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: 0981167
Sex: F
Age: 53
State: AR

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: reports she received the 2nd dose of Covid vaccine on 1/27 at 1430 and started having fever 100.8-100.9 and HA, swollen tongue, around 1/27 2100.

Other Meds: Flonase, Duloxetine, B12 complex, Synthroid, Flovent

Current Illness: no

ID: 0981168
Sex: M
Age: 61
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: NIGHT AFTER VACCINATION : WOKE UP WITH CHILLS AND HOT SWEATS DAY AFTER: SEVERE FATGIUE , EYES WERE RED

Other Meds:

Current Illness:

ID: 0981169
Sex: F
Age: 28
State: MA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Received by COVID vaccine the evening on 12/30/2020 in my left arm and it was done very high up on the arm close to the shoulder and slightly on the backside of my arm. Within 3 hours I had strong pain and limited range of motion.By day 4, after a few days of rest at home, the pain had resolved so I came to work Monday night 1/4/2021. By the end of shift my arm was very sore again and I had a lot of pain when trying to lift it. My shoulder, neck, and back has a general ache and soreness on the left side that sometimes radiates down the arm and worsens when I try to lift my arm. Seen by ortho.

Other Meds:

Current Illness:

ID: 0981170
Sex: F
Age: 54
State: PA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/28/2021
Hospital: Y

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

Lab Data:

Allergies: Compazine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Moderna COVID-19 Vaccine EUA given approximately 7:50 am on 1/25/2021 I left deltoid. By 4 pm, arm sore, noticeable fatigue and headache. Approximately 7 pm, chills started and headache much worse. Temperature was 100.7. Took a Tylenol. Around 8:30 pm became extremely nauseous and began vomiting. Vomited several times, and became dizzy and near syncopal and confused. Eyesight blurred. Husband called 911. Taken to Hospital and was in hospital until 1/27/21.

Other Meds: None

Current Illness: None

ID: 0981171
Sex: F
Age: 62
State: MI

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Vaccine given high up on shoulder, not 3 finger widths down. Persistent pain right shoulder and upper arm, positional discomfort. Pocket of fluid accumulation above right clavicle.

Other Meds: Prempro, calcium, multivit

Current Illness: None

ID: 0981172
Sex: F
Age: 21
State:

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/28/2021
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:

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

Symptoms: headache, sweating and shaking 15 minutes after vaccine During the night woke up with chest tightness and shortness of breath and went to the ED-xray,ekg, IV fluids and Zofran

Other Meds:

Current Illness:

ID: 0981173
Sex: F
Age: 34
State: PA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fever 101, body aches, fatigue, headache

Other Meds: None

Current Illness: None

ID: 0981174
Sex: M
Age: 38
State: OH

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/28/2021
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: PATIENT HAS NO SYMPTOMS OF COVID BUT 7 DAYS AFTER GETTING VACCINE STARTED DEELOPING SYMPTOMS AND TESTED POSTIVE FOR COVID

Other Meds:

Current Illness:

ID: 0981175
Sex: F
Age: 38
State: PA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 17hrs post injection: Nausea Headache Fever 100.6 Injection site soreness 24hrs post injection: Fever 101.8 Headache Nausea Injection site soreness

Other Meds: Hydrochlorolthiazide Modafanil Labatalol Lisinopril Amlodapiene

Current Illness: No

ID: 0981177
Sex: M
Age: 52
State: NH

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
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 Acetone

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Severe myalgias, fatigue, headache, chills began 6 hrs post vaccine; by the next afternoon, fever to 103.1, extreme fatigue, headache, myalgias, altered mentation, right arm pain, swelling, redness; sought medical attention - prescribed prednisone 20 mg daily; fever defervesced late afternoon , but returned the next morning to 101.2, with improving headache, fatigue, myalgias; by 1/24/21, most symptoms except fatigue and local injection site pain had resolved; now still mild fatigue and mild arm pain

Other Meds: Rosuvastatin Acetaminophen Ibuprofen Fexofenadine Vitamin C Vitamin D Zinc

Current Illness: None

ID: 0981178
Sex: F
Age: 69
State: NY

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, streptomycin, terramycin, levoquin, shrimp

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

Symptoms: Rash on thighs

Other Meds: Toprol, pravastatin, Pepcid.

Current Illness:

ID: 0981179
Sex: M
Age: 39
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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:

Symptom List: Rash, Urticaria

Symptoms: PATIENT FELT VERY FATIGUE DAY AFTER VACCINATION AND LATER DEVELOPED A RED RASH ALL OVER BODY.

Other Meds:

Current Illness:

ID: 0981180
Sex: F
Age: 19
State: IA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/28/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Vaccine was administered into the subacromial space/joint of right shoulder instead of deltoid muscle. Patient presents on 1/27/2021 after onset of pain, decreased ROM ongoing since administration. I was able to visualize ecchymotic area where vaccine was administered and patient has photo evidence. The physician responsible for the vaccine administration needs to be retrained on where to give deltoid muscle IM injections and to avoid the extremities where recent surgeries occurred (patient had right shoulder labrum repair in October 2020)

Other Meds: None

Current Illness: None

ID: 0981181
Sex: F
Age: 31
State: MA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/28/2021
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:

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

Symptoms: Got vaccine on 12/30, next day had significant arm pain (7-8) and N/dry heave (? due to pain), was referred to Call Center to get covid testing, went to Urgent Care on 1/3/21 for testing-pain was decreasing and mobility better, pain at rest 2/10, wasn't throbbing; site was observed and ? too high; Covid test neg, RTW on 1/6/21 (0/10 at rest but had position pain, arm was overall improved), had tried to return to jogging , 1/7/21 woke with inc pain again 4-5/10, pain inc again by 1/9/21 to 6-7/10; saw NP/PCP on 1/12/21 and xray was done, MRI done

Other Meds:

Current Illness:

ID: 0981182
Sex: F
Age: 61
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 6-8 hours later: headache, fever, chills, right ear ache, felt like a sinus infection, diarrhea. Took tylenol

Other Meds:

Current Illness:

ID: 0981183
Sex: F
Age: 47
State: FL

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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: NKA

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

Symptoms: Sudden onset SVT tachycardia with rate of 160-174 . No prior history of cardiac disease

Other Meds: MVI

Current Illness: none

ID: 0981184
Sex: F
Age: 34
State:

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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:

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

Symptoms: Redness and slight swelling to left upper extremity. Site also warm to touch.

Other Meds:

Current Illness:

ID: 0981185
Sex: F
Age: 57
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/28/2021
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: vivid dreams, insomnia

Other Meds:

Current Illness:

ID: 0981186
Sex: F
Age: 48
State:

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 01/28/2021
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: Under my left arm was sore after each dose of the Pfizer-BioNTech COVID-19 Vaccine. I suspect swollen lymph nodes. The reaction occurred 7days after the first dose and the next day after the 2nd dose. While the armpit started to feel better before the 2nd dose I wouldn't say symptoms resolved before the 2nd shot.

Other Meds:

Current Illness:

ID: 0981187
Sex: F
Age: 78
State: NY

Vax Date: 01/19/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site of vaccination (upper left arm) red, swollen, itchy, slightly painful 8 days after injection

Other Meds: Estradiol 0.5 patch weekly Lisinopril, 10 mg daily Colace, 200 mg daily Multivitamin daily

Current Illness:

ID: 0981188
Sex: F
Age: 59
State: GA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: Latex Contrast dye (for MRI)

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

Symptoms: Approx 11 hours post injection: Low fever (99.0) Persistent shivering Headache 24 hours post injection: fever (99.9) Body aches Headache Fatigue

Other Meds: Tamoxifen Singulair Allegra Flonase

Current Illness: None

ID: 0981189
Sex: F
Age: 56
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/28/2021
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: Unevaluable event

Symptoms: low grade fever, slept all day, lymphadenopathy under arm, stuffy nose, sore throat, eyes burning. Took covid test and was negative. Also took tylenol to relieve symptoms without success. Symptoms x4 days

Other Meds:

Current Illness:

ID: 0981190
Sex: F
Age: 61
State: IN

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: No

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

Symptoms: A little over 48 hours into my COVID19 shot (Pfizer), I got sick. I was freezing cold, slight headache, no appetite, and tired/achy. I slept for 3 hours and woke up a little after 8 p.m. Temperature was 100.5. After calling work and notifying my doctor, I drank a Powerade and went to bed. This morning, I feel almost normal. Slight headache (maybe from lack of food) and my stomach is still a little upset.

Other Meds: Simvastatin (40MG), Synthroid (137 mg), multi-vitamin, Advil, allergy meds when needed.

Current Illness: No

ID: 0981191
Sex: F
Age: 62
State: MI

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Persistent shoulder and upper arm discomfort. Positional discomfort, pocket of fluid above right clavicle. I believe injection was given improperly, too high up on shoulder, not 3 finger widths down.

Other Meds: Prempro, calcium multivitamin

Current Illness: None

ID: 0981192
Sex: U
Age: 38
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/28/2021
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: hives everywhere, temp 103.8, chills, chest pain, felt like ants on her body, took motrin and felt terrible til 1/24.

Other Meds:

Current Illness:

ID: 0981193
Sex: M
Age: 74
State: IN

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/28/2021
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: IVP

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

Symptoms: Headache Chills Sweating Nausea Pain in injection site Swelling Loss of appetite Joint Pain Lethargic Dry Cough

Other Meds: Losartan 50 mg Rosuvastatin 10 mg Aspirin 81 mg Vitamin D3 Melatonin Osteo Bi- Flex PreserVision

Current Illness:

ID: 0981194
Sex: F
Age: 48
State: KS

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
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: Strawberries

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Red itchy rash around the injection sight

Other Meds: No

Current Illness: None

ID: 0981195
Sex: F
Age: 34
State: MD

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: About 48 hours after injection: arm still very sore, red at injection site, and developed swollen and sore lymph nodes in right arm (site of injection)

Other Meds: Lexapro, birth control

Current Illness: none

ID: 0981196
Sex: F
Age: 34
State: VA

Vax Date: 01/19/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: 1/20/21 day after receiving shot I had a headache, fatigue, foggy brain, soreness in the arm of the injection site. 1/21/21 felt great except I had some memory loss of the day before. Can?t recall everything I did the day after I received my vaccine 1/27/21 red, hot itchy spot around injection site about 2.5?x1.5? in diameter. Temperature on the injection site read 100?F 1/28/21 red, hot itchy spot around injection site 3.75?x2.5? in diameter.

Other Meds: Levothyroxine, Norethindrone, Vacyclivir, children?s multivitamin gummy

Current Illness: Flare up HSV1

ID: 0981197
Sex: M
Age: 47
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
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: Severely swollen lymph node under arm

Other Meds:

Current Illness:

ID: 0981198
Sex: F
Age: 59
State: VT

Vax Date: 01/19/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: penicillin, seasonal

Symptom List: Injection site pain

Symptoms: Rash at injection site appearing 8 days later after arm hurting for 5 days; rash is now getting itchy

Other Meds: Clarinex; Singular; sertraline; Vitamin D; Vitamin B-Complex

Current Illness:

ID: 0981199
Sex: F
Age: 32
State:

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

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

Lab Data:

Allergies: no

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

Symptoms: Burning at injection site immediately upon administration Pain & swelling at injection site within an hour generalized myalgias & malaise 18-24 hours later

Other Meds: no

Current Illness: no

ID: 0981200
Sex: F
Age: 32
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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:

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

Symptoms: Swelling and redness to left upper extremity. Site also warm to touch.

Other Meds:

Current Illness:

ID: 0981201
Sex: F
Age: 29
State: VT

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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: Tremor

Symptoms: Within 5 minutes of receiving Covid Vaccine (Pfizer ), second dose..... Employee complains of difficulty breathing, warm, sweaty, left arm pain, lips swelling, tachycardia (p=140-100). Team called and sent to ER.

Other Meds:

Current Illness:

ID: 0981202
Sex: F
Age: 69
State: WI

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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: Large red area on upper left arm with some swelling, near injection site. Muscle pain at the site, area very hot to the touch -- actually 2 degrees hotter than the same part of my other arm. Upon arising the morning after having this vaccine, my usual aches and pains were much worse than usual. Painful joints of toes, arches, ankles, knees, neck and shoulders. Some dizziness caused me to go back to bed for a while longer. After light breakfast, I took my usual morning supplements, including 2 extra-strength acetaminophen and 3 ibuprofen tablets for pain and inflammation. I felt terrible all day long; unsteady and weak. I took more pain relief caps in th evening. This is the third day after the shingles vaccine, and the arm is still very painful and HOT.

Other Meds: Mobic, Citrucel, extra strength acetaminophen, vitamin D3, vitamin B-Complex, low-dose aspirin, generic Prevacid

Current Illness: None

ID: 0981203
Sex: F
Age: 91
State: IN

Vax Date: 01/15/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
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: Erythromycin

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

Symptoms: Itching, rash, swelling at injection site, about a week after the injection

Other Meds: Lipitor, Maxide, AREDS 2, calcium, vitamin D Stool softener taken morning of adverse reaction

Current Illness: None

ID: 0981204
Sex: F
Age: 61
State: OK

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/28/2021
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: NKA

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

Symptoms: Sore arm at injection site

Other Meds: Furosemide, Cardura, , Latuda, Vitamin D3, Cyclobenzaprine Hydrochloride, Lamotrigine, Breo Ellipta Inh, Lisinopril, Singulair, NAC, Gabapentin, Synthroid, Cymbalta, Seroquel, Vitamin C, Oxycodone/ Acetaminophen, Mobic

Current Illness:

ID: 0981205
Sex: F
Age: 34
State: AL

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: bells palsy left

Other Meds:

Current Illness:

ID: 0981206
Sex: F
Age: 58
State: NY

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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: Wheat

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

Symptoms: Tired. Then aching all over body. Fever. Chills/shaking. Headache, lasting two days.

Other Meds: Multi-vitamin. D3 Flax seed oil. Biotin. Beta carotene

Current Illness: None

ID: 0981207
Sex: F
Age: 50
State: NH

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/28/2021
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:

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

Symptoms: I experienced fever to 101.7F, chills, fatigue and headaches. lasting three days.

Other Meds:

Current Illness:

ID: 0981208
Sex: F
Age: 43
State: KY

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

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

Lab Data:

Allergies: pcn

Symptom List: Pain in extremity

Symptoms: Moderna COVID-19 Vaccine EUA Chills, fatigue, restlessness, fever up to 100.9 beginning at ~5pm -11pm, relieved by tylenol, ~400am headache relieved by tylenol

Other Meds: one 81mg aspirin

Current Illness: none

ID: 0981209
Sex: F
Age: 14
State: MA

Vax Date: 12/30/2020
Onset Date: 01/05/2021
Rec V Date: 01/28/2021
Hospital: Y

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

Lab Data:

Allergies: N/A

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

Symptoms: Patient received the influenza vaccine on 12/30/2020 (unclear which version). On 1/9/2021, she presented to Hospital with 5 days of numbness, paresthesias, and weakness in both lower extremities. Neurological exam, lumbar puncture, and MRI of brain/spine were all consistent with acute inflammatory demyelinating polyneuropathy (a subset of Guillain-Barre Syndrome). She was admitted to the Neurology service, and treated with IVIG. She has been receiving physical therapy, and her strength/sensory symptoms are improving, but still significant.

Other Meds: Aripiprazole 2mg daily, methylphenidate 27mg daily, guanfacine 1 mg nightly

Current Illness: N/A

ID: 0981210
Sex: F
Age: 45
State: NC

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/28/2021
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-- >N/V; Sulfa-- > rash

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

Symptoms: Patient with a PMH significant for allergic rhinitis and cyclic neutropenia, as well a pre-syncope with previous blood donations received COVID-19 vaccine at 0645 and approximately 1 hour later developed a generalized feeling of warmth, followed by lightheadedness/dizziness. She denies frank LOC. She also reports palpitations and a rapid heart rate. She denied any rash, pruritis, dyspnea or chest pain, or N/V/D. Patient works in hospital and was transported to ED and upon arrival vitals were stable with HR of 79, BP 151/84, SaO2 of 100% on RA. Additional information for Item 18: Patient treated with IVF and released. Patient discharged to home and by 1:00pm that day was no longer symptomatic. She does endorse pre-syncope with previous blood draws.

Other Meds: Allegra 180mg daily; flonase daily, melatonin prn

Current Illness: cyclic neutropenia

ID: 0981211
Sex: F
Age: 24
State: IN

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: 2 children-February 16th 2019 5 lbs 9 oz, March 22nd 2021. Horrible body aches and chills. 9 am. Wednesday January 27th, lasted til 11 pm

Other Meds: Lamictal, Keppra, Topamax, Zoloft Pregnant-due date March 22nd 2021

Current Illness: No

ID: 0981212
Sex: F
Age: 84
State: MD

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: No

Symptom List: Vomiting

Symptoms: Her arm was very swollen and very painful

Other Meds: Many. I will not be able to repot all of this if I list all of them. I?M FILLING THIS OUT FOR MY MOTHER. I HAVE BEEN ENTERING V-SAFE FOR HER AND SHE WAS FEELING WELL WHEN WE SPOKE IN THE MORNING, BUT THEN I COULDN'T GET HER ON THE PH

Current Illness: None

ID: 0981213
Sex: M
Age: 27
State: LA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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: no allergies

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 15-20 min after receiving vaccine patient in car became hot, lightheaded, felt like he was going to vomit - had dry heaves x 2 then still in car sat for about 5-10 min then felt better. Since still in parking lot of clinic patient came back in clinic to be check out. At 1:08 pm vitals: BP-120/77, Pulse-70, RR-20, PO2-98%. Patient reports he did not eat anything since dinner night before, usually eats 1 meal a day in afternoon/evening. Patient left about 1 hour after experiencing symptoms that were completely resolved when he left clinic. Attempted to check on patient this am (1/28/2021) at 7:40 am - no answer on phone. Patient did mention he had work today and may not be able to get to phone, yesterday prior to leaving clinic.

Other Meds: none

Current Illness: no illnesses

ID: 0981214
Sex: F
Age: 56
State: VT

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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:

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

Symptoms: 15 minutes after vaccine given, complaints of chest pressure/tightness, tachycardia -pulse=120, c/o forehead pressure. Team called, sent to ED

Other Meds:

Current Illness:

ID: 0981215
Sex: F
Age: 49
State: OH

Vax Date: 01/18/2021
Onset Date: 01/25/2021
Rec V Date: 01/28/2021
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: Percocet, sulfa medications, fentanyl, pork, cats

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Abruptly Monday night 1 week later injection site was overly itchy with several mosquito bite size bumps. Next day quarter size red mark that was hot and inflamed swollen arm with fever as high as 99.8. Fatigue, headache and general unwell. Wednesday severe joint pain. Arm is still red and inflamed. Photos available. Prescribed prednisone. Unclear if this is helping

Other Meds: Vyvanse, Prozac

Current Illness: Na

ID: 0981216
Sex: F
Age: 60
State: MD

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Chills: lasted 6 hours, no treatment other than bundling up I didn't take Tylenol until after these had passed Body Aches: lasted 36 hours from onset. Improved with Tylenol.(1000 mg taken once at hour 8 (after getting up for work in the morning) after symptom onset) Fever 100.8: Gone after Tylenol Mild nausea,: Lasted about 8 hours, no treatment Soreness at injection site: Worst soreness was about 4-8 hours after injection, improved by morning, possibly due to Tylenol. Much improved after 24 hours from injection.

Other Meds: Dexilant 60 mg QD Prozac 20 mg QD Estradiol 0.05 mg patch biweekly

Current Illness: None

ID: 0981217
Sex: M
Age: 45
State: NM

Vax Date: 12/31/2020
Onset Date: 01/05/2021
Rec V Date: 01/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Days after receiving first shot, would wake up within 2 hours of falling asleep with a sharp headache on left side of head. Would sit up and move around and headache would dissipate with 30 minutes. Am not able to lay on back or on side. Received booster on 1/26/2021 and have had same events. OTC pain killers are not working. Once I initially wake up I move to recliner and fall asleep. We have a sleep number bed and have not had this issue in the past, although don't know if it is the vaccine or a unknown subtle change in day to day activities.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm