VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1575259
Sex: F
Age: 46
State: PA

Vax Date: 06/15/2021
Onset Date: 06/29/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: Seen by a nurse practitioner 7/6/21. Referral for EMG testing.

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: My left arm began to ache. Also had numbness /needles running up from shoulder to hand. As if a nerve was affected. These symptoms continue to this day 7 weeks later. Need to take ibuprofen every night to handle the pain.

Other Meds: estrogen cream 0.3mL

Current Illness: none

ID: 1575260
Sex: M
Age: 29
State: FL

Vax Date: 04/13/2021
Onset Date: 04/20/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Xray of chest, EKG and ECHO. Xray showed resent damage to lungs, and ECHO showed shadow on heart, and EKG showed multiple episodes and multiple time frames when happening.

Allergies: none

Symptom List: Anxiety, Dyspnoea

Symptoms: I have experienced dizziness and fatigue, and heart palipatations and blackouts. Difficulty of breathing and loss of strength in limbs and loss of appetite. I get flushed and over heated when the attacks happen. I feel like a burning sensation in my chest along with the dizziness and potential blackouts. I have gone to my primary physician and they tried cefner to no affect, and then sent me to a cardiologist. The attacks can take any where between a minute and longer. Some last thirty minutes and I have experienced several in a twenty four hour period. I am still currently experiencing them.

Other Meds: none

Current Illness: none

ID: 1575261
Sex: F
Age: 34
State: SC

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: Blood pressure at start of reaction 92/53. Blood pressure 15 minutes after start of reaction 128/77.

Allergies:

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

Symptoms: Immediately following administration of vaccine patient reported symptoms of light headedness, nausea and clamminess.

Other Meds:

Current Illness:

ID: 1575262
Sex: F
Age: 29
State: CO

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: NA

Allergies: Benadryl, Morphine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: MY right tonsil swelled for 2 hours and became red, my tongue turned white for a while, became fatigued. very bad vivid dreams. Headache since the injection and it has been 3 days. body aches and pain for 2 days.

Other Meds: Metformin, IVIG, Victoza, Vit D, Prenatal

Current Illness: NA

ID: 1575263
Sex: F
Age: 42
State: CA

Vax Date: 07/13/2021
Onset Date: 07/26/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: none

Allergies: no

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

Symptoms: upset stomach off and on for 3 weeks. upset stomach will feel like knots so it gets uncomfortable. occurs after eating. I was able to rule out foods to see if it was that but it continues.

Other Meds: no

Current Illness: no

ID: 1575264
Sex: F
Age: 26
State: LA

Vax Date: 04/08/2021
Onset Date: 05/09/2021
Rec V Date: 08/16/2021
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: Re-started period after not having it since 2014 b/c of IUD. Avid runner, had to have someone pick me up while on a run because the pain was so bad. Nearly fainted. Period stayed for a few days. Cycled through with a period the next month, too, before not having it again since.

Other Meds: Kyleena IUD

Current Illness:

ID: 1575265
Sex: F
Age: 16
State:

Vax Date: 07/21/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: No Adverse Events. No test or labs done at this time. Patient tolerated well.

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Unauthorized Age Group - No adverse events, just reporting inadvertent deviation.

Other Meds: N/A

Current Illness: N/A

ID: 1575266
Sex: F
Age: 37
State: SC

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: EKGs and labs on 8/12 Cardiologist appointment is 8/18. Allergist appointment is 8/19.

Allergies: NKA

Symptom List: Pharyngeal swelling

Symptoms: 3 hours after I got it, my HR shot up to 178. I was SOB and tight chest and had a lump in my throat and coughing. I was super jittery!! EMS called to take me to the ER. The ER doc said ?I don?t *think* it was anaphylaxis, but an allergic reaction can cause all of your symptoms.? So he?s sending me to an allergist. Since I?ve been home, I keep having episodes of chest pain and SOB and tachycardia mainly upon standing and worse with any kind of exertion- walking, talking, etc. I also now have a referral for a cardiologist. I see both this week.

Other Meds: Prenatal vitamin Zyrtec

Current Illness: No

ID: 1575267
Sex: M
Age: 47
State: MD

Vax Date: 07/13/2021
Onset Date: 07/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: Assessment at Physical Therapy office

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Vertigo, I have done some physical therapy and still I have vertigo.

Other Meds: None

Current Illness: None

ID: 1575268
Sex: F
Age: 15
State:

Vax Date: 07/19/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Unauthorized Age Group - No adverse events, just reporting inadvertent deviation.

Other Meds: N/A

Current Illness: N/A

ID: 1575269
Sex: M
Age: 14
State: NY

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: unknown

Allergies: none

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

Symptoms: Patient described pain in his upper arm and that is arm felt heavy shortly after receiving his first dose of the pfizer covid 19 vaccine being used under an emergency use authorization

Other Meds: unknown

Current Illness: unknown

ID: 1575270
Sex: F
Age: 51
State:

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/16/2021
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: - pain at the site of injection: lasting about a week - headache: tylenol/motrin, lasted approx 36 hrs - cold chills: 18 hours

Other Meds:

Current Illness:

ID: 1575271
Sex: F
Age: 20
State: CA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/16/2021
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: Patient received first dose COVID Pfizer vaccine (LOT#: EW0175). Patient alerted EMT at 2015. Patient stated that she felt dizzy and had a headache. Patient was asked to stay an extra 30 minutes for further observation. Patient agreed. EMT took patients vital signs at 2016. BP: 118/76, HR: 61 O2: 99%. At 2016 patient stated that her dizziness started improving and stated "I feel fine." EMT retook patients vital signs and reassessed patient. BP: 110/71, HR: 65, O2: 98%. Patient stated that her headache was a 1/10 on the pain scale. At 2024 patient stated " I feel better" and she no longer felt dizzy or had a headache. At 2035 EMT retook vital signs and reassessed patient. BP:113/72, HR: 81, O2: 97%. Patient stated "I'm good" and no longer felt dizzy or had a headache. Patient did not want to stay the extra time she had for observation. Patient stated she wanted to leave. Patient was educated by EMT on worsening signs and symptoms of covid vaccine and when to seek EMS and stated that she was leaving AMA. Patient verbalized understanding of education and consented to leaving AMA. Patient walked out of vaccination site at 2038 with a steady gait.

Other Meds:

Current Illness:

ID: 1575272
Sex: F
Age: 46
State: CA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 08/16/2021
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: none

Allergies: codeine

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

Symptoms: Extreme fatigue and brain fog. Extremely tired since the vaccine. Never feel rested even after 8 hours of sleep. Become exhausted and fall asleep most days in the middle of the day. Also have difficulty remembering common words, and am forgetful. This is all new since the vaccine. I thought it was initially just a side effect, but it has not gotten any better 6 months later. I had a routine physical with labs completed in March, and all came back within normal limits.

Other Meds: Multivitamin

Current Illness: none

ID: 1575466
Sex: F
Age: 15
State:

Vax Date: 07/27/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: N/A. Patient tolerated well.

Allergies: NDKA

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

Symptoms: Unauthorized Age Group - No adverse events, just reporting inadvertent deviation.

Other Meds: N/A

Current Illness: N/A

ID: 1575467
Sex: F
Age: 25
State: CT

Vax Date: 05/03/2021
Onset Date: 06/01/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: None

Allergies: gluten, latex, amoxicillin

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

Symptoms: Muscle cramps throughout body

Other Meds: birth control

Current Illness: gluten sensitivity

ID: 1575468
Sex: F
Age: 35
State: GA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: none so far, i will see a doctor if it gets worse

Allergies: no allergies; several food intolerances; hypersensitivity to radiation, alcohol, fragrance

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

Symptoms: Four hours after the vaccine, the arm in which it was injected started to feel very sore (it lasted for about a day and a half). The following day I had a very bad headache and brain fog the entire day. The next day (today) I woke up with a macular rash all over my chest, which is now spreading.

Other Meds: -

Current Illness: -see below

ID: 1575469
Sex: F
Age: 68
State: OR

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

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

Lab Data: CT scan, blood work, urine test, EKG

Allergies: Penicillin, codeine, sulfa, erythromycin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Extreme vertigo on day 10 after vaccination. Had to be transferred to ER for treatment. Ongoing, debilitating vertigo since.

Other Meds: Alprazolam

Current Illness: None

ID: 1575470
Sex: M
Age: 55
State: CA

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: None

Allergies: Sulfa., NSAID & diprivan

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: My chest hurts when I ride my bike. It hurts if I walk around like from one location to another. Not at home.. The first shot I got on May 17th, 2021 I was just fine except for a sore spot from the shot. If was when I got the second shot , I waited for 15 minutes before I got up and left. I then went over to where the bicycle items were and then I seemed fine but after a few minutes I left Walmart and went outside. This is when I felt like I wanted to lay down on the ground. I sat down. After a period of time I felt better. So then got on my bike and rode home. Then for the next 30 hours I felt like sh*t. I did not want to do anything at all. After 24 to 30 hours i started to feel better. However almost w everytime i ride my bike, my chest hurts really bad. I wonder if i am going to have a heart attack. It has stayed the same all along

Other Meds: Omeprezole / for GERD

Current Illness: N/a

ID: 1575471
Sex: M
Age: 57
State: LA

Vax Date: 07/30/2021
Onset Date: 08/09/2021
Rec V Date: 08/16/2021
Hospital: Y

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

Lab Data: CAT SCAN 8/9/2021 MRI 8/9/2021 Blood Work 8/9/2021

Allergies: None

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

Symptoms: Transient Global Amnesia Confused can?t remember stroke like symptoms

Other Meds: Lisonopril, Amlodipine, vitamin c, zinc, glucosamine,aspirin,magnesium,

Current Illness: None

ID: 1575472
Sex: F
Age: 48
State: CA

Vax Date: 04/10/2021
Onset Date: 05/01/2021
Rec V Date: 08/16/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: On 6/21 & 6/22 had nuclear cardiac stress test done. While laying flat having ct scan done, felt pressure.on 6/28, urgent care did ekg and blood work that were normal. Went for cardio Result appt on 6/29 showing front artery not getting 100%, rest of test normal. Ordered angiogram and was awaiting schedule. Angiogram done on 7/1 showed no blockage.

Allergies: PCN, neomycin

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

Symptoms: Beginning of May, started feeling chestpain especially when exercising. Discussed with cardiologist who ordered nuclear stress test. Started feeling heart fluttering like symptoms. On 6/28 went to dentist in afternoon where felt nausea, dizziness, then chestpain and left arm going numb. Went to urgent care to rule out heart attack. On Thursday evening had to call ambulance as had same symptoms of 6/28. They admitted me and did angiogram. Upon release, i asked what other things can cause heart fluttering, dr suggested esophageal spasms, asthma, or thyroid.

Other Meds: Zyrtec and 500 mg Metformin

Current Illness: None

ID: 1575473
Sex: F
Age: 28
State: SC

Vax Date: 03/31/2021
Onset Date: 04/09/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Industrial glues, wall paint, Tide laundry Soap

Symptom List: Unevaluable event

Symptoms: Extreme fatigue, hair loss all starting within a month of getting the vaccine.

Other Meds: Zyrtec & Nasocort

Current Illness: None

ID: 1575474
Sex: M
Age: 42
State: CA

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 08/16/2021
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: Not applicable

Allergies: none

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

Symptoms: Pain and hard to raise past shoulder. Patient has taken tylenol and tried to stretch it and it is still in pain.

Other Meds: none

Current Illness: none

ID: 1575475
Sex: M
Age: 22
State: WA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: Patient felt nauseous at first, so he tried to go to the bathroom, but then felt dizzy and lightheaded. Patient also was pale and had a very sweaty face. When asked he said he was not diabetic. However, he did not eat since 11 o'clock.

Other Meds: none

Current Illness: unknown

ID: 1575476
Sex: F
Age: 61
State: GA

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: n/a

Allergies: nka

Symptom List: Injection site pain, Menorrhagia

Symptoms: I was alerted that patient was fainting and feeling weak after giving Moderna vaccine. I had my store manager call 911 immediately. I kept talking to patient to keep her conscious. Patient breathing was fine, no anaphylactic shock persent. I placed an ice bag behind her head. I took her blood pressure, 90/48 and pulse of 60. Paramedics arrived and took over. Patient got better and refused to go to hospital.

Other Meds: n/a

Current Illness: n/a

ID: 1575477
Sex: M
Age: 16
State: IL

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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:

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

Symptoms: pt got the vaccine. he was standing up waiting for the 15 minute period. he fell down on the floor. his dad put a pillow under his head. he still remained conscious. he asked for a glass of water. then he sat down on a chair for about 10 minutes and felt better. according to dad, patient has a history of passing out while getting vaccinations.

Other Meds:

Current Illness:

ID: 1575478
Sex: F
Age: 40
State: FL

Vax Date: 04/02/2021
Onset Date: 05/12/2021
Rec V Date: 08/16/2021
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: I have all the information if needed. I had blood tests, allergy tests, and an mri.

Allergies: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Parasthesia left side of face. It was debilitating and painful. I had allergy testing and also an mri to rule out other neurological conditions. The outcome was that it was a transient vaccine reaction and should go away. I still feel slight tingling but am almost 100%. It?s been 3 months. I lost 10 pounds and felt very ill.

Other Meds: N/A

Current Illness: N/A

ID: 1575479
Sex: F
Age: 49
State: CA

Vax Date: 01/20/2021
Onset Date: 05/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: DHEA low, estrogen low Ultrasound result-no change in fibroids/cysts

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Not sure if coincidence, but ever since vaccine, my periods have been super erratic, super heavy, unpredictable, super painful, and have been skipping periods. This is very unusual for me, and although it could be age related, I have many other friends who noticed similar issues coinciding with the vaccine. Almost like the vaccine spurned me toward menopause at a faster rate. Again, could be coincidence, but thought it would be useful information if others are reporting it as well.

Other Meds: atorvastatin, baby aspirin

Current Illness: none

ID: 1575480
Sex: F
Age: 32
State: IN

Vax Date: 08/15/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: None

Allergies: None

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

Symptoms: Cold sweats, fever, fatigue, headache, aches, chills, nausea

Other Meds: None

Current Illness: None

ID: 1575481
Sex: F
Age: 83
State: CA

Vax Date: 08/07/2021
Onset Date: 08/13/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: n/a

Allergies: n/a

Symptom List: Nausea

Symptoms: Pt reported swelling around the eye around 6 days after the 2nd covid vaccine was given. Pt stated that she called 911 and was instructed by EMT to use cold compress around the area. Per pt EMT staff confirmed that her breathing, heart, and blood pressure were normal. Pt informed the pharmacy about this event 3 days after the adverse reaction event.

Other Meds: n/a

Current Illness: n/a

ID: 1575482
Sex: M
Age: 17
State: WA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: N/A

Allergies: nkda

Symptom List: Injection site pain

Symptoms: NO ADVERSE EVENT. IT WAS DISCOVERED AFTER VACCINATION THAT PATIENT REPORTED ON CONSENT FORM THAT HE WAS 18 YEARS OF AGE. HE IS ACTUALLY 17 YOA. HE WILL BE 18 IN 2 MONTHS. I HAVE NOTIFIED HIS MOM

Other Meds: n/a

Current Illness: no illnesses

ID: 1575483
Sex: M
Age: 35
State: MT

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: Unkown

Allergies: None

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

Symptoms: Approximately 3-4 minutes after receiving vaccine, the patient lost consciousness and fell face first on floor. The pharmacist on duty (myself) immediately evaluated the patient who was unresponsive and EMS was called. The patient was red/purple in the face, gasping for air and having difficulty breathing, and foaming at the mouth. Epinephrine 0.3mL was administered IM and the patient responded immediately. He was awake and alert until EMS arrive and transported him to the nearest hospital.

Other Meds: Unknown

Current Illness: Unknown

ID: 1575484
Sex: F
Age: 24
State: OK

Vax Date: 04/24/2021
Onset Date: 05/08/2021
Rec V Date: 08/16/2021
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: N/A

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

Symptoms: I have not had a menstrual cycle since receiving the covid-19 shot. I am not pregnant. I have been checked 3+ times by my general doctor for pregnancy.

Other Meds: N/A

Current Illness: N/A

ID: 1575615
Sex: F
Age: 69
State: HI

Vax Date: 03/16/2021
Onset Date: 07/19/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Feeling tired, weak, dizzy and headache. Then on 7/20/21 passed out briefly. 7/22/2021 Hospitalized and Diagnosed with A-Fib and PVC?s. 2 weeks Later diagnosed as Persistant A Fib as it did not stop.

Other Meds:

Current Illness:

ID: 1575616
Sex: F
Age: 48
State: FL

Vax Date: 08/01/2021
Onset Date: 08/02/2021
Rec V Date: 08/16/2021
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: Erythema, Pruritus

Symptoms: Since 8/2/21, been dealing daily with extreme fatigue, lightheadedness, and dizziness. Every night hard time falling asleep and staying sleep, sleep is very scattered and never very long. Most days nausea and stomach pains. Ringing in the ears on some days. Today 8/16/21, new symptoms added: constant chest pain, pain taking a deep breath, and unable to complete a full deep breath. Have not sought medical attention yet, was given the info and link to come here and report my symptoms after completing daily check in today on website

Other Meds: Biotin supplements

Current Illness: None

ID: 1575617
Sex: F
Age: 35
State: IN

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
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: None

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

Symptoms: Around 9pm on August 14, 2021, I started to run a fever and felt a heaviness in my chest. I assumed these were just a sign of the vaccine kicking in. I went to bed to try and sleep it off around 11pm. When I awoke the next morning (August 15th) around 8 am, I saw that my face and lips were swollen and my chest was still heavy feeling. I placed a call to my healthcare provider on their emergency line to let her know what was going on. It was recommend that I take a steroid and Benadryl or antihistamine to alleviate the symptoms. I was told to go to ER if symptoms got worse or to follow up in the office on Monday if it wasn't emergent. I took a dose of Dexamethasone around 9:45am. I then followed that around 11 am with a Zyrtec. I took Benadryl around 10pm on August 15th. By the time I awoke on Monday, August 16th, my symptoms had subsided.

Other Meds: Armour Thyroid Vitamin D Vitamin B12 Vitamin C Glutathione CoQ10 Probiotic Aspirin 81mg Iron L-lysine

Current Illness: None

ID: 1575618
Sex: F
Age: 63
State: IA

Vax Date: 08/07/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: Sulfa

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

Symptoms: On August 15, 2021, the patient noticed a red area of skin around the site of injection. She had no itching or pain. On examination from the pharmacist on August 16th, the area looked slightly inflamed and warm to the touch. The pharmacist traced the red area with a marker so the patient could evaluate whether the area was growing or shrinking. The pharmacist recommended OTC options such as ibuprofen, benadryl cream, or hydrocortisone cream. The patient also had a small bruise right at the site where the needle was inserted.

Other Meds:

Current Illness:

ID: 1575619
Sex: F
Age: 53
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data: unknown what they hospital did for patient at this time.

Allergies: latex allergy, egg sensitivity but no issues with vaccinations in past that contain egg.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: The patient was nervous about getting her COVID-19 vaccination due to autoimmune/Lyme disease health issues. We went over her VAR form, allergies, health conditions, and verified her MD still wanted her to get the covid shot. She came in with her elderly mother. She was given her first dose of Moderna around 7pm. I advised her to stay 15-20 minutes after her vaccination seated to ensure her safety. I noticed she was holding her head in her hand after about 10 minutes. I went out to check on her. She said she felt really tired, weak, had red blotches on her skin, felt heart rate high, back aches or pain. I checked her blood pressure twice and it was 150/101 and 171/101. I called 911 to have her evaluated. She chose to go to the ER via ambulance due to pre-existing health conditions and felt this would be best. I felt so as well. It did seem the EMT and fire department didn't want to take her. I told them about her autoimmune issues and asked if they felt it was wise for her to go get monitored as I know she was very worried about an inflammatory response due to the Lyme/autoimmune disease health conditions.

Other Meds: patient take supplements but did not state which ones, botox injections for cervical dystonia.

Current Illness: none

ID: 1575620
Sex: F
Age: 58
State: IL

Vax Date: 04/15/2021
Onset Date: 05/01/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data: An MRI done on 6/18/21 revealed that the symptoms of neuropathy I experienced were not due to spinal issues. Lab work done on 5/12/21 was normal other than mild vitamin D deficiency.

Allergies: None

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

Symptoms: Two weeks after my second Pfizer COVID-19 vaccine, I began to experience burning in my feet and legs, occasional numbness and tingling in my lower extremities, and frequent muscle twitches, mostly in my legs. My chronic back pain became worse, and I developed pain throughout my body. Walking more than a few blocks became difficult due to the pain. I was seen by my internist and referred to a rheumatologist, Dr. who I saw on 6/25/21. I was diagnosed with fibromyalgia at that time. I started a course of physical therapy. My pain and lower extremity symptoms have gradually been subsiding but are not quite gone. I am not at all sure the symptoms are related to the vaccine, but I am reporting them in case they are helpful in identifying a trend.

Other Meds: Vitamin D, multi vitamin, iron bicglycinate, magnesium glycerinate

Current Illness: Back pain

ID: 1575621
Sex: M
Age: 13
State: NY

Vax Date: 08/01/2021
Onset Date: 08/14/2021
Rec V Date: 08/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Not at all

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

Symptoms: Vascular marks in the legs. It?s seems like trombocitopenia

Other Meds: Ibuprofen

Current Illness: Not

ID: 1575622
Sex: F
Age: 61
State: WI

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data: X-rays completed on 2/25/21 - swelling and inflammation to foot & ankle Labs done on 2/24/21, 3/10/21 and 8/16/21 X-rays completed on 8/16/21

Allergies: None

Symptom List: Pain in extremity

Symptoms: Three days after receiving my second dose of the Moderna vaccine, I experienced extreme inflammation and pain in the joints in my right foot/ leg. Every former joint injury I sustained, some dating back 35-40 years ago, all resurfaced. As a result, I went to Urgent Care for x-rays, my PCP, chiropractic care, and at home physical therapy. Six months later, I am still suffering from the side effects of my second dose of Moderna. After speaking with several peers and medical professionals, I have learned that this is trending throughout much of the medical professional. Today, finally, one MD suggested I report this to your organization.X-rays

Other Meds: Losartan Potassium 50 MG Tabs

Current Illness: None

ID: 1575623
Sex: F
Age: 29
State: KY

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data: None

Allergies: I have had an allergy to a generic medication for an infection

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

Symptoms: I received my second dose of the vaccine and the following day I noticed my arm was red around the injection site. The redness grew a bit and was raised off my skin. It was slightly itchy, painful and I noticed it was warm. I did take the spots tempature out of curiosity and it was 100.7 but has since dropped to 99.7. I also noticed on day 3 that it spread a bit further on my arm.

Other Meds: Nothing

Current Illness: None

ID: 1575624
Sex: F
Age: 25
State: NH

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

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

Lab Data: Have not gone to seek testing yet.

Allergies: Penicillin

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

Symptoms: 12 hours to 3 days post vaccination I did have fever unresponsive to Tylenol and Ibuprofen, body aches, and nausea. Starting 8/17/21 I have been experiencing a heavier menstrual cycle than I've ever experienced with thick quarter sized clots or larger. Currently monitoring.

Other Meds: Sertraline, Norethindrone acetate and ethinyl estradiol

Current Illness: None

ID: 1575625
Sex: M
Age: 38
State: PA

Vax Date: 08/07/2021
Onset Date: 08/15/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data: 8/16: BMP with elevated blood glucose of 118 8/16: CRP elevated at 9.4 8/16: MR Head Rapid Stroke: normal 8/16: CT Heat w/o IV contrast: disconjugate gaze

Allergies: Erythromycin

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

Symptoms: Acute pain in middle of night to left jaw, upper and lower. Followed by parasthesias on left side of face. Visited Hospital ED on 8/16/2021. On prednisone 60mg x5d followed by 50, 40, 30, 20, 10mg taper and acyclovir 1g BID. NSAIDS did not control pain. Left facial weakness. Left facial

Other Meds: Emsam 12mg daily, lamotrigine ER 300mg daily, clonazepam 1mg BID

Current Illness: Generalized anxiety disorder, panic disorder

ID: 1575626
Sex: F
Age: 30
State: CA

Vax Date: 07/28/2021
Onset Date: 08/02/2021
Rec V Date: 08/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None that I know of

Symptom List: Vomiting

Symptoms: I was having chest pain a few days after the vaccine. It went on for days and then one day in the grocery store I started to feel dizzy. I had the chest pain and dizziness for about a week. The chest pain/ pressure is still there but luckily haven't been getting dizzy anymore.

Other Meds: Birth control and acid reducer

Current Illness: None

ID: 1575627
Sex: F
Age: 45
State:

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data: had complete blood panel done, no triggers identified.

Allergies: n/a

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Acute severe hair loss, started after first dose, then intensified after 2nd dose. Lost about ~70% of hair all over scalp during the following 3 months

Other Meds: n/a

Current Illness: n/a

ID: 1575628
Sex: F
Age: 20
State: AZ

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies: Lactose intolerant and gluten intolerant

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

Symptoms: Arm soreness , 103.7 fever , Chills body ache , nausea , muscle pain on legs and feet . Headache , fatigue and persistent rash Still have rashes since administered 2ns shot . I break out on hives constantly . Specially after going tour side in the heat . I get hives at home when I get hot . My hives are raised and painful . I can?t go outside without getting hives . If I drink milk I have hives as well.

Other Meds: Birth control

Current Illness: No

ID: 1575629
Sex: F
Age: 27
State: TX

Vax Date: 06/26/2021
Onset Date: 06/27/2021
Rec V Date: 08/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Heavy headache for three days, fever, intense joint and muscle pain

Other Meds: Acetaminophen

Current Illness:

ID: 1575630
Sex: M
Age: 48
State: TN

Vax Date: 08/11/2021
Onset Date: 08/16/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data: CT head, CBC, CMP, COags

Allergies: unknown

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

Symptoms: Cavernous Sinus thrombosis and hemorrhagic conversion, low platelet

Other Meds: unknown

Current Illness: none

ID: 1575631
Sex: F
Age: 16
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: 16 yr old patient lost consciousness while siting in observation area after received her 2nd dose of pfizer COVID vaccine. She fell from chair to the flood. Her father was siting beside her but did not see which part of her body hit the floor first. Look for injury and no injury was found. Positioned patient supine with legs elevated. VS taken which was stable: P88; resp 18;BP 118/72 and O2 Sat 100%. Patient woke up once laying supine. She states she saw a drop of blood from the vaccination site and she blacked out. Patient feel totally recovered. She was assisted back to her chair. Water and snack offered to her. She was observed for additional 15minutes and then left with her father. Her father was advised to take patient to ER if increased headache, dizziness, or altered mental status with understanding.

Other Meds: no per patient's father

Current Illness: no per patient's father

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am