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: 0986798
Sex: F
Age: 48
State: CO

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

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Moderna COVID-19 Vaccine EUA Very sore, stiff right arm. Pain at its worst running from base of neck to forearm (right arm). Mild full-body aches Headache, turning into headache as base of head Watering eyes, runny nose, sniffles Low grade fever (99F) mild chills

Other Meds: levothyroxine 88 microgram daily dose

Current Illness: none

ID: 0986799
Sex: F
Age: 63
State: NY

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: Vaccine administration error. It is suspected that a ?? needle syringe was used instead of a 1? syringe IM

Other Meds: Unknown

Current Illness: Unknown

ID: 0986800
Sex: F
Age: 43
State: CA

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

Lab Data:

Allergies:

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

Symptoms: chills, body aches, nausea, swelling under left arm pit Had to take off work 01/28/21 no doctor

Other Meds:

Current Illness:

ID: 0986801
Sex: M
Age: 75
State: AL

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: morphine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient was into the clinic yesterday for his first COVID vaccine. Patient had no contraindications for the vaccine. Vaccine was administered to right deltoid. Patient then was asked to sit in the waiting room for 15 minutes for observation. Patient was sitting in waiting room and developed shortness of breath and dizziness. Patient vitals signed were obtained blood pressure was elevated 150s/100, heart rate 120s, oxygen level upper 90's on room air. Patient was brought to an exam room where he could lay down via wheelchair. Multiple vital signs were taken during the duration of his time at the clinic. Blood pressure did come down to 140s/90s, sats remained in upper 90s, heart rate came down to 70-80. Patient remained dizzy the entire time. Patient states that he has a history of idiopathic angioedema as well as a heart stent. Patient goes on the explain that at different times he can have swelling internally. He has had this happen several times in the past to his abdomen, saliva glands, tongue, as well as extremities. Patient and his wife called his primary care physician and MD advised if episode did not resolve to go to the ER. After waiting in the clinic for around 45 minutes the patients wife decided it would be best to go to the ER. EMS was notified. Ambulance responded. Patient was transported via ambulance to ER. Patient wife was called the afternoon of the incident. She states that patient was admitted to the hospital for observation. He was treated with Benadryl, Pepcid, Decadron; CT of head was normal; blood pressure was still elevated; and they were not sure what was the cause of the episode. I called the patient's wife on 1-29-21 to check on patient again. His wife stated that he was been discharged home. They were unsure what caused the episode and to follow up with primary physician in one week. She states that at one week follow up visit they would discuss the need/desire for second COVID vaccine. .

Other Meds: Plavix

Current Illness:

ID: 0986802
Sex: F
Age: 52
State: MA

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: Morphine Ceftin Ceclor

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

Symptoms: Vaccine was on Wednesday 1/27/21 at 8:30. Felt a little off and sore arm during the day Wednesday. Started with some body ache during night ( approximately 13:30 a.m.) at sleep. Woke up at 5 a.m. with fatigue, significant nausea and a headache. Unable to go into work. Headache improved by mid day. The fatigue and nausea continued and gradually decreased, lasted until laterThursday evening. Returned to work at 6:30 a.m. on Friday.

Other Meds: Fexofenadine Levothyroxine Estrogen patch

Current Illness:

ID: 0986804
Sex: F
Age: 63
State: NJ

Vax Date: 01/20/2021
Onset Date: 01/26/2021
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: Augmentin, Levaquin

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

Symptoms: Large red area around the injection sight, swollen and itching

Other Meds: Sertraline 50 mg, Viberzi 100mg, Vit. D

Current Illness:

ID: 0986805
Sex: F
Age: 34
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nka

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: patient may have received an increased concentration of the vaccine due to administration error

Other Meds: unknown

Current Illness: unknown

ID: 0986806
Sex: F
Age: 43
State: CA

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: Morphine causes hyper emesis

Symptom List: Pharyngeal swelling

Symptoms: Dizziness Start in 20 to 30 minutes after the vaccine bad headaches started in Leston an hour followed by chills in the afternoon Two days to 3 days of dizziness headache nausea

Other Meds: None

Current Illness: None

ID: 0986807
Sex: M
Age: 35
State: IL

Vax Date: 12/31/2020
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Red circle found 8-10 days after vaccine which started with itching and then arm pain. Redness continued to spread. General MD prescribed antibiotic and red circle dispersed 2 days later.

Other Meds: Probiotic

Current Illness: Wisdom teeth removed

ID: 0986808
Sex: F
Age: 22
State: CA

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: nausea and muscle ache at site of injection

Other Meds: Birth control Portia QD

Current Illness: None

ID: 0986809
Sex: M
Age: 62
State: NC

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: none

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

Symptoms: patient states the night after the vaccine he had a nosebleed and it stopped on its own. Then he complained of a sore, raw tongue and that it burned when he drinks juice and taste bad. Patient states he had not been exposed to a positive COVID case that he was aware of.

Other Meds: states he takes a blood thinner(plavix) and is a diabetic and has hypertension.

Current Illness:

ID: 0986810
Sex: F
Age: 67
State: CA

Vax Date: 01/17/2021
Onset Date: 01/21/2021
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: Gluten

Symptom List: Rash, Urticaria

Symptoms: Pzfizer-BioNTech COVID-19 Vaccine EUA on 1/21/2021 (4 days after my first vaccine) at 10pm I experienced severe abdominal pains for 4 hours. This was then followed 30 minutes later by severe vomiting for 4 hours. At that time I was able to take a Zofran 8mg tablet to suppress the nausea. (A previous Zofran dose I had taken was immediately vomited up) Vomiting stopped. For 3 days after this I got mild stomach pains after I ate more than a few bites. I was fine after that.

Other Meds: Probiotic and vitamins only

Current Illness: none

ID: 0986811
Sex: F
Age: 18
State: ID

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: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin-rash

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

Symptoms: 10:02am client reported right eye twitching and lightheadedness. Then noted rash on hands, nausea, and DOB. 10:05am 0.5ml 1:1000 Aq Epinephrine given in left thigh as paramedics arrived on scene., vitals taken. 10:18am Oxygen started per face mask and client transported to hospital at 10:20am

Other Meds: unknown

Current Illness: unknown

ID: 0986812
Sex: F
Age: 59
State: RI

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Panic attack, observed & released

Other Meds:

Current Illness:

ID: 0986813
Sex: M
Age: 26
State: NY

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

Lab Data:

Allergies: Unknown

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

Symptoms: Vaccine administration error. It is suspected that a ?? needle syringe was used instead of a 1? syringe IM

Other Meds: Unknown

Current Illness: Unknown

ID: 0986814
Sex: F
Age: 34
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: 27th Jan 2021-Chills & fever, fatigue-doesn't feel good. 28th Jan 2021-Chills on/off, fever-fatigue-doesn't feel good. 29th Jan 2021-AM doesn't feel good PM-feeling better Yes, you can take Tylenol /and or motrin please, if you get worse-go to the ER, and Call your PCM

Other Meds: none

Current Illness: none

ID: 0986815
Sex: F
Age: 26
State: CO

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

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

Symptoms: fever, chills, body/joint aches, nausea, weakness/fatigue. Fever started 7 hours after the injection and lasted about 24 hrs, the rest of the symptoms are still present 48 hrs after the injection.

Other Meds: sprionolactone 100mg ocella birth control pill cyclobenzaprine 5mg

Current Illness: none

ID: 0986816
Sex: M
Age: 68
State: GA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: Patient complained of shortness of breath. Patient has a history of COPD, hypertension, and tachycardia. Patient give 3 Liters of oxygen by face mask. Vitals done every 5 minutes. Monitored patient until no further intervention needed. Patient left via wheelchair with his wife.

Other Meds:

Current Illness:

ID: 0986817
Sex: F
Age: 37
State: GA

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: Darvocet. Morphine. Shellfish. Grapefuit. Chocolate. Lactose

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Thursday morning I awakened sluggish and feeling foggy in the brain. I had chills and a tmeperature of 100.3 with tylenol. At 11:42 am my temp was 102.3. I had severe headache, fatigue, bodyaches, chills. neck stiffness and joint pain, light sensitivity, nausea/loss of appetite. Moderate swelling at injection site (left deltoid) and swollen lymph nodes. Dizziness. I slept most of the day, awakening to use the bathroom and at that time check my temp. Today 1/29/2021 some things have improved. my temp have improved 98.5, my headache is there but not a 10. I still have not eaten today. I am still taking tylenol. The light sensitivity is gone. The neck stiffness is there, but improving.

Other Meds: Zyrtec 10mg. Calcium and Multivitiam supplements.

Current Illness: Anemia. Asthma.

ID: 0986818
Sex: M
Age: 48
State: NJ

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

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

Lab Data:

Allergies:

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

Symptoms: aches, low blood pressure

Other Meds:

Current Illness:

ID: 0986819
Sex: F
Age: 58
State: CO

Vax Date: 01/19/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Erythromycin. Fruit

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

Symptoms: Rash over site. Swollen arm.

Other Meds: ASA, Atorvastatin, Omeprazole, Multivitamin, Metoprolol, Losarten

Current Illness: HTN, Gastroesophageal Reflux Disease

ID: 0986820
Sex: M
Age: 79
State: WY

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: no allergies

Symptom List: Unevaluable event

Symptoms: Facility manager called on 1-29-21 to inform me that patient had shortness of breath upon awakening at 6 am on 1-29-2021. Emergency Personnel were called and patient was taken by ambulance to the ER.

Other Meds: unknown

Current Illness: no know illnesses

ID: 0986822
Sex: F
Age: 75
State: FL

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

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

Symptoms: I noticed today when I was taking a shower that the upper arm at the area of the injection site is reddened. The size of the reddened area is approximately 4 inches by 2 1/2 inches. The reddened area is slightly tender. It has been 10 days since I received the vaccine. I don't know if it is normal for the site to be reddened.

Other Meds: Verapamil Hydrochlorothiazide Atorvastatin Famotidine multivitamin Vitamin d magnesium Vitamin B12

Current Illness: none

ID: 0986823
Sex: F
Age: 28
State: RI

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Panic attack, observed & released

Other Meds:

Current Illness:

ID: 0986824
Sex: F
Age: 65
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: 2-3 hours after vaccine had soreness of injection site. 8 hours after vaccine had fever 101.8, shivering, painful muscles and bones, exploding headache. symptoms didn't resolve until 2 days later.

Other Meds: none

Current Illness: none

ID: 0986825
Sex: M
Age: 17
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Client was inadvertently scheduled at a Moderna Covid vaccination POD per mother, client is 17 y/o and Moderna is licensed for 18 years and above. Mother aware that the vaccination POD was for the Moderna vaccine and for 18 years and above. After realizing that the recipient of the Moderna vaccine was 17 y/o, parent was notified and alerted that the booster dose would not be able to be given due to age of the client.

Other Meds:

Current Illness:

ID: 0986826
Sex: F
Age: 44
State: TX

Vax Date: 01/06/2021
Onset Date: 01/13/2021
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: Food: Orange, Tomato, Tuna, Chocolate, Corn Environmental: Cedar, Oak

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 1 week after injection I woke up with severely swollen lymph nodes in neck, swollen throat and could barely swallow. Right arm at site of injection 1 week prior was acutely hard, elevated, red, warm and tender to touch. I immediately took a benadryl and 5 mg predniosne tablet, water, elevated position to rest. Swelling of lymph nodes in neck improved and gradually resolved 3-4 days later. Right arm redness and size of affected area doubled over the next two days, but then started improving. Resolved in about 8 days.

Other Meds: Vitamin (Nutrafol Women's), B complex drops, Adderall, OrthoTriCyclen generic rx

Current Illness: none

ID: 0986827
Sex: F
Age: 60
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Tetracycline

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Swelling of lips and tongue Intense itching Bright red rash on neck, face

Other Meds:

Current Illness:

ID: 0986828
Sex: F
Age: 53
State: MI

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

Lab Data:

Allergies: Pneumonia vaccine, shrimp, verapamil

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

Symptoms: patient may have received an increased concentration of the vaccine due to administration error

Other Meds: unknown

Current Illness: unknown

ID: 0986829
Sex: F
Age: 49
State: AR

Vax Date: 01/25/2021
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: RA

Lab Data:

Allergies: decongestants, excidrin, celexa, bc powder, ceclor

Symptom List: Nausea

Symptoms: Fever 101.8, chills, shaking, sweating. took Advil and Tylenol alternating every 3 hours. Fever went away after 10 hours Fatigue, slept for most of the following day mild body aches and mild headache for 24 hours, moderate arm pain from injection for 24 hours, could not lift arm. lymph node, jaw line, neck swelling left side, ice pack and Advil, still swollen on day 4.

Other Meds: synthroid, advil, remeron, zyrtec, biotin, vitamin D

Current Illness: none

ID: 0986830
Sex: F
Age: 42
State: NY

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

Lab Data:

Allergies: Unknown

Symptom List: Injection site pain

Symptoms: Vaccine administration error. It is suspected that a ?? needle syringe was used instead of a 1? syringe IM.

Other Meds: Unknown

Current Illness: Unknown

ID: 0986831
Sex: M
Age: 77
State: NY

Vax Date: 01/03/2021
Onset Date: 01/08/2021
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: LA

Lab Data:

Allergies: NKDA

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

Symptoms: The patient was discharged from the facility on 1/4/2021 and was re-hospitalized on 1/8/2021, currently in the MICU. Hospital feels that current admission is due to a reaction to the COVID vaccine but not specific with the presenting symptoms.

Other Meds: Colace, Crestor, Proscar, Flomax, Folic Acid, Lunesta, Metformin, Miralax, Multivitamin Mylanta, Pantoprazole, Senna, Thiamine, Tylenol Valsartan

Current Illness: T11,T12 Compression Fracture

ID: 0986832
Sex: F
Age: 33
State: CO

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: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

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

Symptoms: Patient received 2nd dose of COVID vaccination just prior to ER admission. After receiving the vaccine, she developed difficulty swallowing, difficulty breathing, and the feeling of swelling in her pharynx. She took a claritin after her symptoms developed (prior to presenting to ER). In the ER, she was given methylprednisolone, famotidine, and diphenhydramine. Her symptoms resolved. She was sent home with prescriptions for prn prednisone (10 mg po) and diphenhydramine (50 mg po). Also of note, patient did not she had hives after receiving her first COVID vaccine.

Other Meds: Atarax, inderal, desyrel, cymbalta

Current Illness: N/A

ID: 0986833
Sex: M
Age: 58
State: NY

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: Tremor

Symptoms: Reported Symptoms: Shoulder/Neck pain, achy, chills, headache Date of Onset: 1/9. Symptoms persist for 2-3 days then abate for a day or two before reappearing, ongoing Medication taken for Symptoms: Tylenol

Other Meds:

Current Illness:

ID: 0986834
Sex: F
Age: 75
State: FL

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: Pencillian, No other know other than Demoral

Symptom List: Erythema, Pruritus

Symptoms: Left arm has a red rash starting at the injection site running around the arm to the inside and extending to within 2 inches of the bend in the arm. It itches, is red, but other than the itch it has not bothered me at this point. I went to a walk-in clinic and was told it could be cellulitis. (bacteria) at the injection site. He has placed me on an antibiotic starting today. The rash, swelling on my arm, is hot to the touch and I prefer non-one touch it. The physician at the walk in said to add heat to the site. I have also gotten a cough. He prescribed something for this also. My Covid case was very mild.

Other Meds: Synthroid, Omega Red, Centrum Silver, Bio-Flex, Something for bones

Current Illness: Diagnosed with Covid by Health Dept. December 28, 2020. Did not know had Covid and took first vaccination on 12/30/2020. No adverse reaction. Am having problems with second vaccine. Have spoken to Health Dept. and 24 hour nurse with insurance. They both said to see a physician.

ID: 0986835
Sex: F
Age: 49
State: IL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Yes

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

Symptoms: The client complained of scratch/itchy throat

Other Meds: not known

Current Illness: Yes

ID: 0986836
Sex: M
Age: 73
State: FL

Vax Date: 01/12/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Rash,itchiness,redness

Other Meds: Metformin,Ramipril,

Current Illness:

ID: 0986837
Sex: F
Age: 50
State: MA

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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 28 minutes after accination, SOB mild dizziness with tachycardia. resolved after 15-20 min lying down.

Other Meds:

Current Illness:

ID: 0986838
Sex: M
Age: 74
State: NC

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

Lab Data:

Allergies: none

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

Symptoms: I developed a previously never experienced constipation, with soft, not impacted stool. I'm a physician of Internal Medicine and would equate this w/ something of an atonic colon. I self-administered two separate Fleets Childrens rectal suppositories w/o response, then repeated digital disimpaction every hour or so, for the next 12-16 hours. Began Miralax powder the evening of January 16, 2021 around 7PM and repeated full doses at bedtime, again at approximately 4AM on January 17, 2021 and a fourth full dose at 8AM. The Miralax finally resulted in a more liquid stool that morning around 10AM, w/ relief of the generalized abdominal discomfort

Other Meds: Metformin, lisinopril, atorvastatin, testosterone gel,

Current Illness: none

ID: 0986839
Sex: F
Age: 37
State: WV

Vax Date: 01/06/2021
Onset Date: 01/07/2021
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: keflex, aspirin

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

Symptoms: Approx 1 hour after vaccination of 2nd vaccine, I began having vertigo until noon of that day. headache persisted multiple days after vaccination. Next day after vaccination I developed systemic edema, rash on legs below knees, migraine, generalized pain, malaise, fatigue. also developed reddened warm area to injection site, dx as cellulitis. Psoriasis areas flared, psoriatic arthritis areas increased in pain. Seen primary care physician after symptoms did not cease on day 6 (Monday) after getting dose 2. Said it was side effect from vaccine and prescribed prednisone taper, doxycycline, and lasix

Other Meds: methotrexate, zyrtec, verapamil, celexa, folic acid, ibuprofen

Current Illness: none

ID: 0986840
Sex: F
Age: 48
State: VA

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: IM
Vax Site: LA

Lab Data:

Allergies: Penecillin, Amoxycillin

Symptom List: Pain in extremity

Symptoms: I have a cysts/lesion on the outside of my lip (I thought it was a pimple but it was so big and I never felt anything come on like I always do). I also have internal cold sores - one almost right on the other side of the lesion, one on the other side of my lip. I DO NOT KNOW IF THIS IS A SIDE EFFECT or just a coincidence. I don't have herpes or any history of lip lesions. I don't remember biting my inside lip and they are too high for that type of injury anyway.

Other Meds: Cymbalta, Symbacort, Lisinopril, Oxcarbezaprine, Cyclobenzaprine, Lipitor, Loratadine, Metoprolol Succinate er

Current Illness: none

ID: 0986841
Sex: M
Age: 60
State: WA

Vax Date: 01/15/2021
Onset Date: 01/25/2021
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: Penicillins

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

Symptoms: Rash and swelling in the shoulder area from injection site downward. approximately 4 inches wide and 6 inches long.

Other Meds: losartan-hydrochlorothiazide 100-25 MG per tablet - Blood Pressure

Current Illness: none

ID: 0986842
Sex: F
Age: 47
State: NV

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

Lab Data:

Allergies: NONE

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

Symptoms: THE DAY AFTER THE INJECTION THE AREA WAS RED, ITCHY AND SWOLLEN WHICH I KNOW IS NORMAL. TWO WEEKS AFTER INJECTION MY ARM IS STILL SORE, VERY RED, WARM TO THE TOUCH AND THE REDNESS HAS GROWN FROM A SMALL AREA RIGHT AROUND THE INJECTION SITE TO AN AREA LARGER THAN MY HAND.

Other Meds: NONE

Current Illness: NONE

ID: 0986843
Sex: F
Age: 38
State: AL

Vax Date: 01/04/2021
Onset Date: 01/06/2021
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: Sulfa

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

Symptoms: I got multiple very painful ulcers on the roof of my mouth and just behind my right front tooth.

Other Meds: Binorerhindrone acetate tablet (birth control)

Current Illness: None

ID: 0986844
Sex: F
Age: 80
State: VT

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Developed shingles 2 days after her COVID vaccine.

Other Meds:

Current Illness:

ID: 0986845
Sex: M
Age: 32
State: NH

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

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: VR passed out several minutes after injection. He had brief seizure like activity and quickly regained consciousness within approximately a minute. His BP , HR, RR and 02 saturation were within normal limits afterward. He notes that he stayed up all night working the night shift as a police officer and then had caffeine this morning. He had an identical episode years ago after being sleep deprived and receiving a dental injection. EMS was summoned, but he declined transport to the hospital and elected to go home. He was driven home by his wife.

Other Meds: none

Current Illness: none

ID: 0986846
Sex: M
Age: 66
State: AK

Vax Date: 01/14/2021
Onset Date: 01/15/2021
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: fresh fruits and veg_ irritation in throat, codeine- cough, latex- rash.

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

Symptoms: The first 3-5 days patient had redness and swelling at the injection site. Reports it got better, but then got "lumpy", swelling and redness started spreading, was up to 6 inches in diameter. The past few days it has been improving. Patient has been seen at urgent care on 1/29/21, told there is no cellulitis, most likely reaction to the vaccine.

Other Meds:

Current Illness:

ID: 0986847
Sex: M
Age: 35
State: IL

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

Lab Data:

Allergies: N/A

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 9 hours after vaccine: chills, fever, headache, nausea and body ache for 12 hours. Treated with Tylenol and Zofran. Second night fever occurred again and was again treated with Tylenol.

Other Meds: Probiotic

Current Illness: COVID vaccine #1 12/31/2020

ID: 0986848
Sex: F
Age: 50
State: CA

Vax Date: 01/19/2021
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: RA

Lab Data:

Allergies: Gluten, Latex, preservatives like Blue Lake, Yellow 40 etc.

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

Symptoms: I have noticed increased soreness at the site of the injection and my left shoulder is red, swollen and sore as if I am having an allergic reaction to the vaccine. I have also had moderate to severe headaches and fatigue. I do not have a fever and my daily temperature has been ~97.0.

Other Meds: Thyrogold, ThyroEcho-37, evening primrose, Astra Isatis, Oxicell Kr 22; Miscellized D3 , Neuro Methylation Cream, Adrenal stim

Current Illness: None

ID: 0986849
Sex: F
Age: 68
State: AK

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

Lab Data:

Allergies: Sulfa allergy

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

Symptoms: Moderna covid-19 vaccine EUA Adverse reaction includes one period at night of cold sweats, very painful in area on arm where vaccine was administered, rash on arm at sight of vaccine covering a little less than half my arm circumference, skin there so tender, a slight itching made it bleed slightly.

Other Meds: Juice Plus, Plant based calcium, Vit. D

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm