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: 0971020
Sex: F
Age: 42
State: GA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/25/2021
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: PCN CDN Dilaudid Darvocet Demerol DPT vaccine

Symptom List: Dysphagia, Epiglottitis

Symptoms: Day 1: Severe headaches, severe dizziness Day 3: heart palpations, continued h/a Day 6: rash at injection site, continued palpations Day 7: baseball sized rash at injection site, right arm/chest swelling, palpations Day8: severe dizziness, headaches, and continuing rash Day 10: acute rash face and neck, continued palpations

Other Meds: Allegra Flonase

Current Illness: None

ID: 0971021
Sex: F
Age: 75
State: CT

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
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: house dust, mites papaya

Symptom List: Anxiety, Dyspnoea

Symptoms: I began feeling deeply fatigued and achy about six hours after the vaccination and went to bed. The aches and fatigue continued the next day and evening and, additionally, I had a swelling in my left wrist of the arm that I had the shot in. That swelling was painful; it was about an inch across and looked like it contained fluid. All those symptoms continued for two more days and then the swelling began to subside and is now gone.. Today, the morning of the fifth day after the vaccination, I awoke at 3 a.m. with severe body aches, took two Tylenol and eventually was able to sleep again. I am feeling better but very, very tired and have some bodyaches and headache but not as severe.

Other Meds: Levothyroxine sodium 100 mcg tabs calcium 600 mg Centrum Silver vitamin

Current Illness: None

ID: 0971022
Sex: F
Age: 49
State: NH

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
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: Cipro, walnuts

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

Symptoms: fever, chills, body muscle pain and headache

Other Meds: metformin, trulicity

Current Illness:

ID: 0971023
Sex: F
Age: 42
State: TX

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
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: 40 hours after getting the vaccine, I was very dizzy getting up off the floor. I didn?t notice any dizziness upon waking, during 30 minutes on the stationary bike, but only got dizzy after laying down on my back for stretches. I wasn?t able to stand right away. After a few minutes sitting, I stood and couldn?t walk a straight line. My head was spinning. I had 40-50 oz of water already that morning, Apple Watch said sinus rhythm, heart BPM was up to 111 during exercise and down to 88 2 minutes after exercise. I didn?t push myself during the workout, it was a normal or easier workout than usual. When I called the HCP hotline and they asked for this information and also: head injury, no. Numbness on face, tingling on hands/legs, no. They recommended I go to an ER if I still had symptoms, but by the time I was done with the call, I wasn?t dizzy. I could bend over without symptoms and was walking straight.

Other Meds: Ritual Essential for Women Vitamin, 2 per day. Fluticasone Propionate Nasal Spray 50mcg, 2 sprays per day. Olopatadine HCL 665 mcg, 4 sprays per day

Current Illness: None

ID: 0971024
Sex: M
Age: 45
State: UT

Vax Date: 01/15/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: Codeine

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

Symptoms: Patient reports that on 01/24/2021 he woke up with a sore arm. He reports that he has decreased range of motion and decreased strength in that arm. He denies redness, swelling or visible injury but feels like there is a bruise in his shoulder.

Other Meds:

Current Illness:

ID: 0971025
Sex: F
Age: 43
State: OR

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
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: N/A

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

Symptoms: I received an instant headache, my left arm swelled and was painful from my shoulder down to my hand. Later in the day i became extremely tired, had pain in my neck. The next day i was still very tired, arm pain, headache, body aches, vomiting. Day 4 i am still very tired with body aches.

Other Meds: Trazadone, Venalafaxine, Rosuvastatine, Lisinaprol, baby asprin

Current Illness: N/A

ID: 0971026
Sex: F
Age: 84
State: AK

Vax Date: 01/08/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
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: Pyrexia, White blood cell count decreased

Symptoms: 8th of January got shot. achy right arm and swollen for week. 24th took shower whole shot area was red with rash. could see mark where needle went in. felt tired and arm ached.

Other Meds: Prevagen, Vitamin e 180mg, vitamin d 3 125 mcg, vitamin c 250 mg, CoQ 10 200mg, Collagen 6000mg

Current Illness: n/a

ID: 0971027
Sex: F
Age: 54
State: VA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
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: Pharyngeal swelling

Symptoms: Pt reported "tightness" in chest and stumbled then collapsed on stairs near exit. Pt was beginning to lose consciousness. RN administered two doses of 0.3mg EPI Pen three minutes apart. Pt became more alert and reported improvement in respiratory status. EMS transported patient to hospital.

Other Meds:

Current Illness:

ID: 0971028
Sex: F
Age: 55
State: FL

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: ferrous sulfate

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Sudden onset of pain in injection site, radiating to neck. Decreased range of motion without severe pain. Arm is extremely heavy and unable to be moved very much. Increased with movement and palpation. Unable to work.

Other Meds: B12, Trazadone

Current Illness: none

ID: 0971029
Sex: M
Age: 46
State: AZ

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
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: No known allergy to drug or food.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Vaccine recipient experienced a bit of headache, nausea and vomiting after vaccination on 1/19/2021. On 1/22/2021, he started having palpitations and also mentioned that his blood pressure was really high.

Other Meds: None listed.

Current Illness: History of Hypertension.

ID: 0971030
Sex: F
Age: 41
State: OR

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: 1/21/21: Immediate swelling at injection site, hot to touch and arm soreness 1/22/21: I woke up at 7:30am with a sore throat and right ear pain. This is typical for me when I am starting to fight something off. I was managing okay until around 1pm when I started to low grade fever at 99.8. By around 4pm, my body was really starting to ache and I was getting chills. After the training, I took some Thera Flu, but I couldn?t really move from the couch to the bed because my body was so sore. My fever fluctuated between high 99?s to low 100?s. I felt like I got hit by a truck. I managed to fall asleep around 8:00pm and was able to sleep until 1:00am. I took more Thera Flu, water, and was able to fall back to sleep at 3:00ish am. 1/23/21: I woke again at 11:00am and my aching was still there but not nearly as bad as the previous day but now I felt heavy congestion in my head and chest. I also had sneezing, and a stuffy then runny nose off and on throughout the day. I was also very, very tired and had no energy to do anything but lay there. Today is when the diarrhea started 1/24/21: Body aches at this point are still tolerable but I?m sore. My arm injection site is bruising and starting to itch and still slightly warm to the touch. I have sneezing, a dry cough, and an off and on runny nose and diarrhea 1/25/21: Body aches are mild today, dry cough is here, post nasal drip mucus I am assuming as well. All I want to do is sleep. I?m so tired. No diarrhea today so far but I haven?t had anything to eat yet.

Other Meds:

Current Illness:

ID: 0971032
Sex: F
Age: 59
State: WA

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
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: Nausea, vomiting, diarrhea

Other Meds: levothyroxine, roprinerole, trazadone, ibuprobren, acetaminophen, anti-diarrheal

Current Illness: bronchitis

ID: 0971033
Sex: M
Age: 50
State: FL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
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: Scratchy throat and post nasal drip developed within 15 mins of vaccine administration. VS remained stable. 1700 Diphenydramine 25mg IM administered. 1723 Epineprine 1 mg IM administered. Patient monitored, VS remained stable. Symptoms improved. Patient discharges at 1743. Patient was driven home.

Other Meds:

Current Illness:

ID: 0971034
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/25/2021
Hospital: Y

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:

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

Symptoms: ON Jan 16 complained of lightheadedness then felt better after supper and nap. Next day ok On Jan 22 did not get up, had stroke, taken by ambulance to hospital and transferred to medical facility.

Other Meds:

Current Illness:

ID: 0971035
Sex: F
Age: 55
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Her arm is sore and swollen. Chills, Body aches down her spine, 99.5 temperature. She feels the vaccine is causing depression.

Other Meds:

Current Illness:

ID: 0971036
Sex: M
Age: 80
State: AL

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital: Y

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

Lab Data:

Allergies: No Known Allergies

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

Symptoms: The patient woke up at 0100 on 01/24/2021 reporting shortness of breath, expiratory wheezing, shaking with chills, subjective fever. The patient was seen in the Emergency Department and admitted with a dx of COPD exacerbation. The patient improved nicely after bronchodilators, antibiotic therapy and steroid therapy. The patient was discharged on 01/25/2020 prior to noon.

Other Meds: DENIES

Current Illness: None

ID: 0971037
Sex: F
Age: 67
State: FL

Vax Date: 01/24/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
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: Amoxicillin, sodium penethol, nitrous oxide, oxycodone.

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

Symptoms: When she came home started getting really cold around 5:30 pm yesterday. Started having chills all night and slept with winter coat on. Started getting sick to her stomach all evening, started throwing up last night beginning at 11:00 PM, throwing up bile. Today having fever of 101, didn't take anything for it, but down to 100 now. Took 2 Tums and had such achy joints and sat down in a chair and could not get up from the chair. Took some Tylenol and that helped, but freezing cold. Didn't sleep all night. Has not notified her doctor of the symptoms, just calling us.

Other Meds: Metoprolol titrate, nondrowsy allergy daily, prevagen daily.

Current Illness: None.

ID: 0971038
Sex: F
Age: 55
State: TX

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I had serve tenderness and redness at the site I had dizziness, headache, feeling, tired, I felt like I had flu, chills, nausea, stomach cramps, muscle pain, joint pain. I had some insomnia. I had this for about 3-4 days after. I started feeling better on Saturday and got the vaccine on a Tuesday. I spoke to my Dr. about it and we decided to take Tylenol and a lot of baths.

Other Meds: Vitamin B-6 Vitamin D Folic Acid -1mg /2x day Efexer-25mg/daily Metaphrolof-50mg/daily Lidado- 4mg/daily Cranberry Exact

Current Illness:

ID: 0971039
Sex: F
Age: 59
State: IA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: PCN, Amoxicillin, Cephalosporins

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: hives started 30 minutes after vaccine administered, then she started feeling wheezy and tongue thickness. Rapid response team notified. Epinephrine given and patient transported to ER

Other Meds:

Current Illness:

ID: 0971040
Sex: F
Age: 45
State: KS

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
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: Woke up at 2:30 am on 1/23/21 with fever of 100.8, chills, and headache. I monitored my temperature and it peaked at 101.5 at 5:00am on 1/23/21. I took two Tylenol and my fever started to go down, but it was still elevated between 99 and 100 degrees until around noon. The chills and headache persisted until around 6:00 pm that day. That night and the next day, I was fine - no temperature, chills or headache.

Other Meds: Omeprazole, Escitalopram, Multivitamin

Current Illness: None

ID: 0971041
Sex: F
Age: 31
State: MI

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
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: Singular, pets, outdoor allergens, cold, heat, gluten, estrogen if levels not within normal range

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

Symptoms: Right after vaccination patient felt warm, rash started to appear and had intense itching about 10 minutes in to the event. She had premedicated with Benadryl 12.5mg along with Zyrtec. After itching started she was given an additional 12.5 mg of Benadryl. She was monitored for >30 minutes with improvement of symptoms. Rash still present but she said no longer has itching and that she knew her body well and that she was fine to leave. She stated that her mother was in the car waiting for her since she knew that she might have this type of reaction. We had a long discussion about going to the ER but she said she has Benadryl on her if needed and knew when she needed to get to an ER in terms of symptomatology. We also discussed option of having next dose with an allergist. She would like to call her allergist to discuss options but feels comfortable getting 2nd dose knowing how she reacted this time.

Other Meds:

Current Illness: Mast cell activation syndrome; Postural orthostatic tachycardia syndrome

ID: 0971043
Sex: M
Age: 89
State: NC

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
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

Symptom List: Unevaluable event

Symptoms: Developed pain on right side including arm down into hand and right shoulder.

Other Meds: Valsartan, Pradaxa, Plavix, Crestor, Zetia, Sotalol

Current Illness: Afib

ID: 0971045
Sex: M
Age: 80
State: CA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Sulfa drugs.

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

Symptoms: Sore shoulder for 3 days.

Other Meds: none

Current Illness: none

ID: 0971046
Sex: F
Age: 25
State: PR

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
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: Weakness and paresthesia on the arm where the vaccine was administered

Other Meds: None

Current Illness: None

ID: 0971047
Sex: F
Age: 29
State: OR

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: was feeling fine at home until a few minutes I got to work, Feeling off/weird

Other Meds:

Current Illness:

ID: 0971048
Sex: F
Age: 78
State: DE

Vax Date: 01/17/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
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 known

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

Symptoms: 1/21 Significant itching at injection site. Refrained from touching. By evening progressed to small area of redness and swelling. 1/22 Much larger area, rosy red, swelling and felt hot. Applied ice. Area affected continued to spread. 1/25 Presently extends from shoulder to arm pit, but not under arm. About size of very large orange. Tender, but not painful. Very itchy, still red, hot feeling, and puffy. Hopeful it is safe to receive 2nd dose around 2/14/2021

Other Meds: daily: 1 general vitamin, 1 calcium, 2.5 mg prednisone, 12.5mg lisinopril, 5mg warfarin

Current Illness: none

ID: 0971049
Sex: F
Age: 63
State: PA

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and Sulfur drugs

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Rash all over body. extreme swelling at injection site 8 days after injection Treatment Benadryl. outcome ongoing

Other Meds: Prolia

Current Illness: no

ID: 0971050
Sex: F
Age: 80
State: MD

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
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 that i know of

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Subject: COVID-19 Vaccine I received my COVID-19 vaccine (right arm) on January 24, 2021 at 2 pm. The purpose of this note is to let you know that on Saturday 1/23 i started having sharping (icepick) pains in my head -right side, behind ear and the pains are continuing today 1/25/2021.

Other Meds: Aspirin, chlorthalidone, corguard, losartan, metformin, multivitamin, rosuvastatin, vitamin D3.

Current Illness: none

ID: 0971052
Sex: M
Age: 29
State: GA

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/25/2021
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: Patient complained of dizziness and facial flushing. Recovered spontaneously.

Other Meds:

Current Illness:

ID: 0971053
Sex: F
Age: 60
State: FL

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

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

Lab Data:

Allergies: She'll shellfish. And aspirin

Symptom List: Nausea

Symptoms: I had a rash on my face, started with itchy nose and eyes. The hives spread to the neck. I told the male nurse that was present and he said that had Epinephrine, I had benadryl and he said that I could take one. Half an hour later my rash got worse and I took 20 mg prednisone that I had for my asthma. During the next two days I have had palpitations, fatigue and tiredness. Today my blood pressure was high and I have never had it like that before.

Other Meds: metformin, atorvastatin and trintellix

Current Illness: Asthma and prediabetes

ID: 0971054
Sex: F
Age: 27
State: IN

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

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Injection site pain

Symptoms: Within one hour of receiving the shot, I felt a hot burning sensation going through my body and the burning continued on in the back of my head for the next hour. Ever since the shot I have had numbness on and off in my extremities and in my face.

Other Meds: Levothyroxine, sertraline, magnesium, vitamin c, vitamin D, multivitamin

Current Illness:

ID: 0971056
Sex: M
Age: 70
State: DE

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: A FEW HOURS AFTER RECEIVING MY VACCINE YESTERDAY 1/24/21, I RECEIVED AN EMAIL FROM CDC TELLING ME THAT MY APPOINTMENT IS CANCELLED. I CANT REACH ANYONE BY PHONE SO MY ONLY OPTION IS THIS FORM. MY CONCERN IS THAT IF CDC THINKS MY APPOINTMENT WAS CANCELLED, THEN I WILL NOT GET NOTICE WHEN MY IMPORTANT 2ND VACCINATION WILL BE AVAILABLE TO ME. THANK YOU.

Other Meds:

Current Illness:

ID: 0971058
Sex: F
Age: 57
State: WI

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
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: Codeine, prednisone

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

Symptoms: Approximately 48 hrs. after 1st dose on 1/22/21, body aches, especially the back muscles and nausea. Also headache.

Other Meds: Metformin, glimepiride, Lexapro, Buspar, atorvastatin, gabapentin

Current Illness:

ID: 0971060
Sex: F
Age: 50
State: TX

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Headache, aching, extreme chilling, fever and nausea

Other Meds: None

Current Illness: None

ID: 0971061
Sex: F
Age: 65
State: PA

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
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: none

Symptom List: Erythema, Pruritus

Symptoms: Palm size area rash at injection site 8 days after injection. Itchy, raised, red and warm. Still active today but appears to be diminishing. Ice pack applied.

Other Meds: Levothyroxine 125 mcg daily Progesterone 100 mg daily Estrogen patch 0.25 twice weekly

Current Illness: none

ID: 0971063
Sex: F
Age: 98
State: WI

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/25/2021
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: Sulfonamide Antibiotics

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

Symptoms: Difficulty walking/standing

Other Meds: D-Mannose 500mg 2 caps bid

Current Illness:

ID: 0971064
Sex: F
Age: 56
State: OR

Vax Date: 01/17/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
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; possibly penicillin

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

Symptoms: Moderna COVID-19 vaccine EUA Raised, red, itchy rash at vaccine injection site. Lasting more than 24 hours; subsiding after use of OTC anti-histamine

Other Meds: Estradiol, progesterone, Advil

Current Illness: None

ID: 0971065
Sex: F
Age: 60
State: AK

Vax Date: 01/16/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
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: oxycodone corn

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: itchy, hive and hard and swollen

Other Meds: levothyroxine progesterone estradiol testosterone Vit. D 5000IU Flaxseed oil tablets Probiotic CoQ10 Fibermucil LV-GB Red Yeast Rice Glucose Optimizer Breathe Astragalus

Current Illness: none

ID: 0971068
Sex: F
Age: 51
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
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: Generic Prozac (not presently taking), adhesives, Imitrex

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

Symptoms: Swelling above upper lip where I have derma filler. Very minor but still noticeable the day after the vaccine injection.

Other Meds: Vitamin c gummies, fiber gummies, hair/skin/nails vitamin gummies

Current Illness:

ID: 0971069
Sex: F
Age: 49
State: KS

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
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: seasonal allergies, NKDA

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

Symptoms: 1st dose was on 12/22/2020-day of injection left shoulder pain for 3-4 days then left armpit pain for 3-4 days along with a headache. 2nd dose was on 1/22/2021 at 945am-day of injection right shoulder pain still having , second day after armpit pain and still have, day of injection at approx. 730pm chills, arms and leg muscle so painful you could not touch them for approx. 14-16 hours then was better and came back next night but not as painful and now gone, Headache started approx. 730pm day of injection and has continued and still have, muscles that normal hurt are 10 fold more painful since injection but are finally starting to easy up, fever of 100.9 night of injection only,

Other Meds: Cymbalta 60mg daily, Singular 10mg daily, Valacyclovir 1gm PRN cold sores took 2 tabs that day, Accuretic 20-25mg daily, Xanax 1mg daily, Phentermine 37.5mg daily, Biotin, Cranberry, Zinc I normally take Atorvastatin 80mg daily but stopped

Current Illness: only seasonal allergies

ID: 0971071
Sex: F
Age: 78
State: MI

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pain in extremity

Symptoms: Patient developed generalized hives starting 2 dys after her shot with worsening of her generalized hives thru the 2 dys afterward

Other Meds: Xanax 0.25 mg bid prn, Mevacor 20 mg q day, Prilosec 20 mg q day prn, Ambien 10 mg q hs prn

Current Illness: Urinary tract infection 1/11/21

ID: 0971072
Sex: M
Age: 48
State: MO

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Approximately 30 minutes after injection, client began to experience shortness of breath, nausea, vomiting, hives on face and chest, tightness in chest and severe anxiety attack.

Other Meds: Lisinopril, Amlodipine, Atorvastatin, Plaquenil, Vitamins A,B,C,D, Zinc.

Current Illness: None

ID: 0971073
Sex: F
Age: 45
State: VA

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/25/2021
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: Sulfa Drugs, sensitive to latex

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

Symptoms: My arm had a red circular area around the injection site and was painful as if I had been punched, the day of and the day after I got the vaccine on the 16th of January. This faded and went away. Saturday January 23, I noticed my arm had a hive like rash around the injection site and it itched. As the day progressed the itch grew worse so I put aquaphor on it in the event my skin was dry. Sunday I woke up and my arm had a red circle around the injection site with a raised portion almost as if half a hard boiled egg was under my skin on top of my muscle. The redness comes and goes. I am guessing from clothing irritation? The swelling is down a bit after I took a Benadryl.

Other Meds: Multi vitamin, Glucosamine Chondroitin, Vitamin D, Vitamin C, Vitamin E, Super B Complex, Candesartan Cilexetil 4MG, Topiramate 25MG, Phentermine 37.5 MG, Zafirlukast 20MG , Fish Oil (Krill oil), Cetirizine Hydrochloride

Current Illness: none

ID: 0971074
Sex: F
Age: 58
State: CA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Fatigue, nausea, diarrhea, chest pain

Other Meds:

Current Illness:

ID: 0971075
Sex: F
Age: 42
State: PA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
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: Codeine, Oxycodone, PCN, Rofecoxib

Symptom List: Vomiting

Symptoms: itching and the sensation of shortness of breath on vaccination date of 1/13/21.

Other Meds: Unknown

Current Illness: Denied any acute illness.

ID: 0971077
Sex: F
Age: 83
State: CO

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
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: Codeine - vomitting, Cymbalta - diarrhea, Mold - not specified, pollen extract - not specified, Lipitor - myalgia

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received 1st dose moderna vaccination and shortly after c/o feeling light headed, tingling in legs, dizzy. BP 200's/60's. ED called via radio, take to ED via WC. Pt received care in ED.

Other Meds:

Current Illness:

ID: 0971078
Sex: F
Age: 36
State: CA

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
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: food allergies - stone fruits (cherry, peaches, etc), pollen allergies

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

Symptoms: 7 days after first moderna dose I developed a warm, itchy sensation in my left deltoid - this was in the middle of the night and I kept waking up uncomfortable. When I woke up Saturday morning my deltoid was red and swollen, the muscle was still hot and now starting to ache instead of itch. Throughout Saturday the aching intensified to about a 6/10. Then it radiated into my left armpit and feeling of pain like a hard small ball in my armpit. I went to urgent care, the doctor was not sure if it was delayed allergic reaction or cellulitis so he started me on Bactrim. I have now taken one day of Bactrim - seems to be improving but still have sensation in my armpit/lymphnode.

Other Meds: prenatal multiivtamin

Current Illness: none

ID: 0971079
Sex: F
Age: 48
State: MI

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/25/2021
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: allergic to dust and pollen

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Began with waking to chills and incredible urge to pee. Emptying bladder and urinating were very painful accompanied by pink tinge. The "chills" were incredibly violent and by body was contracting involuntarily in to the fetal position, coming in waves every few seconds. Chills lasted 3 hours. Fever came on just after chills started. The fever of 101.9 lasted with the chills then I had a low grade fever of 99.1, until about 4pm on 12/30/20. Every joint in my body felt like they were on fire for about an hour, and then the pain moved to my spine. Tingling all over my body lasted 2 days (felt like when your foot falls asleep and is waking up). 2 weeks after vaccine, face tingling and chin numbness, and still continues, as does the painful bladder and urnination

Other Meds: B-complex, calcium w/vitamin D, tumeric, vitamin C.

Current Illness:

ID: 0971080
Sex: F
Age: 70
State: NV

Vax Date: 01/16/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

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

Lab Data:

Allergies: PCN, Novocaine solution

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

Symptoms: After injection on 01/16/2021, within 2 days all soreness had dissapted along with swelling and redness. On 01/24/2021 roughly at 04:45 A.M., I began to chill/shiver. The injection site on my right arm had become hot to the touch, peppered with red blotches, swollen and began to hurt again. I did take 1000mg of Tylenol for discomfort. I felt flushed, but no fever to speak of, rather lethargic. Today, 01/25/2021, the injection site is one large reddened, hot, swollen area about a size 3x4 inches. At this time, I have not visited my physician or any Urgent Care.

Other Meds: Lisinopril, Omeprazole, Simvastatin, Fluticasone, Fish Oil, Vit D3, Cetirizine, Calcium

Current Illness:

ID: 0971082
Sex: F
Age: 50
State: CA

Vax Date: 01/05/2021
Onset Date: 01/09/2021
Rec V Date: 01/25/2021
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:

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

Symptoms: headache muscle pain chill fever fatigue bloody nose when blew nose

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm