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: 0979710
Sex: F
Age: 71
State: IN

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Extreme soreness in left arm, worsening into Sunday. Was unable to lift arm. Still experiencing soreness and some discomfort in the arm. Also experienced chills and fever as high as 101 on Sunday (day after injection).

Other Meds: Calcium Citrate, Vitamin D, Multivitamin, Loratadin

Current Illness:

ID: 0979711
Sex: F
Age: 34
State: MI

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: Felt dizzy fifteen minutes after the injection - at thirty minutes felt better and did not want to go to ED for evaluation. Came back to vaccine center an hour later and said she felt "itchy all over," and was going to ED for evaluation. No other symptoms reported.

Other Meds: unknown

Current Illness: unknown

ID: 0979712
Sex: F
Age: 67
State: NY

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: tetanus vaccine, shellfish, peanuts

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

Symptoms: Generalized pruritus associated with itchy throat and sensation of throat tightening. Epinephrine 0.3mg IM and Benedryl 50mg. Symptoms resolved. Refused transport to ED

Other Meds: EpiPen

Current Illness:

ID: 0979713
Sex: F
Age: 25
State: WI

Vax Date: 01/25/2021
Onset Date: 01/25/2020
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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 102-102.5 fever sustained for 12 hours Headache Severe body aches Sever left shoulder pain Nausea/vomiting Fatigue Started 11pm, about 12 hours after vaccine. Treatment: alternating ibuprofen and Tylenol

Other Meds: None

Current Illness: I had COVID 11/18/2020

ID: 0979714
Sex: F
Age: 27
State: LA

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: LA

Lab Data:

Allergies: None

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

Symptoms: Eye lid swelling / can?t open eye all the way. Left eye. Received Botox injection last week and dermatologist said that the Botox and vaccine could be reacting negatively

Other Meds: Ascorbica (accutane) Zinc Biotin Botox

Current Illness: None

ID: 0979715
Sex: F
Age: 60
State: TN

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: UNKNOWN

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

Symptoms: PATIENT C/O NECK PAIN THAT STARTED GOING DOWN HER ARM WITH NUMBNESS AND TINGLING, THEN STARTED SHAKING VIOLENTLEY, SYMPTOMS JUST KEPT GETTING WORSE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 0979716
Sex: F
Age: 74
State: IL

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 01/27/2021
Hospital: Y

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

Lab Data:

Allergies: ALLERGY TO SALICYLATES ONLY ON FILE.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: the patient received the vaccine on 1/8/21, her last day of work was on 1/11/21, patients family reported that she was hospitalized and on life suppose on 1/12/21. She suffers from severe asthma, has several asthma attacks and wound up on the life suppose. Patient passed away on 1/22/21

Other Meds: ALBUTEROL HFA INH, AMLODIPINE 10MG, MONTELUKAST 10MG, SPIRONOLACTONE 50MG, ATORVASTATIN 20MG, MONTELUKAST 10MG. OTC, HERBALS, AND DIETARY SUPPLEMENT UNKNOWN.

Current Illness: ASTHMA

ID: 0979717
Sex: F
Age: 52
State: IA

Vax Date: 01/20/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NONE

Symptom List: Pharyngeal swelling

Symptoms: BIL EYE SHAKING, UNABLE TO FOCUS, EYES PULLING TO THE LEFT, HIGH BLOOD PRESSURE, DIZZINESS, UNABLE TO BALANCE WHILE WALKING, NAUSEA, EMESIS. I WENT TO THE ER BY AMBULANCE. MY EYES RETURNED TO NORMAL AFTER APPROXIMATELY 4 HOURS. I AM STILL HAVING DAILY HEADACHES, AND MY BLOOD PRESSURE CONTINUES TO BE HIGH.

Other Meds: CITALOPRAM 40MG, TERBINAFINE 250MG, CONTRAVE 8-90 MG, DAILY GUMMY VITAMINS

Current Illness: NONE

ID: 0979718
Sex: F
Age: 44
State: WI

Vax Date: 01/20/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 1 day after vaccination developed dizziness, ataxia, left upper and lower extremity weakness that has persisted at least to today (7 days later). Today's exam reveals left arm and leg weakness throughout with normal patellar and brachialis reflexes, but with mild cogwheel regidity at left elbow. Cranial nerves intact and respiratory musculature appears to be functioning normally.

Other Meds: clobazam, lamotrigine, pantoprazole, topiramate, calcium carbonate, albuterol inhaler, diphenhydramine

Current Illness:

ID: 0979719
Sex: F
Age: 54
State: NY

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Latex, glycerin, Sulfa, bananas, chocolate, kiwi, seasonal

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Shortly after injection my arm felt was sore as if I just had a flu vaccine. Approx 1930 my arm then felt as if I just had a tetanus booster then followed by chills, body aches, had 100.5-101 fever (on Friday). Chills on Friday resolved while taking Tylenol as well as body aches. continued with Tylenol 1000mg every 6 hrs. Saturday woke up with no fever, chills body aches resolved.

Other Meds: Tylenol, calcium, vit d, magnesium, curcumin, ASA 81mg, allegra, singular, Synthroid, Toprol XL, Lysine

Current Illness: None

ID: 0979720
Sex: M
Age: 37
State: MD

Vax Date: 01/11/2021
Onset Date: 01/14/2021
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 know.

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

Symptoms: Had pain at the injection site for 2.5 - 3 days only. After 3 days I observed both my lymph nodes in my armpits were swollen and I felt very fatigued. No real pain on lymph nodes just swollen. Lasted for approximately 5 days and returned to normal around January 20th. I am an athletic 37 year old male. Had no illness prior. Had telemedicine appointment with my doctor and he said to report the possible side effects. Also had blood work up done at his requests to confirm everything was ?normal? with me.

Other Meds: Daily Multi Vitamin Daily Fish Oil vitamin

Current Illness: None

ID: 0979721
Sex: F
Age: 74
State: GA

Vax Date: 01/12/2021
Onset Date: 01/14/2021
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: penicillin cefaclor erythromycin gadolinium past reaction to flu vaccine

Symptom List: Rash, Urticaria

Symptoms: rash on arms and thighs facial swelling

Other Meds: nexium aspirin eliquis prednisone acyclovir atorvastatin losartan

Current Illness: hypertension scoliosis herpes

ID: 0979722
Sex: F
Age: 40
State: TX

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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, Ibuprofen

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

Symptoms: 2:00 patient seated in observation area & RN noted she was holding herself, inquired if she was feeling ok and patient reported feeling dizzy and nauseated; RN provided waste basket & suggested that patient be moved to private observation area for some fresh air; patient declined 2:10 patient's symptoms did not improve & moved via wheel chair to private observation area accompanied by RN and EMT 2:14 water provided to patient who was encouraged to remove her hat, scarf, coat and mask; door opened for fresh air 2:16 VS: 116\90 | HR 72 | PO2 98% 2:22 patient provided with gatorade and she stated her waves of nausea has improved; RN recommended that her husband accompany her for 2nd dose of vaccine; patient requested to sit in observation area longer rather than to call husband for ride because he would have to pack up kids; patient refused transport to hospital stating her sx improving 2:26 paramedic returned to vaccination table | RN present 2:30 355ml of gatorade PO intake by patient; patient reported getting dizzy & nauseated 1-2 times when receiving flu vaccine 2:34 patient reported feeling much better and self ambulated to car

Other Meds: none

Current Illness: none

ID: 0979723
Sex: M
Age: 68
State: NJ

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

Lab Data:

Allergies: none

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

Symptoms: Muscle Pain, body pain, fever 102 F

Other Meds: atorvastatin

Current Illness: none

ID: 0979724
Sex: M
Age: 34
State: NM

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: denied allergies

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

Symptoms: Patient had vaccine administered by PA and was walking to do his observation period and stopped to get water from a fountain and leaned forward then fell to the floor was unresponsive and had an approximate 20 sec GTC seizure when the seizure was over he came to and was very confused and diaphoretic for approximately 15 minutes after the seizure. 911 was called by RN, and EMS came to assess the patient while waiting patient was placed into a wheelchair by multiple staff and taken to a cot where oxygen was applied. Vitals were taken and vitals were stable. EMS took blood sugar upon arrival that was stable. Patients sister has significant history of seizures but patient has never had a seizure before. Once patient was no longer sweating, pale and confused he was observed for half and hour. His parents came to get him and drove him home from the event. Patient was stable talking and no confusion or SOB or other symptoms after the half hour and patient was released to his father to drive him home and to monitor him for other symptoms.

Other Meds: Patient presented to an large outreach COVID vaccine event and was monitored by EMS staff and Nurse on site stated no chronic conditions or medications

Current Illness: denied illness

ID: 0979725
Sex: F
Age: 60
State: OH

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

Lab Data:

Allergies: PCN

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

Symptoms: 1/22/21 at 1:30p I received my 2 shot. 2 hrs later I began to experience chest pain while sitting w/o accompanying SX. During the night I continued to have increased frequency and intensity of chest that waxed and waned. At 10:30 a I was awoken with intense CP and subsequently went downstairs to eat yogurt. While standing at the counter I felt myself passing out and called for assistance. I woke up 20 feet away with my husband trying to arouse me. He stated I was unconscious for 2 mins. I was to weakened to get up. He called squad and taken to ED. CXR, labs, EKG done. 2 liters NS infusion done. Discharged to home 6p with continued CP and lightheadness. F/u with PCP today as near syncopal episodes continue day 5 post-injection with CP and moderate H/A.

Other Meds: Cymbalta, Mobic, Tramadol, Vit D3, Mag+, Vit C, Zinc, Krill oil, Probiotics, Tylenol

Current Illness: None

ID: 0979726
Sex: F
Age: 52
State: CA

Vax Date: 01/08/2021
Onset Date: 01/13/2021
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: Penicillin completed immunotherapy for allergies 5-6 years ago

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

Symptoms: Tender arm for a couple of days, then 2nd day after shot two fingers on right hand were extremely achy, felt arthritic. About 5 days after shot began itchy rash on my stomach and back. Rash and itchiness still continues and I'm currently at 2 weeks. Started antihistamine two days ago and it's better but still there.

Other Meds: Serrapeptase Vitamin D Vitamin C Thyroid over the counter supplement Fish oil

Current Illness: none

ID: 0979727
Sex: F
Age: 34
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Near Syncope episode, Sweaty, Heart rate (pulse) slowed down to 50. 10:14 got Vaccination and abt 10:25 woke up in ER . Reported by Nurse who gave Vaccination Injection.

Other Meds:

Current Illness:

ID: 0979728
Sex: F
Age: 55
State: AZ

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient seemed slightly nervous but comfortable receiving her vaccine. She moved to the observation area after. It was observed her face was quite red. She states she had a headache. I sat to talk to her and checked her blood pressure. Her blood pressure was 141/91 and pulse 127. She said her blood pressure was usually normal. She had drank coffee that morning. We continued to monitor her pulse and blood pressure which were both high. Her heart rate went to above 140. She would occasionally shake and said she felt something electrical. She stated her brain felt numb. At that time paramedics were called. She declined to be taken to hospital. She was observed a bit longer than a co-worker gave her a ride home where she said she did have a family member at home.

Other Meds:

Current Illness:

ID: 0979729
Sex: F
Age: 39
State: KS

Vax Date: 01/08/2021
Onset Date: 01/23/2021
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: None

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

Symptoms: 16 days after receiving the shot, I broke out in hives all over the majority of my body. I took 2 Benadryl, but the hives continued to spread. My dr called out prednisone and I continued the Benadryl along with Pepcid. By noon the following day most of the hives were mostly gone. But within 6 hours new hives were forming. I continued the prednisone, Pepcid and Benadryl. The next morning the hives had increased even more so I was given a shot of cortisone at my doctor?s office at 8am. By 1pm that day, the hive had faded and were very faint to see. By 10pm, new spots were visible. Over the night the hives increased and I woke at 4am from the pain and severe itch. I continued the Benadryl and Zyrtec and but stopped the prednisone bc it didn?t seem like it was helping and also appears like my body is trying to detox. I currently have hive on my neck, torso, arms, and legs.

Other Meds: Zyrtec, vitamin C, vitamin D3, zinc, calcium, women?s one-a-day multivitamin

Current Illness: None

ID: 0979730
Sex: M
Age: 88
State: CA

Vax Date: 01/19/2021
Onset Date: 01/26/2021
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: REDNESS AND RASH ITCHING IN THE AREA OF INJECTION, FEELS HOT . AREA 2IN X 3 IN

Other Meds: rosovastatin vitamin D and B

Current Illness: NONE

ID: 0979731
Sex: F
Age: 33
State: CT

Vax Date: 01/11/2021
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: Two muscle relaxers

Symptom List: Unevaluable event

Symptoms: First dose January 11. Sore arm next two days. One week later injection site was warm, red and had a hard ball, chills that night. Then following Saturday started to have itching all over body and left arm had a red mark the size of my hand on it. Not warm to touch just there. Went to walk in clinic prescribed me hydroxine for itching. Itching went away. Following day had burning sensation all over left side of body. Was seen by primary care.

Other Meds: Sertraline 150mg

Current Illness: None

ID: 0979732
Sex: M
Age: 80
State: CA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: None

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

Symptoms: Patient never tested for covid-19 prior to vaccination. Symptoms of stuffed and running nose and small rash may be related to covid-19, cold or flu, or the vaccine. What affect the vaccination will have, if any, on the patient's condition is unknown.

Other Meds: aspirin, meds for high blood pressure, cholesterol, prostate, and thyroid

Current Illness: None

ID: 0979733
Sex: F
Age: 27
State: TX

Vax Date: 01/01/2021
Onset Date: 01/02/2021
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: PNC

Symptom List: Injection site pain, Pain

Symptoms: Red rash on my face about 24 hours after initial dose- went away with Benadryl Rash was itchy and blotchy

Other Meds: Lexapro and levothyroxine

Current Illness:

ID: 0979734
Sex: F
Age: 46
State: TX

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Fever: 101.2*F, Body aches

Other Meds:

Current Illness:

ID: 0979735
Sex: M
Age: 73
State: IN

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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: None

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

Symptoms: same day of vaccination, left side of face/ears swollen, didn't feel right, back pain, arm pit sore, went to walk in clinic today 1/27/2021

Other Meds: None

Current Illness: None

ID: 0979736
Sex: M
Age: 74
State: IN

Vax Date: 01/26/2021
Onset Date: 01/27/2021
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: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Shaking for 2 hours this morning similar to shivering

Other Meds: Rovastatin 5 mg

Current Illness: None

ID: 0979737
Sex: F
Age: 39
State: OH

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Allergy to Percocet, Norco and Hunts spaghetti sauce

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever, body aches, chills, nausea, headache, pain at injection site.

Other Meds: Multi vitamins

Current Illness: N/A

ID: 0979739
Sex: F
Age: 42
State: CO

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: Severe chills, severe muscle and joint pain, extreme lethargy, fainting

Other Meds: Escitalopram

Current Illness: None

ID: 0979740
Sex: F
Age: 12
State: OR

Vax Date: 01/23/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: During a drive-thru Covid-19 vaccination clinic, this 12 year old incidentally received the Moderna vaccine which is only EUA approved for individuals 18 years and older.

Other Meds:

Current Illness:

ID: 0979741
Sex: M
Age: 46
State: CO

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Fever to 102F (oral), approx 36h duration, with accompanying myalgias and chills and soreness at site of vaccine administration, all resolved without use of antipyretics

Other Meds:

Current Illness:

ID: 0979742
Sex: F
Age: 26
State: CA

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: LA

Lab Data:

Allergies:

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

Symptoms: Two hours after I had Palpitations. My heart rate was elevates for24 hours. The next morning I had a fever and joint pains. I had a doctor appt an hour ago and still had a fever of 100, my highest yesterday was 101.9. I also got tested for Covid and it was negative.

Other Meds: Levothyroxine

Current Illness:

ID: 0979743
Sex: F
Age: 22
State: IL

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: Cinnamon

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

Symptoms: Body aches and fatigue evening of injection Subsequent day developed pain/redness at injection site. Following day temp 99.8 and swelling with increased redness and pain at injection site. Taking tylenol and ibuprofen. Prescribed triamcinolone cream topically initially however area was continuing to enlarge. Placed on doxycycline in case of cellulitis.

Other Meds: Nexplanon

Current Illness:

ID: 0979744
Sex: M
Age: 63
State: CA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codeine, Walnut, Dilaudid Morphine Sulfa

Symptom List: Tremor

Symptoms: After receiving first dose of covid vaccine and sitting the observation area, patient complained of a tingling sensation around his lips. The observation nurses continued to observe him, and a few minutes later he developed numbness on his nose, followed by a dry cough. Within a few minutes his lower lip started to swell. Patient showed no signs of respiratory distress, and was alert and oriented. He was then escorted by RN in a wheelchair to the ED for evaluation

Other Meds: None on file

Current Illness: none

ID: 0979745
Sex: F
Age: 30
State: UT

Vax Date: 01/20/2021
Onset Date: 01/21/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: chills, stomach upset, and muscle aches within 24 hours of administration. Symptoms resolved without intervention.

Other Meds:

Current Illness:

ID: 0979746
Sex: M
Age: 45
State: ID

Vax Date: 01/24/2021
Onset Date: 01/24/2021
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: canteloupe

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

Symptoms: Starting at approximately 11:30 pm (11 hours after the vaccination) my husband began having chills, ran a fever of 103.5, had abdominal pain (loss of appetitie) and complained of his hands and head feeling like they were "on fire". The burning sensation was off and on most of the night. He had a bad headache as well. The fever of 103.5 stayed with him up until Wednesday afternoon, only breaking somewhat with Ibuprofen. That brought it down to 101 only. Come Wednesday his symptoms resided. He notified the Primary health clinic, the morning of 1-25-2021.

Other Meds: multivitamin, vitamin B 12, Black cumin seed oil

Current Illness: COVID 19, diagnosed on November 29th, cleared on December 10th to go back to work.

ID: 0979747
Sex: F
Age: 46
State: TX

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

Lab Data:

Allergies: Unknown.

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

Symptoms: Fever: 101.2*F, Body Aches.

Other Meds: Unknown.

Current Illness: Unknown.

ID: 0979748
Sex: F
Age: 51
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: Anxious and jittery

Other Meds:

Current Illness:

ID: 0979749
Sex: F
Age: 34
State: CA

Vax Date: 01/15/2021
Onset Date: 01/24/2021
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: None

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

Symptoms: Rash and itchiness radiating from about 1 inch below injection site. Did not start until 8 days after injection. At this time, rash is about 2.5 inches in diameter.

Other Meds: Biotin supplement, multivitamin

Current Illness: None

ID: 0979750
Sex: M
Age: 48
State: TX

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: Severe headaches, joint pain, night sweats, chills, nausea, fatigue, soreness in throat, extreme soreness at injection site on left arm causing limited movement. It started about four hours plus or minus after injection.

Other Meds: None

Current Illness: None

ID: 0979751
Sex: F
Age: 60
State:

Vax Date: 12/19/2020
Onset Date: 12/21/2020
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: Not to my knowledge

Symptom List: Pain in extremity

Symptoms: There are two events I am reporting, one each from the first dose on 12/19/20, and the second dose on 1/9/21: Approximately 53 hours after Dose #1: Redness on hands and wrist, rash-like small dot appearance on hands and wrists, skin dryness and tightness of hands. I experienced no itching of hands or wrists. Approximately 53 hours after Dose #2: Small, painful red pustule-like occurrence on base of right thumb, with the appearance of a few small dots in it. I experienced no itching of thumb or hand. These events both occurred within the same timeframe following the vaccine doses. Following the first event I was seen in the ER. I checked out fine and they could not say exactly what this was. They said it did not appear to be an allergic reaction to the vaccine because it was not systemic and I had no other symptoms such as trouble breathing. They thought perhaps it was coincidental...I work in the hospital as a radiologic technologist where I hand-wash and hand-sanitize all day. Perhaps I just over-washed that day? However I've worked there for 17 years and never had this happen. The redness and rash dissipated by end of day. Following the second event I did not follow up with any medical provider. This pustule I got happened while I was at home, and otherwise I felt fine so I left it at that. It took several days for the pustule to go away. I hope you don't mind but I am writing to report this information in the event it may be helpful to you and I am also reporting it because I want to know if what I experienced could be considered an immune response to the vaccine? Another words, not an allergic response but an immune response ? I can find absolutely nothing about this on-line and no one knows what to make of it. Thank you.

Other Meds: I occasionally take tylenol

Current Illness: No

ID: 0979752
Sex: M
Age: 30
State: NJ

Vax Date: 01/09/2021
Onset Date: 01/09/2021
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:

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

Symptoms: Reports throat itching. Exam normal.

Other Meds:

Current Illness:

ID: 0979753
Sex: F
Age: 59
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fever, headache, chills, body aches. Took Tylenol pretty much every four hours and fever and all other symptom's were gone by 8:30 am on 01/27/2021.

Other Meds: Bystolic 5 mg, Hydrochlorothiazide 12.5, Multi vitamin, Pepcid 40 mg, Apple cider vinegar gummy, Turmeric gummy, CoQ10, B12

Current Illness: None

ID: 0979754
Sex: F
Age: 50
State: PA

Vax Date: 01/19/2021
Onset Date: 01/22/2021
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: yes

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

Symptoms: Left arm has a red, hot, itchy, hard area where injection was given. Noticed it a few days after injection but it has not gone away.

Other Meds: yes

Current Illness: no

ID: 0979755
Sex: F
Age: 52
State:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Dizzy and lightheaded

Other Meds:

Current Illness:

ID: 0979756
Sex: F
Age: 60
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: Green peppers

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received Pfizer vaccine at 1310. At 1340, she complained of dizziness. Vitals: B/P 132/60, temp 97.3, heart rate 68, oxygen saturation 98%. Patient alert and oriented. 1405 patient stated dizziness is subsiding.

Other Meds: Vitamin C, Zinc, Airborne, Centrum, Vagefem

Current Illness: None stated.

ID: 0979757
Sex: F
Age: 42
State: OH

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: Muscle aches, headache, chills, arm pain, fever

Other Meds: Celexa 10mg

Current Illness: None

ID: 0979758
Sex: F
Age: 53
State: TX

Vax Date: 12/31/2020
Onset Date: 12/31/2020
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: I am allergic to shellfish, penicillin, morphine.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I was flushed, my arm hurt, palpitations, dizziness, foggy brain, fast heart rate, fever, vomitting, nausea, headache, stuffiness, congestion, swelling on the arm at the injection site, pain and rash around the injection site.

Other Meds: I take multivitamins.

Current Illness: No

ID: 0979759
Sex: M
Age: 69
State: CA

Vax Date: 01/16/2021
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: Flagyl

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

Symptoms: Covid Arm. Red area around the spot of the injection. About 4 inches high, 3 inches wide.

Other Meds: Atorvastan. Olmasartan. Multi vitamin. turmeric. Vitamin D. Ginger. Cinnamon. Fish oil. Greens.

Current Illness: none

ID: 0979760
Sex: F
Age: 37
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: PCN, omnicef, amoxicillin

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

Symptoms: Patient felt dizzy and heavy breathing. Took vitals which was WNL, Felt better after drinking water. Was okay to leave on her own accord

Other Meds: metformin, Cymbalta, Topamax, paxil

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm