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

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 0981815
Sex: F
Age: 41
State: NH

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: headache runny nose Nausea severe muscle aches fever 102 degrees chills muscle fatigue shortness of breath cough congestion

Other Meds: none

Current Illness: none

ID: 0981826
Sex: F
Age: 46
State: NH

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Chills, body aches, headache, weak, tired sore arm

Other Meds: none

Current Illness: none

ID: 0981844
Sex: M
Age: 52
State: ME

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NONE

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

Symptoms: Extremely achey Muscles & Joints ALL over with a pounding Severe Headache & Dry Mouth

Other Meds: NONE

Current Illness: NONE

ID: 0981855
Sex: F
Age: 49
State: NH

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Sour stomache headache tired

Other Meds: metropolol - Lisinipril, atorvastatin Plavix asprin

Current Illness: none

ID: 0981873
Sex: M
Age: 59
State: NH

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: chills, head ache, body aches, Fatigue Flu like symptoms.

Other Meds:

Current Illness:

ID: 0981888
Sex: F
Age: 33
State: NH

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: Headache, chills, body aches (lower back, legs and neck). Tiredness, nausea, low grade fever 99.9, dizziness. Symptoms started early on 1/21/21 and lasted till 1/23/21 in the morning.

Other Meds: None

Current Illness: None

ID: 0981903
Sex: M
Age: 41
State: MA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: PINE NUT

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Head ache / aches pain feaver chills / fatique

Other Meds: NONE

Current Illness: NONE

ID: 0981918
Sex: M
Age: 86
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: covid + on 1/21/21; admitted to hospital due to infection Narrative: Patient received the first dose of the COVID vaccine on 1/12/21. The patient tested positive for COVID 1/21/21. Admitted to Hospital on 1/23/21. Patient developed fever, cough, SOB, and diarrhea.

Other Meds:

Current Illness:

Date Died: 01/23/2021

ID: 0981938
Sex: M
Age: 68
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: UNKNOWN/ASYTOLE Narrative: Please refer to section 6. 68y/o male with h/o severe peripheral vascular disease with previous left AKA 2/3/20, s/p bilateral bypasses in the past. Pt recently underwent right AKA on 1/12/21. Per Hospital remote data 1/10/21 pt c/o shortness of breath, CXR demonstrated right lower lobe opacity & left basilar infiltrate. Pt s/p >10 days emperic IV abx. Moderna vaccine 0.5ml IM was administered via left deltoid on 1/22/21 around 16:21. On 1/23/21@05:14 code blue was called as pt found to be unresponsive, breathless and pulseless, facial cyanosis noted, CPR started immediately.Pt found to be in asystole. ACLS guideline followed but no return of spontaneous circulation, At 05:32 pt remained pulseless and breathless and was pronounced. Autopsy currently pending.

Other Meds:

Current Illness:

Date Died: 01/17/2021

ID: 0981945
Sex: M
Age: 95
State:

Vax Date: 01/08/2021
Onset Date: 01/13/2021
Rec V Date: 01/27/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: weakness and fallsNarrative: 95 yo male w/ a PMH significant for Afib, legal blindness, Hx of CVA, cognitive impairment, GERD, HTN, pseudogout, BPH, chronic knee infection, and DJD who received his first dose of the Moderna COVID-19 vaccine on 01/08/21. The pt's COVID-19 screening questionnaire prior to receiving the vaccine was negative. The pt presented to the ED on 01/13/21 for weakness and m PCR test on ultiple recent falls (since receiving his first dose of the COVID-19 vaccine). The pt's COVID-19 01/13/20 was positive and he was admitted. He was started on treatment with remdesivir + dexamethasone on 1/14. The pt initially required supplemental oxygen via low-flow NC, however his oxygen requirements increased to 100% NRB. On 01/16/21 his MPOA elected for hospice care. The pt passed on 01/17/21. Unclear if the COVID-19 vaccine attributed to the patient's hospitalization and eventual death, or whether these events occurred from COVID-19 itself, however this case is being reported the FDA since this vaccine is under an emergency use authorization (EUA).

Other Meds:

Current Illness:

ID: 0981958
Sex: F
Age: 57
State: NY

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: Patient Complain oF Patient alert and oriented x3 complaint oF lightheaded 5 minute aFter receiving 2nd dose of Moderna Covid 19 vaccine. ViTal signs taken as Follows BP 122/74, HR 77, RR 19, Temp 98, O2 Sat 100%. Patient was monitored 80 minutes. Electrolit beverage oFFered and taken tolerated well. Patient stated oF relieF and advised to go to ER For any adverse reactions patient verbalized understanding.

Other Meds: None

Current Illness: None

ID: 0981966
Sex: M
Age: 50
State: HI

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: 24 hours after vaccine was given pt developed redness at injection site 72 hours after vaccine was given patient develop large, red, popular rash on the shoulders, arms, face and neck. Reports rash felt very warm. No itching, no throat swelling.

Other Meds: Amoxicillin, Levothyroxine

Current Illness: pharyngitis

ID: 0981971
Sex: F
Age: 75
State: CA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Paxil, PCN, Shellfish, Acidic Foods NS, Cyclobenzaprine, Vesicare

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

Symptoms: syncopy episode Atrial fibrillation Rapid rate into the 180's

Other Meds: Diltiazem

Current Illness:

ID: 0982004
Sex: F
Age: 71
State: CA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Cold/chills, then feel hot (102 degrees) now (at 8:45 pm 1/27/21)

Other Meds: Glimepiride, Metoprolol, Lisinopril, Metformin

Current Illness:

Date Died: 01/20/2021

ID: 0983720
Sex: M
Age: 75
State:

Vax Date: 12/30/2020
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Death Narrative: Patient had Parkinson's and advanced Dementia. He was on a palliative care unit and a DNR.

Other Meds:

Current Illness:

Date Died: 01/23/2021

ID: 0983721
Sex: M
Age: 71
State:

Vax Date: 01/13/2021
Onset Date: 01/23/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Death Narrative: Patient with Severe Dementia and on Hospice for end of life care.

Other Meds:

Current Illness:

ID: 1293989
Sex: F
Age: 45
State: CA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: penicilline

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

Symptoms: Swollen throat, tounge, dizziness, difficult breathing, increased blood pressure, nauseau, difficulty swollowing, headache. This were the immediate adverse effect withi in 5 to 10 minutes of receiving the shot. Followed by aches, chills, loss of appetite and days of swollend tongue and sore throat and difficulty swolling. My breathing was not affected as I did not experience a full anaphylaxis reaction but I continue with the discomfort a week and a half later. I have been taking benedryl, claritin, and fatmotidine which is what my doctor suguested I take to calm down the allergic reaction and it has helped a bit with the nauseau and the feeling of having a lump in my throat.

Other Meds: Atenolol, topiramate, trazodone, fluticasone

Current Illness:

ID: 1293990
Sex: F
Age: 29
State: ME

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient reports she received second dose of Moderna Covid 19 vaccine lot #039K20A on 01/19/21. On 1/20/21, Patient awoke with fever 100.4, body aches, headache, fatigue, nasal congestion, and sob. Patient contacted the Covid line and followed recommendation to get tested. COVID swab was negative. Patient reports symptoms self resolved on 01/23. Patient reports symptoms were bad enough that she was unable to cover 2 shifts. Patient reports she only developed chills and fatigue after initial dose of Moderna lot #039K20A. VAERS. Patient declines additional concerns at this time. D/c from health service.

Other Meds: None

Current Illness: denies

ID: 1293991
Sex: M
Age: 67
State: CA

Vax Date: 01/07/2021
Onset Date: 01/10/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Bilateral Partial Biceps tendon tears. R medial epicondylitis . Multiple joint pain lasting 2 weeks.

Other Meds:

Current Illness:

ID: 1293993
Sex: F
Age: 46
State: ME

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Patient reports she received 2nd Moderna vaccine lot #013L20A on 01/25/21. On 01/26/21, Patient found a significant purple bruise about the size of a half dollar. On 1/27/2021, the skin adjacent to the bruise was red, inflamed, painful and hot to the touch. Patient contacted PCP who recommended warm compress and monitor for 24 hrs. Patient reports "it's increasing in size and getting." Plan is to see health center. VAERS.

Other Meds: Ambien; Adderall; Lexapro

Current Illness:

ID: 1293995
Sex: F
Age: 62
State: AK

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: my symptoms began with severe headache, then body aches followed within just a few minutes, extreme fatigue and fever that ran from 100.9 down to 99 degrees, loss of appetite. Symptoms lasted for almost 48 hours.

Other Meds:

Current Illness:

ID: 1293998
Sex: F
Age: 42
State: TN

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: 3 hours after injection severe arm pain, very stiff on movement; progressively got worse throughout night. 13 hours later SEVERE body aches worse at hips and low back, severe headache, chills with temp at 101.7. no energy and steadily declining throughout day. no appetite. Also felt very nauseous. Some mild confusion 20 hours later chest pains 01-21-2020 body aches and headache improved. Very weak and shortness of breath.

Other Meds: none

Current Illness: none

ID: 1403017
Sex: M
Age: 44
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia & Fever Narrative:

Other Meds:

Current Illness:

ID: 1403028
Sex: M
Age: 23
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Headache, Myalgia, Fever, Nasal congestion, rhinorrhea, chills, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1403030
Sex: F
Age: 58
State:

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Myalgia, Arthralgia, Fever, fatigue Narrative: Mild flu-like symptoms causing employee to miss a day of work

Other Meds:

Current Illness:

ID: 1403033
Sex: M
Age: 58
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Diarrhea Narrative:

Other Meds:

Current Illness:

ID: 1403035
Sex: M
Age: 74
State:

Vax Date: 10/28/2020
Onset Date: 10/28/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: TIGHTNESS IN HIS FACE, TROUBLE SWALLOWING, FLUSHED FACE, REDNESS, THROAT TIGHTENING Narrative:

Other Meds:

Current Illness:

ID: 1403037
Sex: M
Age: 43
State:

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever Chills Narrative:

Other Meds:

Current Illness:

ID: 1403038
Sex: F
Age: 37
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Myalgia Fatigue, Chills, Injection site pain Narrative:

Other Meds:

Current Illness:

ID: 1403039
Sex: M
Age: 43
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Myalgia, Fever, fatigue, facial flushing Narrative: Facial flushing, fatigue, myalgia, fever to 100.9, arm soreness; resolved in 48 hours.

Other Meds:

Current Illness:

ID: 1403042
Sex: M
Age: 48
State:

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Headache, Fever, Cough Wheeze, Nausea Vomiting & Syncope Narrative:

Other Meds:

Current Illness:

ID: 1403043
Sex: M
Age: 51
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache, Fever, NauseaVomiting, fatigue, chills, shivering Narrative: Headache, fatigue, fever 100.6, vomiting, chills, shivering; taking tylenol

Other Meds:

Current Illness:

ID: 1403044
Sex: F
Age: 33
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache Throat horse, difficult to move, migraine headache. SOB, lethargic Narrative: Took Benadryl at home

Other Meds:

Current Illness:

ID: 1403045
Sex: M
Age: 52
State:

Vax Date: 11/12/2020
Onset Date: 11/14/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Narrative:

Other Meds:

Current Illness:

ID: 1407117
Sex: M
Age: 57
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Headache, Naysea Vomiting, myalgias Narrative:

Other Meds:

Current Illness:

ID: 1407118
Sex: M
Age: 55
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache, Nausea Vomiting, fatigue, chills Narrative:

Other Meds:

Current Illness:

ID: 1407128
Sex: F
Age: 64
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Confusion, Headache, Sedation, Chills, no appetite Narrative: Per nursing report:"2nd Moderna vaccine on 1-25-21. C/o headache, chills, disorientation on Monday [1/25]. C/o feeling tired and sleepy. Called in today [1/27]. No appetite on Monday. States thought she was having side effects from aneurysm which she states has been monitoring x4 years now."

Other Meds:

Current Illness:

ID: 1407129
Sex: F
Age: 38
State:

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

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Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Headache, Myalgia, Tiredness, can't sleep, chills, then feel hot, back pain, joint pain Narrative:

Other Meds:

Current Illness:

ID: 1407131
Sex: F
Age: 35
State:

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Fever WEAK, HEAD FEELS HEAVY Narrative:

Other Meds:

Current Illness:

ID: 1407196
Sex: F
Age: 61
State:

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Headache, Sedation, Fever, Chills, pain @ injection site Narrative:

Other Meds:

Current Illness:

ID: 1407244
Sex: M
Age: 40
State:

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

Vax Type:
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Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Headache fatigue Narrative:

Other Meds:

Current Illness:

ID: 1407245
Sex: F
Age: 43
State:

Vax Date: 01/14/2021
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: CoughWheeze PAIN IN CHEST WHEN COUGHING, FEELS COLD Narrative:

Other Meds:

Current Illness:

ID: 1407251
Sex: F
Age: 47
State:

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia, Fever & NauseaVomiting Narrative:

Other Meds:

Current Illness:

ID: 1407253
Sex: F
Age: 53
State:

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Myalgia FEVER, Left arm the night of vaccination, then body aches, feverish, lethargic and 1/24 started with left axillary pain; symptoms are slowly improving Narrative

Other Meds:

Current Illness:

ID: 1407257
Sex: M
Age: 50
State:

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

Vax Type:
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Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: NauseaVomiting Narrative:

Other Meds:

Current Illness:

ID: 1407259
Sex: F
Age: 42
State:

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

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Myalgia, Fever, no appetite Narrative:

Other Meds:

Current Illness:

ID: 1407261
Sex: M
Age: 35
State:

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

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies:

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

Symptoms: chills, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1407270
Sex: F
Age: 52
State:

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

Vax Type:
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Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Arthralgia severe arm pain, Narrative:

Other Meds:

Current Illness:

ID: 1407272
Sex: F
Age: 33
State:

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

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

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

Symptoms: Myalgia, Fever, chills Narrative:

Other Meds:

Current Illness:

ID: 1417138
Sex: M
Age: 57
State:

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

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

Symptoms: FATIGUE, HA, CHILLS, JOINT PAIN, TENDER LOCAL LYMPH NODE TO SIDE OF INJ, PAIN INJ SITE, COUGH, SOB, SORETHROAT, LOSS OF TASTE/SMELL,

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am