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: 0987055
Sex: F
Age: 53
State:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: COVID Vaccine Clinic. Upon staff member receiving second dose of vaccination, Team took staff member back to vestibule area for injection (proactive)due to previous reaction to first dose. Staff member was positioned supine on cart for injection. Within 5 minutes, staff member felt dizzy and became nauseated. Blood pressure 119/81 HR 90.Po2 at 100% on room air. Still complained of feeling faint and dizzy. Staff member remained supine and was monitored until symptoms subsided. 1550 Staff member was feeling much better. Symptoms gone per staff member. Staff member ambulated independently without dizziness. Staff member went home with husband in stable condition. Staff member encouraged to contact PCP for any further concerns. Staff member was evaluated in ED. fluids given, Zofran for nausea and Benadryl. CTOH was completed and resulted as no abnormalities. Staff member was discharged to home in stable condition.

Other Meds:

Current Illness:

ID: 0987056
Sex: M
Age: 70
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa drugs

Symptom List: Anxiety, Dyspnoea

Symptoms: HE stated after he received his vaccine at 1301 and stood up he immediately felt dizzy and lightheaded. His vitals were taken- 138/85, O2 sat 98% RA, HR 69 (fluctuated between 65-69). He was given a bottle of water. He was alert, oriented, denies pain at the injection site. Admits to Hx of Afib which has resolved years ago, allergies to sulfur drugs and denies any other history. He was advised to wait another 20 min for observation. Patient also advised to diall 911 if he encounters issues later- verbalized understanding.

Other Meds: Neurotin

Current Illness: History of pinched nerve on right side of neck down to right arm

ID: 0987057
Sex: F
Age: 16
State: MT

Vax Date: 01/28/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Patient age is less than approved age of vaccine. She reported a very sore arm on 1/29/21 but no other side effects

Other Meds: Fluoxetine, Glucagon kit, Lamotrigine, BD insulin syringe

Current Illness: Type I Diabetic

ID: 0987058
Sex: F
Age: 47
State: NE

Vax Date: 01/21/2021
Onset Date: 01/29/2021
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 penicillin, compazine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Site where shot was given is red and warm to touch and slightly itchy. Symptoms began on day 8 following first dose of Moderna vaccine.

Other Meds: Women's multivitamin

Current Illness: None

ID: 0987059
Sex: F
Age: 67
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:
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: Moderna COVID?19 Vaccine EUA On the next day: Fever t=102.5 F, Severe fatigue, Nausea, Stomach Pain after taking Tylenol. Please note that in April 2020 I was sick with Covid-19 for almost 2 weeks. It might be possible that my reaction to the 1st dose is due to the presence of antibodies in my system, i.e. it's very similar to what many people experience after the 2nd dose.

Other Meds: Levothyroxine 88 mg Rosuvastatin 10 mg + CoQ10 200 mg Aspirin 81 mg Losartan Atenolol 12.5 mg Turmeric 1500 mg Multivitamins

Current Illness: None

ID: 0987061
Sex: M
Age: 81
State: IL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: None

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

Symptoms: chills, slight headache

Other Meds:

Current Illness: None

ID: 0987062
Sex: F
Age: 25
State: NC

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

Lab Data:

Allergies: Gluten intolerance

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Numbness/tingling in bottom lip around 3 hours after shot, went away around 6 hours after shot Woke up next day with significant muscle aches, fatigue mainly in my upper body (arms, neck, back). As the day progressed, dizziness and brief period of accelerated HR (have had incidents of elevated HR a couple months ago before receiving the vaccine)

Other Meds: Paroxetine Sprintec

Current Illness: None

ID: 0987063
Sex: F
Age: 84
State: LA

Vax Date: 01/14/2021
Onset Date: 01/22/2021
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: Pharyngeal swelling

Symptoms: Approximately 8 days after 1st Covid 19 ( Moderna) vaccination, patient developed a large red area around injection site. she came by the pharmacy 7 days after this started and first informed the pharmacy. The patient commented the area has been getting larger each day. We measured the red area; the dimensions were 3.5" x 3". It was warm and hard. It was recommended to her to take diphenhydramine.

Other Meds: tylenol after vaccination crestor omeprazole amlodipine trazadone hydrochlorothiazide

Current Illness: n/a

ID: 0987064
Sex: M
Age: 52
State: IL

Vax Date: 01/22/2021
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: Pollen, dust, ragweed

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: headache fatigue nausea

Other Meds: Clonazepam .25mg, 1 per day Oxcarbazepine 300mg, 2 per day Trazodone 50mg, 1 per day Wellbutrin 150mg, 1 per day Albuterol sulfate (2 puffs per day)

Current Illness:

ID: 0987065
Sex: F
Age: 53
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Body aches, fever, severe migraine headache Took Motrin Symptoms subsided

Other Meds: Multivitamin, Probiotic, Brisdell

Current Illness: N/A

ID: 0987066
Sex: F
Age: 37
State: CA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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: 5 minutes after the injections, body warm with a flushed Sensation throughout entire body. Felt oozy, dizzy, sat about 5 minutes. At location where she did receive the injection, was juice, crackers. Sore arm for 2 days.

Other Meds:

Current Illness:

ID: 0987067
Sex: F
Age: 63
State: AZ

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: Lightheadedness, Nausea, Vomiting,

Other Meds:

Current Illness:

ID: 0987068
Sex: F
Age: 36
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:

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

Symptoms: Headache body aches fever. Now my arm is red and hot and my lymph node in that arm is swelled.

Other Meds:

Current Illness:

ID: 0987069
Sex: F
Age: 75
State: VA

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

Lab Data:

Allergies: Cipro-stomach problem

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

Symptoms: I noticed that same afternoon one side of my mouth/throat was sore, in the back on the left. I tried gargling with salt water, then later with baking soda in water. Ate some yoghurt later. No real difference. Today (next day) I see white blotches on side of tongue in back. I feel fine other than this, no other adverse reactions. Hurts....bothersome still in the back of my throat when talking or eating.

Other Meds: Prozac 20, Wellbutrin 150xr, Singulair 10, Flonase

Current Illness: none

ID: 0987070
Sex: F
Age: 49
State: AZ

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: Not aware of any allergies reaction to anything

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

Symptoms: Hives all over body, includes neck. Swollen lips and eyes.

Other Meds: No medications

Current Illness: No symptoms

ID: 0987071
Sex: F
Age: 35
State: HI

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: Benzonatate

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

Symptoms: 830am vaccinated, 12pm mild-mod headache and fatigue (sore arm at inj site), persisted, 10pm worse headache, fatigue, mild body aches started at shoulders and upper back and neck, able to fall asleep by 11pm, woke up at 1am in severe pain, migraine, head pressure, joint pain of every joint in my body, hands were swollen, felt like my joints were pulsating, very painful to bend or move any of my joints, muscle aches so bad any tiny movement hurt, even lying still hurt my back because of the pressure onto my back, even my spine felt tender, stiff neck I could barely look down or up but i could turn head left and right, stomach ache and nausea, my arm that was given vaccine was severely in pain and tender to touch and swollen at area of inj. There was light headed sensation w/ movement and position, pressure in my head felt like my head was going to explode and my eyes were burning. Because so severe, I took 1000mg tylenol, lathered by entire body in eucalyptus oil and peppermint on my hands, I was able to fall asleep at 3am but it was restless sleep I kept waking up because any movement I made in bed I'd have severe pain. 6am I felt moderately better all symptoms 50% improved, applied eucalyptus oil on again, started work at 730am I could barely function at work I have brain fog, just thinking focusing eyes concentrating makes migraine worse, +photopphobia, phonophobia, just typing is very hard to do because it hurts my joints, the vertigo worsened and the slightest looking down to the keyboard while typing causes lightheaded sensation. No improvement and it's now almost 1pm. I didn't take any pain medication or apply any essential oils.

Other Meds: Wellbutrin XL, modafinil

Current Illness: None

ID: 0987072
Sex: M
Age: 34
State: IL

Vax Date: 01/10/2021
Onset Date: 01/11/2021
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: Sulfa

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

Symptoms: Tender mass the size of my fist developed on armpit under vaccine arm.

Other Meds: Zolpidem

Current Illness: None

ID: 0987073
Sex: F
Age: 44
State: PA

Vax Date: 01/17/2021
Onset Date: 01/17/2021
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: Pollen, Septran, Penicillin, Amoxycillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fever (101-102 deg F), chills, whole-body joint pains (odd localized neck and back pains), could not work, had to sleep 9 pm + and next day. Felt giddy with high fever when visiting the bathroom. Recovered after 1.5 days.

Other Meds: None

Current Illness: None

ID: 0987074
Sex: M
Age: 73
State: TX

Vax Date: 01/08/2021
Onset Date: 01/19/2021
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: Penicillin Sunflower seeds Some adhesive tape

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Rash over 50% of body and getting worse Stared around 11:00am. 50% covert by 10:00pm Went to ER Treated with Benedryl, Pepcid, Soul Medrol by I V

Other Meds: A Lodi pine 5 mg Losartan/hot 100

Current Illness: None

ID: 0987075
Sex: F
Age: 57
State: FL

Vax Date: 01/12/2021
Onset Date: 01/13/2021
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 Known

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

Symptoms: Initial symptoms started with itching on right arm, then all over. She used Benadryl with no relief. Then Used Calamine Lotion with no relief. Then noticed about a week later started with a rash on multiple sites in various parts on entire body. Then Pain started all over body aches. Especially in groin region and it moves. Headaches started approx. 10 days later and using Aleve with no improvement, then Motrin with some improvement. Rash continues.

Other Meds: Omega 3 Heart Smart Vitamin Probiotic

Current Illness: None

ID: 0987076
Sex: F
Age: 27
State: WA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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: none

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

Symptoms: Approx 12 hours after 2nd covid vaccine, patient developed myalgias in arm, armpit, neck, progressing to 'large' - 2cm? tender lymph node in left anterior cervical chain with pain radiating to axilla. T max 100.1 on day 2. Pain/chills resolved with NSAIDs. Over the next 14 days, lymphadenopathy slowly decreased in size. On day 14, she presented to clinic with persistent non tender lymph node, 1cm in size, mobile without c/f infection. Expectant management advised. Reaction reported due to duration of LAD; appears to be on average 10 days.

Other Meds: vyvanse 40mg

Current Illness:

ID: 0987077
Sex: M
Age: 65
State: FL

Vax Date: 01/19/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Gluten

Symptom List: Unevaluable event

Symptoms: Sore arm

Other Meds:

Current Illness:

ID: 0987078
Sex: F
Age: 55
State:

Vax Date: 01/20/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: "I received my second COVID vaccine on 1 20/2021 at 1100. (Pfizer) At 2100 I had a slight headache and body aches and went to bed. I slept poorly and felt as though my heart was racing overnight. When I awoke at 0700 on 1/21/2021, I felt very lightheaded with sitting upright at the side of my bed and ""blacked out""/lost my vision, but was still conscious. I proceeded to lie back down on my bed. I began to feel nauseous and again attempted to sit up to go to the bathroom. I again blacked out. I lowered myself to my bedroom floor and laid there to rest for several minutes and then crawled to my bathroom. I began retching and had emesis of frothy sputum. I then felt the urgent need to have a BM and sat on my toilet, but was again lightheaded. I bent forwards to not pass out and completed the task and then laid down on my bathroom floor to recover. I was gradually able to crawl down the stairs and located my cell phone and contacted a friend. I pulled myself up to my couch and sat for some time. I checked my BP and it was WNLs, but low for me, as I generally take 2 antihypertensives in the AM. I did not take them at all on the 21st. I gradually was able to walk to the kitchen and drank several glasses of water and tea. In addition to these symptoms, I had severe pain up and down my spine, in my knees, shins and buttocks. I applied Thermacare heating pads to my occiput and sacrum. I had no appetite and was very lethargic, napping for nearly 6 hours, on and off. I took Tylenol later in the day when I was able to eat a banana and yogurt. By evening, I had a headaches and body aches, but no more dizziness. When I awoke 1/22/2021, I was not dizzy, but my head felt ""huge"" and ""off"". My body continued to ache severely and I was unable to come to work. Tylenol helped diminish the pain slightly. I was again very fatigued. I did not leave my house, feeling unsafe to drive. By 1400 I felt better and was able to eat dinner that evening. I finally felt safe to take a shower Thursday PM 1/23 I awoke at 0615 to work. I was able to work until 1700, feeling fatigue, but no other symptoms. I did take Naproxen prior to coming to work for low back pain"

Other Meds:

Current Illness:

ID: 0987079
Sex: F
Age: 37
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: unknown

Symptom List: Injection site pain, Pain

Symptoms: headache, fever, chills

Other Meds: unknown

Current Illness: unknown

ID: 0987080
Sex: M
Age: 80
State: PA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/29/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Client developed a mild covid infection 12/8/21 and recovered. He was admitted 12/25 with hypogycemia and mild weakness and sent home He was given his first dose of the Moderna vaccine 1/4/21 at approximately 9AM covid vaccine clinic He developed weakness the next day (1/5) prompting admission to a hospital and then transition to subacute rehabilitation briefly Work up at hospital revealed progressive respiratory failure and pneumonia requiring intubation and progressive ascending weakness and sensory loss without upper motor neuron changes. MRI : nerve root enhancement LP : protein 40, +/- 80 lymphocytes, cultures negative B 12 and B6 normal extensive CSF testing still pending campylobacter and Musk antibodies negative Neurology diagnosed likely AIDP (Guillain-Barre) and an EMG is planned for the near future. Neurology felt the cause of his GBS was likely his covid infection verses his Moderna vaccination He was treated with plasmapheresis. Client received dexamethasone, remdesivir, and zosyn and doxycycline when progressive leukocytosis and procalcitonin elevation was noted. Candida was cultured from tracheal aspirates but felt most likely d/t colonization with an option to treat further if he did not continue to improve. He is now extubated, unable to swallow and has profound weakness and distal sensory loss. He will transition to Acute rehab in the near future. Comorbidities:as described in the above section and... DM2, CKD3, HTN, DJD, BPH ( h/o prostate surgery), h/o Lumbar surgery and hernia repair, GERD, hypothyroidism, hyperlipidemia. Possible etiologies of his AIDP ( GBS) would include his recent covid infection, the Moderna Vaccine, or other undiagnosed infection. He got his flu shot 9/25 ( fluzone sanofi) so this is not likely to be the culprit

Other Meds: prilosec 20 bid flonase 50 mcg nasla spray qhs glipizide 5mg ac breakfast/supper lipitor 10 mg qhs dorzolamide/timolol/ eye drops bid OU latanprost eye drops 1 qhs OU senekot bid prn loratidine 10 mg daily synthroid 125 mcg daily ipratropi

Current Illness: COVID infection 12/8/21

ID: 0987081
Sex: F
Age: 52
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 52 year old female who has completed a 15-minute observation period with the following signs and symptoms of an adverse reaction: loss of consiousness and other - hypertension. Moderna COVID-19 vaccine# 2 in series administered. Action(s) taken: Transferred to higher level of care Allergy to COVID-19 vaccine documented in Allergies activity: Yes Patient advised to discuss second dose considerations with a clinician

Other Meds:

Current Illness:

ID: 0987082
Sex: F
Age: 46
State:

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: LA

Lab Data:

Allergies: Na

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Within 5 minutes of receiving Moderna vaccine I felt disoriented. Within 10 minutes my face began to feel numb. This lasted for about 3 hours, then lifted.

Other Meds: Advil and Tylenol

Current Illness: Na

ID: 0987083
Sex: F
Age: 30
State: CA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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: NO

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever Headaches vomiting

Other Meds: NO

Current Illness: NO

ID: 0987084
Sex: F
Age: 55
State: FL

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: Sulfa

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

Symptoms: Violent explosive vomiting and temp of 103.

Other Meds: Paxil buspar levothyroxine prevacid eliquis vitamin c vitamin d zinc prebiotic multivitamin

Current Illness: Kidney infection

ID: 0987085
Sex: F
Age: 39
State: CA

Vax Date: 01/08/2021
Onset Date: 01/25/2021
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: Ferric Gluconate (IV insertion)

Symptom List: Nausea

Symptoms: Jan 9 after getting the vaccine I had shortness of breath, chest tightness. My doctor said it was bronchial spasms. On the 25 of Jan 2021 by blood pressure was 158/107 and sustained at that high currently. Tingling in the hands, arms and feet. Headaches,tightness and pressure in the chest and short of breath, nausea and overall malaise.

Other Meds: Vitamin C&D

Current Illness: Polycystic kidney disease, hypertension.

ID: 0987086
Sex: F
Age: 61
State: SD

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Patient reported she started feeling chilled at work at 6:00pm that evening. Did not sleep well due to the arm pain form the injection site. Achy, low grade fever.

Other Meds: Gabapentin, Atoisastatin, Duloxetine HCL, Jaurdiarce, Metformin HCL, Victoza, Zolpidem

Current Illness: None

ID: 0987087
Sex: F
Age: 35
State: NJ

Vax Date: 01/11/2021
Onset Date: 01/12/2021
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: raw carrot/celery

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

Symptoms: severe malaise, lethargy, myalgia, bone pain, difficulty concentrating, subjective fever, chills, sweats.

Other Meds: cetirizine

Current Illness: none

ID: 0987088
Sex: F
Age: 40
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Arm and face swelling, fever, bloodshot eyes, rapid heart rate, body pain, nausea, and headache. Took Tylenol, fluids, Benadryl, and rest.

Other Meds: None

Current Illness: None

ID: 0987089
Sex: M
Age: 36
State: NJ

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

Symptom List: Tremor

Symptoms: Temp 100.3 F, severe chills, body aches, mild headache, malaise. Minimal response to tylenol. Lasted about 8 hours

Other Meds: Finestaride

Current Illness: None

ID: 0987090
Sex: F
Age: 58
State: WA

Vax Date: 01/15/2021
Onset Date: 01/20/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Demerol, theophylline, Ceclor, Neosporin, Vicodin. Sensitivity to prednisone and nsaids. Allergic to raw potatoes.

Symptom List: Erythema, Pruritus

Symptoms: Side effects started the same day I received the vaccine, which were reported on the V-safe app. Started with very sore arm, within 24 hours progressed to extreme fatigue, joint and body aches, loss of taste and headache. I also experienced some mild nausea. By Wednesday evening, I began to experience heart palpations which I listened to as a nurse which sounded like PVC's. I have never had this happen to me before. I assessed my vital signs and noted that as the arrhythmia progressed, my O2 sat level began to decrease and my pulse began to increase. I could hear a definite pause in my heart rhythm. Within an hour, I had chest pain in the area of my left chest over my heart which progressed into a feeling of pressure as if someone was standing with a foot on my chest. As time went on, this sensation radiated into my back at an angle from left to right. It was at this point that I had my father take me to the emergency room. When I got there, my pulse was in the low 100's and my blood pressure was 230/130. I have never had this happen to me before. I ended up on a nitroglycerin drip. My magnesium level was low and my sodium level was low normal. I was kept in the emergency room until Thursday evening then transferred to Progressive Care Unit where I remained until early evening on Friday.I was sent home on 2 different cardiac medications, Coreg and Lisinopril. I am to follow up with my PCP and a cardiologist. Both are brand new to me. I am now feeling better, but I am very reluctant to have the second covid vaccine. Also, the Hospital does not know what happened to me. (Facility where I received my Covid vaccine.)

Other Meds: Probiotics, vitamins, Claritin prn for seasonal allergies, Tylenol as needed. Use prn for pain on occasion.

Current Illness: Seasonal allergies. No other known illnesses or issues. Was not diagnosed with any heart issues or blood pressure issues ever in the past. Was not taking any kind of prescription medication.

ID: 0987091
Sex: F
Age: 34
State: KY

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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

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

Symptoms: Injection site turned red the size of tennis ball. Warm to touch, hard to the touch and very tender Low back and hips very achy

Other Meds: Zoloft

Current Illness: None

ID: 0987092
Sex: F
Age: 28
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Imitrex, Tramadol

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

Symptoms: high fever 102.6, severe body aches, chills,sweats, headache, neck pain,weakness, fatigue, nausea, runny nose, 48 hrs and going

Other Meds:

Current Illness:

ID: 0987093
Sex: F
Age: 36
State: PR

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

Lab Data:

Allergies: no

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: On the same day, 3 to 4 hours after I recieved the second dose of the Moderna vaccine, I had extreme tiredness and pain on the injection site ( left arm). The next day (morning after) I developed low grade fever, chills, back pain, general malaise, weakness, and a lot of pain on the arm I recieved the injection . I also had tender axillary lymph nodes, first on the same side I recieved the vaccine, a day later on both sides. Symptoms were the worst during the 24 hours after recieving the vaccine. After this, the only remaining symptoms were tender axillary lymph nodes and pain in the injection site. I used Acetaminophen for symptoms.

Other Meds: none

Current Illness: none

ID: 0987094
Sex: F
Age:
State: MI

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: Headache, 101.1 fever, body aches.

Other Meds: Celexa, armour thyroid, vit D, alive vitamin

Current Illness:

ID: 0987095
Sex: F
Age: 65
State: CA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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: None

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

Symptoms: Immediately after injection, left arm at injection site was painful to touch, not just sore. 2 days later, that had stopped. On 1/26/21, my left arm at the injection site started to be slightly itchy. The following morning, the area was constantly itching. That evening, I looked at my left arm at the site, and I have broken out in hives, the muscle is swollen and warm and I am having to take an antihistamine twice a day so it does not itch but it continues to be red, itchy and swollen.

Other Meds: Levothyroxine, Amlodipine, Prilosec, Prozac, Multi Vitamin; Sudafed, Astragalus

Current Illness: None

ID: 0987096
Sex: F
Age: 50
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: LA

Lab Data:

Allergies: unknown

Symptom List: Pain in extremity

Symptoms: headache, chills, fever, nausea

Other Meds: unknown

Current Illness: unknown

ID: 0987097
Sex: F
Age: 66
State: IA

Vax Date: 12/27/2020
Onset Date: 12/27/2020
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: environmental; augmentin; latex; nuts

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

Symptoms: neuropathy both arms extending fingertips to shoulders

Other Meds: Flovent inhaler

Current Illness: none

ID: 0987098
Sex: F
Age: 49
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no allergies

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

Symptoms: PT stated had not eaten breakfast or lunch today. Received tragic news prior to appointment. 5 min after vaccination felt dizziness heart racing ,pulse 96, 2:05 pm BP 158/80 Pulse-87, SP02 97% RR 12 2:06 pm. Given crackers and water. 2:30 pm BP 138/80 P 78 Pulse ox 98% RR 12. Patient feeling better "normal" agreeing to wait for 25 more minutes. 2:55 pm. Patient feeling well instructed to call 911 if symptoms recur or worsen.

Other Meds: unknown

Current Illness: Unknown

ID: 0987099
Sex: F
Age: 35
State: NJ

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

Lab Data:

Allergies:

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

Symptoms: 35 year old woman, history of shingles 8 years ago. Developed shingles rash in same distribution as she had 8 years.ago 9 days after receiving second dose of pfizer-biontech covid 19 vaccine.

Other Meds:

Current Illness:

ID: 0987100
Sex: F
Age: 22
State: IN

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Patient felt dizzy and passed out.

Other Meds:

Current Illness:

ID: 0987101
Sex: M
Age: 40
State: IL

Vax Date: 01/09/2021
Onset Date: 01/09/2021
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: Pencillin, meloxicam

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fatigue/chills/nausea later that day, (Saturday) runny nose on Monday, nasal congestion on Wednesday, tested positive for COVID-19 (PCR) on 1/15/2021

Other Meds: Descovy, Valacyclovir, finasteride, vitamin D, psyllium fiber

Current Illness: None

ID: 0987102
Sex: F
Age: 24
State: ID

Vax Date: 01/28/2021
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: Environmental allergies (grasses, sagebrush, trees, mold, dust, pollen, smoke)

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

Symptoms: Mild shortness of breath within 30 minutes of vaccination, alleviated by Benadryl given at the clinic. Flu like symptoms starting that evening (unsure what time, as I was trying to sleep). Arm soreness where I received the vaccine, muscle aches that kept waking me up throughout the night, headache, fever, slight congestion, chills and sweating, nausea, dizziness when I stand up, fatigue. As of 4:00 PM on 1/29 (the day after the vaccine) I am still experiencing this list of flu-like symptoms.

Other Meds: None

Current Illness: Covid, starting 1/7/21 but symptoms gone by 1/22

ID: 0987103
Sex: M
Age: 46
State: CA

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 30 minutes after injection started feeling extreme anxiety, panic, and feelings of doom. Fast heart rate, headache, and fatuige.

Other Meds: Levothyroxine - 150mcg (4 per week) Levothyroxine - 175mcg (3 per week) Paroxetine - 20

Current Illness:

ID: 0987104
Sex: F
Age: 28
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: RA

Lab Data:

Allergies:

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

Symptoms: Fever Tmax 101.1 Weakness Dizziness Chills Hot flashes Body aches L arm weakness and pain Nausea Sore throat Congestion

Other Meds: Metformin Vitamin D

Current Illness:

ID: 0987105
Sex: M
Age: 68
State: OK

Vax Date: 01/09/2021
Onset Date: 01/19/2021
Rec V Date: 01/29/2021
Hospital: Y

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

Lab Data:

Allergies: shellfish

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

Symptoms: The patient noted weakness starting in the legs on January the 19th, 10 days after receiving the first dose of the vaccine. The weakness progressed to the point that he was able to ambulate only with assistance. He was seen in my neurology clinic on January 28th and his evaluation suggested an ascending, painless weakness of the legs with rapidly progressive symptoms. He was admitted to Hospital on the same day. His evaluation is consistent with Guillain Barre Syndrome and he has been started on plasmapheresis to treat the condition.

Other Meds: 1) ASA 81 mg a day 2) Jardiance 25 mg daily 3)Gabapentin 300 mg TID 4) Insulin 60 units at bedtime 5) Lisinopril 10 mg daily 6) Pravastatin 80 mg daily 7) Janumet XR 50-500 two pills daily

Current Illness: Not applicable

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm