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: 0976120
Sex: F
Age: 40
State: DC

Vax Date: 01/08/2021
Onset Date: 01/08/2021
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: NSAIDs, Topical niacinamide, Shellfish

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt ate lobster risotto for lunch after having the vaccine, approx. 1.5 hours later she became nauseous a began to vomit. Vitals were stable, she was given Pepcid, Benadryl and Zofran before being transported to the ER

Other Meds: Bupropion, Tri-Sprintec, Pure Encapsulations Multivitamins

Current Illness:

ID: 0976121
Sex: F
Age: 37
State: LA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillins, cephalosporins, morphine

Symptom List: Anxiety, Dyspnoea

Symptoms: Barely able to lift arm for 12 hours, fever (102), shaking chills, headache, tachycardia, dizziness

Other Meds: Seasonique birth control

Current Illness: Plantar fasciitis

ID: 0976122
Sex: F
Age: 35
State: VA

Vax Date: 01/06/2021
Onset Date: 01/12/2021
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: sulfa penicillin

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

Symptoms: No symptoms or side effects immediately following the vaccine. 1 week after receiving Moderna vaccine my right arm was swollen and it was hard at the injection site. I had a bright red rash that extended from below my shoulder down to my elbow that was raised and itchy. Rash did not develop anywhere else on the body; there was no difficulty breathing. Rash resolved on its own without any medications after three days.

Other Meds: Nature Made Prenatal + DHA

Current Illness: none

ID: 0976123
Sex: F
Age: 58
State: NJ

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

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

Lab Data:

Allergies: Augmentum, Antiemetics, Benzos, narcotics, muscle relaxants, Ventolin, bee stings, mold, pollen-tree, flower, apple and pear skin, grass, evergreens, chocolate, eggs (but I eat them with out symptoms-did not eat for two weeks prior to inject), garlic salt, fragrance, nitrile gloves (mucosal contact only) adhesive tape-localized response only.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Having Ehlers Danlos and Mast Cell Degranulation as well as Dysautonomia... Anaphylaxis is often referred to as slow roll and without the typical face swelling and rash. It is more subtle and can be harder to detect. And that was my experience: as follows: I became faint and briefly passed out within 2 minutes of injection. I stabilized quickly within a 30 minute hold although developed increasing nausea, I and med tech was satisfied that it might just be my dysautanomia. I spent the evening with severe headache vomiting as passed out again. I experienced throat tightening but not full closure. The next day I had flue like symptoms that I assume were normaland vaccine related. When this passed in the evening I again suffered nausea and dizziness, vomiting and throat tightening when I tried to eat. These symptoms were not similar to the flush feelings earlier in the day. The symptoms ebbed and waned for 2 days with increased frequency as I took chromalyn , Benadryl with some effect at first and ate with great care as not to introduce more allergens. I had increased chest pain, sweating, fainting, throat tightening became severe Benadryl was not effective. I was having trouble swallowing. I was forced to us an epi pen and call 911. This is a typical anaphylactic response for EDS< Mast Cell patients. It became clear that I could not get past this on my own and the symptoms were increasing. I started to shake with chills and feared shock as my chest pains increased. The epi pen injection and hospital visit via ambulance occurred Monday 1/25-1/26. I became very faint during the Ems intake with the techs having to hold me up to check vitals etc.. My HR dropped despite the EPi. At the ER I was given IV steroids, IV Benedryl and Potassium, tablets and fluids throughout the night, admitted for evaluation.

Other Meds: Benadryl, Chromelyn, Zyrtec, Zonizamide, Aloe vera, Vitamin D,

Current Illness: none

ID: 0976124
Sex: F
Age: 37
State:

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Fever: 101 Arm tenderness Body aches

Other Meds:

Current Illness:

ID: 0976125
Sex: F
Age: 41
State: MD

Vax Date: 01/19/2021
Onset Date: 01/23/2021
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: No

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

Symptoms: Got the vaccine on 1/19/2021 Tested positive for COVID 1/23/2021

Other Meds: Labetalol Metformin Elderberry Vitamin C VITAMIN D3 ESCATOLPRAM

Current Illness: Tested Positive for COVID on the 23rd of January.

ID: 0976126
Sex: F
Age: 38
State: CA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pain/swelling at injection site, headache, joint pain, all over body pain, fatigue, nausea, dizziness

Other Meds:

Current Illness:

ID: 0976127
Sex: F
Age: 39
State: CA

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Latex, phenergan

Symptom List: Pharyngeal swelling

Symptoms: Patient with sore arm day of event. Next day began to have some blinking of right eye, on medial side, which persisted for next two days. On 1/25/2021 began to have some numbness of right side of face starting on temple/ forehead, then beginning to extend down towards chin, before coming around the left side of face and becoming completely circumferential. Patient states felt leathery to the touch at that time due to decreased sensation. No facial asymmetry or weakness to muscles of facial expression noted by patient at any time. Patient went to sleep that night, fully resolved on waking in the AM.

Other Meds: Zoloft, tranexamic acid, fenofibrate, losartan, ferrous sulfate

Current Illness:

ID: 0976128
Sex: F
Age: 53
State: CA

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: fever chills body aches nausea headache arm pain

Other Meds:

Current Illness:

ID: 0976129
Sex: F
Age: 27
State: NV

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: Nausea, lightheadedness, near syncopal episode, fevers, joint pains, headache

Other Meds:

Current Illness:

ID: 0976130
Sex: F
Age: 40
State: IA

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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Dust, fir trees

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

Symptoms: Butterfly face rash. Have pictures to document.

Other Meds: LoOvral, lexapro, lorazepam, vitamin d, probiotic

Current Illness: None

ID: 0976131
Sex: F
Age: 32
State: KY

Vax Date: 01/17/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: none known

Symptom List: Rash, Urticaria

Symptoms: On day of vaccine and day after had mild soreness and very mild swelling at injection site Exactly one week later - Sunday Jan 24 AM - same area of arm had a rectangular red rash, mild, more pronounced around edges of area; about 1.5" wide and about 2" high; slightly swollen. Site was also itchy and warm. Symptoms the same on Monday Jan 25. On Tuesday Jan 26 redness is going away, slightly less rash in texture, and only occasional itchiness.

Other Meds: Xyzal 24 hr antihistamine - taken daily Lola multivitamin - prenatal/menstrual - taken daily

Current Illness: none

ID: 0976132
Sex: F
Age: 38
State: VA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: arm soreness slight fever (100.0) fatigue lightheaded/dizzy

Other Meds: Buproprion HCL Vitamin D Cetirizine

Current Illness:

ID: 0976133
Sex: F
Age: 81
State: CA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Not in file

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

Symptoms: Patient was in 15 minutes observation after COVID vaccination when she started experiencing SOB at 4:18 pm. Started with O2 treatment at 3 ml flow rate, notified site lead immediately. Under site lead supervision, attempted to take VS : HR 90 irregular, RR 40 irregular, unable to take BP due to equipment malfunction. No T due to no thermometer in observation room. Patient is diaphoretic states SOB, dizziness. Denies Chest pain. No N/V. At around 4:20 pm, one dose ( 0.3 ml) of epi-pen adult was administered left lateral thigh and called Emergency service ambulance per protocol. At 4:30 pm, EMS ambulance and police were arrived. Detailed patient care information was provided and handed over the care to the team. At 4:40 pm, patient left with emergency ambulance team.

Other Meds: Not available

Current Illness: Not available

ID: 0976134
Sex: F
Age: 46
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: Latex Dermabond

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

Symptoms: Chills, fever of 102, body aches, headache, fatigue, dizziness, soreness at injection site and under the arm

Other Meds: Lexapro Levothyroxine

Current Illness:

ID: 0976135
Sex: F
Age: 74
State: LA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
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: Sharp pain in chest for a minutes the night of the injection and then went away. The next morning, sharp pain in the stomach for a few minutes and then went away.

Other Meds:

Current Illness:

ID: 0976136
Sex: F
Age: 30
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: No known allergies

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

Symptoms: A large raised welt/bump appeared underneath where the vaccine had been administered. I iced the inflamed area, and today it has been spreading. The are is now 3 inches long, and 1 inch tall. Area is no longer raised, but is still warm to the touch, sore and red.

Other Meds: Folic acid B-6

Current Illness: No illnesses

ID: 0976137
Sex: F
Age: 37
State: CA

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: Onset 1 hour after administration. High blood pressure: systolic over 167. Nausea and vomiting. She was sent home and took a nap. Her blood pressure improved to 155/79.

Other Meds:

Current Illness:

ID: 0976138
Sex: M
Age: 25
State: MA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
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: Peanuts, treenuts

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Headache Chills Fatigue Muscle aches Arm pain All beginning 24hr after receiving dose throughout the day

Other Meds:

Current Illness: Covid-19 (symptoms beginning 04jan21)

ID: 0976139
Sex: F
Age: 50
State: CT

Vax Date: 01/15/2021
Onset Date: 01/22/2021
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: no known allergies

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

Symptoms: Upper arm, around injection site, became swollen, red, and warm on 1/22/21-one week after the vaccine; I took 250mg acetaminophen and put ice pack on arm. Occasionally the site itches very slightly; ice reduces itch. Upper arm was sore to touch on Friday night/Saturday morning, but has not been such since then. No loss of function and all affect to activities of daily living.

Other Meds: Armour Thyroid

Current Illness: none

ID: 0976140
Sex: F
Age: 51
State: CA

Vax Date: 01/14/2021
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: 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: pain in arm on the 21st injection welted up, was red, hot and painful pain in armpit icky feeling swollen arm

Other Meds:

Current Illness:

ID: 0976141
Sex: F
Age: 40
State: NJ

Vax Date: 01/18/2021
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: LA

Lab Data:

Allergies: No

Symptom List: Unevaluable event

Symptoms: 8 days after injection, redness below injection site, raised, warmth, firmness, itchiness.

Other Meds: Adderall XR

Current Illness: No

ID: 0976142
Sex: M
Age: 46
State: MI

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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:

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

Symptoms: That evening extreme funny feeling in left arm. Next day chills. After slight pain above chest and below neck. Lathirgec and joints creeking. These feelings off and on even to today. Unable to go to work and stayed in bed with very little movement for over 12 hours. Able to function once I got up.

Other Meds: Fluxotine

Current Illness:

ID: 0976143
Sex: M
Age: 35
State: IN

Vax Date: 01/06/2021
Onset Date: 01/07/2021
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: No

Symptom List: Injection site pain, Pain

Symptoms: The Morning after the vaccine I woke up with extreme fatigue and body aches. It lasted about 8 hours. I still was tired at night and woke up 2 days after the vaccine and felt fine.

Other Meds: Omeprazole Multivitamin

Current Illness: No

ID: 0976144
Sex: M
Age: 37
State: NJ

Vax Date: 01/21/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Flu like symptoms including chills, body aches, fever, and fatigue for 4 days after vaccination shot

Other Meds: Claritin: multi-vitamin

Current Illness: None

ID: 0976145
Sex: M
Age: 37
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: SYR
Vax Site: LA

Lab Data:

Allergies: NA

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

Symptoms: Shot at 0710 on 1/25 First chill at 1900 Full blown frozen chills at 2310 Woke up HOT + fever @ 0215 ~100.5 Fever broke at 0600... sweaty! Woke up at 0800 with headache and foggy Felt normal by 1400 on 1/26

Other Meds: Propranolol Melatonin Lysine Vitamin C Zinc Quercetin

Current Illness: None

Date Died: 01/21/2021

ID: 0976146
Sex: F
Age: 86
State: CA

Vax Date: 01/07/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Resident is asymptomatic

Other Meds: Multivitamin Liquid (Multiple Vitamins-Minerals) Give 5 ml via G-Tube one time a day for (SUPPLEMENT) Aspirin Tablet Chewable 81 MG Give 1 tablet via G-Tube one time a day for (CVA PROPHYLAXIS) Norvasc Tablet 5 MG (amLODIPine Besylate) G

Current Illness: No symptoms after COVID vaccinations

ID: 0976147
Sex: F
Age: 34
State: CO

Vax Date: 01/14/2021
Onset Date: 01/19/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: We here the injection site is on my left arm there?s a rash. That?s itchy, red and heat or warmth coming from the area. The redness almost looks like a bruise the size of a 4x4. I?ve noticed these symptoms at least five days or so after the vaccine was given.

Other Meds:

Current Illness:

ID: 0976148
Sex: F
Age: 53
State: TN

Vax Date: 12/30/2020
Onset Date: 01/01/2021
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: Sulfur

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

Symptoms: dry cough

Other Meds: No

Current Illness: None

ID: 0976149
Sex: M
Age: 54
State: CA

Vax Date: 01/05/2021
Onset Date: 01/07/2021
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: Nausea

Symptoms: Dizziness/vertigo starting ~ 8 am, 1 1/2 days after the vaccination, lasting for most of the day.h

Other Meds: None

Current Illness: Headaches

ID: 0976150
Sex: F
Age: 51
State: TN

Vax Date: 01/22/2021
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: Peanuts, Sulfa, niacin

Symptom List: Injection site pain

Symptoms: Excess mucus production, choking on sputum, body rash,- Similar reaction when nut products consumed in the past. 1 alavert sublingual tablet taken, 2 puffs of albuterol inhaler and benadryl tablet taken

Other Meds: Levothyroxine, Cymbalta, Pravastatin, Buspar, Tylenol, Ibuprophen

Current Illness:

ID: 0976151
Sex: M
Age: 72
State: NJ

Vax Date: 01/21/2021
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: Iodine injection

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

Symptoms: felt very weak could not obey commands when spoken to, felt nausea. lasted approx. 12 hours

Other Meds: Metorprolol Er (Succ) 25 Mg once a day Levothyroxine 75 MCG once a day Vitamin B-12 once a day CQ-10 300 MG once a day Metformin 500 MG once a day Gabapentin 100 MG once a day Zing 50 Mg. once a day Hydroeye once a day Aspirin

Current Illness: None

ID: 0976152
Sex: M
Age: 45
State: GA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: nkda

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

Symptoms: received 1st dose in series around 3pm on 1/19/2021 in right deltoid developed severe headaches for the next 48hrs with onset around 6pm 1/19/2021 developed numbness and visible bruising on middle finger right hand on 1/20/2021. The numbness and bruising resolved by 1/21/2021 but continue to experience 1-3 instances a day where my finger will go numb and get cold. These episodes resolve in 20 -90 minutes. They are decreasing in frequency ( I have only had one today on 1/26/2021 )

Other Meds: finasteride 1mg qd naproxen 220mg prn

Current Illness: none

ID: 0976153
Sex: F
Age: 69
State: FL

Vax Date: 01/13/2021
Onset Date: 01/17/2021
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: Penicillin, Ampicillin, Darvon

Symptom List: Tremor

Symptoms: Since taking the vaccine, after a few days, I continue to have nightmares, heart palpatations, severe headaches, constant diarreah, lump feeling in upper chest and throat.

Other Meds: Losartan

Current Illness: Physical therapy for shoulder surgery, shot of cortizone

ID: 0976154
Sex: F
Age: 45
State: WA

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none known

Symptom List: Erythema, Pruritus

Symptoms: large swelling and pain at injection site, severe headache, shoulder and neck soreness, joint pain beginning approximately 16 hours after injection lasting until approximately 30 hours after injection, @approximately 40 hours upper right lip swollen for approximately 15 hours

Other Meds: HCTZ

Current Illness: n/a

ID: 0976155
Sex: F
Age: 39
State: MI

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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: none

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

Symptoms: Injection site very sore, muscle very sore for 6 hours; injection site and muscle mildly sore for 6 hours.

Other Meds: gummy multi-vitamin, gummy vitamin d

Current Illness: none

ID: 0976156
Sex: F
Age: 41
State: OH

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Bananas, pineapple, mango, walnuts, almonds, pecans, kiwi Prednisone

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

Symptoms: Within less than 10 minutes of receiving the vaccine I began to feel a tingling sensation inside my mouth. That moved to my lips within the following 10 minutes and my pulse increased. I received benadryl at the triage area of the vaccination clinic and monitored. My BP was unusually high (140/90). In the days that followed, the injection side was swollen and raised, the muscle around it knotted, and incredibly painful. I had some slight symptoms such as headache and nausea. Those all subsided by Friday, 1/22/2021. One week later (today, 1/26/2021) the injection sight is suddenly reinflammed; the knot has returned and is larger than before, the skin is raised and red and hot to the touch, and it is extremely itchy. I was advised at the vaccination clinic that I would be able to receive the second dose, but that I should take benadryl prior to receiving it. Now I'm wondering if I should receive it at all. Why should it be reinflammed, a week later?

Other Meds: Claritin

Current Illness: No illnesses

ID: 0976157
Sex: F
Age: 16
State: IL

Vax Date: 01/22/2021
Onset Date:
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: Asthenia, Chills, Headache, Myalgia

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0976158
Sex: F
Age: 30
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: 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: fever of 102.8 for 20 hours, chills, headache, body aches

Other Meds:

Current Illness:

ID: 0976159
Sex: F
Age: 37
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
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: allergic to Tylenol

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

Symptoms: Pt. C/O hot flash and dizziness at the time of vaccination then 2 minutes later she developed a migraine headache at 4:37. She had difficulty walking from her chair to the medical cot due to pain but responded to taking a dose of her own medication of 400mg of Advil and also placing cold packs no her forehead and neck. The pain gradually eased and she was able to leave the clinic at 17:06 feeling better.

Other Meds: Advil or Aspirin for migraine headaches

Current Illness: denies

ID: 0976160
Sex: F
Age: 43
State: IN

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: SIGNIFIGANT SWELLING AT VACCINE SITE, SWOLLEN LYMPH NODES UNDERARM AND UP NECK ON RIGHT SIDE, FATIGUE, LOW FEVER, ACHES & CHILLS, HEADACHE

Other Meds: Vitamin D, Zinc, Synthroid, Trintillix

Current Illness: no

ID: 0976161
Sex: F
Age: 47
State: NM

Vax Date: 01/23/2021
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: Patient stated she has a history of asthma attacks and has to occasionally use her epinephrine pen to aid in breathing due to a new onset of an allergy to salad dressing.

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

Symptoms: Patient in observation area for a 30 minute observation period. Patient upon sitting down began to cough. Patient given water with no resolve to coughing. Patient stated she has a history of asthma attacks and has to occasionally use her epinephrine pen to aide in breathing due to a new onset of an allergy to salad dressing. Patient taking to first aid area assessed by Medic. Lungs were clear to auscultation and patient O2 sat was 95% on RA. Patient denied any difficulty breathing. Provider evaluated patient and at 1240 patient given 4 puffs of albuterol inhaler-patient's personal inhaler used. After reassessment/observation provider released patient home.

Other Meds: Unknown

Current Illness: Unknown

ID: 0976162
Sex: F
Age: 76
State: CA

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: IM
Vax Site: LA

Lab Data:

Allergies: Sulpha antibiotics

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

Symptoms: Patient vaccinated at 1215. Reaction began at 1250. Pt was told she would be observed for 30 minutes due to previous history of a reaction to the typhoid vaccine. After 30 minute observation patient stated she was light headed, dizzy, warm, and nauseous. Nausea subsided at 1325. Stated she was still dizzy at 1335 and stated her throat started to feel scratchy and difficult to swallow. Rapid Response called and patient evaluated. Patient transported to ED for further evaluation.

Other Meds:

Current Illness:

ID: 0976163
Sex: F
Age: 42
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Pertussis vaccine

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

Symptoms: Fever, chills, nausea, stomach pain, headache, ice pick headaches, gray spot in right eye vision, joint pain, muscle aches

Other Meds:

Current Illness:

ID: 0976164
Sex: F
Age: 35
State: GA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: amoxicillin

Symptom List: Vomiting

Symptoms: chest and shoulder muscles painful when inhaling. Corrected with continuous CPAP use and 3-4 200mg ibuprofen tabs.

Other Meds: Farxiga 10mg [Everyday] Metformin HCL XR (Glucophage XR) 1000mg bid [Everyday] Repaglinide (Prandin) 1mg bid [Everyday] Amlodipine Besylate (Norvasc) 10mg (Evening) [Everyday] Escitalopram (Lexapro) 20mg [Everyday] Cryselle Tab (Birth

Current Illness: none

ID: 0976165
Sex: F
Age: 10
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: after vaccine child while sitting in chair rolled to the right side and slumped over side of chair and then had 20-30 second tonic clonic generalized seizure. incontinent of urine. appeared plae and pupils dilated. after event tired, briefly confused, and had no memory of seizure. returned quickly to baseline neurological statues.

Other Meds: none

Current Illness: none

Date Died: 01/18/2021

ID: 0976166
Sex: F
Age: 93
State: CA

Vax Date: 01/07/2021
Onset Date: 01/18/2021
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: NONE

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

Symptoms: ASYMPTOMATIC

Other Meds: Gabapentin Capsule 100 MG, Give 1 capsule orally one time a day for (NEURALGIA) Losartan Potassium Tablet 50 MG, Give 1 tablet orally one time a day for (HYPERTENSION) HOLD IF SBR<110 OR HR<60 Norvasc Tablet 5 MG (amLODIPine Besylate), Give

Current Illness: NONE

ID: 0976167
Sex: F
Age: 28
State: NV

Vax Date: 12/24/2020
Onset Date: 12/24/2020
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: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme difficulty concentrating, unable to think.

Other Meds:

Current Illness:

ID: 0976168
Sex: F
Age: 30
State: MD

Vax Date: 01/22/2021
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: Sulpha

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

Symptoms: Successive severe migraines- not typical of my usual migraines. My usual medications are not working

Other Meds: Topirimate Sumatriptan Bupropion

Current Illness: None

ID: 0976169
Sex: F
Age: 43
State: KY

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: IM
Vax Site: RA

Lab Data:

Allergies: NKFA Medications: Stadol, Relpax, Imitrex, Vancomycin

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

Symptoms: 1/25/21 @ approximately 2000 began to chill and shiver. Continued throughout the night waking up intensely shivering, and body aches. Temperature 105.1 at the highest. 1/26/21 fever subsided after ibuprofen and tylenol, body aches and fatigue continued. 1/26/21 @ 2055 no fever but continued body aches and fatigue.

Other Meds: I had not taken any prescribed, over-the-counter or dietary supplements for 2 weeks or longer.

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm