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: 0974403
Sex: F
Age: 76
State: NY

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
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: Feeling dizy

Other Meds:

Current Illness:

ID: 0974405
Sex: F
Age: 54
State: GA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Low back pain Constipation

Other Meds: Blood pressure

Current Illness: None

ID: 0974406
Sex: F
Age: 41
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Chills, body aches, vomiting

Other Meds:

Current Illness:

ID: 0974407
Sex: F
Age: 47
State: IL

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
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: Tachycardia, sweating, uncontrollable shaking, clamy hands and vomitimg

Other Meds: B-12 supplements

Current Illness: None

ID: 0974408
Sex: F
Age: 33
State: SC

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa-based drugs and cat/dog dander; seasonal allergies

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

Symptoms: Shot was administered on 1/20/2021. By that Friday, my upper right arm (over my bicep) developed a red patch, which I had attributed to dermatographia. Over the weekend, it began to raise up a bit from my skin and swell, and became warm to the touch. By Monday, 1/24/2021, the swelling had stopped, but the redness was noticeable on other parts of my upper arm, but not around the shot location. There is a bruise there from the shot, but no redness. The redness and warmth changes throughout the day, and at times is "itchy below the skin's surface", where I'm not able to scratch.

Other Meds: Protonix 20mg; Zinc tablet; Zoloft 100mg; Loestrin; Zyrtec

Current Illness: Currently trying to determine cause of abdominal pain and discomfort and watery-loose stool (before this vaccine was administered)

ID: 0974409
Sex: M
Age: 53
State: KY

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
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: Nizoral

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

Symptoms: 1/21/2021, blood glucose levels were fluctuating from very low to high, normally stable and consistent. 1/22/2021 spiked a temp of 101.9 that would come and go, nausea with eating, high anxiety with feeling of fatigue and being in a fog. Feels good when first getting out of bed in the morning but about an hour or two he feels tired with his anxiety level rising. PCP contact with new orders to increase daily dose of Prozac to assist with the anxiety and rest. Patient stated that he has been resting and was feeling a little better today.

Other Meds: Rosuvastatin, metformin, Saxenda, Prozac, ASA, lisinopril

Current Illness: No

ID: 0974410
Sex: F
Age: 42
State: CA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
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: Allergic to penicillin and sulfa drugs

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Vomiting due to severe nausea

Other Meds: Melatonin

Current Illness: None

ID: 0974411
Sex: F
Age: 57
State: CA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: Fever, body aches and chills began Tuesday, 1/26/21 @ 1:10am. Took Tylenol, but fever and chills did not go away completely. Right arm continues to be extremely sore even after taking Tylenol

Other Meds: N/A

Current Illness: Covid positive illness 6-7 weeks prior to vaccination.

ID: 0974412
Sex: F
Age: 26
State: MA

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, apple, eucalyptus

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I am not sure if the event that happened Sunday was directly related to the vaccine at all since it happened two days later, or if it was just a coincidence, or if the vaccine was just a physical stimulus trigger. I just wanted to let you know just in case! But out of nowhere, I had an episode (never had it before) where I can only describe it as what it might feel like to be drugged. I was delirious, confused, disoriented, dizzy. I wasn't able to leave bed without the room spinning. I had chest tightness and headache. When I would close my eyes, I would feel such head pressure that it felt like my body was on a boat during a tsunami. I would feel shaking and spinning inside my head. I never felt anything like it before. I was struggling to stay conscious. In the moment, I remember wondering if it was a brain aneurysm or if I was dying. I was scared, felt like I needed to call for help, but I was unable to. I allowed myself to fall asleep/lose consciousness (not sure which), and when I woke up an hour or so later, I felt a little better. I was still a bit confused on what happened and felt physically weak, but the episode had resolved. Hours later, I called the on-call service at my doctor's office because I couldn't shake the feeling that something wasn't right. She instructed me to go to the emergency room. By the time I got to the emergency room and got seen, this was a good 8-9 hours or so after the episode occurred. The PA-C at the ER ran bloodwork and a uranalysis (I do not know what he tested for since I was not given the results), as well as had me hooked up to a heart monitor. He said everything looked normal and that he would not run a CT scan since he did not think I had an aneurysm or anything indicating the need to expose me to radiation to perform a CT. I asked for an EEG and he said they do not do that at the emergency room. He discharged me to follow up with my PCP. While in the ER, I would have episodes of staring blankly into space at random, uncontrollably, and for an undetermined amount of time. I told the doctor, and he wasn't concerned. Yesterday (01/25/2021) I met with my PCP via telehealth and explained everything. He thinks it could have been my previously-diagnosed conversion disorder; however, I have not had that manifestation of it in the past. I expressed to him that I am very scared to get the second dose of the vaccine since I do not know if this event is related or not, and I do not want to die. I have two cats who need me! He did not think it was related to the vaccine, since it happened two days after the injection. But conversion disorder comes on with physical/mental/emotional trauma/stimuli. For the most part, I was feeling okay mentally. The vaccine was the only change to my normal routine. My previous conversion disorder effect was the loss/difficulty of the ability to swallow. I have not had an episode of that in years. The symptoms I experienced seem to be possible manifestations of the disorder when I did some research, but it does not fully explain what I experienced. I asked for a referral to neurology, just to be safe, and I have the appointment tomorrow (01/27/2021). I still feel residually weak, slight chest tightness, and overall feeling off/weird. Again, I do not know if this is directly related to the vaccine, but I wanted to make you aware just in case!

Other Meds: Clonazepam, Zyrtec, Zofran, Famotidine, Ibuprofen, Tylenol

Current Illness: none

ID: 0974413
Sex: F
Age: 26
State: ND

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient c/o fever 100.3, headache, and chills.

Other Meds:

Current Illness:

ID: 0974414
Sex: F
Age: 80
State: CA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
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: Heart palpitations at 2:am and then again at about 9: am the next day after the vaccination

Other Meds: I take a vitamin every day that has magnesium Zink, and calcium

Current Illness: none

ID: 0974415
Sex: F
Age: 42
State: TN

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
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: Rash to chest area 10-15 min following vaccine dose. Patient was given 1 ml of Benadryl IM. No other issues / complaints. Denied breathing difficulty.

Other Meds:

Current Illness:

ID: 0974416
Sex: F
Age: 36
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: First 24 hours sore arm and felt achy and out of it. Thought I was starting to feel myself by Sunday midday but then suddenly on Sunday afternoon almost exactly 48 hours after the shot I started to feel extreme confusion and short term memory loss. My body started shaking, I felt very hot and then very cold (back and forth) and began experiencing shortness of breath. It was all very scary and I ended up in the ER.

Other Meds: Vitamin C

Current Illness: None

ID: 0974417
Sex: F
Age: 24
State: CA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/26/2021
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: Doxycycline Base, Anhydrous - Other Pcn [Penicillins] - Dyspnea

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

Symptoms: Patient noted palpitation and came to ED. No similar reactions to vaccines in the past. EKG sinus tachycardia but otherwise normal EKG. Pt was given Benadryl 50mg PO x1, monitored in ED and discharged home.

Other Meds: drospirenone/ethinyl estradiol YASMIN birth control tablet, sulfamethoxazole/trimethoprim BACTRIM antibiotic

Current Illness: Unknown

ID: 0974418
Sex: F
Age: 61
State: OH

Vax Date: 01/15/2021
Onset Date: 01/19/2021
Rec V Date: 01/26/2021
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: PCN, Sulfa, Zithromax

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

Symptoms: Developed a rash red with red pustules ( No drainage) on my fingers approx 3 days after injection. I have since developed these all over both hands palms and top as well as my arms, feet and legs its itchy and painful. . Saw Dr today and he is unsure what the rash is. but says it could be related to shot. Gave me a Medrol Dose pack.

Other Meds: Celexa, Omeprazole, Norvasc, Multi vit, Fish Oil.

Current Illness: None

ID: 0974419
Sex: F
Age: 49
State: NE

Vax Date: 01/19/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: ON 1/21/21 DEVELOPED NAUSEA, BODY ACHES AND WEAKNESS. SHE CALLED HER DOCTOR, WHO TOLD HER TO WAIT OUT THE SYMPTOMS OR GO TO THE ER IF THEY GOT WORSE. SHE DID NOT GO TO THE ER.

Other Meds:

Current Illness:

ID: 0974420
Sex: F
Age: 41
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/26/2021
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: N/A

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

Symptoms: Chills, nausea, fever, sweats x 24 - 48 hours; headache, fatigue, painful swollen lymph nodes (left posterior cervical) x 72 hours

Other Meds: Advil 400 to 600 mg, MVI, Riboflavin, Mg, Ashwaganda, Aloe, probiotics

Current Illness: N/A

ID: 0974421
Sex: M
Age: 17
State:

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
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: Patient had a syncopal episode within 10 minutes of the administration of the vaccine. He fell off of the examining room table and hit his head causing lacerations that required suturing and possibly a concussion.

Other Meds:

Current Illness:

Date Died: 01/23/2021

ID: 0974422
Sex: F
Age: 85
State: MD

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient developed fever to 102 within 24 hours with decreased mentation. Stopped eating/drinking despite aggressively treating fever. Was DNR B status. Family agreed to a trial of IV fluids on 1/21 but was not successfully started until 1/22 after several attempts. Family wanted only comfort measures with no transfer to hospital. Patient continued to have fevers to 102-103 range. Patient passed on 1/23 . Patient did test positive for COVID in early September without significant illness. She was in usual state of health prior to vaccination.

Other Meds: depakote, seroquel, aspirin, loratidine, prilosec, senna plus, vitamin D, gabapentin

Current Illness: none

ID: 0974423
Sex: F
Age: 84
State: MD

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: DRUG ALLERGIES: Mupirocin, Sulfa, Levaquin, Vancomycin,Cefdinir

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

Symptoms: Moderna COVID-19 Vaccine EUA Inability to eat (nausea), unpleasant taste, extreme weakness, inability to think appropriately (unable to recall words, slow thought process), diarrhea -- all occurred for two days and have resolved themselves without treatment; still weak but am increasing liquids, salts, immodium (not today), frequent rests, cancelling Physical Therapy and private clarinet instruction

Other Meds: PRESCRIPTION MEDS: Advair diskus, Amiodarone HCL, Amlodipine besylate, Levothyroxin, Neurontin, Simvastatin,Singulair, Toprol XL, Tramadol, Valsartan, Xeralto, Ambien, Astelin, Flonase, ProAir Inhaler, Patanol eyedrops SUPPLEMENTS/OTC: Mult

Current Illness: Extreme back pain due to scoliosis and arthritis

ID: 0974424
Sex: F
Age: 46
State: WI

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient reported her tongue felt tingly 5 minutes following the first dose. She reported this finding at today's visit. She said she just took a Benadryl when she got home following her first dose. I did question if she has had anaphylaxis in the past to any meds, etc, and she said no, but reported having allergic symptoms with an antibiotic. No other allergic history to vaccines, meds, etc. Patient wanted to continue with second dose of vaccine today. Vaccinated at 1615. Patient reported tongue tingling at 1640. 25mg PO Benadryl given at 1640. Patient left the clinic at 1700 stating that she felt ok to leave. She had Benadryl at home and knew who to call if symptoms worsened. Writer called the patient back on 1/26/2021 at 1100. Patient stated that at 1900 last night (1/25/2021) she had to go to the Emergency room and received 2 doses of Epinephrine. She then had to stay the night to be observed. Patient stated that she was being discharged today.

Other Meds:

Current Illness:

ID: 0974425
Sex: F
Age: 57
State: WY

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: PCN, Sulfa

Symptom List: Unevaluable event

Symptoms: Pt states her hands were turning red at which time RN was called to assess. Bilateral hands were red and blotchy. She states she feels the need to frequently clear throat but is not short of breath. She states her lips feel tingly. No angioedema noted, redness is not spreading from palms of hands. No redness or rashes noted at injection site. Pt was given 50mg of diphenhydramine prior to leaving. She waited in lobby with staff observation for another 15 minutes, Redness in hands was resolved. Educated pt to call emergency services should symptoms persist or worsen. Pt verbalizes understanding. This RN will call later today and tomorrow to follow up with pt.

Other Meds: none

Current Illness: none

ID: 0974426
Sex: M
Age: 57
State: OK

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
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: NKDA client does have seasonal allergies

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

Symptoms: Approx 26 hours after receiving the vaccine client started c/o "chest didn't feel right, and it could be my stomach. I also noticed a swollen lymph gland under my left armpit. It is 2inches wide by 4 inches long. I called my oncologist and they just said to watch it, take ibuprofen. I have a similar thing happen usually right before I take my chemotherapy." He denies fever, red streaks.

Other Meds: Tamsilosin, Fexaphenadine

Current Illness: hx of blood cancer

ID: 0974427
Sex: M
Age: 48
State: FL

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/26/2021
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: SIRS - systemic inflammatory response - rigors, chills, fever 104 for 8 hours and delirium

Other Meds: Lexapro, pepcid, prilosec, claritin, pravachol

Current Illness: none

ID: 0974428
Sex: F
Age: 81
State: NC

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: On the first day, my arm was sore and I was a little tired. I had some abdominal pains on the day after the vaccine with diarrhea. After 24 hours of that pain, I could get up and move around. About a week I felt better.

Other Meds: I take atorvastatin, lisinopril and a mulitvitamin

Current Illness: No

ID: 0974429
Sex: F
Age: 34
State: MA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/26/2021
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: Penn

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

Symptoms: Chest pain, High blood pressure, Heart rate was fast and i also had tingley hands . It happened about 45 Minutes after i had the vaccine. I was then sent out to the hospital.

Other Meds:

Current Illness:

ID: 0974430
Sex: M
Age: 42
State: IA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 12 hours after vaccination, the patient realized he had a heaviness in his chest and just didn?t feel ?right?. His Apple Watch told him he was in afib. So the patient was taken to the ER by his wife where this was confirmed with an EKG. He was cardioverted back to normal sinus rhythm and he was prescribed Eliquis. Patient has no prior heart arrhythmias or medical concerns. Patient is slightly overweight, but has not had any arrhythmia or history of a fib in the past. Patient was discharged to follow up with his family physician. All of his blood work was normal.

Other Meds: Omeprazole

Current Illness: None

ID: 0974431
Sex: F
Age: 32
State: NE

Vax Date: 01/12/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
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: Vaccinated 1/12/2021. Left arm became sore next day, and continues through today. Reported as normal course of arm pain which became much more intense on 1/22/2021. Large red, raised rash, warm to touch present. Spreading noticed over next several days. As of today, 1/26/2021, patient reports rash has decreased, is no longer warm to touch. Pain is still present, but less intense than previously.

Other Meds: Effexor 150mg multi vitamin

Current Illness: none

ID: 0974432
Sex: F
Age: 75
State: NJ

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
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: Sulfa, flu vaccination, sensitivity to many others. Lobster (not all shellfish), rice. Bandaid glue

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

Symptoms: At about 10:25 am itching of neck and face. At about 10:40 am mild cutaneous swelling of lip. Symptoms rebounded overnight

Other Meds: Amlodopine, vit D 3, Allegra 180, nasacort, niacinamide, atorvastatin, baby aspirin

Current Illness: None

ID: 0974433
Sex: U
Age: 43
State: NJ

Vax Date: 01/20/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient experienced fever with T-max of 102, chills, arthralgias, muscle spasms, and headache. No medical treatment required. Patient took a sick day from work to recover.

Other Meds:

Current Illness:

ID: 0974434
Sex: F
Age: 35
State: KY

Vax Date: 01/19/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List: Injection site pain

Symptoms: I developed significant joint pain in my knees approximately 3 days after my second COVID19 vaccination. I have no history of joint pain and have no recent changes in my activity level or medical history. Even walking as a casual pace causes pain. It is not severe enough to interfere with activities of daily living, but it is certainly noticeable. I cannot think of any other potential cause of this pain. The it has been approximately 4 days since this pain began, and it has not improved.

Other Meds: Escitalopram, divalproex, cetirizine, Aurovela Fe 1/20, cholecalciferol, L-methylfolate

Current Illness: None

ID: 0974435
Sex: M
Age: 49
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: fever 101F, sore arm, large red swollen arm near injection site and warm to touch- possible cellulitis, referred to PCP for evaluation.

Other Meds: Lipitor, vitamin D

Current Illness: History prior positive covid 19 disease on 12/18/20.

ID: 0974436
Sex: F
Age: 74
State: PA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
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: none

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

Symptoms: By the late afternoon/early evening I had developed a rash that covered my body from the bottom of my feet to the top of my head. The rash was clearly visible but not bumpy. It was extremely itchy. I took Benadryl and soaked in an Epsom Salt bath several times that night as I was unable to sleep due to the intense itching. The next morning (Saturday) I called my doctor and was prescribed a steroid to combat the itching but was told not to take it until Monday so as not to interfer with the antibodies my body was obviously producing in response to the vaccine. I was also instructed to start taking one Zyrtec tablet each morning and two Benadryl tablets each night. On Monday morning (01/25/2021) I began taking Methylprednisolone (4mg Dospak 21s) which relieved the itching. At this time the rash is greatly reduced and the itching has almost stopped. I will continue the meds until the dosage is completed.

Other Meds: Centrum Silver for Women 50+ Omeprazole Cap 20mg Hair Skin & Nails Softgels Linzess 72 ,mcg* as needed

Current Illness: none

ID: 0974437
Sex: F
Age: 75
State: CA

Vax Date: 01/16/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
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: Itchy rash at injection site, starting 6 days after vaccine

Other Meds: prednisone 2mg daily, atorvastatin, atenolol, levothyroxine, amlodipine, doxycycline

Current Illness:

ID: 0974438
Sex: M
Age: 38
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
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: Seasonal allergies

Symptom List: Erythema, Pruritus

Symptoms: Patient awoke with shivering at 03:00 AM this morning, later developed diaphoresis, swelling of the eyes, lips, and tongue at 08:00 AM. Patient presented to the emergency department and was treated for allergic reaction; received prednisone and famotidine per patient MAR. Symptoms resolved and the patient was discharged with a prescription for a prednisone taper.

Other Meds: Citalopram 20mg, methylphenidate Er 36mg, sildenafil 100 mg, testosterone CYP 100 mg/mL.

Current Illness: None

ID: 0974439
Sex: F
Age: 17
State: NE

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: DEVELOPED BODY ACHES, FEVER, HEADACHE, AND CHILLS

Other Meds:

Current Illness:

ID: 0974440
Sex: F
Age: 61
State: IN

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Fever. Dizzy. Nauseous. Body aches. Soreness.

Other Meds: Vit c,d Synthriod Metforman Paxil Cholesterol

Current Illness:

ID: 0974441
Sex: F
Age: 43
State: MS

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
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: NKDA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Symptoms - Arm tenderness, chills, increased heart rate (110), low grade temperature (100.2), chest heaviness; treatment Tylenol as needed

Other Meds: losartan 25 mg daily and pantoprazole 20 mg BID

Current Illness: none

ID: 0974442
Sex: F
Age: 79
State: AK

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
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:

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

Symptoms: mild pain at injection site, mild headache for few hours after vaccine

Other Meds:

Current Illness:

Date Died: 01/03/2021

ID: 0974443
Sex: M
Age: 76
State: TN

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 01/26/2021
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: N/A

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

Symptoms: Patient received Moderna COVID vaccine on 12/30/2020 at a Pharmacy clinic where he was a resident. Nurses at the facility reported that he was responsive and showed no signs of any adverse effects until 1/2/2021 when he was observed slightly unresponsive and staring at the ceiling and trembling. He had a fever of 101F at this time. The facility ordered labs and a rapid COVID test (all of which came back normal) and started IV antibiotics. A few hours later, patient began bleeding from his eyes, nose, and mouth and was sent to the local ER. The patient refused being admitted to the ICU for possible sepsis/hemorrhage and died the following day on 1/3/2021. All healthcare professionals involved agreed that this was not likely due to the vaccine, but needed to be reported nonetheless.

Other Meds: Unknown

Current Illness: Unkown

ID: 0974444
Sex: F
Age: 80
State: MI

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/26/2021
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: PT called to hospital today 01/26/21 reporting 2 hours after vaccine developed HA, Throat and jaw discomfort, denied SOB, called 919 . Pain subsided at that time and she did not seek ER care, but called reporting "severe side effects"

Other Meds:

Current Illness:

ID: 0974445
Sex: F
Age: 33
State:

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: The next day after receiving my vaccine around 0500 a.m., I started getting severe headache and left arm pain. At about 0700 a.m., I started getting body aches, chills, and low grade fever of 100.4. After taking Tylenol and Advil interchangeably throughout the day, I was able to break the fever. I continued to have body aches, chills, severe headache the next day (Sunday). And by Monday, only a minor headache remained but all other symptoms were resolved.

Other Meds: Tylenol

Current Illness:

ID: 0974446
Sex: F
Age: 57
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
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: "Severe headache and fever of 102.2 night of vaccine. The site of the vaccine was the size of a grapefruit. The site felt very warm and very painful. Fatigue and horrible body aches. On Sunday, continued to take Tylenol and was thinking of going to urgent care. I was tired lethargic, had chills and felt nauseous. I rested all day and at this point the injection site was the size of an orange. Monday--The site of the injection is the size of a lemon. I have not taken any Tylenol or any other medications for fever. At around 12:30pm I started to feel chills, nauseousness and very warm." -followed up at urgent care-told to take Tylenol and motrin and rest--on Tuesday still feeling achy, tired and slightly swollen arm

Other Meds:

Current Illness:

ID: 0974447
Sex: F
Age: 30
State: IL

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
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: Sulfa

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

Symptoms: Sweating, chills, fever, nausea, Tachycardia, lightheaded

Other Meds: Motrin, Tylenol, Pepto-Bismol

Current Illness: None

ID: 0974448
Sex: F
Age: 46
State: MD

Vax Date: 01/20/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
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: Penicillin codeine

Symptom List: Vomiting

Symptoms: Swelling around dermal filler

Other Meds: Metformin, levothyroxine, Effexor. Losartan Dermal filler

Current Illness:

ID: 0974449
Sex: F
Age: 19
State:

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
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: iodinated contrast media, lansoprazole, omeprazole, ranitidine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 19 y.o. female who arrived to the emergency department for 19-year-old female with history of COVID infection several months ago was receiving her COVID vaccine this morning when she developed nausea and tightness in her throat about 15 minutes after the injection. Epinephrine was administered prior to transfer to the ED. She denies any rash. She does feel slight shortness of breath. She denies headache earache sore throat or rhinorrhea cough vomiting diarrhea fever chills or abdominal pain. She has had hives and tightness in her throat from several medications in the past including Prevacid Prilosec Zantac and iodinated contrast media. No new medications. Anaphylactic type reaction and patient advised to not receive the 2nd vaccine. PMH: Diabetes mellitus Initial Vital Signs Blood Pressure 01/25/21 0902 132/85 Heart Rate 01/25/21 0902 92 Respiratory Rate 01/25/21 0902 16 Temp 01/25/21 0925 36.6 ?C (97.9 ?F) Temp Source 01/25/21 0925 Oral SpO2 01/25/21 0902 99 %

Other Meds:

Current Illness:

ID: 0974450
Sex: F
Age: 37
State: MI

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/26/2021
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: NA

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

Symptoms: I was puking, lethargic, headache, body aches from Dec. 30- Jan. 2. On Jan 2, 2021 I went to the ER. I was given sodium chloride, nausea med and an allergy med.

Other Meds: PRENATAL VITAMENS ADDERAL TRAZODONE VENLAFAXINE VICTOZA

Current Illness: ON DECEMBER 14, 2020, I TESTED POSITIVE FOR COVID-19.

ID: 0974451
Sex: F
Age: 60
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/26/2021
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: Increased heart rate 160, Arrythmia Specific PVC, with in 6 hours of Injection. Stopped that night. arrhythmia a couple times in following 10 days. No treatment.

Other Meds:

Current Illness:

ID: 0974452
Sex: F
Age: 33
State: GA

Vax Date: 01/05/2021
Onset Date: 01/10/2021
Rec V Date: 01/26/2021
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: Right anterior cervical, supraclavicular, and axillary tender lymphadenopathy, started 5 days after vaccination, still present after 2 weeks

Other Meds: Allegra 180 mg PO daily Multivitamin 1 tab PO daily Fish oil 1 tab PO daily Vitamin D3 3000 IU PO daily

Current Illness: HSV 1 primary outbreak started 11/30/2020

ID: 0974453
Sex: F
Age: 57
State: VA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/26/2021
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 known

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

Symptoms: Sat. 1/23 knuckles very red, Sun. 1/24 Knuckles red and dry, Mon 1/25 Knuckles red and swollen, no pain. Tues. 1/26 had 30 seconds where it was hard to breathe, "like gasping for air".

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm