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: 0977405
Sex: F
Age: 30
State: AL

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: Penicillin, Mustard

Symptom List: Dysphagia, Epiglottitis

Symptoms: I exp fluctuating temp 97.3 jump up to 99.5 it will go down 15-20 without taking any medication. I was exp lower joint pain and really bad headache. My temp now feels leveled out.

Other Meds: Ibuprofen, Tylenol

Current Illness: No

ID: 0977406
Sex: M
Age: 30
State: OK

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: Chills, aches, 100.07 temp

Other Meds: Lamotrigine

Current Illness: None

ID: 0977407
Sex: F
Age: 48
State: MO

Vax Date: 12/30/2020
Onset Date: 01/03/2021
Rec V Date: 01/27/2021
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: Zithromax, macrobid

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

Symptoms: All over joint pain

Other Meds: Dyazide, potassium, Wellbutrin, protonix, estrogen

Current Illness: None

ID: 0977408
Sex: F
Age: 50
State: PA

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: Blaxin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approximately 7 days after injection left arm with welt that spread out over arm warm, itchy and painful

Other Meds: Cymbalta, singulair, lesinopril

Current Illness: Astham, EBS, Fibromylagia

ID: 0977409
Sex: F
Age: 63
State: VA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: Aspirin, Lortab, Provera, Dilaudid, Beer, and Cumcumbers

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

Symptoms: Dizziness, fast heartbeat, lips felt funny like they were thick, headache, and tongue felt thick.

Other Meds: none

Current Illness:

ID: 0977410
Sex: M
Age: 66
State: GA

Vax Date: 01/16/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: none

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

Symptoms: Redness and soreness after receiving vaccine which went away. Approximately 7 days after receiving vaccine, patient is complaining of a rash in the injection area as well as stiffness.

Other Meds: unknown

Current Illness: unknown

ID: 0977411
Sex: F
Age: 30
State: MA

Vax Date: 12/27/2020
Onset Date: 12/27/2020
Rec V Date: 01/27/2021
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: no

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After the vaccine I got chills beginning at 10pm. About 1am I got a fever but was already taking started tylenol and motrin because I developed a headache also. The fever went as high as 101.2. On Tuesday I woke at 2am soaked in sweat and the fever had broke. Later that day the fever returned at 100.5 but broke on its on. By Saturday I woke up again with SOB and super cold. Fever had returned at 101 so I went to Urgent Care because the fever just kept returning. A chest xray was done and it showed my lungs were really inflammed. The fever returned later but went away. The SOB is still here. And on 1/19 I got the same feeling with SOB, 101.1 fever and felt awful all over again. So I visited with my PCP and another chest Xray and blood work was done again. The chest xray showed normal but was started on a Flovent enhaler to help with the breathing and SOB.

Other Meds: Level Thyroxin, Prenatal, Albuterol, A, B, C and Zinc Vitamins

Current Illness: COVID

ID: 0977412
Sex: M
Age: 37
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/27/2021
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: Chills, headache, dehydration, syncope - 12 hours post-dose

Other Meds:

Current Illness:

ID: 0977413
Sex: F
Age: 62
State: PA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/27/2021
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: post vaccination rxn: HA and vomiting; fever of 100.4-100.6 for 24 hours

Other Meds:

Current Illness:

ID: 0977415
Sex: F
Age: 41
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
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: Seafood - prior episodes hives, sensation of throat closing, itchy gum and throat

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 41 yo healthy woman with history seafood allergy, developed sensation of throat tightness/closing 7 minutes after vaccination. She stated this was similar to sensation she has after exposure to seafood and that these respond to diphenhydramine. She looked well and had stable vitals. She was observed for10 minutes and did not have worsening symptoms. She was given diphenhydramine 50mg orally and monitored for an additional 60 minutes. She was breathing comfortably, had no dyspnea or wheezing, or swelling of lips, gum, or oropharynx. She reported improved symptoms and was allowed to return to her home. On follow up telephone call 3 hours later, she reported complete resolution of the symptom.

Other Meds: None

Current Illness: None

ID: 0977416
Sex: F
Age: 75
State: IN

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: nonenone

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

Symptoms: About 24-26 hours after the vaccine, I had chills for about 3 hours. Vaccine was on Monday, 1/25, Chills on Tuesday, 1/26

Other Meds: Flecanide, Eliquis, Paxil, Lipitor, Levothyroxin, aspirin 81 mg., Cal/mag/zinc, biotin, lutein, vitamin D3

Current Illness: none

ID: 0977417
Sex: F
Age: 77
State: NC

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/27/2021
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: Codeine Hyromet

Symptom List: Rash, Urticaria

Symptoms: Next morning 1/23 woke up with acute vertigo, dry heaves and chills. Next day only dizziness when raising or lowering head.

Other Meds: Vit. D 25mg Potassium citrate 10meq tid Allopurinol 10 Metformin 1000mg bid Anastrozole 1mg Losartan 50mg Atorvastatin 40 mg

Current Illness: none

ID: 0977418
Sex: F
Age: 29
State: MA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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

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

Symptoms: Chills, fever, pounding headache, myalgia, severe pain at site of injection. Racing heart. Could not sleep

Other Meds: Melatonin

Current Illness: COVID (12/28/2020-01/11/2021)

ID: 0977419
Sex: F
Age: 50
State: NY

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: Sulfa, latex

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

Symptoms: Fever of 101. Very bad headache & all over body aches.

Other Meds: Sertraline, HCTZ

Current Illness:

ID: 0977420
Sex: F
Age: 44
State: MO

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
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 Drugs

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

Symptoms: I received the 2 vaccine on Thursday Jan 21, 2021. Vaccine was given in my left arm. Injection site became hot and red. On Friday Jan 22 I started feeling unwell and had body aches. By Friday night I became very cold to where my body was shaking. My joints and muscles ached and I became very weak. Saturday Jan 23rd I spiked a fever to 101.7. I took Tylenol to help control the body aches and help bring down the fever. I got little relief. I continued to run a temp all day on Saturday, had body aches, joint and muscle pain. I also became very nauseated and lethargic. I had headaches the entire time

Other Meds:

Current Illness:

ID: 0977421
Sex: F
Age: 29
State: VA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
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: No

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

Symptoms: Severe fatigue, paresthesias, and pre-syncope if tries to leave a supine position.

Other Meds: Propranolol, amlodipine

Current Illness: None

ID: 0977422
Sex: M
Age: 50
State: MD

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: None

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

Symptoms: At 1:30 am the following morning I woke up very nauseous and started vomiting. Was nauseous all that day needing to take nausea medicine. Unable to eat anything I started to vomit stomach acid. It is now 2 days later and I still have a degree of nausea and am unable to work today. I got the 2nd vaccine on Monday. It is Wednesday and I still have no appetite for food and have lost about 7 lbs since the weekend. I feel that I am starting to round the corner to recovery though.

Other Meds: Metformin Glipizide Sim Aston Losart an Vitamin D

Current Illness: Kidney stone 1 week prior requiring ER visit

ID: 0977423
Sex: F
Age: 65
State: CO

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Sulfa, Vancomycin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Rash began on back, moved to neck and chest, arms, hands and tops of legs. My dr. advised to take Claritin.

Other Meds: Triamterene-HCTZ 75-50 MG (daily), Vitamin D2 1.25 MG (once weekly), Meloxicam, Escitalopram Oxalate 10 mg (daily), Meloxicam 7.5 mg (daily)

Current Illness: None

ID: 0977424
Sex: M
Age: 69
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 1/22/2021 - Extreme Fatigue, Headache, Nausea, Dizziness 1/23/2021 - Headache, Pain at Injection Site 1/23/2021 - Present - Blurred Vision in Left Eye

Other Meds: Celebrex 200 mg, Tamsulosin 0.4 mg, Atorvastatin 10 mg, Amlodipine Besylate 10 mg, Osteo Bi-Flex, Turmeric, Vitamin B Complex, Magnesium, Vitamin D. Baby Aspirin 81 mg., Fish Oil/Flaxseed Oil

Current Illness: None

ID: 0977425
Sex: F
Age: 63
State: FL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: Celebrex seasonal allergies levaquins

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

Symptoms: FEVER,HEADACHE,BODY ACHES,NIGHT SWEATS,DIZZINESS,SORE THROAT,RUNNY NOSE,STIFFNESS IN HANDS AND FEET- UNABLE TO TWIST OPEN A BOTTLE TOP.

Other Meds: losartan 50 mg daily MVI vit d vitc Align preservision fish oil

Current Illness: none

Date Died: 01/21/2021

ID: 0977426
Sex: M
Age: 70
State: GA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Patient has a history of advanced melanoma with brain metastasis. He developed seizure disorder as well and had some mild seizures at home over the prior month. He received the vaccine at 4pm and was monitored in the office for 15 minutes. He then went home with his daughter whom he lives with. He ate dinner with her and read until 8pm when he went to his room. She found him in his room at 9pm unresponsive with seizures. Hospice was alerted and recommend oral valium. He continued to be unresponsive and expired the following day at 7:30 pm.

Other Meds: Tramadol, Dexamethasone, Pantoprazole, Dilatin, Plaxis, Aspirin, VImpat, Keppra, Clopidogrel

Current Illness: 1. Melanoma with brain metastasis 2. Seizure disorder

ID: 0977427
Sex: F
Age: 69
State: FL

Vax Date: 01/12/2021
Onset Date: 01/24/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies, Biaxin

Symptom List: Unevaluable event

Symptoms: The injection site on my right upper arm is swollen, red, itchy, and warm to the touch. Measures 4? long and 3? wide and is oval shaped. I noticed an itch on 1/24/21 @ night and again the next morning and upon close inspection found the reddened oval shape that was warm and swollen. It continues today on 1/27/21. I am not exhibiting any signs of anaphylaxis. My concern is whether is is safe form me to receive the second Moderna vaccine on February 9th.

Other Meds: Cojentix, Rosuvastatin, Centrum Silver, Acylcovir, Asprin, Adair Disc

Current Illness: None

ID: 0977428
Sex: F
Age: 67
State: MO

Vax Date: 12/29/2020
Onset Date: 01/02/2021
Rec V Date: 01/27/2021
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: Information left on Patient Safety Hotline: Employee on cycle of Cefdinir, finished last dose on 12/31/2020. On 1/2/2021 employee broke out in a bad rash, hives, patches of red all over body. Went to ED. Employee reports same type of reaction after receiving shingles and pneumonia vaccines.

Other Meds:

Current Illness:

ID: 0977429
Sex: F
Age: 42
State: NJ

Vax Date: 12/31/2020
Onset Date: 01/03/2021
Rec V Date: 01/27/2021
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: Amocyxillin and Erythromycin

Symptom List: Injection site pain, Pain

Symptoms: pain in toes of the right foot as well as redness and swelling. Feeling of nerve pain to touch and with pressure

Other Meds: Birth Control patch - Xulane

Current Illness: n/a

ID: 0977430
Sex: F
Age: 37
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
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: Injection site pain, Menorrhagia

Symptoms: Preasure in head and neck as well as inflammation

Other Meds: Levothyroxine 50mcg daily Alprazolam 0.5mg daily Woman one a day multivitamins

Current Illness: Gastrointestinal problems Under active thyroid

ID: 0977431
Sex: M
Age: 51
State: TX

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: NKA

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

Symptoms: Moderna COVID-19 Vaccine EUA Fever and body aches started four hours after receiving second dose. First dose presented with only injection sight soreness for three days. Currently, as of reporting time, fever is still present going on 18+ hours. Before using Acetaminophen, temp reached 100.0*F. With OTC Tylenol, 675mg, temp reduced to 99.2*F. Currently at time of reporting, no APAP, temp is 99.6*F with aches.

Other Meds: Total Daily Dose: Allopurinol 300mg Carvedilol 50mg Rosuvastatin 10mg Aspirin 81mg Magnesium 800mg Fish Oil 1200mg Vitamin D3 4000 IU Cinnamon 2000 mg

Current Illness: N/A

ID: 0977432
Sex: M
Age: 69
State: SC

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient presented to waiting room after having COVID 19 vaccine #1, feeling short of breath after 5 minutes in waiting room. Color pale, skin diaphoretic. Laid patient in clinic room bed; BP 142/82 Pulse 60 (Patient avid swimmer)Pulse Oximetry 92%. O2 per nasal cannula at 2L. Patient has leukemia and received monoclonal antibodies last March. Pulse oximetry fluctuated from 92%-97% with O2 on. 911 called and report given and taken to ED per stretcher per ambulance. Patient at discharge not short of breath alert and oriented and BP 138/72-62.

Other Meds:

Current Illness:

ID: 0977433
Sex: F
Age: 58
State: PA

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: antibiotics, apertaime

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Approximately two day after vaccination developed redness, lump, and itching at vaccination site.

Other Meds: Nadolo, synthroid

Current Illness: no

ID: 0977434
Sex: M
Age: 34
State: IN

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Fever, body aches, chills

Other Meds: Lisinopril, zyrtec

Current Illness: None

ID: 0977435
Sex: F
Age: 44
State: FL

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: azochol, dipentum

Symptom List: Nausea

Symptoms: Received shot Wednesday at 7:00. By 4:00 she was felling fatigued and developed muscle aches and leg cramps. By Friday she was extremely sleepy and her whole body hurt. She was having chills and "brain fog". This lasted through Monday. Today (Wed) she feels better but "just ok". Still with drowsiness and fatigue.

Other Meds: losartan hctz, propranolol, buspirone, multivitamin, probiotic, vitamin d, vitamin c, Pepcid,

Current Illness: n/a

ID: 0977436
Sex: F
Age: 37
State: IN

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: Injection site pain

Symptoms: From midnight on the 26th through approx 2pm on the 26th: headache, restlessness, intermittent nausea, nasal congestion then runny nose and overall fatigue feeling.

Other Meds: Zyrtec, women?s multi vitamin, vit D, cranberry supplement

Current Illness: None

ID: 0977437
Sex: F
Age: 30
State: AL

Vax Date: 12/28/2020
Onset Date: 01/02/2021
Rec V Date: 01/27/2021
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, Mustard

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

Symptoms: I was supposed to get my menstrual on 1/2 dint get it until 14 days later which is highly unusual. I did take several pregnancy tests results (negative).

Other Meds: Ibuprofen, Tylenol

Current Illness: Abdomen (uti)

ID: 0977438
Sex: M
Age: 44
State: MO

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
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: Penicillins, Sulfonamides, Seasonal environmental allergies

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

Symptoms: Four to five itchy red medium-sized hives that appeared on my back around 2 hours after the vaccine was administered. Resolved following administration of Zyrtec 10mg PO.

Other Meds:

Current Illness:

ID: 0977439
Sex: F
Age: 21
State: FL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
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: No known allergies

Symptom List: Tremor

Symptoms: Patient experienced flushing, tingling, and itchy throat/tongue, rash within minutes of receiving first dose of vaccine. Administered diphenhydramine 25 mg PO in vaccine clinic and called rapid response. Patient was taken to ED where they noted mild lip swelling. The itchy throat and rash resolved in the interval between vaccination and presentation to the ED. In the ED, she received famotidine IV and steroids. Epinephrine was deferred since patient had no shortness of breath or other respiratory symptoms. She was observed in the ED for 5 hrs and discharged with EpiPen and steroid taper.

Other Meds:

Current Illness:

ID: 0977440
Sex: F
Age: 41
State: PA

Vax Date: 01/01/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: Nsaids, shellfish

Symptom List: Erythema, Pruritus

Symptoms: Fever 103 start 4 hours after vaccine and still persist after 24 hours, rigors, headaches, back pain, left side weakness and numb, severe myalgias, confusion

Other Meds: None

Current Illness: None

ID: 0977441
Sex: M
Age: 69
State: KS

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
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: headache / upset stomach / temperature 100

Other Meds: none

Current Illness:

ID: 0977442
Sex: F
Age: 59
State: VA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/27/2021
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: Penicillin pfenergen

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

Symptoms: Slight swelling of tongue, throat-days 1 and 2 , tingling and numbness in face intermittently for almost 2 weeks , headaches, dizziness Completely normal on 1/22/21

Other Meds: Lyrica. Allegra, vit C, zinc , biotin, vit D

Current Illness: Undiagnosed condition since 2009. Upper body tingling numbness burning for which I take 300 mg Lyrica/day

ID: 0977443
Sex: F
Age: 44
State: NM

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: Patient described feeling flushed and hot all over, some tightness in the chest, anxiety and ringing in her ears, tension in her neck and arm in the left side where she received the vaccine. Took her pulse and lay her on a cot, gave her water. After about 20 minutes of rest, she felt well enough to drive home.

Other Meds:

Current Illness:

ID: 0977444
Sex: F
Age: 44
State: MA

Vax Date: 12/31/2020
Onset Date: 01/06/2021
Rec V Date: 01/27/2021
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: funny sensation in the feet or extremities post vaccination. She is 6 days post vaccination. She does not have pins and needles, loss of sensation or weakness. She describes it as more of a ?tickly? sensation

Other Meds:

Current Illness:

ID: 0977445
Sex: F
Age: 30
State: TX

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
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: None

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

Symptoms: Injection site swelling within 45 mins of injection. Swelling is red, painful, and warm to touch. 43 hours hours later swelling is about 2 inches wide and 1.5 inches in height, still red, warm, hard, and painful.

Other Meds: Zyrtec 10mg daily

Current Illness: COVID-19 infection in December 2020

ID: 0977446
Sex: F
Age: 76
State: NC

Vax Date: 01/18/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: Neosporin/Neomycin

Symptom List: Pain in extremity

Symptoms: Slightly swollen, warm/hot to touch, red rash around injection site 8 days after injection . Noted on 1/26/2021

Other Meds: Pravastatin, Metoprolol, Amlodipine

Current Illness: None

ID: 0977447
Sex: F
Age: 33
State: MO

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies: erythromycin

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

Symptoms: NO IMMEDIATE RESPONSE Day 2, into day 3 my Right lid swelled shut (which I have had happen numerous times) and then on day 3 into day 4 my upper lip swelled and then I had fever blisters cover my top, swollen lips. I have a history of Asthma and it has also caused me to have mild flare up causing me to use my inhaler more than once a day.

Other Meds:

Current Illness:

ID: 0977448
Sex: F
Age: 62
State: FL

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
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 Macrobid Gluten Dairy? Bacitracin Bandaid adhesive

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

Symptoms: Metallic taste post injection Fever 102 degrees (by 8pm eve of shot) Tylenol only reducing fever to 101 Severe chills/shakes Insomnia Confusion Dizziness Tachycardia (125 bpm) persistent the first night) Loose stools Incontinence

Other Meds: Estrogen Synthroid Vitamin C Vitamin B12 Restasis Baby aspirin Vitamin K2 Curcumin Vitamin D Miralax

Current Illness: None

ID: 0977449
Sex: F
Age: 57
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: No

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

Symptoms: Approximately 22 hours after vaccine, I had extreme chills and muscle aches especially back pain. Felt terrible for approximately 19 hours including fever up to a 102?. Headache fatigue muscle pain . Laid in bed all day, woke up next day with a mild headache. Other symptoms resolved

Other Meds: None

Current Illness: None

ID: 0977450
Sex: F
Age: 32
State: IA

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
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:

Symptom List: Vomiting

Symptoms: Employee received her 2nd COVID-19 vaccine on Friday, January 22. On day 3 of her vaccination she developed neck pain that decreased her ability to turn her head from side to side or look up/down. She has taken Ibuprofen and one of her husband?s baclofen for relief, and she states that it did not touch the pain, rating it a 5/10. She has not had any changes in sensation to any of her other extremities, and this pain does not radiate anywhere. She does state that she does also have a slight headache, but no sensitivity to light.

Other Meds:

Current Illness:

ID: 0977451
Sex: F
Age: 72
State: GA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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: penicillin gandolinium contrast dye dexamethasone flushing sensitive avocado

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: side effects sore arm chills diarrhea

Other Meds: benadryl tylenol lisinopril levothyroxin carvedilol atorvastatin

Current Illness: breast cancer thyroid high blood pressure coronary artery disease gallbladder sludge

ID: 0977452
Sex: F
Age: 45
State: PA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/27/2021
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: Day 1 post vaccine: 1) arm pain 2) tired and achy Day 2 post vaccine: 1)full body aches 2) weak 3) one dizzy spell lasting briefly

Other Meds: none

Current Illness: none

ID: 0977453
Sex: F
Age: 32
State: IN

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
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: Cefzil, Xanax

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chills w/ uncontrollable shivering, body aches, exhaustion

Other Meds: n/a

Current Illness: n/a

ID: 0977454
Sex: M
Age: 69
State: TX

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: elevated temp of 102, fatigue, chills,

Other Meds: amlodipine, atorvastatin, levothyroxine

Current Illness: tested positive covid 19 12/12/2020

ID: 0977463
Sex: F
Age: 32
State: GA

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/27/2021
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: Nuts

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

Symptoms: within 24 hours of the initial shot I began to experiencing spotting (intermittent vaginal bleeding) for the next 3 days. I also experienced hypersensitivity in my breasts, especially my nipples. So much so that I could not allow running water from the shower to touch them or sleep on my stomach. This also started within 24 hours of receiving the first shot and lasted for 5 days.

Other Meds: Apri (Birth Control) Concerta (ADHD) Trazadone (Insomnia)

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm