & no tingling on her Lt. injection site arm. Pt said that she was fine & other discomfort. Pulse:60 at 8:51 am. BP:101/64, P:56 at 8:58 am. Cont. monitor pt. Pt alert & conscious. BP:101/64, P 54, SPO2:97% at 9:02 am. BP:101/64, P:56, SPO2:97% at 9:12 am. Pt was monitor for 30 min., & left the facility at 9:14 am without distress noted & in stable condition.

Other Meds: None

Current Illness: No

ID: 1510444
Sex: M
Age: 16
State: AZ

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: After my son received his 2nd Dose of the Pfizer on the scheduled date at approx.10:45 am, we went home and were just relaxing and at approx 1:54 pm. My son in a panic yelled for me to come into the bathroom and he showed me his urine and it was bright red with clots (Gross Hematuria). I know the time because as soon as I saw it I took a picture (of which I still have on my phone). I proceeded to access how he was feeling and after he said he felt okay just scared-no pain or anything, I called his Pediatrician whose office instructed me to take him to the ER and that is what I did. He was not rough housing, there was no trauma and again no pain. This has never happened before.

Other Meds: None

Current Illness: Nazel stuffiness approx. two weeks ago

ID: 1510445
Sex: F
Age: 74
State: VA

Vax Date: 05/12/2021
Onset Date: 05/14/2021
Rec V Date: 07/28/2021
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: Hydrochlorothiazide *Diuretics* Losartan Potassium *Antihyertensives* Percocet Demerol/Versed IV

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Severe burning rash with bumps on shot site that included most of the upper arm.. Severe muscle pain. Severe fatigue with low grade fever. The muscle pain lasted for two weeks. The rash lasted longer, about three weeks. The rash faded over time, not all at once.

Other Meds: Amitriptyline HCL (Elavil) Amlodipine Besylate (Norvasc) Azathioprine (Imuran) Estradiol/Vitamin E - Fluticasone Propionate Nasal Spray Rosuvastatin Multivitamin Take on tablet daily Calcium Citrate

Current Illness: Sciatic pain in right leg

ID: 1510447
Sex: M
Age: 57
State: TX

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/28/2021
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: Patient previously received J&J COVID-19 vaccine at a different facility. He then scheduled an appointment online for the Pfizer COVID-19 vaccine with Pharmacy. He did not let the pharmacy know about the previous J&J vaccine and received the first dose. Previous J&J date is unknown to pharmacy. Patient currently has no unusual symptoms at this time.

Other Meds:

Current Illness:

ID: 1510448
Sex: F
Age: 32
State: IN

Vax Date: 06/26/2021
Onset Date: 07/27/2021
Rec V Date: 07/28/2021
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: Fever of 102.9

Other Meds:

Current Illness:

ID: 1510449
Sex: F
Age: 43
State: OH

Vax Date: 01/25/2021
Onset Date: 03/22/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: I started getting joint pain in all of my joints. It got progressively worse. In May, I got into my doctor and also I had a lot of fatigue. My hips and my hands is where it's the worse but includes elbows, shoulders and sometimes the knees. June 12 - Rheumatoid specialist - put me on a prednisone taper to see if my symptoms would be resolved - 2 weeks. I responded to that. Currently, I take Motrin as needed for pain but it doesn't help that much.

Other Meds: Celexa 20 mg daily

Current Illness: no

ID: 1510450
Sex: M
Age: 72
State: MN

Vax Date: 04/14/2021
Onset Date: 06/01/2021
Rec V Date: 07/28/2021
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: salmon

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

Symptoms: new onset granulomatous polyangiitis with Acute renal failure, + CANCA, + proteinase 3, sinus disease, nasal ulcers, but bland UA

Other Meds: BP meds, meds for DM, meds for COPD

Current Illness: none

ID: 1510451
Sex: F
Age: 62
State: NY

Vax Date: 03/13/2021
Onset Date: 04/01/2021
Rec V Date: 07/28/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: About 2 weeks after my second Moderna shot I began experiencing extreme random joint pain. The pain began in my hands and comes on suddenly and lasts for about 1 day. There is no swelling and is not warm to the touch. It comes and goes and began affecting also in my elbows. There is sometimes muscle pain in my upper arm. The pain eventually began showing up in my hands and knees. The pain quickly comes on very strong and usually goes away by the next day. It is very unusual. I couldn't take the pains any longer so by June 11, 2021 I visited my Primary Dr. She prescribed Prednisone for 5 days. I was pain free for one week. The pain episodes came back same as in the past. It affects random areas I mentioned. Dr. recommended I see a Rheumatologist. It took some time to get an appointment but, I have one for Aug. 2, 2021.

Other Meds: Baby aspirin, calcium, magnesium, vitamin c, Fish Oil, Probiotic, Multi mineral,

Current Illness: none

ID: 1510452
Sex: F
Age: 64
State: WA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 07/28/2021
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: Patient received 2nd dose Moderna COVID-19 vaccine on 07/26/2021. During the billing process, insurance reported patient received 1st dose Pfizer COVID-19 vaccine. WAIIS was checked and pharmacy was contacted to confirm 1st dose Pfizer vaccination. Her vaccination card portrayed 1st dose Moderna COVID-19 vaccine. Patient received 1st dose Pfizer from Pharmacy in on 06/10/2021 per RPh (confirmed 7/28/21 via phone) and image of consent form (via fax same day). Patient was contacted and counseled to watch for any unusual symptoms and answered any other concerns patient had.

Other Meds:

Current Illness:

ID: 1510453
Sex: M
Age: 82
State: FL

Vax Date: 03/19/2021
Onset Date: 04/19/2021
Rec V Date: 07/28/2021
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: Nil

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

Symptoms: Patient is a surgeon, developed pain and swelling right palm and 5th finger with swelling, gradual development of pain and decreased ROM right shoulder and neck. He believes this is a manifestation of post vaccination arthropathy with tenosynovitis as reported.

Other Meds: Atenolol, Cialis, Hyzaar, Vytorin

Current Illness: Nil acute

ID: 1510454
Sex: M
Age: 44
State: IL

Vax Date: 07/01/2021
Onset Date: 07/24/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: Had hives 3 times over a 20 year span but don't know from what.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 21 hours after; hives all over left side chest, waist, ankles, inner thighs. Although after a Benadryl it subsided, it did come back several days again. Otherwise 24 hours after the shot exprienced, slight fever, chills, muscle aches, headache, head sinus pressure, joint pain, diarrhea and nausea. Also several days later arm still hurts. 3 days after had shooting pain in injection arm, leaving me to not use my left arm. 4th day much better.

Other Meds:

Current Illness:

ID: 1510455
Sex: F
Age: 51
State: AR

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: facial swelling, mostly eye lids. Noticed it later that evening.

Other Meds: Oxycodone S/325 Gabapentin 800mg. Baclofen 10mg

Current Illness:

ID: 1510456
Sex: F
Age: 31
State: TX

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: Codeine.

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

Symptoms: Fast heartbeat, shortness of breath, dizziness.

Other Meds: No.

Current Illness: No

ID: 1510457
Sex: M
Age: 37
State: VA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
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: NONE

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

Symptoms: Patient has needle phobia, but he did not disclosed it at the time of the vaccine. 5 mins after I gave him the shot, other customers shouted that someone is fainting. He had a normal pulse, but upon checking, his blood pressure was low. EMT came to the scene, but the patient denied to be transported to the hospital. He is doing fine and he was able to go home without support.

Other Meds: NOT AWARE

Current Illness: NONE

ID: 1510458
Sex: F
Age: 46
State: VA

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: Zofran, percocet, sulfa drugs, ultram

Symptom List: Unevaluable event

Symptoms: Heart palpitations, shortness of breath, body aches. 2 days after last dose of vaccine Still have occasional heart palpitations if I walk to long.

Other Meds: None

Current Illness: No

ID: 1510459
Sex: F
Age: 16
State: MN

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
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: Patient became dizzy, cold and clammy, Starring and not responsive for 1 minute. Jaw was clamped down but upon asking the patient then spoke 2 minutes into episode. Vitals were stable. Rapid response was called. Patient was observed, given fluids and sent home.

Other Meds: None

Current Illness: None

ID: 1510461
Sex: F
Age: 45
State: WA

Vax Date: 03/04/2021
Onset Date: 05/13/2021
Rec V Date: 07/28/2021
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: methotrexate intolerance

Symptom List: Injection site pain, Pain

Symptoms: Patient was hospitalized on 5/13/21 with severe COVID about 6 weeks following her 2nd COVID vaccine dose. While hospitalized, patient was started on Remdesivir x 5 days in addition to dexamethasone. Her respiratory status continued to decline so was started on high flow O2 approximately on day 6 which continued x 2 days. Steroids were continued but patient could not maintain O2 sats with any activity. Approximately on day 13, the attending physician performed another CT and diagnosed bacterial pneumonia so started on IV antibiotics. Patient also received Lovenox bid for VTE prevention. Dose is unknown. Tessalon Perles were used PRN for cough. Patient was discharged on 5/28/21 on oral antibiotics. At home, O2 sats continued to drop into the 80's during any activity so patient reported to Urgent Care. Approximately 1 week later, after continued SOB, another visit to PCP on 6/9 prompted home oxygen to be ordered and delivered on 6/15.

Other Meds: Lisinopril 20/HCTZ 25 daily Celebrex 200 mg bid Omeprazole 20 mg daily Hydroxychloroquine 200 mg bid Atenolol 50 mg daily Leflunomide 50 mg daily Vitamin D 5000 IU daily Orencia 125 mg SubQ weekly -- last dose was 5/9/2021

Current Illness:

ID: 1510462
Sex: F
Age: 56
State: VA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 07/28/2021
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: pt called two days after vaccine to inform me (pharmacist) that she experienced hives on her face, ears, and back. started one hour after vaccine injection. she called her doctor's office and was advised to take Benadryl. she reports that her symptoms are much improved from initial reaction but is still needing to take Benadryl. she states she will be monitored by her PCP.

Other Meds:

Current Illness:

ID: 1510463
Sex: F
Age: 59
State: TX

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 07/28/2021
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: Environmental allergies. Eggs if eaten on multiple days; dairy if eaten on multiple days.

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

Symptoms: I woke up fine with a slight headache. Within 30 minutes, the nausea and dizziness set in. I went to lay down and then experienced abdominal pain, dry heaving and vomiting. I took Tylenol, Gatorade, ondansetron for nausea.

Other Meds: D3, Emergen-C, One-A-Day multi-chews, Montelukast, Xyzal

Current Illness: None

ID: 1510464
Sex: F
Age: 23
State: NC

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 07/28/2021
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: Sulfa

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Upon waking at 0600 on 5/21/21 - experiencing dizziness, weakness, lightheadedness, and fainting twice within five minute time span upon waking. Day continued on with dizziness and weakness. Dizziness subsided a few hours later, weakness lasted all day. Treatment - resting, fluids, and limited time standing. Outcome - weakness and times of lightheadedness occurred for 1-2 weeks after vaccine.

Other Meds: -Taytulla -Fluoxetine -Singulair -Vitamin C -Vitamin D -Vitamin B12

Current Illness: N/A

ID: 1510465
Sex: M
Age: 35
State: OK

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Shortness of breath 15 minutes after giving the vaccine that then went away, then 1 hour later his arm on the injection side swelled up before the elbow and he had numbess and tingling. It went away after taking ibuprofen and benadryl

Other Meds:

Current Illness: Diabetes, smoker

ID: 1510466
Sex: F
Age: 45
State: KS

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: I have not had a menstrual period since I received the 1st dose of the vaccine. I had intense hot flashes for several weeks after receiving the vaccine, that have now subsided. My doctor's office ran blood tests to check my hormone levels and they are now at peri and post menopausal levels (depending on the hormone).

Other Meds: Vitamins: prenatal multivitamin, D3, vitamin C, Fish Oil, Zinc, Turmeric, Zeaxantin/Lutein

Current Illness: None

ID: 1510467
Sex: F
Age: 39
State: IL

Vax Date: 07/01/2021
Onset Date: 07/02/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: Environmental

Symptom List: Nausea

Symptoms: 1st Dose: Experienced warming/flushing sensation throughout my entire face around 8hrs after shot. Had a fever of 101. Took Tylenol. Experienced dizziness and nausea that lasted for about 1-2 hours. The next day, I woke up and felt tired and had a moderate headache along with muscle aches in the upper back. 2nd Dose: Developed terrible stomach ache around the 6hr mark after the shot. Felt relatively ok until about a few hours later?really tired. Woke up feeling head pressure, body aches and nausea. Symptoms lasted on and off for the next 24-36hrs. It is going on 6 days of being late menstruating when I am always regular. Neck pain, arm soreness, feeling foggy. Winded with minimal exercise.

Other Meds: Zyrtec, Zoloft, probiotics

Current Illness:

ID: 1510468
Sex: F
Age: 31
State: CA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Labored breathing, confusion/brain fog, disorientation and loss of focus, fever, extreme body chills, cold sweats, generalized aches and pains, severe malaise. Was not able to drive anywhere to seek medical evaluation. Did not yet feel threatened enough to call for ambulance but was scared about the breathing and mentation changes. The first dose of the Moderna lot 011D21A caused hematemesis which I self treated with omeprezole for 3 days. The other symptoms from the first dose were all common side effects. The second dose was much more severe.

Other Meds: Ritual multivitamin and Alaya collagen

Current Illness: None

ID: 1510469
Sex: F
Age: 58
State: UT

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 07/28/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: The clinician injected vaccine into my bursa. Dizziness heart racing, Pain swelling. Unable to use left arm still. Had Mri that confirmed. Had a cortisone shot, no change. Unable to sleep without it waking me up every time I move. Can?t use my arm for anything. Severe pain!!

Other Meds:

Current Illness:

ID: 1510470
Sex: F
Age: 41
State: MN

Vax Date: 05/19/2021
Onset Date: 06/08/2021
Rec V Date: 07/28/2021
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: Penicillin

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

Symptoms: I've had chicken pox like blisters arise on my right arm, left leg and stomach area near belly button. These have not gone away and it's been 2 months. New ones come but they are starting to calm down a slight bit. These pox blisters leave deep wounds when popped and are very itchy. The ones that are now gone have left scars that are hopefully temporary.

Other Meds: Suboxone, Adderall

Current Illness: None

ID: 1510472
Sex: F
Age: 28
State: OH

Vax Date: 07/26/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
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: Two days after receiving vaccine, patient started to develop cold symptoms and swelling in her face that got progressively worse throughout the day.

Other Meds: None

Current Illness: None

ID: 1510473
Sex: F
Age: 12
State: CA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
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: Amoxapine

Symptom List: Erythema, Pruritus

Symptoms: Registered nurse withdrew a pre-filled Pfizer Covid-19 syringe from the refrigerator and administered the vaccine to the patient. Nurse administered 0.3 ml in the right deltoid. Nurse realized after administering that she gave an expired dose. The vaccine was drawn on 7/27/21 @4:42pm. The vaccine was good to be used until 7/27/21 @10:42pm. The nurse administered the vaccine on 7/28/21 @9:49am. Patient was observed for 15 minutes - no adverse reactions noted during observation. The nurse stated she did not look at the label to verify the vaccine was good to use.

Other Meds:

Current Illness:

ID: 1510474
Sex: F
Age: 57
State: WA

Vax Date: 07/19/2021
Onset Date: 07/23/2021
Rec V Date: 07/28/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: N/A

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

Symptoms: Severe chest pains

Other Meds: Lisinopril 25mg Multi-vitamin Biotin

Current Illness: N/A

ID: 1510475
Sex: U
Age:
State: VA

Vax Date:
Onset Date:
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: arm pain, head ache, nasua

Other Meds:

Current Illness:

ID: 1510476
Sex: F
Age: 15
State: OH

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Within 5 minutes of receiving vaccination, the patient began to feel like she was dreaming and passed out while she was seated. We moved the patient to the floor where she regained consciousness . The patient had further complaints of numbness in the arms, light- headedness and was nauseated and vomited. 911 was called and responded, and the patient said she was ok and did not want to go to hospital.

Other Meds: None

Current Illness: None

ID: 1510477
Sex: F
Age: 32
State: CA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: Had generalized tonic-clonic convulsions. CT scan of the head revealed a subarachnoid hemorrhage in the L cerebral hemisphere.

Other Meds: Unknown

Current Illness: IBS, bipolar disorder

ID: 1510478
Sex: F
Age: 49
State: CA

Vax Date: 05/01/2021
Onset Date: 05/07/2021
Rec V Date: 07/28/2021
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: Penicillin

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

Symptoms: Lymph nodes swollen and sore, extreme fatigue now lasting 12 weeks and counting. I have tried vit C IVs and am still suffering extreme fatigue

Other Meds: Metformin, Spirolactain, estrodial, progesterone, testosterone, Arbour thyroid

Current Illness: None

ID: 1510479
Sex: M
Age: 69
State: NY

Vax Date: 01/19/2021
Onset Date: 07/03/2021
Rec V Date: 07/28/2021
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: 6+ months later I developed bloating, sensation that food was not passing through my GI tract at normal speed. No vomiting or signs of obstruction, no pain or tenderness.

Other Meds: Amlodipine/valsartan allopurinol rosuvastatin vitamin D

Current Illness: None

ID: 1510480
Sex: F
Age: 30
State: PA

Vax Date: 06/02/2021
Onset Date: 07/03/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: After the first shot it took me about a week to recover from it. After the second shot Ive been experiencing extreme exhaustion and much more sleep than im used to sometimes as much as 12-14hrs, muscle aches and soreness regularly, regular headaches and some nausea. Its been about a month since ive had my second shot and it seems to be getting worse with the exhaustion and headaches.

Other Meds: 30mg capsule amphetamine salts ER 50mg tablet spironolactone 2mg estradiol (3x daily)

Current Illness: None

ID: 1510481
Sex: F
Age: 37
State: WA

Vax Date: 07/20/2021
Onset Date: 07/23/2021
Rec V Date: 07/28/2021
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: Vicodin Latex

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

Symptoms: About 2 days after injection, localized pain at injection site About 3 days pain increased and spread to left shoulder After the 4th day there was major pain in my left shoulder joint, left shoulder muscles, left shoulder blade, left side of my neck, base of the head and pain radiated down my arm - into my left elbow and hand. It was constant throbbing pain all day and night with our without movement. About a pain level of 6 to 7 and I have a high pain tolerance. On July 27th and 28th I took two 500 tabs of acetaminophen two times each day for pain. It did not eliminate the pain, only reducing it to tolerable level of 4 with restricted movements and extremely reduced activities. I cannot perform regular activities at this time. Prescription by Dr. Prednisone 20 MG one per day for five days Cetirizne hcl 10 MG one per day if needed These are to help reduce swelling and inflammation of the left arm, shoulder, neck and back I am still in discomfort after 2 days on the prescribed medication and acetaminophen. I still wake up and have difficulty using my left arm/ side to us full capacity.

Other Meds: Levothyroxine 125 mcg 1x per day 45 before eating Cephalexin 500mg 4x per day with food Hydrocortisone 1-2.5% on hand, ears, knee and face 1x per day as needed.

Current Illness: Cat bite infection left toe

ID: 1510482
Sex: F
Age: 56
State: SD

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 07/28/2021
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: Prostaglandin reaction after the birth of a child required epinephrine IV.

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

Symptoms: Severe tinnitus. I have never had this before and stopped the Ibuprofen and all NSAIDS but the tinnitus has continued all the time ever since.

Other Meds: Synthroid, HRT, multivitamin, Glucosamine and Chondroitin, Ibuprofen as needed

Current Illness: Back pain from a disc at L5-S1

ID: 1510484
Sex: M
Age: 52
State: FL

Vax Date: 07/21/2021
Onset Date: 07/22/2021
Rec V Date: 07/28/2021
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

Symptom List: Vomiting

Symptoms: Pain at injection site, chills, body aches

Other Meds: Hctz Lisinopril Atenolol Novolog Metformin Temazepam Oxycodone Roboxin Lexipro Gabapentin

Current Illness: Diabetes II Critical illness neuropathy Lumbar and neck pain Cluster headaches Diabetic neuropathy

ID: 1510485
Sex: F
Age: 31
State: GA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/28/2021
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: LATEX

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: ADMINISTERED FIRST DOSE MODERNA VACCINE: APPROX 10 MINUTES POST VACCINATION PATIENT STATED SHE WAS EXPERIENCING LIGHTHEADED, DIZZINESS. I HAD PATIENT LIE DOWN W/ FEET ELEVATED AND PLACED ICE PACK ON BACK OF NECK. SYMPTOMS IMPROVED OVER 10 MINUTES. PATIENT WAS ABLE TO SIT WITHOUT RETURN OF SYMPTOMS. PATIENT KEPT ICE PACK ON BACK OF NECK FOR ADDITIONAL 15 MINUTES. PATIENT REMAINED AT PHARMACY FOR 30 MINUTES SYMPTOM FREE

Other Meds: NOT STATED

Current Illness: NONE STATED

ID: 1510486
Sex: F
Age: 41
State: NY

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/28/2021
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: pollen, some fruits if they are not organic I may feel itchy throat

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

Symptoms: Immediately after injection I felt a very slight dizziness. But in about 4-5 mins I felt that I'm passing out. I was still able to stand up and make a few steps to call for help. A pharmacist helped me to get back to my seat, because i could not stand and move and I didn't hear people around me. The pharmacist gave me three bottles of water and a bottle of juice. After the second bottle of water I felt better.

Other Meds: none

Current Illness: none

ID: 1510487
Sex: F
Age: 47
State: CO

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 07/28/2021
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: Soy Several Medications

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Within a couple of minutes of the first dose I started to have shortness of breath, wheezing and tightness in my chest. The day after I started to get PVC Tachycardia and Bradycardia. It was similar to the symptoms I had with Covid-19. I also haad severe fatigue bone pain, muscle pain nausea headaches. Fevers, night sweats but no cough. I had Covid-19 in March 2020 and I required a lot of medical treatment. I was on bed rest for 90 days and required Physical Therapy and Occupational Therapy. I have also had Dura Swelling reoccur since the vaccine. Before the vaccine my heart problems were controlled and most symptoms had resolved by December of 2020. All of these Covid-19 like symptoms persisted for two weeks after the vaccine. I was given a course of Prednisone and that helped most symptoms. My heart medications have needed to be greatly increased since the vaccine. My Heart Function has also decreased. I did not have any symptoms after the second dose of the vaccine and it seemed to actually improve all my symptoms except for my heart and brain injuries.

Other Meds: metoprolol Cosentix Tramadol PRN

Current Illness:

ID: 1510488
Sex: F
Age: 38
State: HI

Vax Date: 04/02/2021
Onset Date: 07/27/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Immunized on 4/2/21 and 4/23/21. sinus pressure, loss of taste and smell since 7/26/21. Covid test positive on 7/27/21

Other Meds: none

Current Illness: none

ID: 1510489
Sex: F
Age: 13
State: FL

Vax Date: 06/17/2021
Onset Date: 07/01/2021
Rec V Date: 07/28/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Vasculitis of hands. Patient presented redness, pain and itching of hands and palms intermittently starting approximately 4 weeks post-vaccination.

Other Meds: Vyvanse 10mg

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm