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: 0986391
Sex: F
Age: 42
State: TX

Vax Date: 01/14/2021
Onset Date: 01/15/2021
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: Report of body aches, HA, nausea, dizziness, fever and vomiting 1 day post vaccination. Treatment: Ibuprofen Outcome: symptoms resolved, No interference with ADL.

Other Meds:

Current Illness:

ID: 0986392
Sex: F
Age: 62
State: TX

Vax Date: 01/19/2021
Onset Date: 01/25/2021
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: None Known

Symptom List: Anxiety, Dyspnoea

Symptoms: Vaccine given on Jan 19. Normal reaction following days with some redness and swelling. Then it started going away on Jan 24 On Jan. 25 7days after vaccine it started to itch. And get a little redder, hotter and more swollen so Itook a Tylenol. Jan. 26. Spot where vaccinated became redder, more swollen, hotter. Later that day it started with chills followed by fever. (100 degree) Took Tylenol Jan. 27 woke up no fever but arm was the same. I was very tired with muscle aches, headache and loss of appetite. Later that day fever arrived again. 100degrees. Took Tylenol Jan. 28 called Drs. Office to see if this was normal. Feeling much better today. Jan 29. Arm is much better and feeling better.

Other Meds: Vascepa, Losartan, B-12, and Vit. D3 once a week

Current Illness: None

ID: 0986393
Sex: F
Age: 57
State: MI

Vax Date: 01/01/2021
Onset Date: 01/26/2021
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: Latex, Demerol, sodium pentathol

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

Symptoms: Extreme pain in new knee replacement so much so almost falling. Pain non stop. Hurts to stand. Feels weak. All joints extremely painful but knee replacement worse. It?s 5 months old

Other Meds: Plaquenil, lamictal, Motrin, norco, multivitamin

Current Illness: None

ID: 0986394
Sex: F
Age: 54
State: TX

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: allergic to aspirin - will have hives/rash

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient reported having rash and itching (generalized hives), tingling to arms/legs, a little tightness to her throat. Symptoms started few minutes after vaccination. Patient was seen by EMS and observed for about 30 mins. Symptoms then worsened and EMS administered IV Benadryl and transported patient to ER.

Other Meds:

Current Illness:

ID: 0986395
Sex: F
Age: 60
State: AL

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: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Chills, Fever, Headache, Fatigue, Body aches;12 hrs duration; treated with Tylenol

Other Meds: Levothyroxine, Sucralfate, Pravastatin, Hydrochlorothiazide, Omeprazole, Albuterol, Aspirin, fish oil, VIT C, Vit D, Zinc

Current Illness: none

ID: 0986396
Sex: F
Age: 58
State: GA

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: PCN

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

Symptoms: Temo 101. body aches headache

Other Meds: vitamins

Current Illness: Covid #1 1/3/2021

ID: 0986397
Sex: F
Age: 21
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: Pyrexia, White blood cell count decreased

Symptoms: chief complaint of a possible allergic reaction onset today. Patient received the first dose of the COVID vaccine. Afterward she noticed her face and neck felt mildly swollen. Her chest also became mildly red. At this time she feels a little improved but her face still feels like it is swollen. Patient was transported here by EMS

Other Meds: fluticasone (flovent), albuterol, ortho-cyclen, zyrtec, marijuana

Current Illness:

ID: 0986398
Sex: F
Age: 44
State: TX

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Had first vaccination on 1/6/21. After second injection, severe pain under her right arm with swelling that has not subsided after 24 hours.

Other Meds:

Current Illness:

ID: 0986399
Sex: F
Age: 34
State: CA

Vax Date: 01/19/2021
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: Amoxicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Itchiness, redness, slightly warm to the touch, slight swelling of left arm surrounding injection site starting on 1/28/2021. Site is about 5 inches in diameter.

Other Meds: None

Current Illness: None

ID: 0986400
Sex: F
Age: 65
State: CA

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

Lab Data:

Allergies: Cantelope

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient states she felt slightly dizzy after getting up to leave facility upon completing her 30 minute post vaccination monitoring. Vitals taken after patient was seated in a chair. BP 130/70 P 84 O2 sat 98%. Patient requested to hydrate, rest and remain in post vaccination monitoring an additional 30 minutes until 1000. Discharged at 1000 and instructed her to call 911 with any emergent issues after departure from facility- verbalized understanding and form signed.

Other Meds: Albuterol PRN Advair PRN

Current Illness: NONE

ID: 0986401
Sex: F
Age: 29
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: dose given too early

Other Meds:

Current Illness:

ID: 0986402
Sex: F
Age: 76
State: OH

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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: lips numb

Other Meds:

Current Illness:

ID: 0986403
Sex: F
Age: 72
State: FL

Vax Date: 01/13/2021
Onset Date: 01/19/2021
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: penicillin, codeine, morphine derivatives

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

Symptoms: One week after the vaccine my left arm showed a bright red rash (1 1/2 inches wide by 3inches long) over the injection site. it faded over the next 9 days. No pain. Initially felt a little fatigue after shot, but this side effect was delayed. Since I am unble to get second dose in right arm due to Lymphedema from Breast Cancer surgery (2004), I want to be sure I can get second dose in that arm.

Other Meds: Bystolic 10mg, HCTZ 12.5mg , KCl 20 mg, Synthroid .05mg, Nortriptyline 2x10 mg, Vitamin D2 1.25 mg (50000 unit)

Current Illness: None

ID: 0986404
Sex: M
Age: 43
State: WA

Vax Date: 01/22/2021
Onset Date: 01/26/2021
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: Peanuts

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

Symptoms: Received vaccine at living premises by outside source on 1/22/21. On 1/26/21 caregiver called clinic (PCP) and appointment made. Noted to have rash on trunk, and back that he said was burning. Did not itch. No difficulty breathing or swallowing, or other symptoms.

Other Meds: Ferrous Sulfate, omega 3 acid ethyl esters, benztropine, risperidone, clonazepam, prazosin, chlorhexidine mouth rinse,

Current Illness: None

ID: 0986405
Sex: F
Age: 71
State: OH

Vax Date: 01/20/2021
Onset Date: 01/24/2021
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: Red dye

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

Symptoms: Red area growing, hard, itching

Other Meds: Lovastatin 20mg, Furosemine 20mg, Armodafinil 200mg, Myrbetriq 50mg, Vitamin D; B12,

Current Illness:

ID: 0986406
Sex: F
Age: 67
State: MI

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: shingles pain flair up. right mid riff and left arm, and left neck, cheek, and foot. A burning pain and dizziness. the pain is very intense causing me to lay down and close my eyes. This has happened everyday for two weeks now. everyday is the same and has not gotten better.

Other Meds: naturethroid, probiotic

Current Illness:

ID: 0986407
Sex: F
Age: 36
State: CA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: Morphine Sulfa Daptomycin

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

Symptoms: Lightheadedness reported . Apple juice given. BP 112/81. BP at 1726: 96/63 HR 62. Reports feeling stable and left clinic.

Other Meds: Motrin, Zoloft, pantoprazole

Current Illness: None

ID: 0986408
Sex: F
Age: 48
State: CA

Vax Date: 01/27/2021
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: Neosporin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: welt appeared under the patients right ear.

Other Meds: None

Current Illness: none

ID: 0986409
Sex: F
Age: 66
State: CT

Vax Date: 01/01/2021
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: Some seasonal allergies Had topical itching after IV Demerol and morphine at administration site post surgery Had topical itching after Percocet or period an Had rash and sensitivity after takin nitrifurantantoin for bladder infection

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Night 3 of vaccine woke in am with right mild thigh gnawing, a sensation never experienced before. Duration 1-2 hours. Night 4 woke 2 am with more intense discomfort left knee, again not like anything experienced before but did not require Tylenol. It was gnawing and annoying, Night 5 woke around 4 am with left lower leg/ side of foot mild ache which lasted a few hours. Stretching, changing positions had no effect on any of three nights. Day after vaccine while exercising I perspired more than usual and was tired. Did not concern me in any way and would not have reported unless had above symptoms. Question- Do any of the above symptoms indicate I should not get dose 2? Thank you

Other Meds: Losartan HCTZ, synthroid, rest as is, ezutimibe Multivitamin, calcium, fish oil supplement, probiotic and B12

Current Illness: Had multiple bee stings over summer. Last one had very slight raspy throat after

ID: 0986410
Sex: M
Age: 70
State: NV

Vax Date: 01/26/2021
Onset Date: 01/27/2021
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: None

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

Symptoms: COVID-19 Vaccine headache, chills, fever, body aches particularly along the spine, fatigue Advil taken to help relieve symptoms. Lasted two days.

Other Meds: tamulosin, omeprosol, levithyroxin, Glucosamine and Chondroitin, baby aspirin

Current Illness: None

ID: 0986411
Sex: F
Age: 51
State:

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

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

Symptoms: 2nd dose given too early

Other Meds:

Current Illness:

ID: 0986412
Sex: F
Age: 54
State: TX

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Syncope episode, fever, arm pain, neck pain, nausea, vomiting Still not feeling well

Other Meds: Tylenol - prior to vaccine Claritin - after vaccine

Current Illness: None

ID: 0986413
Sex: F
Age: 50
State: OR

Vax Date: 01/20/2021
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: I have sensitivity to the following: Soy products Milk Latex Gabapentin

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

Symptoms: The injection site started to itch and then a small welt appeared; the size of a flea bite. Within several hours of my first noticing the bump, another small bump appeared and my upper arm was "reddish" in color. I took a "Claritin" at 5 pm on Thursday, January 28, 2021 but the swelling continued. By noon on Friday, January 29, 2021, the two small flea bit size bumps have merged into a large bump the size of a quarter. The redness around the bump is gone but the bump is red and itchy.

Other Meds: I do not take any prescription medication, dietary supplements, or herbal remedies.

Current Illness: NONE

ID: 0986414
Sex: F
Age: 61
State: CA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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: Gabapentin, steroids, mepivicaine, valium, klonapin, depakene, baclofen

Symptom List: Injection site pain, Pain

Symptoms: On January 16, the day after being vaccinated (1/15/21), I woke up with my arms, hands, legs and feet tingling and numb all over and it lasted on and off all day January 16 and on and off all day January 17 and has persisted every day until Monday, January 26 when the symptoms became worse. Instead of tingling in all extremities (with some numbness) the sensations changed to a pins and needles sensation with burning and random electrical shock sensations. I want to note that, yes, I have radiculopathies - however, I have never had them change so suddenly and increase in intensity so fast. Also, the pins and needles sensation with burning and random electrical shocks are brand new symptoms for me (my radiculopathies have not presented this way before). I reported these symptoms to my primary care provider today (1/29/21) and she instructed me to report my symptoms to VAERS and she is referring me to neurology. Note: I received my vaccination outside of my health care system and received it through the county because I could get the vaccination sooner that way. I did not report these symptoms sooner because they were not listed as a possible adverse effect of getting the COVID19 Moderna vaccination. However, as these symptoms have worsened over the past 2 weeks I have become concerned. I have not added any OTC medications or supplements to the ones listed prior. I have gone to a chiropractor twice during this time for relief of my back pain with no positive outcomes. Waiting to see the neurologist.

Other Meds: Nortriptyline, Ativan, Tylenol, multivitamin, Vit D, Vit K2, CoQ10, magnesium glycinate, fish oil, melatonin, probiotic, Vit B12, alpha lipoic acid, curcumin

Current Illness: none

ID: 0986415
Sex: F
Age: 60
State: NY

Vax Date: 01/20/2021
Onset Date: 01/20/2021
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: "Moderna COVID-19 Vaccine EUA". At the site of the injection, my left arm got very swollen, red, and hot. It began itching right away and that became worse over the course of the day and the following days. I felt deep exhaustion, and my body hurt all over especially my joints. I had stomach cramps, diarrhea, and nausea.

Other Meds:

Current Illness:

ID: 0986416
Sex: M
Age: 72
State: CA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: The day following the vaccine injection, Sunday, January 24, as I was finishing a 45 minute hike I began feeling dizzy. I made it home, then felt nauseous and threw up, more drive heaves than food. I laid down for awhile. Since then I have felt woozy when I get up and start moving around. The wooziness comes and goes. I still have the symptoms.

Other Meds: Carbidopa-Levodopa 25-250 3x a day Cyclobenzaprine 5 mg at bedtime Vitamin D3 5000 IU Bifido digest Magnesium 250 mg C0Q10 100 mg Pomi-T Life Extension Ultra Prostate formula Life Extension Curcumin Elite & Turmeric Extract Osteo Bi-flex

Current Illness: none

ID: 0986417
Sex: F
Age: 35
State: CA

Vax Date: 01/12/2021
Onset Date: 01/19/2021
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: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: delayed hypersensitivity reaction. large 6x6cm indurated plaque around inoculation site on arm. very painful. lasted for about 4 days then resolved without treatment.

Other Meds: prenatal vitamins

Current Illness:

ID: 0986418
Sex: F
Age:
State: TX

Vax Date: 12/27/2020
Onset Date: 12/27/2020
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: Did not want to report

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I experienced low back pain, body aches, chest tightness and chills. I also experienced a low grade fever, extreme fatigue, severe body pains which lasted two days. I saw my PCP who put me on a muscle relaxer with Benadryl. Today I continue having chest pain with congestion and I am not able to move around due to the body aches and pain.

Other Meds: Did not want to report

Current Illness: Did not want to report

ID: 0986419
Sex: F
Age: 63
State:

Vax Date: 01/18/2021
Onset Date: 01/19/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: starting on 1/19: headache; burning behind eyes and sore throat; x 3 days which have now resolved - now dizzy when standing; fatigue - arms feels heavy when taking shower; pale; remains very weak and tired; dizzy - feels like anemia - tried to work last night but broke out in cold sweat and pale so sent home from work last night - sxs are not worsening

Other Meds:

Current Illness:

ID: 0986420
Sex: F
Age: 21
State: IL

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: RA

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: Pt. received the Pfizer vaccine for first dose. when she came back for the 2nd dose, she was inadvertently given Moderna as the 2nd dose. It was discovered later in the day when we were checking on the status of the vaccines.

Other Meds: unknown

Current Illness: none

ID: 0986421
Sex: M
Age: 28
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain

Symptoms: Symptoms: Alternating fever and chills (mild), full-body muscle ache (moderate), sensitivity to touch (moderate), dizziness (moderate), difficulty focusing (moderate-severe), fatigue (moderate-severe) headache (SEVERE). Treatment: Took the day after the shot off of work and slept a LOT (approx 18 hours on and off), stayed hydrated and fed. Did not take painkillers due to hearing it would interfere with vaccine uptake. Most symptoms except for headache had gone away by 30-hour mark. Only some lingering fatigue and achiness left over past 36-hour mark.

Other Meds: Lamotrigine, occasional lorazepam

Current Illness: N/A

ID: 0986422
Sex: F
Age: 17
State: MD

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

Lab Data:

Allergies: NKDA

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

Symptoms: 17 Year Old

Other Meds: None

Current Illness: None

ID: 0986423
Sex: M
Age: 58
State: GA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa Drugs

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

Symptoms: Pt reported to Covid-19 vaccination clinic for Pfizer lot #EL3302 first dose.Reported allergy to sulfa drugs and was in observation for 30 minutes. At approximately 25 minutes post vaccination at 10:15am, Pt signaled that he wanted to leave & was instructed to stay 5 more minutes. Pt anxious and began to shake, saying he could not breathe. Vitals were 147/88, HR 86, O2 98% on RA. Pt was reclined on floor and reported being cold and was striking his head on the blanket; head stabilized. Patient was alert and oriented x3, but complained of chest pain. EMS called, arrived at 10:25, Vitals: 144/92, HR83 O2 99% on 2L. Pt stable & transported to hospital by EMS at 10:35am

Other Meds: Lipitor, Aspirin, Plavix, Nitroglycerine

Current Illness: none

ID: 0986424
Sex: F
Age: 66
State: CA

Vax Date: 01/21/2021
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: Reglan (restless leg) Latex (contact dermatitis)

Symptom List: Tremor

Symptoms: Pain at injection site days 1-3, subsided. On day 8, pain at injection site resurfaced at night. Then in morning of day 9, itchy red rash appeared near injection site.

Other Meds: Centrum multi-vitamin senior women Calcium 1200 mg slow. release Citrucel 4 tablets per day Miralax 1 1/2 capfuls per day

Current Illness: none

ID: 0986425
Sex: F
Age: 59
State: CA

Vax Date: 01/13/2021
Onset Date: 01/15/2021
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: I took on the 13th and on the 15th at night I felt pins and needles on my left side by my left arm for 3 hours then it went pins and needles it started to go everywhere, bottom, stomach, right and left, and my head. I almost felt tingling. At the same time my heart beat started to go fast, for maybe 5-6 hours. 97-105 beats an hour. I got scared I called my husband he felt my heart racing at my neck. I called my son (son is a doctor) he said if my heart beat goes over 110 then I needed to call 911. It lasted till about 4 AM and I was able to sleep. Everything the pain and heartbeat both started to go down. My heartbeat to went back down to 85. In the morning I was fine. On the 16th at night I felt my neck left side lymph node on the left getting swollen, like a bump. I called my son again and he said my lymph node getting swollen due to vaccine, it stayed until Sunday night and it started to get better. When you push it was painful.

Other Meds: Vitamin D3 5000 a day, Vitamin C 1000 a day, Losartan 25 MG twice a day for blood pressure, Atorvastatin 40 MG once a day

Current Illness:

ID: 0986426
Sex: F
Age: 43
State: AL

Vax Date: 01/21/2021
Onset Date: 01/23/2021
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: None known

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

Symptoms: Took vaccine on 1/21/21. Symptoms on 1/23/21 included widespread rash, lips swelling, hives, dizziness, trouble breathing. Received epinephrine, steroids, benadryl. Diagnosed with acute anaphylaxis due to possible allergy to Polyethylene Glycol

Other Meds:

Current Illness:

ID: 0986427
Sex: M
Age: 65
State: CA

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

Lab Data:

Allergies: None

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

Symptoms: c/o of dizziness and s/p vaccine IM of Pfizer, lasting only a few minutes. Denies any associated sxs. Denies any chest pain, nausea, vomiting. Denies history of any similar reactions. c/o coldness to Right arm lasting a few minutes. B/P 124/62, rr 18 Pulse 77, spO2 98%. Pt instructed to call 911 or go to ER for worsen sx. Pt Verbalized understanding and Patient signed form.

Other Meds: Denies any medications taken today.

Current Illness: None

ID: 0986428
Sex: F
Age: 38
State: TX

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: Seasonal allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Tingling from injection site L deltoid down through L hand and fingers.

Other Meds: Singulair

Current Illness:

ID: 0986429
Sex: M
Age: 28
State:

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: 2nd dose given too early

Other Meds:

Current Illness:

ID: 0986431
Sex: F
Age: 40
State: CA

Vax Date: 01/29/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: anaphylaxis to some medications. ADRs to TDaP

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

Symptoms: Tingling sensation in throat 5 minutes after vaccine to 45 minutes after. Sensation didn't decrease. Went back to work at unit. Has history of anaphylaxis to certain medications and ADR to TDaP

Other Meds:

Current Illness:

ID: 0986432
Sex: M
Age: 35
State: MI

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Headache, body aches, lethargy, stiff neck, nausea

Other Meds: None

Current Illness: None

ID: 0986433
Sex: F
Age: 44
State: TX

Vax Date: 01/27/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Fever 102-103 with vomiting and chills for three days. starting to feel better now.

Other Meds:

Current Illness:

ID: 0986434
Sex: F
Age: 43
State: IL

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/29/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Next day fever 100.8 and chills. 2 days later very bad headaches that lasted until 1/23. ER visit on 1/21 for chest pressure, lightheadedness, dizzy. Cardiac work up- negative. Discharged. Still lightheaded and dizzy 1/22 - 1/24. On 1/25 sharp chest pains went to see my PCP. She prescribed a steroid pack. 1/26 at 3:30 pm felt weak, felt like I was going to black out. Went back to the ER- full cardiac work up, head CT, admitted to the hospital for observation. Stress test on 1/27. Everything normal. Follow up with PCP on 1/29 still very lightheaded. Ordered a 48 hour heart monitor and Neurology consult.

Other Meds: Tylenol

Current Illness: None

ID: 0986435
Sex: F
Age: 65
State: TX

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: Redness and flushing to face, neck and chest beginning 45 mins after receiving the vaccine. Took benadryl with good effect. Symptoms completely resolved by the following morning.

Other Meds:

Current Illness:

ID: 0986436
Sex: F
Age: 53
State: PA

Vax Date: 01/07/2021
Onset Date: 01/14/2021
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:

Symptom List: Vomiting

Symptoms: Developed a local reaction to the injection site about the size of a silver dollar, after about a week it grew in size and developed a rash on the back of the arm . Rash was raised and itchy took Benadyl for 2 weeks for relief.

Other Meds:

Current Illness:

ID: 0986437
Sex: F
Age: 48
State: PA

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache, Fever- 102.3, Severe Body aches, Severe chills, couldn't feel botoms of feet, metallic taste in mouth, hives, tiredness, stuffy nose, confusion, delerium.

Other Meds:

Current Illness:

ID: 0986438
Sex: F
Age: 62
State: MN

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: None

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

Symptoms: Headache, temperature, vomiting, chills

Other Meds: Atenolol, Rosuvastatin, omeprazole

Current Illness: None

ID: 0986439
Sex: F
Age: 56
State: IL

Vax Date: 12/30/2020
Onset Date: 12/30/2020
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: cefprozil - rash reglan - exacerbates RLS

Symptom List: Injection site swelling, Limb discomfort

Symptoms: About 5 min after the immunization, the patient developed headache, nausea and some dizziness. Left the clinic and noticed some eyelid swelling and took some benadryl. The swelling didn't resolve so she presented to the ED. She was also found to be hypertensive in the ED and required treatment for both the swelling in her eyes and the hypertension. All symptoms resolved in about 90 min and the patient was discharged home without incident

Other Meds: unknown

Current Illness: None

ID: 0986440
Sex: F
Age: 55
State: SC

Vax Date: 01/12/2021
Onset Date: 01/14/2021
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: Unknown

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

Symptoms: Headache, fever, body aches, GI issues, cough feels like something is restricting the back of left lung when taking deep breath, no smell or taste.

Other Meds: Unknown

Current Illness: Unknown

ID: 0986441
Sex: M
Age: 78
State: NC

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

Lab Data:

Allergies: no known allergies

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

Symptoms: elevated temperature

Other Meds: farxiga; amlodipine besylate; Zofran; acetaminophen; levsin; metoprolol; albuterol sulfate.

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm