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: 0921828
Sex: F
Age: 58
State: MS

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
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: Employee reported temp of 101.0, with chills, Head ache, body aches, diarrhea, arm pain & night sweats.

Other Meds:

Current Illness:

ID: 0921829
Sex: M
Age: 81
State: MN

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
Hospital: Y

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

Lab Data:

Allergies: Lisinopril

Symptom List: Anxiety, Dyspnoea

Symptoms: Received COVID-19 Moderna vaccine on 12/28. Developed nausea, vomiting, diarrhea, fever, and hypoxia at facility the day follow vaccine administration (12/29). He was sent to the hospital on 12/29 and admitted for post vaccine fever where he had a chest x-ray that showed infiltrates but WBC count was normal and fever resolved upon admission to hospital. Provider documented "expected reaction to vaccination in a patient with previous COVID exposure". He returned to the facility on 12/30.

Other Meds: Acetaminophen, Aspercreme Lidocaine Liquid 4 %, Biotene Dry Mouth Liquid (Mouthwashes, ,Calcium Antacid Tablet Chewable 500 MG (CalciumCarbonate Antacid) ,Carbidopa-Levodopa Tablet, Coumadin Tablet, Fiber formula, furosemide, gabapentin,Ins

Current Illness: COVID and pneumonia

ID: 0921830
Sex: F
Age: 26
State: PR

Vax Date: 12/15/2020
Onset Date: 12/16/2020
Rec V Date: 01/05/2021
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: no

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

Symptoms: Fever, chills, body aches, headache and abdominal pain. Took second dose yesterday, I was feeling fine and it all came back.

Other Meds: no

Current Illness: no

ID: 0921832
Sex: F
Age: 35
State: SC

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

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

Lab Data:

Allergies: Shellfish, latex

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Feeling of warmth, flushing, pruritic, eyelid swelling

Other Meds: Montelukast 10 mg as needed for allergies Lidocaine topical patch prn

Current Illness: None

ID: 0921833
Sex: F
Age: 54
State: WA

Vax Date: 12/26/2020
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: Grasses, penicillins, septra, sulfas

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

Symptoms: large rash surrounding injection site.

Other Meds: Naproxen OTC

Current Illness: None

ID: 0921834
Sex: F
Age: 23
State: CA

Vax Date: 12/23/2020
Onset Date: 01/01/2021
Rec V Date: 01/05/2021
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: left work early on 1/01/2021, feeling congestion, headache, cough, fever, chills, and body aches, tested for COVID-19 and is Positive

Other Meds:

Current Illness:

ID: 0921835
Sex: F
Age: 50
State: MD

Vax Date: 12/26/2020
Onset Date: 01/02/2021
Rec V Date: 01/05/2021
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: Oral allergies: peaches and cantaloupe. Seasonal allergies. NKDA.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Received COVID moderna vaccine dose number 1 in left arm on 12/26/20. On 1/2/21 developed redness, swelling, warmth, to entire upper arm. 1/4/21 saw PCP for continued redness, swelling, warmth, and pain of entire left upper arm. PCP diagnosis: delayed vaccine reaction. Currently treating w/ ibuprofen, ice, and antihistamines. 1/5/21: Left upper arm improved but remains lightly red and swollen.

Other Meds: Vitamin D3 10.000 units per day. Famotidine 20 mg once a day. Allegra 180 mg once a day. Metformin 1,000 mg once a day Rosuvastatin 5 mg once a day Valsartan 80 mg once a day Bijuva once a day

Current Illness: Chronic urticaria Type 2 diabetes

ID: 0921836
Sex: F
Age: 25
State: CT

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: seasonal

Symptom List: Pharyngeal swelling

Symptoms: Fatigue, chills, nausea, headache. Next morning, felt dizzy. Tried to get up. Sat at table, felt dizzy again, passed out, felt like she was deep sleep, was told she was foaming at the mouth. Felt better afterwards.

Other Meds: Calcium, Multivitamin, Fish Oil, Birth Control

Current Illness: no

ID: 0921837
Sex: F
Age: 62
State: MS

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

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

Lab Data:

Allergies: Vancomycin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache, dizziness, earache

Other Meds: Losartan, synthroid, Armour, norvasc, Xanax, Arimidex, citrucil, zinc, vitamin d, vitamin c,

Current Illness: None

ID: 0921838
Sex: F
Age: 38
State:

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
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: over 50 allergies to food and drugs

Symptom List: Diarrhoea, Nasal congestion

Symptoms: itching and tingling in airway, throat, some shortness of breath

Other Meds: numerous medications

Current Illness: impetigo

ID: 0921839
Sex: F
Age: 23
State:

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever of over 101, chills, body aches. Treated with OTC ibuprofen. Symptoms resolved over the course of 48 hours

Other Meds:

Current Illness:

ID: 0921840
Sex: M
Age: 52
State: NJ

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: NKA

Symptom List: Rash, Urticaria

Symptoms: Patient was injected with only the adjuvant suspension. Once the error was discovered the pharmacist reconstituted the vaccine as it should be and gave patient the vaccine. So, pt received 2 adjuvant....one by itself and the second in the reconstituted vaccine.

Other Meds: Ibuprofen 600mg, Minocycline 100mg

Current Illness: NONE

ID: 0921841
Sex: U
Age: 63
State: CA

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

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

Lab Data:

Allergies: aspirin, betadine, lisinopril, penicillins class, tetracycline

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

Symptoms: 15-30 minutes after the vaccine, patient developed tongue swelling patient was taken to ED and given IV Benadryl 50mg and symptoms resolved

Other Meds: atenolol, atorvastatin, metformin, hydrochlorothiazide

Current Illness: none

ID: 0921842
Sex: M
Age: 26
State:

Vax Date: 12/30/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Shellfish

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

Symptoms: Lips swelled and went numb. Hands swelled and went numb. Rash/redness covering upper body. Hives on arms. Nasal passages clogged

Other Meds:

Current Illness:

ID: 0921843
Sex: F
Age: 58
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: NKDA

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

Symptoms: Patient reports chills, joint and muscle aches, extreme fatigue, nausea, insomnia and a general sense of not feeling well.

Other Meds:

Current Illness:

ID: 0921844
Sex: F
Age: 38
State: WA

Vax Date: 12/24/2020
Onset Date: 01/02/2021
Rec V Date: 01/05/2021
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: Shellfish, PCN

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

Symptoms: HSV2 outbreak - took valcyclovir and acyclovir Hives? Or other rash

Other Meds:

Current Illness:

ID: 0921845
Sex: M
Age: 28
State: KS

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

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

Symptoms: Tightness of chest, elevated heart rate, muscle and joint aches, fatigue, exhaustion, pain at injection site. No treatment sought as of yet.

Other Meds: Adderall XR - 40 mg

Current Illness: None

ID: 0921846
Sex: F
Age: 62
State: NJ

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

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

Lab Data:

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: NAUSEA AND HEADACHE

Other Meds: none

Current Illness: NONE

ID: 0921847
Sex: F
Age: 18
State:

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

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

Lab Data:

Allergies: Omnicef

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Tongue felt ?tingly and weird?. Tongue was not swollen 25mg Benadryl po given. Pt left in private vehicle 98% o2 hr 72 Gait steady and without distress

Other Meds: Maxalt, Zofran, albuterol

Current Illness: Asthma,anxiety, migraine

ID: 0921848
Sex: M
Age: 40
State: AR

Vax Date: 12/22/2020
Onset Date: 12/24/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: COVID vaccine Tuesday. Some soreness at the site that resolved over 2 days. Over the past 24 hours, developed some mild parasthesias [nonspecific]. Aren't painful, but tingling is annoying, contributed to restless night last night. Response 12/26: Acetaminophen, Start B-complex with Fe, report if not already done Chart 12/26: Reported. A bit better this am but will start vitamins Chart 12/29 [excerpt] Still having same symptoms of parasthesias. Started multivitamin as well as acetaminophen. I've noticed it affects only the right side of my body, and that it's purely sensory, no motor changes. Still mild, but not been sleeping well Responded, scheduled appt. ? Vaccinated in L deltoid. Describes R side of body feels 'Cold' [dysesthesia] on R side of body and extremities. No weakness, no change in ROM. No joint swelling. No rash. Sensation feels less on R but still sense of touch. Thinks this is about the same- notices more when lies down in bed than in daytime. Symptoms persist 1/5/2021: Referred to Neurology at his request

Other Meds: None

Current Illness: Myopia, hemorrhoids. Restless legs (undiagnosed)

ID: 0921849
Sex: F
Age: 19
State: CO

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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:

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

Symptoms: Employee had a complaint of a shooting pain 6/10 between her left elbow and her left wrist, with itching between her left elbow and her left wrist. Employee also had a complaint of a numb feeling at the base of her middle and ring fingers on her left hand, 5 1/2 hours after receiving her Hepatitis B vaccine. Vital signs obtained and ice pack applied to left arm at the injection site. Employee states, "I don't need the ice pack after 10 minutes and return to work. Staff notified.

Other Meds:

Current Illness:

ID: 0921850
Sex: F
Age: 25
State: TX

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: NKDA No allergies

Symptom List: Unevaluable event

Symptoms: 1 day after vaccine, redness and swelling occurred at injection site. Fever occurred. Redness and swelling continued x 1week after injection. Itching began on 1/4/21. Redness, swelling and itching continue to remain on 1/5/21.

Other Meds: birth control pills

Current Illness: n/a

ID: 0921851
Sex: F
Age: 18
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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:

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

Symptoms: None stated.

Other Meds: was not age 18 at time of vaccination

Current Illness:

ID: 0921852
Sex: F
Age: 60
State: TN

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: PENICILLIN MORPHINE BENADRYL

Symptom List: Injection site pain, Pain

Symptoms: Still have slight fever Headache Fatigue Chills

Other Meds: ELMIRON CELEXA TYLENOL XANAX BUPROPION HCL XL SELENIUM VIT D2 CALCIUM CITRATE DOXYCYCLINE BUSPIRONE HCL EYE VITAMIN CAPS SYSTANE PROLIA INJ

Current Illness: EYE CHALAZION INTERSTITIAL CYSTITIS

ID: 0921853
Sex: F
Age: 60
State: TX

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: Bee strings

Symptom List: Injection site pain, Menorrhagia

Symptoms: I felt prickly sensation on face. My voice became hoarse after 30 minutes and remained hoarse for about 5 hours.

Other Meds: Nighttime Sleep-Aid containing diphenhydramine

Current Illness: none

ID: 0921854
Sex: F
Age: 18
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: Patient under age 18 at time of vaccine

Other Meds: was not 18 at time of vaccination

Current Illness:

ID: 0921855
Sex: F
Age: 49
State: MT

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
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: red chili pepper, cat dander

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt. observed for 30 minutes after vaccine. About 1hour after leaving area of vaccine observation she began to feel shortness of breath, tightness I throat, and throat felt full. I was informed about 1 hour after these symptoms had begun to develop. I advised to go to emergency room. Taken to ED by co-worker. Spoke with patient 1-5-2021. Returned to work today. Had severe joint pain, especially in left wrist that evening.. Still has achy joints and states she is exhausted.

Other Meds: Insulin, Levothyroxin, gabapentin, Amlodapine, coreg (generic), effexor, Ibuprofen, Benadryl prn, Vitamin D supplement

Current Illness: none

ID: 0921856
Sex: F
Age: 14
State: OR

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

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Syncopal episode that last about 5 seconds

Other Meds: None

Current Illness: None

ID: 0921857
Sex: F
Age: 79
State: MI

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
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:

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

Symptoms: Malaise, Wobbly, T. 99.2

Other Meds:

Current Illness:

ID: 0921858
Sex: F
Age: 66
State: GA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: Bactrim

Symptom List: Nausea

Symptoms: Patient reports dizziness for 24 hours post vaccine and a hot flash, nausea and upset stomach that night

Other Meds:

Current Illness:

ID: 0921859
Sex: F
Age: 52
State:

Vax Date: 11/18/2020
Onset Date: 11/19/2020
Rec V Date: 01/05/2021
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 reports having a fever, runny nose, headache, body aches, and inflamed joints x 1 day following administration of her second dose of Shingrix. Symptoms resolved without intervention.

Other Meds:

Current Illness:

ID: 0921860
Sex: F
Age: 55
State: IL

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: GENERALIZED PAIN, CHILLS, HEADACHE

Other Meds:

Current Illness: NONE

ID: 0921861
Sex: F
Age: 65
State: MI

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
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:

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

Symptoms: T. 102.3

Other Meds:

Current Illness:

ID: 0921862
Sex: M
Age: 45
State: OR

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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:

Symptom List: Tremor

Symptoms: Patient started to have bilateral numbness in hands 15 minutes after vaccine. He was monitored for approx 30 minutes and never developed other symptoms.

Other Meds:

Current Illness:

ID: 0921863
Sex: F
Age: 44
State: RI

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: Keflex, Levaquin

Symptom List: Erythema, Pruritus

Symptoms: Ee entered observation @ 1630. This nurse asked Ee if she was feeling okay around 1645. Stated she felt as if she had a "lump in her throat". Denied any type of SOB or breathing issues. @ 1650, Ee stated she felt an itching, burning, and tingling to her lips and chin. Ee also had mild edema noted to her lips. Also stated that she had onset nasal congestion. Benadryl 25mg given @ 1652. Ee remains @ observation @ present time, 1706. @ 1715 Ee stated that she had mild itching to entire body. Around 1720, stated that the symptoms were easing up. @ 1725, Ee stated that the symptoms were better, but slight itching still remained. Insisted on leaving observation, stated she was okay. Ee left observation @ 1726.

Other Meds: Dexilant, Cymbalta, Singular, Dyazide, Xyzal, Vit C, Zinc, Elderberry, Mag

Current Illness:

ID: 0921864
Sex: F
Age: 29
State: NC

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
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: no known allergies

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

Symptoms: Within 10 minutes following vaccine administration, patient had vomiting, lightheadedness, weakness, and verbalized feelings of being cold along with a very flushed appearance. Skin was slightly moist and very warm to touch. Complained she felt the same as when she was diagnosed with the coronavirus infection in March of 2020. Patient continued to experience ongoing weakness in all extremities, dizziness followed by complaints of some changes in her sense of the light with her eyes closed. Shortly thereafter patient began complaining of her heart "speeding" up. Medic arrived and transported patient to the local emergency room. On 1-2-2021 patient provided additional information including that later on the evening of the adverse event the arm where the injection was given became painful and itchy. Patient stated the pain and itching extended into Friday 1-1-2021 and then on into Saturday, 1-2-2021 she developed a sore throat, and some difficulty swallowing (described it as feeling something "stuck" in her throat) along with hoarseness. The patient also verbalized she remained weak, with a very sore arm and some small blisters which had formed on the same arm as where the injection had been given. A couple of the blisters the patient described where on the thumb of her hand as well her arm.

Other Meds: vitamins Pepcid sertraline acyclovir

Current Illness: none

ID: 0921865
Sex: M
Age: 43
State: PA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: N/a

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

Symptoms: Felt weak, dizzy, blurred vision and nausea Vitals normal except for several episodes of O2 stat 89-90. No wheezing . One dose of Diphenhydramine 25 mg dose. Back to normal in 1 hr.

Other Meds: N/a

Current Illness: None

ID: 0921866
Sex: F
Age: 97
State: MI

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: T. 100.2

Other Meds:

Current Illness:

ID: 0921867
Sex: F
Age: 49
State: KY

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/05/2021
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: None

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

Symptoms: I developed a small knot at the injection site the day after i received it. By the following evening it had grown to the size of a baseball. It was red, warm, indurated and it itched. Though when I attempted to scratch it was very painful. I took Benadryl on the evening January 2nd and have taken cetirizine for the past two days. It has gotten slightly smaller and the itching has improved though not completely resolved.

Other Meds: Lexapro 10mg daily, wellbutrin 150mg daily, pepcid 20mg daily Vitamin C, Vitamin D, Super Vitamin B-complex, Zinc

Current Illness: None

ID: 0921868
Sex: F
Age: 45
State:

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
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: simvastatin

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

Symptoms: dizziness, flushing, chest tightness

Other Meds: lisinopril, escitalopram, atenolol, glyburide, rosuvastatin, metformin, insulin,

Current Illness: none

ID: 0921869
Sex: F
Age: 38
State: CA

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: fever, chills, body aches, nausea, cough, COVID-19 tested on 1/02/2021 and came back Positive

Other Meds:

Current Illness:

ID: 0921870
Sex: F
Age: 46
State: WA

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

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

Lab Data:

Allergies: Unknown

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

Symptoms: Patient is a 46 y.o. female. Chief Complaint Patient presents with ? Allergic reaction ? ? allergic reation to covid vaccine ? ? Patient had a covid vaccine ? Patient works for dermatology and cosmetic. The patient is a CMA Had filler injections on the face. Jaw line and Nasolabial folds on 12/29/2020 Juviderm and Define Resilin . Has had facial fillers for three to four years. No other implants or silicone in other body locations ? No history of sulfa allergy No history of anaphylaxis. ? About 120 after the Moderna vaccination, was in the car still in the parking lot got a flush feeling and got hot chest tightening, heart pounding. Weird taste in the month. Did not feel like she was going to vomit. Then got shaky. Face feels numb and swollen. Is not itchy. No hives. ? Patient husband was driving, turned around And then pulled up. The RN on the observation deck gave EPI pen in the left thigh while she was still in the car. ? ? Driving home from getting Covid vaccine. Felt flushed, weird taste in mouth, chest tightening, palpitations, face swelling. ? Is patient concerned about a specific cause for the current symptoms? Yes Covid vaccine Onset of symptoms: 2:25pm 1/3/2021. Symptoms include: hives, rash or generalized itching, throat or tongue tingling, itching, or swelling and facial swelling. Rash distribution: Face. How are symptoms changing over time? worsening. ? Patient describes symptoms as severe. Has patient tried any treatment for these symptoms? Yes epi in left thigh What makes the symptoms better? Epi made breathing better What makes the symptoms worse? nothing ? Associated symptoms: ? o Fever No ? o Sore throat No ? o Recent illness No ? o Exposure to person(s) with similar rash No ? Objective: BP 106/72 | Pulse 77 | Temp 97.8 ?F (36.6 ?C) (Oral) | Resp 14 | SpO2 97% General:well-hydrated, well nourished, no acute distress HEENT: swelling where fillers have been used around the lips, nose, cheeks Neck: nontender, no masses Lung: clear to auscultation bilaterally Heart: regular rhythm, tachycardia noted and no murmurs, clicks, or gallops. Extremities: extremities normal, atraumatic, no cyanosis or edema Skin: flushed on face and neck and chest No urticaria No other rashes Neuro: alert, orientation normal, speech normal pupilary response normal bilaterally extraocular motions normal tongue midline no facial weakness or asymmetry we have pictures in her medical record. this appears to be a dermal filler reaction. the patient did receive epi as the first nurse who responded while she was in the car saw the facial eyelid swelling and redness and administered IM epi. Once we were able to move the patient into the clinic is was apparent that the person had no anaphylaxis symptoms. she was not itching, did not have hives, no stridor or wheezing or hypotension. she was discharge on a Medrol dose pack. advised not to get a second vaccine dose.

Other Meds: unknown

Current Illness: Had filler injections on the face. Jaw line and Nasolabial folds on 12/29/2020 Juviderm and Define Resilin . Has had facial fillers for three to four years. No other implants or silicone in other body locations. she has had Botox in the past on her face.

ID: 0921871
Sex: F
Age: 77
State: MI

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
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:

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

Symptoms: T.102.9 upset stomach

Other Meds:

Current Illness:

ID: 0921872
Sex: F
Age: 66
State: AK

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Ampicillin and penicillin.

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

Symptoms: Patient was experiencing headache, lightheadedness, generalized itching, shortness of breath, wheezing, and nausea after 8-10 minutes of COVID-19 vaccine administration. Vital signs were stable RR 22 and SpO2 96% on RA. She was speaking in full sentence, no acute distress, with expiratory wheezing. No central cyanosis or new rash. After 15 minutes, she reports improvement on her symptoms. She was given Benadryl po and Albuterol 2 puffs in the clinic with improvement on her symptoms. Lungs have more air movement and less wheezing after the albuterol treatment. She was send home and educated in ED precautions.

Other Meds:

Current Illness:

ID: 0921873
Sex: M
Age: 26
State: MN

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: Unknown

Symptom List: Vomiting

Symptoms: Developed slight nausea about 10 minutes after vaccine administered. Started having sensitivity to light, lightheaded, dizzy, sweaty/clammy then dry heaves.

Other Meds: N/A

Current Illness: Fell on sidewalk on 1/3/21, did not hit his head.

ID: 0921874
Sex: F
Age: 25
State: CA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Malaise, feverish, joint pain, muscle ache

Other Meds: Vitamin C 1000mg, Flonase, Singulair 10mg, Vitamin D3, Women multivitamin, Emergen-C diet supplement

Current Illness: Covid + on 12/10/20

ID: 0921875
Sex: F
Age: 80
State: MI

Vax Date: 01/02/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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:

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

Symptoms: Itching and redness at injection site

Other Meds:

Current Illness:

ID: 0921876
Sex: F
Age: 30
State: IA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Painful, red, puffy/swollen at injection site

Other Meds:

Current Illness:

ID: 0921877
Sex: F
Age: 36
State: IL

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/05/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient experienced redness and hives on neck and face area with itching. Applied Ice to neck area and administered 50 mg of Benadryl PO at 2pm

Other Meds:

Current Illness:

ID: 0921878
Sex: F
Age: 57
State: LA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: Sulfa in the past.

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

Symptoms: Took vaccine and was monitored for 30 minutes. She left the area and went on to her duties. Approximately 1 hour later, she reports noticing a hot flushing sensation starting at the top of her head. It gradually was going down to include her face and back upper body. She notice splotching of her skin large half dollars size on her front of her body. Smaller red spots on the back. There was a clear line of demarcation at her breast line around to her back. No SOB or respiratory issues. Went home and took a 50 mg. Benedryl. The rash has lightened at this time 16:32 PM same day of vaccine.

Other Meds: Caduet

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm