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: 1528622
Sex: F
Age: 62
State: MT

Vax Date: 03/10/2021
Onset Date: 07/19/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Symptoms started on 7/19/2021, and tested positive on 7/23/2021. Patient admitted to hospital on 7/26/2021.

Other Meds:

Current Illness:

ID: 1528623
Sex: F
Age: 46
State:

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 08/05/2021
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: I developed numbness and tingling in bilateral arms, hands and face,. Weakness in right arms and hands. Went to emergency room and given steroids. Saw immunologist and informed vaccine immune reaction- nerve damage from vaccine. After 7 months, still having numbness and tingling upper body, hands,, feet.

Other Meds: Multivitamin Vitamin C Vitamin D

Current Illness: None

ID: 1528624
Sex: M
Age: 53
State: MN

Vax Date: 08/02/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
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: Severe, shooting neuropathy pain in feet and up back of legs began within 6 hours of receiving vaccine and lasted for approximately 26 hours. One small area of shingles appeared on the lower left side of back at approximately the 36 hour mark. The neuropathy pain was unlike anything experienced before.

Other Meds: Lyrica 150 mg Nortriptyline 25 mg Pantaprazole 25 mg

Current Illness:

ID: 1528625
Sex: F
Age: 23
State: PA

Vax Date: 05/17/2021
Onset Date: 05/19/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Doxycycline

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 2 days following my second dose of the Moderna vaccine I developed burning pain in my vaginal area. After going to the gynecologist she initially diagnosed me with genital herpes (as that is what it visually looked like). She followed this up with 1 blood test to confirm the herpes virus. The test came back negative, so the virus never existed in my body. I got another blood test after describing these events to my general practitioner, as she thought it was herpes too. That blood test also came back negative. I have had to endure 3 painful weeks of non-sexual/non-herpes genital ulcers, only to be treated with a topical steroid (Clobetasol Propionate Cream 0.05%. The reasoning for this outbreak is still unknown, despite its similarities to the herpes virus. There are a few studies published online of instances of young adolescent girls having acute genital ulcers, but having covid-19. I have never tested positive for covid and do not believe I ever had it .

Other Meds: None

Current Illness: None

ID: 1528626
Sex: F
Age: 79
State: FL

Vax Date: 07/28/2021
Onset Date: 07/29/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: NOT KNOWN

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

Symptoms: PATIENT DEVELOPED CELLULITIS ON THE LEFT FOOT (SAME SIDE AS INJECTION) WITHIN 24 HOURS OF RECEIVING THE VACCINE. PATIENT SAID AREA WAS RED AND HOT TO THE TOUCH. PATIENT REPORTED NO PREVIOUS INJURY OR OTHER MEDICAL ISSUES RELATED. PATIENT REPORTED NO LOCAL INJECTION SITE REACTION OR OTHER ADVERSE EVENTS.

Other Meds: NOT KNOWN

Current Illness: NOT KNOWN, NO INJURY OR OPEN WOUND TO AFFECTED AREA.

ID: 1528627
Sex: M
Age: 53
State:

Vax Date: 03/05/2021
Onset Date: 07/21/2021
Rec V Date: 08/05/2021
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: Patient contracted COVID post-vaccination

Other Meds:

Current Illness:

ID: 1528628
Sex: M
Age: 84
State: MT

Vax Date: 02/02/2021
Onset Date: 07/30/2021
Rec V Date: 08/05/2021
Hospital: Y

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: Unknown LOT number for second dose in vaccine series. Symptom onset of 7/30/2021. Tested positive on 8/3/2021. Patient admitted to hospital on 8/2/2021 and is currently hospitalized.

Other Meds:

Current Illness:

ID: 1528629
Sex: F
Age: 38
State: CT

Vax Date: 06/16/2021
Onset Date: 06/19/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Bactrim, Sulfa drugs

Symptom List: Pharyngeal swelling

Symptoms: I had COVID infection 3/2021 and have recovered except lingering fatigue. About 3 days after the vaccine, I had several severe anxiety attacks with increased heart rate. I was prescribed Xanax to help with my anxiety. At my doctor's visit, I had elevated blood pressure 137/86. I was not prescribed any medications except to keep an eye on it and try to relax. I also had a late menstral cycle. It was 10 days late and normally I am very regular.

Other Meds: Multivitamins

Current Illness: none

ID: 1528630
Sex: F
Age: 81
State:

Vax Date: 03/17/2021
Onset Date: 04/17/2021
Rec V Date: 08/05/2021
Hospital: Y

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: Patient presented to the ED and was subsequently hospitalized for rapid atrial fibrillation on 4/17/2021. Patient hospitalized for intermittent atrial fibrillation on 4/21/2021. These visits are within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1528631
Sex: F
Age: 60
State: TX

Vax Date: 04/07/2021
Onset Date: 05/19/2021
Rec V Date: 08/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 5/19/21 woke up to severe neck ache left side, then pustules developed on left arm. Started treatment w/antiviral and gabapentin on 5/24/21. Now 8/5/21 still have PHN with most pain at injection site.

Other Meds: Ambien 5mg, Adderall 10mg, advil 200mg

Current Illness: no illnesses

ID: 1528632
Sex: F
Age: 66
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: None reported

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

Symptoms: Vaccine participant received Moderna dose 2 fewer than 24 days after the first dose. Moderna dose received on 03/27/2021

Other Meds: None reported

Current Illness: None reported

ID: 1528633
Sex: M
Age: 71
State: FL

Vax Date: 01/19/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Similar left arm pain in left are as which I experienced after first injection. Very uncomfortable for 4 days.

Other Meds: Allopurinol Crestor Carvedilol Lisinopril

Current Illness: None

ID: 1528634
Sex: F
Age: 71
State: MN

Vax Date: 02/25/2021
Onset Date: 07/23/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies: Diphenhydramine, Pseudoeph-dm-gg-acetaminophen

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

Symptoms: hospitalized at her local hospital 7/26/2021, transferred to hospital on 8/1/2021, currently hospitalized

Other Meds:

Current Illness:

ID: 1528635
Sex: M
Age: 35
State: GA

Vax Date: 07/26/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
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: N/A

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

Symptoms: Shingles appeared on my left abdominal area(got shot in my left arm) roughly a week after vaccination.

Other Meds: N/A

Current Illness: N/A

ID: 1528636
Sex: F
Age: 28
State: AR

Vax Date: 07/02/2021
Onset Date: 07/03/2021
Rec V Date: 08/05/2021
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: abilify,prozac, antibiotic

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

Symptoms: Pfizer COIVD 19 EUA- Pt was vaccinated @ 0957 7/2/21 at 1 am next morning pt woke up with widespread itching and rash all over body, feet swelled, fever 103. Pt called the pharmacy was told to call which was closed Saturday. Pt took Tylenol, ibuprofen & benadryl. Monday she was feeling better so she did not call . Fever broke on 7/6/21 and rash went away on 7/8/21

Other Meds: klonipin

Current Illness: none

ID: 1528637
Sex: F
Age: 52
State:

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 08/05/2021
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 presented to doctor's office and reported: "Started with left upper arm pain, erythema, and swelling. The next day she had a fever. Two days later, the erythema resolved but the shoulder began to throb with a sharp stabbing pains when she would move her arm. Now having significant neck muscle tenderness. The pain is now making her nauseous because it is down to her fingers. She has not been able to use that arm due to the pain. She has been icing it on and off, which does help to reduce the swelling. Denies any current fever. Reports pain 5/10." She called clinic again on 6/10/2021, note states: "She states she was told to call back if symptoms did not go away, and she is still experiencing 6-10/10 throbbing/aching/sharp pains from shoulder to wrist on left side. States the swelling and redness have gone down and the Flexeril/Tylenol/Ibuprofen help some, but the pain is still excruciating. Ultrasound on 6/17/21 should no evidence of blood clot. She declines appointment." She was treated for left shoulder impingement syndrome on 7/22/2021 .

Other Meds:

Current Illness:

ID: 1528638
Sex: F
Age: 64
State: IL

Vax Date: 04/14/2021
Onset Date: 04/21/2021
Rec V Date: 08/05/2021
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: None

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

Symptoms: The lot number for the first dose of vaccine taken on 03/17/2021 is: 044A21A. And the lot number for the second dose of vaccine taken on 04/14/2021 is: 036B21A. About a week after the second dose, my skin on clavicle started changing and getting harder and there are two sections the size of a little finger, also it is on my back and neck and right arm and below the panty line. the hard skin feels like a callus. It is mainly on my torso.

Other Meds: Yes

Current Illness: None

ID: 1528639
Sex: F
Age: 69
State:

Vax Date: 03/11/2021
Onset Date: 04/23/2021
Rec V Date: 08/05/2021
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: Following second dose on 4/8, developed low grade fevers and fatigue around 4/23/21. Labs showed elevated LFTs, anemia and thrombocytopenia. Bone marrow biopsy on 6/30/21 showed acute myelomonocytic leukemia.

Other Meds: blood pressure and high cholesterol medication

Current Illness:

ID: 1528640
Sex: F
Age: 35
State: MN

Vax Date: 08/04/2021
Onset Date: 08/05/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Patient stated she had a formaldehyde allergy and cherries

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient stated she had a formaldehyde allergy, after thorough review of ingredients and discussing risk with pharmacist patient decided to get the vaccine. She was observed for 30 minutes after vaccination. At 15 to 20 minutes after vaccine patient started to experience hives, 50 mg of oral benadryl was given. The patient was offered IM Benadryl and an Epipen, she declined both.

Other Meds:

Current Illness:

ID: 1528641
Sex: F
Age: 21
State: IN

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: My temp was up to 102.9 blood pressure spiked to 140/110 pulse was 160 and respiration?s were in the 40s. I had body aches like no other diarrhea and a headache that was excruciating.

Other Meds:

Current Illness:

ID: 1528642
Sex: F
Age: 46
State: OK

Vax Date: 07/30/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
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: N/A

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

Symptoms: Pt. states that after receiving the 1st dose Phizer 07/30/2021 (Noted 07/30/2021 MMR 1st dose received), started experiencing symptoms 08/01/2021 of pain throughout the right leg and shortness of breath. 08/02/2021 Primary visit and was determined to have a blood clot located in the PVT calf. Prescribed a blood thinner. (Previous history of DVT 13yrs). Recommendation to continue prescription with follow up to ER if continue or shortness of breath.

Other Meds: Adivan

Current Illness: N/A

ID: 1528643
Sex: M
Age: 72
State: NY

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 08/05/2021
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 known

Symptom List: Unevaluable event

Symptoms: 17 hrs. after shot - racing pulse; diarrhea; tingling pain in feet, ankles, shins, knees. 24 hrs after shot - same as above plus long spiking pains that came ands went in various parts of body, feeling of being on 4 cups of coffee - like a powerful reaction was going on in my body; one more episode of diarrhea and then it stopped. 4 days after shot - did not feel well late afternoon; 11 pm presented with insomnia, worst nausea ever had (no vomiting), extremely painful feet, fatigue, muscle weakness, slight chiils, long pains in my colon that would come and go. Most symptoms gradually got better over the next two months. Racing heartbeat gradually slowed down over two weeks. Nausea, intestinal distress, lack of appetite, sick feeling have not resolved. I have not felt good since taking the first Moderna shot. Upon advice of my doctor I did not get a second Moderna shot. Now because of the COVID Delta variant, I need a second shot of Pfizer or J&J. Can you offer any advice as to which one I should get? slight headache, general systemic sick feeling, no appetite

Other Meds: Pepsid 20 mg @ bedtime, Mirtazapine 1 mg (tapering off)

Current Illness: None

ID: 1528645
Sex: M
Age: 52
State: IA

Vax Date: 03/02/2021
Onset Date: 07/09/2021
Rec V Date: 08/05/2021
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: Penicillin, sulfa

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

Symptoms: probable trigeminal neuralgia. severe pain in left side of face, mainly in lower and upper jaw. intensity comes and goes since the first episode. in first 9 days, beginning July 9, had several episodes of severe pain daily, lasting from 5 min to 2+ hrs. For next 12 days, had no severe pain episodes, but had constant dull pain in same area. Had two more severe pain instances in same area over a 24 hr. period on July 30-31, and since then have had constant but bearable pain in same area.

Other Meds: n/a

Current Illness: n/a

ID: 1528646
Sex: F
Age: 34
State: NE

Vax Date: 04/09/2021
Onset Date: 05/16/2021
Rec V Date: 08/05/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: She was given Moderna vaccine on 4/9/21. She was given Pfizer vaccine on 5/16. Patient unknowingly re-scheduled second vaccine appointment at a different location than 1st vaccine.

Other Meds:

Current Illness:

ID: 1528647
Sex: F
Age: 16
State: AR

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient was inadvertently administered incorrect COVID vaccine. Due to age patient should have received Pfizer COVID vaccine, Janssem vaccine was administered. Attempted to call patient several times 8/2/21 no answer or on voice mail. Called pt. today grandmother answered pt. was home, informed grandmother of incident and she stated patient was doing well and no S&S of adverse reactions.,

Other Meds: none

Current Illness: none

ID: 1528648
Sex: F
Age: 75
State: MN

Vax Date: 04/08/2021
Onset Date: 04/30/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient hospitalized for peripheral vascular disease on 4/30/2021. Patient hospitalized for wound dehiscence, hypotension on 5/7/2021. These visits are within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1528649
Sex: F
Age: 41
State: MD

Vax Date: 04/20/2021
Onset Date: 05/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Irregular sense of smell- most food smells like rotten meat, artificial scents smell sickly sweet (overripe pineapple smell) Abnormal menstruation- menses cycle reduced to 21-22 days. Prior to vaccine, menses were a predictable 27 days.

Other Meds: none

Current Illness: none

ID: 1528650
Sex: F
Age: 71
State: OH

Vax Date: 07/30/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Wheat Dairy

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sore arm, pain on right side of hip and rear end, tingling sensation, started breaking out in Shingles on the right side from top of rear end to the bottom of rear end

Other Meds: Vitamin C Vitamin D Magnesium B-12

Current Illness: None

ID: 1528651
Sex: M
Age: 40
State: IN

Vax Date: 08/04/2021
Onset Date:
Rec V Date: 08/05/2021
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: N/A

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

Symptoms: Patient received Pfzier Vaccination on 4/10/2021 at the health center. Patient came to clinic on 08/04/2021 for his 1st Covid vaccination and had chosen the Moderna vaccine. Patient stated that this will be the 1st Covid shot he had gotten. Looked into database and noticed that patient has received the Pfizer in April 2021. Patient was contacted to inform him that he doesn't need to get another Moderna vaccination.

Other Meds: N/A

Current Illness: N/A

ID: 1528652
Sex: F
Age: 66
State: KY

Vax Date: 03/24/2021
Onset Date: 08/02/2021
Rec V Date: 08/05/2021
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: Nausea

Symptoms: PATIENT IS HAVING CONGESTION, HEADACHE AND COUGH.

Other Meds:

Current Illness:

ID: 1528654
Sex: M
Age: 33
State: WI

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
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: Patient sneezed/coughed and then passed out in chair about 5 minutes after vaccine administration. He slumped over in his chair, I ran over to him and held him up. I shook his shoulders and shouted his name. Patient was shaking, he had his eyes open but was not coherent. After about 20 seconds patient came to and was able to tell me his name, birthday, where he was at, etc. He was very sweaty, dizzy, lightheaded, and shaky. We had called 911 and gotten patient water and a chocolate bar. He improved rather quickly. All checked out well with the paramedics. Patient felt much improved and left about 40 minutes after his shot was administered.

Other Meds:

Current Illness:

ID: 1528655
Sex: M
Age: 74
State: MI

Vax Date: 03/10/2021
Onset Date: 07/29/2021
Rec V Date: 08/05/2021
Hospital: Y

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: Patient was vaccinated with Moderna on 2/10/21 and 3/10/21. Patient was admitted to the hospital, COVID positive, on 7/29/21 for respiratory failure with hypoxemia secondary to COVID 19 pneumonia. Hospitalized for 5 days.

Other Meds:

Current Illness:

ID: 1528656
Sex: M
Age: 56
State: VA

Vax Date: 04/28/2021
Onset Date: 06/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: So I had diarreha for about 3 days.

Other Meds: Yes

Current Illness: No

ID: 1528657
Sex: F
Age: 57
State: TX

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 08/05/2021
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: Shellfish, Vicodan, erythomycin

Symptom List: Tremor

Symptoms: Symptoms: Brief, acute, localized, rolling pain in descending colon beginning upper section just below ribcage on left side of abdomen. Successive days, 7 in total, pain proceeded along descending colon, continuing as brief and localized to a small section at a time, ending in sigmoid colon on day 7. Treatment: None. As pain was intense but brief, I just waited it out. Time Course: 7 days Outcome: As far as I can tell, I am now symptom free with no other adverse effects.

Other Meds: Lipitor 20MG; Prinzide 20/2.5MG

Current Illness: None

ID: 1528658
Sex: F
Age: 49
State: MO

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 08/05/2021
Hospital: Y

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: Pt. reports that symptoms started 2 hours after vaccination (weakness, SOB, headache, leg pain). She stated she had left-sided pain including the left side of her chest that developed last p.m. with shortness of breath. She had the leftsided chest pain that felt like a stabbing and a sharp knife running from the lateral left side through her chest. Shortness of breath. Hospitalized with PE.

Other Meds:

Current Illness:

ID: 1528659
Sex: F
Age: 74
State: MA

Vax Date: 02/13/2021
Onset Date: 02/15/2021
Rec V Date: 08/05/2021
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: Numbness/pain in feet, traveling up legs. Followed by numbness in hands and arms, mostly left side. Numbness in face.

Other Meds: amlodipine, lorazemam, vitamins B12, C, D

Current Illness:

ID: 1528660
Sex: F
Age: 22
State: AR

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
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: Pfizer BioNTech COIVD 19 vaccine EUA- Pt. was given pfizer vaccine that was not properly diluted. Should have been diluted with 1.8 cc diluent was actually diluted with 0.8 by mistake. Pt notified of incident and to watch for reactions, No reactions at time of vaccination or within 15 minutes afterward.

Other Meds: none

Current Illness: none

ID: 1528662
Sex: F
Age: 42
State: MD

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 08/05/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever 102.8 degrees- sustained over 72 hours Chills- 48 hours Body Ache- 48 hours Pain and swelling at injection site

Other Meds: none

Current Illness: none

ID: 1528663
Sex: F
Age: 63
State: FL

Vax Date: 07/30/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
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: codeine, sulfa, vibramycin

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

Symptoms: started out as what looked like someone punched her and then sort of red

Other Meds: progesterone, atorvastatin 40mg

Current Illness: none

ID: 1528664
Sex: M
Age: 43
State: IL

Vax Date: 07/27/2021
Onset Date: 07/28/2021
Rec V Date: 08/05/2021
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: Latex

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

Symptoms: A day after my 2nd vaccine I experienced muscle cramping/pain in neck/shoulder blade area, forearms, calves and hamstring, muscle spams throughout body, palpitations, brain fog, unbalanced, and hypnic jerks. It has been nine days since my 2nd dose and symptoms seem to be worsening.

Other Meds: Amlodipine .5 MG

Current Illness: None

ID: 1528665
Sex: M
Age: 12
State: SC

Vax Date: 07/22/2021
Onset Date: 07/26/2021
Rec V Date: 08/05/2021
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: headache, fatigue, dizziness, nausea. Not explainable by other cause. Tested for COVID and negative. Clinically well appearing with normal VS and exam so elected expectant care, supportive care, monitoring.

Other Meds: None

Current Illness: None

ID: 1528666
Sex: F
Age: 48
State: FL

Vax Date: 07/23/2021
Onset Date: 07/26/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: nkda

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

Symptoms: normal for first 3 days except pain at injection site. Then, gradually feeling drained and numbness and tingling in thighs. Feels as if walking through water. Feeling sluggish and heavy.

Other Meds: multivitamins

Current Illness: GBS, HTN

ID: 1528667
Sex: F
Age: 56
State: TX

Vax Date: 05/15/2021
Onset Date: 05/16/2021
Rec V Date: 08/05/2021
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: Allergic to Norco and flax seed

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

Symptoms: First day after vaccine left arm numb and tingling, severe headache, fluish, fatigue, on 05/17/2021 yearly OB/GYN appointment. Pap smear results were candida but no symptoms of infection. Started amoxicillin 05/24/2021 UTI and Strep B Also in conjunction my primary care diagnosis was acute vaccine allergic reaction. Steroid shot to try and slow vaccine effects Bell?s palsy for two weeks left side of face, conditions worsening. Extreme chest pain leading to pneumonia and then bronchitis. Every 4-5 days intestinal cramping and feels like my bowels are falling out Dizzy spells, fainting, random nausea and occasional vomiting, small rashes that come and go, extreme shortness of breath from the beginning

Other Meds: Multi vitamin, progesterone, nature thyroid

Current Illness: None

ID: 1528668
Sex: F
Age: 41
State: NC

Vax Date: 01/03/2021
Onset Date: 01/06/2021
Rec V Date: 08/05/2021
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: Reglan

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

Symptoms: I actually started to notice an adverse event with the 1st dose (Lot EL0140 IMLA). On 1/6/2021 I notice a knot swelling in my right arm pit. The inflammation traveled like a rope like formation to my elbow. It was red, inflamed and painful to the touch. I contacted my PCP and thought I had a blood clot. I was sent for an ultrasound to check for a DVT on 1/6/2021 and it was negative for a blood clot. I started taking aspirin and a week later, started on an antibiotic Doxycycline. It has improved but not completed resolved. I went ahead and proceeded to get my 2nd dose (EL3246 IM RA). I had no symptoms or adverse event with my 2nd dose.

Other Meds: Fiasp Insulin; Metoprolol; Flonase; Crestor; Gabapentin; Cymbalta; Tirosint; Aspirin; Motrin

Current Illness: None

ID: 1528670
Sex: M
Age: 66
State: FL

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 08/05/2021
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: As a military veteran, I have had a low level form of tinitus since serving during Vietnam era. Since receiving Moderna second injection, following 1-2 weeks, my tinitus has significantly increased from a level 2 to a level 7-8 and has remained at that level to date ( approx 5 months). I have completed a TON of research on line, and have discovered that there are many websites operated by audiology physicians that are reporting possibly thousands of patients are discovering a link between exasperated tinitus or NEW tinitus findings. Ironically however; the CDC or media is not reporting ANY SUCH adverse reaction, as I am suspecting out of fear that vaccine levels will plummet. Im not sure many people are taking the time to report this, but I am, and I am telling everyone I know of this side affect that occurred to me. I got vaccinated not for myself, but for a 95 y/o that lives in my household. She is frail yet healthy. I REGRET getting the vaccine, and would have elected to remain A SHUT IN, rather than listen to a train in my head for the rest of my life. This SUCKS !

Other Meds: hydrochlorothazide 25 mg for BP

Current Illness: none

ID: 1528671
Sex: M
Age: 77
State: TN

Vax Date: 04/03/2021
Onset Date: 04/15/2021
Rec V Date: 08/05/2021
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: Increase in heart beat without physical activity followed by chest paid, not continually but on and off.

Other Meds: Vitamin D, Multi vitamin centrum 55 plus, Turmeric capsule

Current Illness: None

ID: 1528672
Sex: F
Age: 50
State: NM

Vax Date: 01/28/2021
Onset Date: 07/29/2021
Rec V Date: 08/05/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: head congestion, headache, chest cold, lost of taste and smell and had diarrhea x one day

Other Meds: Lisinopril, Metformin, Ferrous Gluconate, Glyburide

Current Illness: None

ID: 1528673
Sex: M
Age: 38
State: ID

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 08/05/2021
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: Erythromycin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Severe headaches, feeling of overall unwell, extreme swelling of lymph nodes in axilla and groin, fever, pain and swelling at the injection site. Ongoing pain at the injection site MONTHS later with intermittent swelling of lymph nodes on the side the injection happened.

Other Meds: NA

Current Illness:

ID: 1528674
Sex: F
Age: 28
State: AR

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
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: Pfizer BioNTech COIVD 19 vaccine EUA- Pt. was given pfizer vaccine that was not properly diluted. Should have been diluted with 1.8 cc diluent was actually diluted with 0.8 by mistake. Pt notified of incident and to watch for reactions, No reactions at time of vaccination or within 15 minutes afterward.

Other Meds: none

Current Illness: none

ID: 1528676
Sex: M
Age: 49
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 08/05/2021
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 reported

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

Symptoms: Moderna, dose 2 administered fewer than 24 days after the first dose. Moderna dose 1, administered on .3/27/2021

Other Meds: None reported

Current Illness: None reported

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm