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: 0981383
Sex: F
Age: 47
State: IN

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fatigue, sore arm, joint and body aches most significant in lower back

Other Meds: escitalopram 20mg, 1 tablet, every morning-0600 buproprion HCL SA, 200mg, 1 tablet twice daily-0600&2100 simvastatin 40mg, 1/2 tablet, 2100 melatonin 10mg, 1 tablet, 2100

Current Illness: none

ID: 0981384
Sex: M
Age: 58
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Aspirin

Symptom List: Anxiety, Dyspnoea

Symptoms: fatigue lasting 48 hours

Other Meds: Plavix, DDAVP, Lipitor, Xalatan, Neurontin, Flomax, Reglan, Omeprazole, Oxybutynin Chloride, Lisinopril, fluticasone propionate, Seroquel, Probiotic, Melatonin, Trazadone, Depakote, Vitamin C, Vitamin D3, Roxicodone

Current Illness:

ID: 0981385
Sex: M
Age: 66
State: FL

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Apprx 7 minutes after receiving vaccine, I experienced a sensation in my chest, upper arms, and neck areas. I also experienced a slight metallic taste in my mouth. I also sensed a somewhat increased heart rate and some slight dizziness. I did NOT experience any breathing difficulties but maybe had a very slight wheeze sensation. These reactions lasted only about 8 to 10 minutes then started easing away. I was monitored a full 30 minutes and then released after reporting I felt ok then.

Other Meds: Atenolol 50 mg 2 X per day; Lisinopril 20 mg 2 X per day; Simvastatin 20 mg 1 per day; Aspirin 81 mg 1 per day; Cimetidine 200 mg or Famotidine 10 mg as needed for heartburn; Loratidine 10 mg as needed for nasal congestion; Vitamin D3 (1000

Current Illness: None

ID: 0981386
Sex: F
Age: 37
State: OH

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Sore arm for a couple days but felt completely fine. Exactly a week after injection, the site became itchy, red, warm, and swollen. Used hydrocortisone cream and ice for relief but discovered heat helped more. Itchiness did not last long but redness and heat lasted a few days and spread around the injection site. Felt totally fine otherwise, no fever etc. It went away in its own in a couple of days.

Other Meds: 125 mcg Synthroid. Women?s multivitamin and Vitamin D supplement.

Current Illness: None

ID: 0981387
Sex: F
Age: 47
State: GA

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:

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

Symptoms: Dizziness, chills, fever and headache

Other Meds: None

Current Illness: None

ID: 0981388
Sex: F
Age: 50
State: AK

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: NSAIDs, Adhesive bandage, Latex, Toradol, Tylenol regular strength

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

Symptoms: Customer received FIRST COVID-19 vaccine at 1015 in medical center and transferred to post vaccine observation. At 1035 customer called out to provider. Customer reports feeling acute nausea and she states she feels as if she is going to throw up. She appears slightly pale and significantly anxious. Customer is moved to ante room, closer to emergency supplies. Customer denies feeling SOB, difficulty breathing or tongue/throat swelling. Reports feeling sweaty, with waves of nausea and intermittent ULQ pain that she describes as sharp and bandlike across the diaphragm. She episodically calls out in pain and clutches her left chest below her ribs stating that it feels better when she puts pressure at the site. Customer admits to having significant anxiety and a history of panic attacks. HR 102, 02 99%. Lungs CTA. Customer accepts Benadryl 50mg PO @ 1043. Customer monitored at site. Over the course of the next 15 minutes, she reports feeling better and more relaxed. Customer reports full resolution of symptoms @ 1100. BP 108/82, P 101, O2 100% RA, RR 16. Customer is agreeable to extended monitoring after receiving Benadryl. She has been driven to the vaccination site by a family member and states she will not be alone at home. She is instructed to watch for progressive s/sx of reaction including increase in throat symptoms, swelling, itching/rash, SOB, chest pain or any other symptoms that are outside her baseline. Instructed to contact EMS for transport to ED. Customer instructed to contact PCP Team prior to next vaccine appointment to discuss post vaccine course and discuss risks/benefits and/or pre-treatments prior to next vaccine. Customer agrees with plan and denies further questions/concerns. Customer released from site at 1115, ambulating independently with steady gait, no obvious s/sx of distress.

Other Meds:

Current Illness:

ID: 0981389
Sex: F
Age: 22
State: IN

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: IM
Vax Site: LA

Lab Data:

Allergies: Amoxicillin, Zithromax, cefaclor

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Chest pains that come and go, my feet and hands itching, migraine, chills, nausea, rash

Other Meds: Nikki birth control

Current Illness: None

ID: 0981390
Sex: M
Age: 44
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: At approximately 2 AM, the next day, I started to have uncontrollable chills which results in excessive chattering of my teeth. I had trouble getting warm and had to utilize multiple blankets to gain heat, which is not normal. I was very warm and most likely developed a fever. I did not eat until 2 PM that day and the started feeling better later that night. I was forced to miss work to recover. I returned to work today, 1/28 but I remain tired and a little lethargic.

Other Meds: busprirone, Zoloft, metropol, multivitamin

Current Illness: No

ID: 0981391
Sex: F
Age: 59
State: NY

Vax Date: 01/19/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Eight days after inoculation, around 5:00 pm I noticed a red welt to the right and slightly below the injection site. I still have the red welt today. It does not hurt, but is tender to the touch and somewhat raised. For the initial 7 days post-vaccine there was no reaction whatsoever, not even a tiny red mark.

Other Meds: None, but took 2 Extra Strength Tylenol morning of 1/27/21 for a headache--first NSAID taken within 2 weeks of vaccination.

Current Illness: None

ID: 0981392
Sex: F
Age: 77
State: CT

Vax Date: 01/23/2021
Onset Date: 01/27/2021
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: sulfa (vomiting), prednisone (facial swelling, itching, redness), lisinopril (raynaud's), boniva (vomiting).

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Palpitation, shaking, weakness, sudden onset on 1/27/21 at 8:00am. Was seen in the ED and found to be in sinus tachycardia; resolved without intervention.

Other Meds: Atorvastatin Calcium 10 mg Tab sig: TAKE 1 TABLET BY MOUTH EVERY OTHER DAYView Betamethasone Dipropionate 0.05 % Oint sig: 1 application topically to affected area (finger) daily clonazePAM 0.5 mg Tab sig: TAKE 1/2 TO 1 (ONE-HALF TO ONE) TA

Current Illness: None

ID: 0981393
Sex: F
Age: 30
State: NY

Vax Date: 01/12/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: day # 11 developed pustular and vesicular rash at site of injection and over ipsilateral forearm. treated with topical steroid

Other Meds: fluoxetine, cyclobenzaprine, meloxicam

Current Illness: cervical cord compression

ID: 0981394
Sex: M
Age: 58
State: IN

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: SYR
Vax Site: RA

Lab Data:

Allergies: Penicillin

Symptom List: Rash, Urticaria

Symptoms: Late afternoon still working started with scratchy throat later on in shift @4pm started feeling yucky flu like symptoms. Went home and cleaned up and went to bed. I slept most of the next day. I work up the 2nd day and felt much better

Other Meds: Several. type 2 diabetes high blood pres. Cholesterol

Current Illness: None

ID: 0981395
Sex: F
Age: 32
State: TX

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: LA

Lab Data:

Allergies:

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

Symptoms: On night of vaccine, the chills started. Lasted throughout the night. On the entire day of 1/27/2021- I had chills, my internal temp felt like 89?, even though I had a low grade fever. I had a migraine that felt like my head was going to explode. It caused body aches and neck pain, sinus pressure, dizziness, weakness, nausea, pain in arm at injection site.

Other Meds: Vitamin D, meloxicam

Current Illness:

ID: 0981396
Sex: F
Age: 80
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: metformin, glipize, losartan, loviastatin

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

Symptoms: High blood pressure going up and down

Other Meds: medforman,

Current Illness: no

ID: 0981397
Sex: F
Age: 49
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Nausea, body aches, HA, fatigue, back pain

Other Meds: Methotrexate, Zofran, Gabapentin, Cymbalta,

Current Illness: none

ID: 0981398
Sex: F
Age: 54
State: OH

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: 01/05/21 Sore arm, severe headaches which was worse if laying down, fatigue, and general aches & pains in joints the very next morning 8:00 am. I took 2 Tylenol 500 mg each & rested. My scalp felt like it was on fire & itched severely. My scalp was red but no lumps of bumps observed. That evening when changing into pajamas, I noticed both my legs had purple blotches from above my knees down to both feet. It looked worse when I stood. As a nurse, I knew this was mottling. I have never had this in my life. I immediately took 3 baby aspirin 81 mg each. I was so exhausted, I went to bed. 01/06/21 I woke up feeling better. My scalp still itched but not as bad. My legs were still mottled from above my knees down to feet, still worse when I stood. I took 3 baby aspirin 81 mg each at 08:00. My arm still was sore but less severe. Mild headache & ache and pains in joints. The mottling in my legs has continued & improved but I notice it mostly after showering now. I reported these symptoms to my doctor. He has advised not to get second dose & to continue aspirin 81mg daily. Prior to getting the vaccine I informed the infection control nurse about my symptoms that began 12/23/20 & the negative covid test taken on 01/04/21. She recommended I take the vaccine.

Other Meds: None

Current Illness: Sinus infection, loss of taste & smell for 2 weeks, headaches, fatigue, tested negative to covid virus (tested 01/04/21)

ID: 0981399
Sex: M
Age: 74
State: PA

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: None

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

Symptoms: Unable to blink left eye. Unable to smile with left side of mouth. Both appeared by the next morning. I noticed it around 10:00am. Left leg heavy cramp the night of around 5:30. It went away when I stretched it and did not return.

Other Meds: Rosuvastatin calcium 20mg morning Amiodipine besylate 5mg evening Bayer aspirin 80mg morning

Current Illness: None

ID: 0981400
Sex: F
Age: 43
State: SD

Vax Date: 01/17/2021
Onset Date: 01/18/2021
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: The arm had a little knot then it went down the it continue to ache with pain, I started taking Tynelno 500 for pain and it didn?t calm down pain got worst, where my back started to pain on left side up my neck! My neck hurts so bad on the left side! When I turn my neck it hurts!

Other Meds:

Current Illness:

ID: 0981401
Sex: F
Age: 30
State: NY

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Symptoms started at 11 PM 11/27/21 (approx 12 hours from the 2nd vaccination). Symptoms mild at first with just fatigue and bodyaches. Progressively worsened throughout the night to a headache, severe chills, and fevers with Tmax 101.7. Fever kept rising, so Motrin 600mg was taken at 5AM. Fever went down, ongoing chills and low-grade fever persisted.

Other Meds: None

Current Illness: Diagnosed with covid-19 1/9/21. Symptom onset 1/8/21. I was out of quarantine 1/18/21.

ID: 0981402
Sex: F
Age: 38
State: AK

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: NKA

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

Symptoms: C-O was working in the vaccine clinic today assisting in scheduling customers. She obtained her second COVID-19 vaccine at approximately noon today. At 1330 she approached my desk with c/o left sided abdominal pain, scratchy throat, voice changes, and feeling tachycardic. Denied hx. Anaphylaxis or hx. Adverse reactions to any vaccines. She was given 50mg of diphenhydramine at 1332. At this time her pulse was 125, oxygen saturation 97%, unable to obtain BP due to small cuff size available. Med rec completed. Medical history taken, no contraindications to COVID-19 vaccine noted. She was advised to lay down during this time and reported feeling a little better within 30 minutes of taking diphenhydramine, though noted onset of headache starting and mentions hx migraines. By 1409 her pulse was reduced to 98 bmp. 1434 C-O reported feeling a little lightheaded upon standing from laying, pulse 92 and oxygen saturation 98. C-O was advised to sit and dangle for a time and then she decided to lay back down. At 1443 C-O reported improvement in symptoms except now had headache and drowsiness, BP 118/78, Pulse 90, oxygen saturation 98. C-O requested to leave to coordinate pickup from relative and I felt she was stable and did not require further treatment or monitoring at this time so agreed she could leave

Other Meds:

Current Illness:

ID: 0981403
Sex: F
Age: 41
State: IN

Vax Date: 01/25/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Fever of 103, chills, soreness, exhaustion

Other Meds:

Current Illness:

ID: 0981404
Sex: F
Age: 40
State: NY

Vax Date: 01/14/2021
Onset Date: 01/21/2021
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: Unevaluable event

Symptoms: About 7 days after I received my first dose of the Moderna vaccine I began to have a delayed reaction. It started with an itch near the injection site that was red and looked like a hive. It itched and the rash increased in size over the next couple of days. As it healed, the itch decreased and the rash started to resemble the look of ring worm around the injection site. After about 72 hours it was almost completely gone. After about 4 days my arm was completely back to normal. I was never in pain from this, just a little bit of discomfort from the itching. I applied Cortisone cream which helped with that. It freaked me out more than anything. However after discussing it with a couple of healthcare professionals I wHowever after discussing it with a couple of healthcare professionals I was able to calm down. I can provide pictures of arm if needed.

Other Meds: NONE

Current Illness: NONE

ID: 0981405
Sex: F
Age: 36
State: OH

Vax Date: 01/18/2021
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: Penicillin and Sulfa medications

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

Symptoms: About one week after the vaccine had a 5-6 inch red rash at and around injection site. At this point I have had it about two day It is itchy, mild pain, and hot to the touch. At this point the rash is still present. It appears to be what is known as COVID arm or Hypersensitivity reaction.

Other Meds: none

Current Illness: none

Date Died: 01/18/2021

ID: 0981406
Sex: F
Age: 71
State: TN

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 01/28/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

Symptom List: Injection site pain, Pain

Symptoms: Stroke, death

Other Meds: multiple, unknown

Current Illness:

Date Died: 01/24/2021

ID: 0981407
Sex: F
Age: 48
State: MO

Vax Date: 01/06/2021
Onset Date: 01/24/2021
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: Expired in sleep on 1/24/21

Other Meds:

Current Illness:

ID: 0981408
Sex: F
Age: 58
State: MI

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: soreness around the injection site, hot to the touch, swelling from half way down to the elbow to up and over the shoulder blade, thick feeling tongue, inability to raise the arm

Other Meds: estradiol, Vitamin C, Vitamin D, Calcium and vitamin D, Gabapentin

Current Illness: psoriatic arthritis

ID: 0981409
Sex: F
Age: 43
State: TX

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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: Pork and Beef/ Seasonal allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Raised red rash in patches over entire body whichd began immediately upon administration of vaccine. No itching. Treated with PO Bendryl 50 mg immediately and then taken every 4 hours for 24 hours. Body aches and chills for 3-4 day. Diarrhea began within 24 hours and resolved Saturday (1/16). Also vomiting on Thursday x 4 dayss. Rash remains today but decreased in intensity. Rash areas over entire body appear dry and scaly on 1/27/2021.

Other Meds: Proair Inhaler

Current Illness: None

ID: 0981410
Sex: F
Age: 80
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: metformin, glipize, losartan, loviastatin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: High blood pressure going up and down

Other Meds: medforman,

Current Illness: no

ID: 0981412
Sex: M
Age: 51
State: GA

Vax Date: 01/25/2021
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: N/a

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

Symptoms: Covid Dx: July 2020,. Post initial vaccine, fever, chills, exhaustion for the first 27 hours. Night sweats days 2 and 3. Low grade fever tends to be persistent at night time. Day 3 and Day 4, increased GI symptoms with nausea. Ibuprofen has been used to control symptoms and discomfort.

Other Meds: N/A

Current Illness: N/a

ID: 0981413
Sex: F
Age: 30
State: KY

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

Symptoms: The same day that I got the vaccine I began to get a headache about 4.5 hours later. I couldnt get the headache to go away even after taking ibuprofen and Tylenol. Later that night I began to run a fever over 100.5 and had chills and body aches. The entire next day my body felt so weak that I could not lift my head off the pillow. I also had nausea. These symptoms lasted until Thursday night around 8pm.

Other Meds: Paxil 20mg daily

Current Illness: none

ID: 0981414
Sex: M
Age: 78
State: MA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: I think I was Lisinopril and it made me cough so they switched it.

Symptom List: Injection site pain

Symptoms: One is as yesterday progressed I got more and more tired. I had trouble staying awake. I was extremely tired. I tried my hardest to stay up awake until bedtime to try and not mess up my sleep schedule. When I went to bed I slept for 10 hours which is unheard of for me. I am still tired this morning. The other thing is on my Eliquis I take it twice a day, I set my cell phone to go off. I apparently just turned my phone when it went off in the evening, I didn't remember to take my 2nd dose of my medication. I worried if the vaccine caused some confusion. I am going to call my Primary Care doctor today. I did call the VA as well and talk to a nurse who said that I should be feeling better today.

Other Meds: Finasteride 5 MG once a day, Tamsulosin.04 MG once a day, Eliquis 5 MG twice a day, Metoprolol 12.5 MG once a day, Furosemide 20 MG once a day, Cream I use every day Metronidazole .075 for my nose, Nasal spray Fluticasone Propionate at

Current Illness:

ID: 0981415
Sex: F
Age: 35
State: KS

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: N/A

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

Symptoms: Symptoms started at 5am (Friday)the day following vaccination. Symptoms included body ache, severe headache, chills, shivering, and sweating. The symptoms disappeared around 6am (Saturday) the day after symptoms started. No treatment given.

Other Meds: Levothyroxine- 100 mcg/day Collagen- 1 scoop/day Ovasitol- 1 scoop/day

Current Illness: N/A

ID: 0981416
Sex: M
Age: 52
State: CO

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: none

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

Symptoms: Fever x 3 days 102.1 (highest temp) , chills, headache. Swelling of hands and feet with rash/redness on hands and feet. That started on Jan 27 2021 x2 days after vaccine. Hasn't subsided yet.

Other Meds: lisinopril, simvistatin

Current Illness: none

ID: 0981417
Sex: F
Age: 22
State: NC

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

Lab Data:

Allergies: Sulfa Drugs

Symptom List: Tremor

Symptoms: 22 year old female presented int eh COVID vaccine clinic for Pfizer #2. After having sulfa drugs in the past, her platelets did drop. Lot: EL3247 Administered at 9:54 EE reports that very soon after receiving the vaccine, she began to itch all over. No shob, lip tingling, itching in her mouth or throat. The only itching is on her skin. Once her 30 minutes wait time was over, she told the observer that she was itchy. I responded to the observation area. 10:34 o2 - 100 HR - 96 EE is pink, AA), does not appear to be in distress. She has just gotten off of work and is headed home to go to bed. She lives at home with her mom. Her mom is a PA. Discharged pt. She will go home and take benadryl and tell her mom.

Other Meds: DepoProvera; Levothyroxine

Current Illness: N/A

ID: 0981418
Sex: F
Age: 51
State: NC

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

Lab Data:

Allergies: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: About 45 minutes after my shot the left side of my face began to get tingly and numb. (Like when you have had dental work and the feeling is coming back) This continued for about 3 days. I also had a very bad headache Thursday-Friday and then a low grade fever Friday afternoon. I never have a fever. I cannot tell you the last time I had a fever. I contracted Covid in October and did not have a fever then.

Other Meds: Singulair

Current Illness: None

ID: 0981419
Sex: F
Age: 36
State: MO

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: None

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

Symptoms: Fever, body aches, headache since 11 p.m. on 1/27/21. Continue to have symptoms as of 0830 a.m. 1/28/21. Resting in bed. Notified employee health office & will contact pcp & employee health if symptoms worsen.

Other Meds: None

Current Illness: None

ID: 0981420
Sex: M
Age: 56
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no allergies

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

Symptoms: Patient had left clinic and returned to work. Patient had vertigo episode about 45 min after receiving vaccine - became dizzy, multiple episodes of vomiting and diarrhea, pallor. Patient drove back to clinic arrived at 3:10 pm; patient extremely pale, c/o nausea and dizziness, felt anxious and mild fatigue also. Temp upon arrival 97.8 (F). Vital signs as Below: 3:12pm: BP-164/100, P-69, RR-22, PO2-96% 3:16pm: BP-138/96, P-68, RR-22, PO2-95% 3:22pm: BP-144/101, P-74, RR-20, PO2-95% 3:32pm: BP-142/100, P-74, RR-20, P02-97% 3:45pm: BP-117/76, P-70, RR-20, PO2-96% Zofran 1 dose given at 3:25pm, patient laid on side around 3:35pm then seen by in-house provider at 3:54pm. Patient drank small sips of water around 4:00pm and felt better, less nausea and dizziness. Per Dr. patient able to leave with wife as transportation. Patient contacted by Manager that evening and reported feeling better, all symptoms improved. Attempted to contact patient this am - no answer, left message to call back to verify symptoms resolved. Dr. report: Patient was noted to have vertiginous reaction, starting 45 minutes after 1st dose of vaccine with dizziness and nausea. Patient is known to have a history of vertigo. His symptoms resolved within 30 minutes with treatment including rest and Zofran. No further vertigo or other side effects noted. No signs of acute allergic reaction occurred during this period.

Other Meds: aspirin, atorvastatin, losartan, metformin

Current Illness: allergic rhinitis, inner ear issue (per patient)

ID: 0981421
Sex: F
Age: 68
State: NJ

Vax Date: 01/18/2021
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: NONE

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Yesterday, nine days after receiving my first Covid Moderna vaccine, I developed a large, red, raised, lump on my arm at the spot where I was vaccinated. I still have it today. It is uncomfortable and concerning. For the two days immediately following the vaccine, my arm muscle was very sore. That went away.

Other Meds: NONE

Current Illness:

ID: 0981422
Sex: F
Age: 67
State: OR

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: SYR
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: I received the 2nd dose at 0900, the took Ibuprofen 200mg and 1 Zyrtec tab at 10am. I had no symptoms until 0500 the next morning, 1/26. I woke up with aching joints, aching eye sockets, hyper sensitive skin sensations, slight headache, abdominal cramping, and lethargy. The abdominal cramping subsided in a few hours. I slept the whole day, missing a day of work. I took Ibuprofen 200mg at noon. On 1/27 at 0100 am, I woke with aching joints and skin hypersensitivity. I missed a second day of work, sleeping until 10am that day. Symptoms had subsided upon waking .

Other Meds: Calcium

Current Illness: none

ID: 0981424
Sex: F
Age: 79
State: SC

Vax Date: 01/14/2021
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: Demerol

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

Symptoms: Client received vaccine on 1/14/2021. Started noticing generalized itching on 1/23/2021, on Monday 1/5/2021 arm where received vaccine was red, firm and warm to touch Client went to md office for eval and was advised not to get the second dose

Other Meds:

Current Illness: received injections in her back the next Friday prior to the reaction starting on Saturday

ID: 0981425
Sex: F
Age: 46
State: VA

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:

Symptom List: Pain in extremity

Symptoms: Dizziness, light headiness, weakness, around 7:35ish the next day of vaccination, had a head ache pretty much all day.

Other Meds:

Current Illness:

ID: 0981426
Sex: F
Age: 48
State: GA

Vax Date: 01/26/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: NONE

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

Symptoms: FLU-LIKE SYMPTOMS: HEAD AND MUSCLE ACHES, SORE THROAT, FEVER, CHILLS

Other Meds: NONE

Current Illness: NONE

ID: 0981428
Sex: F
Age: 37
State: TX

Vax Date: 01/20/2021
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: no

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

Symptoms: Exactly 1 week after my first dose of Moderna in exactly the same area vaccinated my right arm started itching. The following morning I woke up to the area swollen and reddish arm . It does not hurt just experiencing a lot of itchiness.

Other Meds: Only my birth control and daily vitamins

Current Illness: no

ID: 0981429
Sex: F
Age: 67
State:

Vax Date: 01/19/2021
Onset Date: 01/19/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: erythema and firm right deltoid 4 x 4.5 cm

Other Meds:

Current Illness:

ID: 0981430
Sex: F
Age: 36
State: AL

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

Lab Data:

Allergies: NKA/NKD

Symptom List: Vomiting

Symptoms: Around 6PM the evening after receiving the vaccine my arm became noticeably sore and I began to feel achy all over. I became noticeably more tired than usual around 8PM and went to bed about 8:30. At around midnight I woke up hurting all over, joints and muscle aches. I felt suddenly very nauseated and got up to go to the bathroom toilet. Once crouched down over the toilet I became very lightheaded and dizzy. My vision went white and starry and remained this way for my guess is around 5 minutes. My husband says I was showing seizure like activity, moaning and "clenching up." Once my vision cleared up I still felt awful, lightheaded, weak, dizzy. I sat up with a cold cloth on my head. My husband during the coarse of this was terrified and called an ambulance. The EMT's arrived and informed me the episode had occurred because I was hyperventilating. My chest was uncomfortable at this time and my fingers were tingling. They calmed me down and check my vitals which were stable. I went back to bed and slept after that. I had another feeling of dizziness and nausea about 7AM the next day which resolved. I felt very tired, weak, and achy all day the next day.

Other Meds: Adepex 37.5mg daily Citalopram 40mg daily Lo Loesterin daily

Current Illness: N/A

ID: 0981431
Sex: F
Age: 48
State: NC

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Bells Palsy left face. left facial numbness and partial paralysis

Other Meds: metformin, multivitamin

Current Illness: None

ID: 0981432
Sex: F
Age: 76
State: GA

Vax Date: 01/18/2021
Onset Date: 01/25/2021
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: States that the day after vaccination her arm was sore. Three days ago, patient noticed a large rash under right breast then she noticed small rash at injection site. Recommended for patient to follow up with primary care doctor- patient agreed. Will also discuss with doctor if she should receive second dose.

Other Meds:

Current Illness:

ID: 0981434
Sex: F
Age: 61
State: MA

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: all narcotics and Flaxseed

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I had rush in my chest and a taste in my mouth when it was administered then couldnt swallow food 2 hours later could swallow liquid I took benedryl 3 different times throughout the night, next day could swallow food.

Other Meds: xanax

Current Illness: asthma

ID: 0981435
Sex: F
Age: 36
State: TX

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: Rash began day 1 and resolved by day 2. Joint pain day 1-3. Fatigue and diarrhea.

Other Meds: None

Current Illness: None

ID: 0981436
Sex: F
Age: 59
State: MS

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: PCN

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

Symptoms: mild fever, body aches, headache, later on sore throat

Other Meds: vitamin C and multivitamin

Current Illness: n/a

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm