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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 0985431
Sex: F
Age: 77
State: WI

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/29/2021
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: Pt reported feeling like she was going to pass out at around 10pm on 1/26/21 and lowered herself to the floor in her bathroom. Was discovered on the floor around noon, 14 hours later, by staff after noticing her food tray was untouched . Arrived in ED via EMS. Pt was febrile with rectal temp 100.7 c/o weakness. Pt had a WBC count of 11.2, absolute neutrophil 9.9, and creatine kinase 3214. Pt was alert and oriented and reported having been hospitalized for a few weeks in November 2020 with Covid-19 and having received her first dose of covid vaccine at approximately 11:30 on 1/26/21. Hospitalist voiced concerns that this may be a reaction to covid vaccination.

Other Meds:

Current Illness:

ID: 0985432
Sex: F
Age: 52
State: PA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: penicillin, codeine, eggs, and egg products

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt. states that she developed bilateral facial redness around mouth around 09:50 am after receiving the first pfizer vaccine to left arm at 09:40 am.

Other Meds: vitamin b 12

Current Illness: ankylosing spondilitis

ID: 0985433
Sex: F
Age: 39
State: IA

Vax Date: 12/28/2020
Onset Date: 12/31/2020
Rec V Date: 01/29/2021
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: Penicillin, Minocycline

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

Symptoms: I experienced swollen lymph nodes to my neck and was getting worse over course of couple of days. I went to see a doctor at Iowa Falls Clinic.

Other Meds:

Current Illness:

ID: 0985434
Sex: M
Age: 35
State:

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Occular nerve inflammation, causing temporary blindness in right eye for 36 hours

Other Meds:

Current Illness:

ID: 0985435
Sex: M
Age: 36
State: OH

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: fevers, rigors, body aches, fatigue and mild cognitive impairment. onset about 12 hours after vaccine. improved with acetaminophen and ibuprofen

Other Meds: daily multivitamin

Current Illness: none

ID: 0985436
Sex: F
Age: 79
State: IN

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: Lisinopril, Losartin, Amlodipine, Penicillin Plus products containing Carba Mix , Balsam of Peru , Hydroperoxidies of Linalool, Proplis.

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

Symptoms: feeling hot but no fever, slight headache, slight nausea, general tiredness . atypical for me. 36 hours

Other Meds: Rosuvastatin, Carvedilol, Raloxifine, Dorzolamide, Premarin, Centrum Silver vitamin, Calcium, Fish Oil

Current Illness: none

ID: 0985437
Sex: F
Age: 58
State: MA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/29/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Patient received Moderna Covid-19 vaccination IM. She developed pruritic lips and a headache within 5 minutes. Zyrtec, and Benadryl administered PO with good effect. Patient did endorse anxiety.

Other Meds:

Current Illness:

ID: 0985438
Sex: M
Age: 65
State: GA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Pharyngeal swelling

Symptoms: I had extreme sharp pain in my prostate gland that lasted for approximately 2 hrs. It subsided eventually but my prostate was irritated for 1.5 days. Like a dull pain.

Other Meds: Abiraterone, alfuzosin, prednisone, alprazolam,simvastatin, lisinopril, zolpidem, trazadone, ibuprofen and clindamycin

Current Illness: Prostate cancer

ID: 0985439
Sex: F
Age: 58
State: WA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/29/2021
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: all over aches, dizzy, shot site PAIN

Other Meds: multi vit., adderal, anti itch med., meletonin

Current Illness: none

ID: 0985440
Sex: F
Age: 62
State: IN

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: PCN

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Felt "off" when I woke up. Pounding headache started at approximately 1:30 pm on 1/28/21, not helped with Advil. One bout of diarrhea. Headache finally eased late evening 1/28.

Other Meds: Advil

Current Illness: Head cold

ID: 0985441
Sex: F
Age: 69
State: OH

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
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: Left arm soreness from 1600 1/26/2021 lasting till 1/28/2021 at 20000. On 1/27 extremely tired, chills, nausea. Did not go to work. Foggy thinking. Highest Temp 99. On 1/28, able to go to work, continued tired, foggy thinking. Temp nl. On 1/29 able to go to work a little less tired. Arm soreness gone.

Other Meds: Levothyroxine 100 mcg. Vitamin D 500 mcg. Tylenol .

Current Illness: None

ID: 0985442
Sex: F
Age: 82
State: PA

Vax Date: 01/15/2021
Onset Date: 01/25/2021
Rec V Date: 01/29/2021
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: Red welt at injection site. Warm to touch and tender. Spread from 1/2 X 1 1/2 inch to wider and more diffuse from first day. Still there 4 days later...today January 29th.

Other Meds: Metoprolol Succ 50mg; Rosuvastatin 10mg;Protonix 40mg; MethanamineHip 1gm 2x/day; Claritin 10mg; Align; ConenzymeQ 10 100 mg; Pepsid COmplete; Cranberry pills; Folic Acid 400mg; Vit D3 125mg; Omega 3 1000mg; Furosemide Spray; Folic Acid 400

Current Illness: Urinary tract infection

ID: 0985443
Sex: F
Age: 60
State: IN

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Left arm pain - 6 hours after injection Headache after 24 hours - Tylenol

Other Meds: Bisoprolol Vitamin D MgSO4

Current Illness: N/A

ID: 0985444
Sex: M
Age: 35
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/29/2021
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: n/a

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

Symptoms: Sore arm radiating to shoulder and neck, CHILLS, headaches, groggy mind

Other Meds: n/a

Current Illness: n/a

ID: 0985445
Sex: F
Age: 43
State: NY

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: Fever of 102, chills, body aches and headache

Other Meds: None

Current Illness: None

ID: 0985446
Sex: F
Age: 52
State: NY

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
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: morphine

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

Symptoms: Started the day after the second injection at about 5pm. Red Slightly raised, warm patch two inches below injection site measuring about 3 inches by 3 inches with an irregular shape and burning sensation.

Other Meds: Topiramate 25mg 1 tab 2x's day Prempro 0.45-1.5mg daily HCTZ 25 mg daily

Current Illness:

ID: 0985447
Sex: F
Age: 67
State: MN

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: Codeine, Penicillin

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

Symptoms: Pt developed pins/needles sensation in right hand 10 minutes post-vaccination. wrist to finger tips. Denies pain, numbness. Assessed by RN (denies airways, breathing, swelling problems). Denies hives

Other Meds:

Current Illness: N/A

ID: 0985448
Sex: F
Age: 26
State: PA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: Severe migraine, body aches

Other Meds:

Current Illness:

Date Died: 01/28/2021

ID: 0985449
Sex: F
Age: 87
State:

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient was an 87 y/o female admitted for septic shock. She was started on and eventually maxed on 3 pressors. CT abd showed colonic obstruction with dilatation of large and small bowel. Patient was made DNR in the ED. Palliative care consulted on case. Family opted for comfort care. Patient was asystole on monitor. No spontaneous breath/cardiac sounds ausculted. Patient did not withdraw to pain. Pupils fixed and dilated. She was pronounced and 1230 on 1/28/21

Other Meds:

Current Illness: colonic obstruction with dilatation of large and small bowel

ID: 0985450
Sex: F
Age: 32
State: CO

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Employee received second dose of Moderna vaccine on 1/28/21. Within 15 minutes she started to feel warm, dizzy, headachy, general numbness and tingling & nauseated. Symptoms persisted/worsened and she then began to experience a scratchy throat and a sensation that her throat was swelling up. Patient given 50ml Benadryl IM. Many symptoms still persisted but no furthering of anaphylactic symptoms and eventual reduction in these symptoms as well. Patient stabilized after 3-3.5 hours and was allowed to be taken home by a family member and advised to continue monitoring for any ongoing or new urgent symptoms w/instructions to go to ER or call 911 if so.

Other Meds: N/A

Current Illness: N/A

Date Died: 01/24/2021

ID: 0985451
Sex: F
Age: 101
State: KY

Vax Date: 01/06/2021
Onset Date: 01/24/2021
Rec V Date: 01/29/2021
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: NKA

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

Symptoms: COVID-19 + 1/11/2021, EXPIRED ON 1-24-2021

Other Meds: predniSONE Tablet 20 MG Mucinex Tablet Extended Release 12 Hour 600 MG (guaiFENesin ER) Acetaminophen Tablet 500 MG RisaQuad Capsule (Probiotic Product) BISACODYL 10MG SUPPOSITORY Morphine Sulfate (Concentrate) Solution 100 MG/5ML H

Current Illness:

ID: 0985452
Sex: F
Age: 56
State: MN

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/29/2021
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: 12 hours post vaccine, chills and fever, headache, full body aches, abdominal pain and nausea. Severe symptoms lasted 36 hours, same symptoms but less severe lasted 72 hours. Now Friday, no fever or body aches, abdomen still sore. But feeling better

Other Meds: Multi vitamin, cucurmen, boswellia, vitamin c, zinc, vitamin d, zyrtec.

Current Illness: None

ID: 0985453
Sex: F
Age: 48
State: AZ

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: Latex

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

Symptoms: Day of Injection: Mild pain to left deltoid. Day one post injection: Left arm pain (difficulty in raising arm pain 8/10 if moved), extreme chills and body aches, itchiness and redness around injection site approx. 3 inches by 2 inches, progressing during day to red raised patches with itchiness. Day two post injection: raised patches more defined with raised border surrounding rash site.

Other Meds: L Lysine, L Carnitine, Oregano Oil, Women's Multivitamin, Probiotics, L Theanine, Omega 3 Fish Oil

Current Illness: None

ID: 0985454
Sex: F
Age: 65
State: TX

Vax Date: 01/16/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: demerol

Symptom List: Injection site pain, Pain

Symptoms: Appears the dose was given in the subcutaneious fat not in the deltoid muscle on the left arm, there is a slight bruise and a 3 in diameter ride patch on left arm, slightly raised

Other Meds: lipitor 20 mg aspirin 81 mg zinc vitamin D3 vitamin C multivitamin vitamin k elderberry vitamin B12

Current Illness: none

ID: 0985455
Sex: F
Age: 28
State: WI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: 2nd dose Moderna given at 0729 0740 throat felt like closing, bright red flushed 0741 Epi given 131/92 94 0742 head/face shaking rapid eye movements with attempted eye contact, Alert/oriented appropriate in conversation, sitting position 0743 110/83 face redness resolving, flush/red BUE, feeling better 0744 106/76 Rapid Response called 0747 106/68 benadryl 25 given 0751 911 called per Dr. recommended for further eval/potential reactions 0752 129/95 80 99% room air 0756 ambulance here 0801 left via stretcher with EMS to nearby hospital ED, patient tolerated activity to stretcher well 0925 reported by vaccinator of team member return to pick up rest of belongings to go home, tolerated activity well.

Other Meds:

Current Illness:

ID: 0985456
Sex: M
Age: 87
State: FL

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/29/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Patient had auditory hallucinations same evening as the shot, then began to have generalized weakness, worsening SIADH symptoms and visual hallucinations leading to subsequent hospitalization for 5 days and the SNF for 10 days. Never had hallucinations prior to event

Other Meds: Desmopressin 0.1mg (nightly), Simvastatin 40mg, Sodium Chloride (1 gm TID), Omeprazole 20mg QD, ASA 81mg QD, Calcium 500mg + D, Glucosamine Chondroitin, Smarty Pants Vitamin, Magnesium

Current Illness: None

ID: 0985458
Sex: F
Age: 63
State: MT

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Itchy, painful red rash on left arm, measures 6 inches long by 2.5 inches wide

Other Meds: Effexor Prempro

Current Illness: None

ID: 0985459
Sex: M
Age: 31
State: OK

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient received Pfizer vaccine for dose 2 in series instead of Moderna. Patient received Moderna for dose 1 on 12/30/2020. He was inadvertently given Pfizer for dose 2. The error was caught almost immediately. The immunization clinic team notified the clinic's medical director immediately upon identifying the error and informed the patient of the error. The patient was provided verbal and written information and advice concerning the medication error. During the 15-minute post-vaccination monitoring, the patient reported that he had no untoward effects from receiving the pfizer vaccine. Clinic director had contacted the patient via telephone at 8 pm that same evening and the patient reported no untoward effects from the pfizer vaccine. The patient was advised that given the CDC's current recommendations, an additional dose of either vaccine is not recommended at this time and antibody testing for determining vaccine efficacy is also not recommended at this time. The patient voiced understanding.

Other Meds: None reported

Current Illness: None reported

ID: 0985460
Sex: F
Age: 48
State: PA

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: Seasonal Allergies, morphine

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

Symptoms: High fever, felt really hot, body aches, chills, headache

Other Meds: Metformin, Prazosin, Bupropion, Lisinopril, Levothyroxine, Vitamin E, Iron pills, Rovastatin, Pantoprazole,

Current Illness: None

ID: 0985461
Sex: M
Age: 61
State: OK

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: Severe headache, muscle pain in the neck, shoulder,pain in the lymph nodes, severe chills. 2:30 p.m

Other Meds: To many to list

Current Illness:

ID: 0985462
Sex: F
Age: 40
State: WA

Vax Date: 01/11/2021
Onset Date: 01/15/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs

Symptom List: Injection site pain

Symptoms: Shingles involving R. flank, with first lesion presenting 15JAN. Treated with valacyclovir, amitriptyline, prednisone. Treatment still ongoing on 29JAN

Other Meds: Erenumab

Current Illness: none

ID: 0985463
Sex: F
Age: 37
State: NY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: fever of 101, diarrhea, aches, chills, delirium because of fever, excessive fatigue

Other Meds:

Current Illness:

ID: 0985464
Sex: F
Age: 54
State: AZ

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/29/2021
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: Day1 of vaccine 1/25/21-at 7 pm started having chills fever, body aches and severe headache. Day 2-1/26/21-all same symptoms as day 1 took Tylenol and Excedrin with no relief or help. Day 3-1/27/21-nothing, no symptoms.

Other Meds:

Current Illness:

ID: 0985465
Sex: F
Age: 35
State: CO

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: NKDA

Symptom List: Tremor

Symptoms: Employee received second dose of Moderna vaccine on 1/28/21. Within 30- 45 minutes she started to feel chills, dizzy, headachy, foggy vision & nauseated. Symptoms persisted/worsened and she then began to experience a scratchy throat. Patient given Benadryl IM. Many symptoms still persisted but no furthering of anaphylactic symptoms and eventual reduction in these symptoms as well. Patient stabilized after about 3 hours and was allowed to be taken home by a family member and advised to continue monitoring for any urgent symptoms and seek emergent care as needed.

Other Meds: N/A

Current Illness: N/A

ID: 0985466
Sex: F
Age: 67
State: PA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: The County Office of Public Health Received a shipment of Moderna Covid-19 vaccine on Wednesday, January 27th. It was immediately put into refrigerated storage. The refrigerator unit is monitored using a DDL and attached to an alarm system so that staff are quickly notified of temperature excursions. At 7:30 the next morning 1200 doses of vaccine were removed for administration at a mass vaccination clinic. At 8:25 100 doses were removed from the prepared Credo cooler and allowed to come to room temperature for no less than 15 minutes. The 6 vials were distributed to vaccination stations where nurses began to draw up vaccine. One nurse noticed that her vaccine was not entirely thawed. All other vials were inspected and two others were found to be partially frozen as well. It was also discovered that one of the pre-drawn doses had been administered to subject of this report. The patient was monitored for approximately one hour, while the staff consulted moderna and medical staff about the safety and validity of the dose administered. No adverse signs or symptoms were noted during that time.

Other Meds: Simvastatin for cholesterol

Current Illness:

ID: 0985467
Sex: F
Age: 64
State:

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 01/29/2021
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:

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

Symptoms: swollen gland, left side of neck.

Other Meds:

Current Illness:

ID: 0985468
Sex: M
Age: 73
State: WI

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: NKDA

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

Symptoms: Patient got up to go to the bathroom at 4:30 AM 2 days after he was vaccinated experienced dizziness and fell. He was not injured. I spoke with patient at 9:00 AM this morning and he was still experiencing some dizziness. Patient plans to call his PCP today

Other Meds: 3 x 200mg Ibuprofen tablets were taken on Wednesday evening because patient had been out snowshoeing that day

Current Illness: None

ID: 0985469
Sex: F
Age: 64
State: PA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: Body aches and fever

Other Meds:

Current Illness:

ID: 0985470
Sex: M
Age: 53
State: TX

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Report of pain and soreness of left arm where injection was given. Treatment: Tylenol with no improvement. Outcome: Does not interfere ADLs

Other Meds:

Current Illness:

ID: 0985471
Sex: F
Age: 23
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/29/2021
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: N/a

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

Symptoms: Moderna Sore are for a few days Very tired and achey following day Felt normal after 48 hours.

Other Meds: Adderall Multi-vitamin

Current Illness: Tested positive for covid-19 on 12/1/202

ID: 0985472
Sex: F
Age: 50
State: MA

Vax Date: 01/01/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: Denies allergies

Symptom List: Pain in extremity

Symptoms: This writer did not administer vaccine. Pt received vaccine at clinic and reported feeling shaky and nausea . Denies sob chest pain headache feeling dizzy or lightheaded. No respiratory distress

Other Meds: Topical cream reported for arthritis Migraine medication 25 mg po once daily PRN reported

Current Illness: Denies

ID: 0985473
Sex: M
Age: 66
State: IL

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache, chills, joint pain, fever

Other Meds: Breo inhaler, Vit. C, Vit. B

Current Illness:

ID: 0985474
Sex: F
Age: 43
State: IL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: Clarithromycin - anaphylaxis

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

Symptoms: Patient received her first dose of COVID-19 vaccine with the PFIZER product on 01/08/2021. Today, 01/29/2021, she presented for her second vaccination in the series and was erroneously given the MODERNA COVID-19 product. No adverse events noted

Other Meds: Keppra 1000mg BID

Current Illness: Unknown

ID: 0985475
Sex: F
Age: 75
State:

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
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: Moderna Covid-19 Vaccine EUA Itching and redness around injection site 8 days following injection

Other Meds:

Current Illness:

ID: 0985476
Sex: F
Age: 57
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/29/2021
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: N/A

Symptom List: Vomiting

Symptoms: Neck pain/tenderness, Shoulder tenderness moving to right side, lymphadenopathy

Other Meds: Metfomin Pravastatin levothyroxine Hydochlorothiazide

Current Illness: N/A

ID: 0985477
Sex: F
Age: 26
State: NY

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: nkda

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: neck pain developed less than 24 hours after baccine

Other Meds: ibuprofen nortrell adderall

Current Illness: none

ID: 0985478
Sex: F
Age: 26
State: NY

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
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: Had the vaccination 1/28. The night of I had chills and nausea. I also vomited twice, had body aches and pain in my arm.

Other Meds:

Current Illness:

ID: 0985479
Sex: M
Age: 75
State: TN

Vax Date: 01/14/2021
Onset Date: 01/20/2021
Rec V Date: 01/29/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 5-inch area around injection site, red and warm to touch, irritated by sleeve on initial day of rash, rash lasting 3 days. No other symptoms.

Other Meds: Vit D3 Fluticsone 50 mcg nasal spary Pulmicort 180 mcg flexhaler Triamterene 37.5 mg/HCTZ 25 mg Pravasttin 40 mg Advil

Current Illness: none

ID: 0985480
Sex: F
Age: 73
State:

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital: Y

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

Lab Data:

Allergies: STATINS-HMG-COA REDUCTASE INHIBITORS

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

Symptoms: after second dose of vaccine, patient had Internal jugular (IJ) vein thromboembolism, acute, right; Mucositis; Sore throat. Admitted for Chemotherapy-induced neutropenia; Infection of venous access port. Discharged after one day.

Other Meds:

Current Illness: hyperlipidemia, uterine leiomyosarcoma with metastasis to the right lung

ID: 0985481
Sex: M
Age: 23
State: OR

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
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: Soreness in arm at injection sight. Muscular pain and general fogginess of thinking for the next 24 hours with intermittent migraines.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm