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: 0968996
Sex: F
Age: 40
State: VA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/24/2021
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: Full body itching including eyes and throat, blurry vision, headache, fatigue, dizziness, 1-101 fever

Other Meds:

Current Illness:

ID: 0968997
Sex: F
Age: 49
State: KS

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/24/2021
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: adverse reaction to mycins-vomit blood

Symptom List: Anxiety, Dyspnoea

Symptoms: fever of 103 degrees with chills, uncontrollable shaking, vomiting beginning around 8:00 PM, Tylenol did not reduce fever, went to ER and was admitted post chest x-ray, CT scan, dopplers. While admitted was treated for adverse reaction and pneumonitis diagnosed in ER. Treatment included iv fluids, iv antibiotics (Rocephin), magnesia, potassium, anti-nausea mediation, breathing treatments, Lovenox injections, blood draws for labs multiple times per day.

Other Meds: meloxicam, Humira (not taken since 11/2020 due to Covid infection which progressed into pneumonia), pro-air inhaler, Symbicort, Zyrtec, Nasacort, omeprazole, previously took prophylactic amoxicillin for MBL deficit however hospitalist disch

Current Illness: Covid-19 onset of symptoms on 12/7/20 with positive test 12/8/20.Diagnosed with pneumonia on 12/16/20. Diagnosed with pneumonitis on 12/29/20 with ER visit due to fever, chills, vomiting same date as vaccination Hospitalized 12/29/20-1/4/2021 with discharge diagnoses of vaccine reaction, pneumonitis, leukopenia, hypokalemia, elevated LFTs * note that per vaccination release, being two weeks s/p Covid 19was the time frame indicated to receive vaccine post Covid 19 infection

ID: 0968998
Sex: F
Age: 22
State: OR

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/24/2021
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: none

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

Symptoms: Moderna COVID-19 Vaccine EUA rash at injection site; approximately 2.5 inches, itchy, red, hot, slightly raised; the rash appeared last night, 7 days after receiving the first dose of the moderna vaccine; there were no symptoms at the time of injection or afterwards until now.

Other Meds: adderall, wellbutrin, lamotragine, valacylcovir, vitamin c, calcium, vitamin d

Current Illness: none

ID: 0968999
Sex: F
Age: 28
State: AL

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Itchy skin, mild rash on arms.

Other Meds: Fish oil

Current Illness: None

ID: 0969000
Sex: F
Age: 64
State: MN

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/24/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: I am reporting the following reaction, as I was unable to enter it on V-safe due to the site not functioning properly. Twelve hours post vaccination: onset of shaking chills, temperature 101 F, severe headache, nausea, myalgia, arthralgia and fatigue Twenty four hours post vaccination: severe headache and moderate nausea, myalgia, arthralgia and fatigue, temperature 98.8F Forty eight hours post vaccination: moderate headache, mild nausea and fatigue Seventy two hours post vaccination: slight headache, nausea and fatigue Ninety six hours post vaccination: symptoms resolved

Other Meds: none

Current Illness: none

ID: 0969001
Sex: M
Age: 57
State: TN

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/24/2021
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: Toradol

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

Symptoms: Redness at shot site, left arm soreness, fever, chills, body aches

Other Meds: Cozaar, tenormin, aldactone, tricor, zoloft, lipitor, Minoxidil, norvasc, celexa,

Current Illness: None

ID: 0969002
Sex: M
Age: 48
State: FL

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Symptoms started 12 hrs after infection: 1-left deltoid pain, moderate intensity. 2-MULTIPLE symptoms that are known/listed, which are: fatigue, headache, muscle pain, joint pain, fever and chills, and nausea. Also lightheaded once. Treatment: OTC meds, ibuprofen 200mg every 6 hrs, acetaminophen ES 500mg in between ibuprofen every 6hrs; Outcome: started to feel improved by 18 hrs from onset of symptoms using meds; moderate improvement at time from over 24, 36 hrs, still noting some fatigue, VERY minimal brief head pains, and mild left deltoid pain

Other Meds: 1-doxycyline 100mg daily 2-Vitamin d3 1000iu daily

Current Illness: rosacea, face

ID: 0969003
Sex: F
Age: 65
State: UT

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Macribid, Sulfa

Symptom List: Pharyngeal swelling

Symptoms: A week after covid injection, large red itchy patch on upper arm. Pain going into neck. No treatment; Wondering about 2nd shot, especially since more severe effect. Please contact me, for instruction on what to do.

Other Meds: Hydrochlorothiazide, Fish Oli, Calcium, One Daily, MCT, Coconut oil, Lutein

Current Illness: none

ID: 0969004
Sex: F
Age: 28
State: CO

Vax Date: 01/08/2021
Onset Date: 01/17/2021
Rec V Date: 01/24/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Rash bilateral ankles/feet/ legs and hands

Other Meds: Zyrtec, IUD

Current Illness:

ID: 0969006
Sex: F
Age: 52
State: TX

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
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: Penicillan Sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Day 2 - Soreness to arm area; Day 7 - Severe headaches; Day 9 - Rash and itching on site area, redness and swelling, hot to touch, headaches; Day 10 - Redness has spread to a bigger area, itching, hot to touch, headaches

Other Meds: Dexilant Linsopril

Current Illness: N/A

ID: 0969007
Sex: F
Age: 43
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: 101.6 degree fever from 10pm on the day of the vaccination, to 5am the next morning. Fever accompanied by severe body aches, joint pain, and chills. Following fever, body aches and joint pain continued for 12 more hours, along with severe headache, fatigue, swollen lymph nodes in left armpit, and swollen glands in neck. Also had moderate nausea and abdominal pain, as well as mild diarrhea. Improvement of all symptoms after first 36 hours, with lingering fatigue.

Other Meds: None

Current Illness: None

ID: 0969008
Sex: F
Age: 41
State: NJ

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/24/2021
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: Initially felt some anterior cervical lymphadenopathy Difficult to sleep that night due to muscle aches, had to continuously stretch in bed, headache, some nasal congestion (resolved quickly), muscle aches continued in the morning but worsened around 11:30am on 1/24 and developed fever to 100.9. Muscle aches and fever lasted until taking Tylenol a few hours later.

Other Meds: Levothyroxine, Claritin D, multivitamin

Current Illness: None

ID: 0969009
Sex: F
Age: 36
State: PA

Vax Date: 01/02/2021
Onset Date: 01/09/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: Levothyroxine, Benadryl, Zithromycin

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

Symptoms: One week post vaccination, injection site became red, swollen and hot to touch. Developed body tremors, headaches, neck tightness, severe pain and reduced range of motion. Twice weekly migraines.

Other Meds: Tirosint, Cytomel, Adderall, B12, Vitamin D, Iron Sulfate

Current Illness:

ID: 0969010
Sex: F
Age: 68
State: MD

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/24/2021
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: bactrim

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

Symptoms: Moderate hive like rash which began 30 hours after vaccine. Severe itching and local swelling

Other Meds: Lasix tadalafil omeprazole Claritin vitamin D potassium

Current Illness: none

ID: 0969011
Sex: F
Age: 37
State: MA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Three hours after 2nd dose developed redness and warmth at the neck, pain and swelling at the injection site, as well as generalized fatigue. Approximately 16 hours after 2nd dose body aches, headache, significant fatigue lasting for 24 hours

Other Meds: N/A

Current Illness: N/A

ID: 0969012
Sex: F
Age: 75
State: CO

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 01/24/2021
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: n/a

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

Symptoms: patient called roughly 1 hour after getting vaccine indicating she was blowing her nose when it started to bleed. It was a consistent flow and had been going on for 5 minutes before calling the pharmacy. She had placed a clip on her nose to see if it would stop, but when asked to check she said it still has not stopped. Asked her what medications she was taking and if she was on blood thinners. she indicated no. Looked up adverse events on Moderna covid-19 vaccine and it didn't indicate nose bleeding, package insert states "intentionally blank". Advised patient to head to the ER and I would call to check up on her.

Other Meds: patient had taken a muscle relaxer at 3:30 am before the vaccination. She does not remember the name of the muscle relaxer

Current Illness: n/a

ID: 0969013
Sex: F
Age: 24
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Chills, muscle aches and fatigue

Other Meds:

Current Illness:

ID: 0969014
Sex: F
Age: 61
State: TN

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: Penisilyn

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Rash in my chest, under my breast and some in the side. Experience some tingling, itching in my legs.

Other Meds: Synthroid50 mg, Cabergoline .5 mg 1/2 twice a week, progesterone 200 mg, Estradiol 0.05 twice a week. Fish oil, Hemagenics (support red blood cells), Zinc , B complex, Vitamin C, D3, A, Glucosamine

Current Illness:

ID: 0969015
Sex: F
Age: 71
State: CA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: Penicillin rash Cephalexin. Rash Toradol shot Rash Contrast iodine in ct scan. Itchy throat ,dizziness Ativan very anxious

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Itchy mouth and tongue 15 minutes after shot. Told nurse and saw Doctor. Waited additional 45 minutes. No other side effect.

Other Meds: None Mouth was itchy no other symptoms

Current Illness: None

ID: 0969016
Sex: F
Age: 74
State: NM

Vax Date: 01/11/2021
Onset Date: 01/18/2021
Rec V Date: 01/24/2021
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: On day 8 after receiving vaccine (1/18/2021), I woke up scratching my left arm at vaccination site. There was a 4X5 inches red, hot and itchy area. The redness and itchiness subsided slowly over 5 days. The night of the 17th of January, the vaccination area was completely normal with only slight bruise left from the injection site.

Other Meds: chlorthalidone, lisinopril, pantoprazole, atorvastatin, premarin, escitalopram, vitamin D and B12

Current Illness: none

ID: 0969017
Sex: F
Age: 71
State: SC

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

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

Lab Data:

Allergies: None

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

Symptoms: None

Other Meds: None

Current Illness: None

ID: 0969018
Sex: F
Age: 46
State: CO

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: Penicillin anaprox

Symptom List: Unevaluable event

Symptoms: Hives itching headache fatigue nausea joint and muscle pain concentration problems

Other Meds: Na

Current Illness: Na

ID: 0969019
Sex: F
Age: 41
State: IN

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
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: Latex, bee sting

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

Symptoms: Sharp pain at bridge of nose that became a tightening across entire face and forehead, rapid heartbeat, nausea, numbness in lips, sinuses pushing on roof of mouth, difficulty swallowing for about 15 minutes about a half hour after taking vaccine. Then about 6 hours same symptoms but without rapid heartbeat, swallowing issues were worse, took Benadryl, after about an hour symptoms lessened and I fell asleep. Next morning roughly 13 hours later would randomly have tightness in face and under chin. Lasted off and on all day.

Other Meds: N/A

Current Illness: N/A

ID: 0969020
Sex: F
Age: 65
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/24/2021
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: penicillan wheat soy oats barley

Symptom List: Injection site pain, Pain

Symptoms: nausea, couldn't get out of bed, couldn't concentrated, couldn't walk, exhausted 7pm 1/6/21 til 1/8/21

Other Meds: multivitamin metoprolol trazodone doxycycline diclofenac glucosamine chondrotin D3 iron Vit A

Current Illness: Covid 19 exposure on Nov 13th 2020. Symptoms Nov 16th. Diagnosed Nov 18th

ID: 0969021
Sex: F
Age: 86
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: Gluten & lactose intolerant Beta blockers Lasix

Symptom List: Injection site pain, Menorrhagia

Symptoms: Had a sore throat & chills second night after receiving vaccine. Today Sunday 1-24-20 woke up with "head cold" like symptoms runny nose, constant sneezing, itchy eyes & sore throat

Other Meds: Triamatene Flecanaide Warfarin Pantoprazole Hydeodone.Acetaminophne

Current Illness:

ID: 0969022
Sex: F
Age: 22
State: OR

Vax Date: 01/16/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
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: none

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

Symptoms: COVID-19 Vaccine EUA; rash at injection site; approximately 2.5 in., red, itchy, hot, slightly swollen; appeared 18 hours ago, which was 7 days after first dose of the covid vaccine; I experienced no symptoms/side effects at the time of the vaccine or afterwards until now, except minor soreness in left arm (injection site) the day after the vaccine.

Other Meds: welbutrin, lamotragine, valacyclovir, adderall, vitamin c

Current Illness: none

ID: 0969024
Sex: M
Age: 88
State: CA

Vax Date: 01/20/2021
Onset Date: 01/24/2021
Rec V Date: 01/24/2021
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: No allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: No treatment. Just sitting it out although I will see my family doctor tomorrow.

Other Meds: Lipitor; Vitamin D; Timolol Maleate eye drops; Flaxseed oil; Vitamin complex; Latanoprost eye drops; Aspirin (81 mg); Metroprolol succ

Current Illness: None

ID: 0969025
Sex: F
Age: 68
State: WA

Vax Date: 01/02/2021
Onset Date: 01/07/2021
Rec V Date: 01/24/2021
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: Moderna vaccines received on 1/2/2021. I took Motrin, Sulfated with minimal relief, then localized symptoms worsening. By date of 1/18/2021, most symptoms subsided except the mild tenderness in L arm.

Other Meds: L deltoid injection site tenderness and redness started 1/4/21; swelling started 1/7/21; redness and bruises started 1/10/21; swelling on L deltoid radiating to area between L shoulder joint and L lateral neck worsening, large patchy rednes

Current Illness: None.

ID: 0969026
Sex: F
Age: 31
State: KY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/24/2021
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: Dilaudid (full body hives)

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

Symptoms: Experienced severe redness about 2.5-3? in diameter around vaccination administration site Area was very swollen, warm to the touch, tough, and incredibly painful which caused me to have difficulty moving my arm/using my arm in general and limited my normal daily activities for 4 total days. Pain, swelling, redness, and toughness began to dissipate around Day 5 and was markedly improved by Day 8 when I completely returned to normal activities. Additionally, the first day after the vaccination, I experienced muscle aches/pains and severe generalized fatigue that almost made me call out from work. This fatigue and muscle pain was very strong for ~72 hours after the vaccination. However, I was still able to go to work, though my productivity was not the same given the amount of fatigue I experienced and the inability to utilize my right arm to the same degree I would during a normal work day.

Other Meds: Prenatal vitamin Allegra Protonix 40mg daily Adderall 30mg daily

Current Illness: None

ID: 0969027
Sex: F
Age: 30
State: OR

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

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

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: On the evening and day following receiving the second dose of the Pfizer vaccine, I experienced chills, body muscle aches, headache, and fever (99.7-100.2 degrees). I was unable to get out of bed or go to work. I took ibuprofen at first, for my muscle pain but was told I should instead take Tylenol to reduce my fever and address my pain. My fever and chills recurred last night at about 8pm and I took more Tylenol. Today, I am still experiencing some pain in my arm (injection site) and some chills/dizziness, but am taking Tylenol and have not experienced any recurring fever since last night. I am continuing to drink a lot of fluid and take a low dose of Tylenol at regular intervals.

Other Meds: Fluoxetine 40MG Mirtazapine 45 MG Prazosin 1MG Vitamin D 25MCG

Current Illness: N/A

ID: 0969028
Sex: F
Age: 56
State: MD

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: Not known

Symptom List: Injection site pain

Symptoms: Migraine headache; Pain and swelling in right arm where 1st vaccine was shot. Slight Redness in the same arm of injection. Slight Fever ~ 100 F for the 1st two days after vaccine #1. Body chills. Body aches. Tiredness. I felt a bit weak during the first night of the vaccine. I also felt a slight tightness on my chest or slight pain in my chest the first night.

Other Meds: 1 Metformin 500 mg per day 1 Levothroxine 25mcg per day

Current Illness: None

ID: 0969029
Sex: F
Age: 60
State: TX

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

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

Lab Data:

Allergies: Injectable iodine - big one Gluten and dairy intolerant Penicillin, macrodactin, sulfa - systemic rash Tramadol - violent emissions Phenergan- adverse neurological response

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

Symptoms: Within 3 min of injection - lightheaded, racing heart beat. Increased PAC sensation. Strong metallic taste.. HR/PACs resolved mainly within 10-15 min. Lightheaded, extreme fatigue and metallic taste eased after about 45 min.

Other Meds: Simvastatin, linzess, advair HFA, multi vitamin, calcium, acetyl L-carnitine, lutein, zyrtec, flonase

Current Illness:

ID: 0969030
Sex: F
Age: 61
State: MA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
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: In addition to normal: soreness in left arm, experienced facial numbness on left side of head...cheek, jawline, left lips, ear around left eye.

Other Meds: Lisiniprol Sertraline

Current Illness: None

ID: 0969031
Sex: M
Age: 34
State:

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 01/24/2021
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: Member complained of lightheadedness. Monitored from 12:48 to 1:00pm. Vital signs taken - within normal range. SpO2 at 99%. Afterwards stated he felt dizzy as well, placed on gurney and encouraged to take deep breaths. A few minutes later, stated he felt better and went home.

Other Meds:

Current Illness:

ID: 0969032
Sex: F
Age: 63
State:

Vax Date: 01/13/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
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: Erythema, Pruritus

Symptoms: Woke up to find itching on upper left arm., and saw rash. Did not scratch area. When undressing, felt soreness in upper arm. Upon touching the area, felt swelling and feeling of fluid (soft and squishy). Unable to get seen by provider's office. Visited Urgent Care late in the afternoon. Physician prescribed amoxicillin, 10 day course, twice a day. Symptoms improved by next day.

Other Meds:

Current Illness:

ID: 0969033
Sex: F
Age: 63
State: MN

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/24/2021
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: I am submitting this report because I did not download the app until day three post vaccination. The app would not allow me to report my vaccine reaction retroactively to include the previous days. Twelve hours post vaccination: slight chills without fever, severe headache, nausea and fatigue Twenty four hours post vaccination: severe headache, moderate nausea and fatigue Forty eight hours post vaccination: moderate headache, mild nausea and fatigue Seventy two hours post vaccination: symptoms resolved (*Correction: I believe I may have recorded the date for vaccine #1 incorrectly on the form I previously submitted regarding a reaction to my second vaccination. When asked if I had received any previous vaccinations within the past 4 weeks, the correct date for my first Covid-19 vaccination should read 12/28/2020, 10:00 am)

Other Meds: none

Current Illness: none

ID: 0969034
Sex: F
Age: 48
State: FL

Vax Date: 01/15/2021
Onset Date:
Rec V Date: 01/24/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: I had my vaccination last Friday had a slight reaction (my arm was swollen, red, itchy, much like how I react to yellow fly bites and I was extremely fatigued) that lasted till about Monday, went away, and now is back almost to the minute of when it started last week. It's like a cycle, my arm starts itching inside like crazy, like bugs are crawling on my bone, then it gets bigger & redder, I get hot & nauseous, diarrhea for 3 days, stomach cramps, headache, fatigue, achy...when I cool down, the itchiness subsides some for a while, then in a couple of hours it starts itching again.

Other Meds: Albuterol Advair IBU allergy & sinus

Current Illness: NA

ID: 0969035
Sex: F
Age: 41
State: ID

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/24/2021
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: IV contrast dye, Penicillin, Sulfa antibiotics

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Endorsing nausea, shortness of breath, throat swelling, tingling in tongue. EMS called and IM epinephrine 0.3 mg given. Follow IM epinephrine she reported improvement in mouth/tongue tingling, worsening nausea and shortness of breath. She was transferred to the ED for worsening/persistent symptoms. In the ED she was observed 2.5 hours, given Decadron, H1 and H2 antihistamine and IV fluids and discharged home.

Other Meds: Flonase, Tresiba, metformin, Ortho-cyclen, triamcinolone

Current Illness:

ID: 0969036
Sex: M
Age: 71
State: CA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
Hospital: Y

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

Lab Data:

Allergies: atorvastatin (CK elevation), tamsulosin (rash)

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

Symptoms: Patient with known recent diagnosis of terminal hepatocellular carcinoma and necrotizing myositis on prednisone, within 2 hours after vaccine experienced vomiting and chest pain, on CT abdomen/pelvis in ED found to have bleeding from known hepatocellular carcinoma leading to hemoperitoneum treated with embolization of left hepatic artery and left gastric artery - given known underlying HCC, this is unlikely to be related to COVID vaccine.

Other Meds: Calcium carbonate, sarna lotion, cholecalciferol, cholestyramine, entecavir, guaifenisin, hydrocortisone cream, hydroxyzine, pantoprazole, polyethylene glycol, polyvinyl alccohol tears, prednisone 60mg daily, simethicone, sulfamethoxazole-t

Current Illness: Hepatocellular carcinoma s/p TACE 12/8/20, hepatitis B cirrhosis, Waldenstrom's macroglobulinemia, h pylori gastritis, necrotizing myositis/myopathy on prednisone (diagnosed 1/2/21)

ID: 0969037
Sex: F
Age: 58
State: PR

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/24/2021
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: penicilin

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

Symptoms: Pain in the vaccine area, fever, tiredness. Arnica cream

Other Meds:

Current Illness:

ID: 0969038
Sex: F
Age: 20
State: KY

Vax Date: 01/16/2021
Onset Date: 01/24/2021
Rec V Date: 01/24/2021
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

Symptom List: Pain in extremity

Symptoms: small lump for the first 7 days after vaccine given. on day 8 deltoid that vaccine was given in became red, warm, swollen and itching. no other symptoms

Other Meds: none

Current Illness: none

ID: 0969039
Sex: F
Age: 48
State: IN

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: Demoral Adhesive

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

Symptoms: Flu like aches and pains, low grade fever, nausea

Other Meds: Levothyroxine Bp meds Tegretol

Current Illness: NA

ID: 0969040
Sex: F
Age: 36
State: NY

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
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: Latex allergy- get a slight rash and itchy

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

Symptoms: The morning after the vaccination, I woke up and felt slightly nauseous. When I got out of bed, and went to the bathroom, everything went white and I fell. I was able to get up on my own but had to lay back down. I thought I would be unable to go to work but after resting for about 15 minutes, I was able to get up, finish getting ready for work but continued to get lightheaded if I stood in one spot for too long. I was very tired and out of it the rest of the day, and having chills throughout the day. All of this in addition to my arm being very sore and my back hurt from my fall. I also had a very bad headache, and later in the day, around 430pm, my temp was 100.2. I took tylenol and went to bed around 630.

Other Meds:

Current Illness:

ID: 0969041
Sex: F
Age: 30
State: CA

Vax Date: 01/15/2021
Onset Date: 01/24/2021
Rec V Date: 01/24/2021
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: Amoxicillin

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

Symptoms: Location site is itchy, red rash, warm to the touch.

Other Meds: Wellbutrin, Lexapro, GI tract wellness probiotic, Vitamin B12, Vitamin D3, Marshmallow Root, Ginkgo Biloba, Green Tea extract, Tumeric, Omega 3, Yin Chiao, Adaptogen Tinctures

Current Illness: Strep throat

ID: 0969042
Sex: M
Age: 50
State: CA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/24/2021
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: Fever, chills, body aches, headaches, fatigue starting approximately 10 hours after the injection lasting for about 36 hours. This is in addition to the expected injection site pain that lasted for about 3 days.

Other Meds: None

Current Illness: None

ID: 0969043
Sex: F
Age: 45
State: OR

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/24/2021
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: no

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Vertigo, nausea beginning 1/24, slightly under 48 hours from 2nd vaccine administration.

Other Meds: acetaminophen, ibuprofen

Current Illness: n/a

ID: 0969044
Sex: F
Age: 65
State: PA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: redness at injection site

Other Meds: gabapentin 400mg metformin jardiance celexa Synthroid lisinopril calcium 600mg brimonidine buspar sinemet

Current Illness: type 2 diabetes

ID: 0969045
Sex: F
Age: 47
State: AL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
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: Chicken, chocolate, eggs, morphine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Headache, fatigue, abdominal pain and cramping, diarrhea, mild swelling at injection site, pain at injection site and arm

Other Meds: Vyvanse 30 mg XR Premarin Multivitamin Allegra D CoQ10 Flonase Omega 3 Ezetimibre Xyzal Elderberry Tylenol Levsin

Current Illness:

ID: 0969046
Sex: F
Age: 34
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/24/2021
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: Fever, chills, sweating, nausea, body aches, fatigue. Lasted for a week.

Other Meds: Paroxetine, cyclobenzaprine, diclofenac

Current Illness: Pulled muscle

ID: 0969047
Sex: F
Age: 37
State: CA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/24/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Severe body aches, restless legs, fever

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm