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: 0987907
Sex: F
Age: 36
State: TX

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/30/2021
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: hives development within 24 hours on bilateral arms

Other Meds:

Current Illness:

ID: 0987908
Sex: F
Age: 61
State: NJ

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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: Vicodin, dilaudid

Symptom List: Anxiety, Dyspnoea

Symptoms: A itchy red rash formed around the injection site. It looks almost like hives. After 18 hours, the itching is less.

Other Meds: Sinemet, Amantadine,clonazepam

Current Illness: None

ID: 0987909
Sex: M
Age: 44
State: GA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
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: On Friday my body was achy, sore all over and I slept a lot. I also had a slight headache. Today, Saturday I feel much better. I?m still a little sore but not achy and no fever.

Other Meds: Levothyroxine, finasteride, escitalopram

Current Illness:

ID: 0987910
Sex: F
Age: 30
State: NJ

Vax Date: 01/09/2021
Onset Date: 01/16/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Ceclor

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Hives/itching noted slightly below injection site 7 days after injection. The small hives then merged to one large raised red patch (approx 3 inch x 2 inch). Redness/swelling decreased after 48 hours and resolved completely within 3-4 days without treatment.

Other Meds: None.

Current Illness: None.

ID: 0987911
Sex: F
Age: 75
State: WI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: vibramycin ibuprofen

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA injection site soreness

Other Meds: LEVOTHYROXIN loratadine LANSOPRAZOLE Preservision Areds 2 sucralfate calcium low dose aspirin detrol LA

Current Illness: none

ID: 0987912
Sex: F
Age: 27
State: NY

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
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:

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

Symptoms: One day after vaccination, developed chest tightness and chest pain that is non-exertional. Self resolves, appears to be worsening. Advised ED referral for chest pain workup

Other Meds:

Current Illness:

ID: 0987914
Sex: F
Age: 33
State: IA

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 01/30/2021
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: Received COVID vaccine on Friday afternoon, 1/22, developed some slight abdominal cramping 1/24 and 1/25, had severe abdominal and back pain resulting in miscarriage evening of 1/25. Estimated date of delivery: August 27, 2020 Also had known subchorionic hematoma, diagnosed on 1/19 via ultrasound at physician's (OBGYN) office

Other Meds: Zyrtec, 200 mg Progesterone

Current Illness: Subchorionic hematoma, diagnosed by ultrasound on 1/19/2021

ID: 0987915
Sex: F
Age: 79
State: AZ

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: Tetanus, penicillin, cardizem, zestril, erythromycin, Percocet,

Symptom List: Pharyngeal swelling

Symptoms: Fatigue, sore arm, redness, began last night.

Other Meds: Amlopidine,arnuity, aspirin, cranberry,dymista,digoxin, fish oil, follicle TB, furesimide, levethyroxine, losartin, mag oxide, metformin, multivitamin, potassium, probiotic, propranolol, symbicort, restasis, rovustatin, sustained,tresiba,

Current Illness: None

ID: 0987916
Sex: F
Age: 62
State: NY

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: indomethacin, contrast dye, PCN, phenytoin, shellfish, sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient is a 60-year-old female with past medical history of HTN, SLE presents emergency department with throat itching after receiving the COVID-19 vaccination. Patient states that she previously had allergic reaction to contrast dye in the past and is having a similar sensation in her throat. She admits to nausea but denies any voice changes, difficulty swallowing, wheezing, rash. Patient denies requiring admission recommendation from allergic reaction past. Patient received Allegra prior to receiving the vaccination. This is her first dose of the vaccination.

Other Meds: None

Current Illness: No active medical problem

ID: 0987917
Sex: M
Age: 75
State: KS

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/30/2021
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: Fever, Chills, Aching all over, vomiting, diarrhea, headache, tiredness

Other Meds: exquis, losartan, dilmiazide,

Current Illness: none

ID: 0987918
Sex: F
Age: 30
State: TX

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: unknown

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

Symptoms: After receiving the first dose of pfizer covid-19 vaccine, pt had stated she had itchy and burning sensation in right and left jaw, as well as same sensation on the upper lip. Treatment for symptoms included oral intake of Cetirizine 10mg. Pt was observed for 30 minutes without any developing reactions.

Other Meds: unknown

Current Illness: unknown

ID: 0987919
Sex: F
Age: 47
State: LA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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: NKA

Symptom List: Rash, Urticaria

Symptoms: ARM NUMBNESS, ARTHRALGIAS, ARM PAIN, LETHARGY

Other Meds: Tylenol

Current Illness: N/A

ID: 0987920
Sex: M
Age: 70
State: IN

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: Demerol, bee sting, flue vaccinations

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

Symptoms: Sore arm, headache, light headed, stiff neck. Took over the counter aspirin.

Other Meds: None

Current Illness: None

ID: 0987921
Sex: F
Age: 74
State: TX

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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: Penicillin

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

Symptoms: Itching Rash around injection site appearing 7 days after received.

Other Meds: Pantoprazole, calcium, vitamin D3, baby aspirin, travoprost

Current Illness:

ID: 0987922
Sex: M
Age: 28
State: UT

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: body aches, chills, lip tingling

Other Meds: Ritalin, Zoloft

Current Illness: No

ID: 0987923
Sex: F
Age: 34
State: NJ

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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: NKDA, food sensitivity to onion and garlic

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

Symptoms: Starting at 0215 on 01/29/21 I was woken up abruptly with Severe joint pain, body aches, fever, at 101.8, nausea and vomiting, chills, headache, fatigue. These severe symptoms lasted until around 2300 on 1/29/21. Mild body aches and headache continue through 1/30/21.

Other Meds: Multivitamin, 10mg Fluoxetine

Current Illness: COVID + test 01/17/2021

ID: 0987924
Sex: F
Age: 40
State: MD

Vax Date: 01/15/2021
Onset Date: 01/26/2021
Rec V Date: 01/30/2021
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: I have allergies to pretty much anything in the air. I'm also allergic to minocycline and doxycycline. When I did go through extensive allergy testing, I think I was allergic to nickel as well.

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

Symptoms: I did not present any allergic reactions until 11 days after my initial vaccination, which seems extremely odd. I was expecting to see something shortly after receiving the vaccine. I did take pictures. Around the injection site, it looked like hives and definitely continued to get larger in the proceeding couple of days. I contacted my doctor via email and asked about this. I put ice on the injection site. And, I already take allergy meds, so that should help. I took 3 rounds of Benadryl for 2 days. You can still see a ring around the area, but the hives seem to be gone.

Other Meds: Paxil, IUD, GERD medication, daily zyrtec, and sometimes Sudafed for nasal congestion.

Current Illness: None.

ID: 0987925
Sex: F
Age: 32
State: CA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Increased swelling and pain 24h post injection

Other Meds: Celexa, tri-lo-sprintec

Current Illness:

ID: 0987926
Sex: F
Age: 74
State: GA

Vax Date: 01/21/2021
Onset Date: 01/30/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Vaccination site started itching 8 days after vaccine and 9 days after vaccination she developed a large orange-sized raised red circle at the vaccination site. She will go to a minute clinic this afternoon if it does not go away.

Other Meds: hctz, calcium, vitamin c, Vitamin E, B complex, oxybutynin

Current Illness: none

ID: 0987927
Sex: F
Age: 29
State: IN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I experienced fever and chills approximately 14 hours after injection. 20 hours after I started experiencing nausea and vomiting. This all subsided around 34 hours post injection.

Other Meds:

Current Illness:

ID: 0987928
Sex: F
Age: 16
State: IL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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: latex

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

Symptoms: Patient was given COVID vaccine and is only 16 years old.

Other Meds: none

Current Illness: none

ID: 0987929
Sex: F
Age: 75
State: CA

Vax Date: 01/14/2021
Onset Date: 01/23/2021
Rec V Date: 01/30/2021
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; Latex

Symptom List: Unevaluable event

Symptoms: Nine days after injection a red 1 inch circle appeared at shot site. Next day it double in size. It continued to get bigger each day for seven days. It was red and itchy over whole area. It grew to 3 inches wide by 4 inches long . By the seventh day the redness began to subside as did the itching. Went to doctor on 1/29/2021 which was the seventh day and she prescribed topical Triamcinolone Acetonide Cream and ice . As of today the eight day, the area was less red and was blotchy with less itching.

Other Meds: Vitamin D daily; calcium supplement

Current Illness: None

ID: 0987930
Sex: F
Age: 89
State: ND

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/30/2021
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: No

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

Symptoms: Flu like symptoms, fever, fatigue, chills, weakness, achy muscles. Difficulty breathing.

Other Meds: Not sure

Current Illness: None

ID: 0987931
Sex: F
Age: 58
State: NC

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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: Erythromycin Gluten

Symptom List: Injection site pain, Pain

Symptoms: Experienced the typical symptoms described on fact sheet, fever, chills, tiredness, headache, injection site soreness, and body aches. My body aches were severe and I had severe episode of my fibromyalgia symptoms to reoccur. I was totally wiped out for a full day (literally stayed in bed) my arms and legs were heavy and hard for me to lift so I was extremely weak; and thus far for today I am still not 100% as the pain is still very noticeable and I?m totally exhausted. Fibromyalgia symptoms are still present and just don?t feel well at all.

Other Meds: Estradiol 1mg daily Valtrex 500 mg daily Omega 3 Vitamin D3 Cymbalta 20 mg 3 a day Buspirone Hcl 7.5 mg 1 BID Amitiza 8mcg 1 BID Hydroxyzine HCL 50 mg 1 TID Serovital hgh

Current Illness: Anxiety

ID: 0987932
Sex: F
Age: 32
State: IA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: Augmentin

Symptom List: Injection site pain, Menorrhagia

Symptoms: First shot no issues pain nothing. Second Shot Wednesday at 3:30, extremely sore arm around 7pm (2x worse than Tetanus shot IMO) chills and body aches around 2AM- chills resolved around 4AM. Whole body still aches (hair even hurt to shampoo), some dizziness and lightheadedness on quick motions.....7/10 migraine and I felt 50% of normal energy 12hrs later (checked temperature and was 98.9). But still could not get warm all day. . Developed a fever around 6pm (100.0)....felt 20% of normal energy shook with chills till midnight when i woke up drenched in sweat and had to change my clothes. Next day still have 6/10 migraine and 5/10 body aches. Woke up at 6AM on Friday and felt 70%. Today, Saturday feel 85% but woke up once in night soaked with sweat requiring clothing change. Side note I am breastfeeding my 10mo old son still

Other Meds: Sertraline Vitamin D Calcium Multivitamin QPM PATIENT is currently breastfeeding her 10mo old son

Current Illness: N/A

ID: 0987933
Sex: F
Age: 40
State: NJ

Vax Date: 01/18/2021
Onset Date: 01/25/2021
Rec V Date: 01/30/2021
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: Large (8'' x 5'' x 1" ), elevated, swollen, firm, itchy, ununiform color (red, white) abdominal urticaria on the injected side that started on the 7th day after the injection and is lasting for 5 days (not yet fully resolved)

Other Meds: vitamin D

Current Illness: none

ID: 0987934
Sex: F
Age: 48
State: TX

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
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: No

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fatigue, Nausea, Diarrhea, Vomiting, headache

Other Meds: No

Current Illness: No

ID: 0987935
Sex: F
Age: 50
State: NJ

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
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: It made my 9th cranial nerve inflame and caused me pain which caused my glossopharyngeal neuralgia to come back after being gone for 7 years.

Other Meds: ibersartan

Current Illness: hypertension

ID: 0987936
Sex: F
Age: 29
State: WA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/30/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/a

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

Symptoms: Constant stomach pains with a continuous loop of constipation and diarrhea. High levels of pain through the left arm and around the injection site.

Other Meds: Testosterone

Current Illness: N/a

ID: 0987937
Sex: F
Age: 39
State: OR

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin and Vicodin

Symptom List: Nausea

Symptoms: Swelling, heat, redness and pain in the injection site. Mild headache, body aches, muscle fatigue, nausea, chills and low grade fever.

Other Meds: Aleve 220mg Lisinopril HCTZ 10-12.5mg Vitamin C 1000mg Vitamin B12 1000mg Vitamin D3 2000iu Fish oil 1400mg L-Lysine 1000mg Zinc 50mg

Current Illness: N/A

ID: 0987938
Sex: F
Age: 40
State: MD

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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, morphine

Symptom List: Injection site pain

Symptoms: While body is Achy, muscles pain everywhere, joint pain, things that touch my skin are painful, very tired but unable to sleep, injection site is very painful to the point it hurts to move it

Other Meds: Xtampza, ocycodone, trazanidine, losartan, wellbutrin, cymbalta, birth control

Current Illness: None

ID: 0987939
Sex: M
Age: 41
State: NY

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/30/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever, chills, body aches , LLQ abdominal pain , one episode of diarrhea and is having constipation

Other Meds: none

Current Illness: none

ID: 0987940
Sex: F
Age: 80
State: CA

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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: Penicillin, Opiates (sensitivity)

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

Symptoms: Sudden swelling, heat, and itching below the injection site while at rest occurred approximately 1 week after receiving 1st dose. Prior to that I only experienced minor soreness in my left arm on the day after the injection.

Other Meds: Amlodipine, Olmesartan, Metoprolol, Hydrochlorothiazide, Atorvastatin, ASA, Potassium chloride, Vitamin D3.

Current Illness:

ID: 0987941
Sex: F
Age: 25
State:

Vax Date: 01/01/2021
Onset Date: 01/27/2021
Rec V Date: 01/30/2021
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: Tremor

Symptoms: 102.8F degree fever Malaise Severe myalgia Chills Headache Joint pain

Other Meds: Lutera Trazodone

Current Illness: None

ID: 0987942
Sex: M
Age: 57
State: NJ

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/30/2021
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: Cipro

Symptom List: Erythema, Pruritus

Symptoms: Symptoms- Itching, neck, ear ice pack was applied to neck Pt was observed for 30 min and released by physician

Other Meds: N/K

Current Illness:

ID: 0987943
Sex: M
Age: 59
State: NY

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
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: Erythromycin

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

Symptoms: I was awakened last evening with a wave of cyclic nausea. I couldn?t vomit to relieve the discomfort. I too a Pepcid Compleye, which lessened the issue; however, the side effect persists through today.

Other Meds: Crestor daily; tamsulosin . Tadalafil , prn

Current Illness: None

ID: 0987944
Sex: F
Age: 34
State:

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
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: Swollen, sometimes itchy, red rash on the arm around the vaccine injection site.

Other Meds:

Current Illness:

ID: 0987945
Sex: M
Age: 56
State: IN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Slight dizziness, 100.8 fever, joint pain, chills, extremely tired. Rotated Tylenol and Motrin every two hours overnight. Still have a low-grade fever 20 hours later but feeling better.

Other Meds: None

Current Illness: None

ID: 0987946
Sex: F
Age: 69
State: GA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/30/2021
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: Penicillin

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

Symptoms: Evening of shot, sore arm and extreme fatigue. Following day, tired with ?brain fog?. Third day, brain fog worsens, depression begins. Fourth day, confusion, withdrawal from interacting with others, worsening depression. Subsequent days, increasing confusion and severe memory problems. Becoming alarmed at inability to respond and ?find words?. By weekend, (5 days after shot) suicidal ideation, stopped talking to people (I live alone, but would regularly speak to neighbors and family prior to this episode). This rather alarming condition finally began to lift about 2days ago. I have a decades-long history of depression and have taken medication for it on and off since my 30?s. I must say I have concerns about getting a second shot next month because of the major depression as well as memory problems. ( I have been experiencing memory challenges for the last few years, and my Mom died of Alzheimer?s.)

Other Meds: Lexapro, Lipitor, Inderal, D3, calcium/magnesium/zinc tablet, low dose aspirin, melatonin , magnesium L-threonate

Current Illness: None

ID: 0987947
Sex: F
Age: 49
State: FL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/30/2021
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: No

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

Symptoms: Blood in Urine, lasted for 1-2 days

Other Meds: Lefludimide, Meloxicam, Prednisone

Current Illness: Rheumatoid arthritis

ID: 0987948
Sex: F
Age: 47
State: KS

Vax Date: 01/21/2021
Onset Date: 01/24/2021
Rec V Date: 01/30/2021
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 known

Symptom List: Pain in extremity

Symptoms: Skin rash on shoulder where the shot was administered.

Other Meds: Cod liver oil Digestive enzymes

Current Illness: None

ID: 0987949
Sex: F
Age: 35
State: NM

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: Pecans

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

Symptoms: Burning in leg and soreness

Other Meds: n/a

Current Illness: n/a

ID: 0987950
Sex: F
Age: 25
State: NY

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/30/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: When injection was given and needle removed, the vaccine squirted out of the patient's arm. Dose was received but unsure of quantity.

Other Meds:

Current Illness:

ID: 0987951
Sex: M
Age: 53
State: TX

Vax Date: 01/16/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
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: NSAIDs, Aspirin

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

Symptoms: Moderna COVID-19 Vaccine EUA Rash formed on arm about 12 days after vaccine (first noticed it on this day). Press seems to be calling it "COVID Arm".

Other Meds: Tamsulosin 0.4mg, CBD Oil 15mg; Atorvastatin 10mg; Levothyroxine 112 mcg; Jardiance 20mg; Omega 3 1280mg; Alive multi-vitamin; Tramadol 5mg

Current Illness: None

ID: 0987953
Sex: F
Age: 67
State: FL

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
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: None

Symptom List: Vomiting

Symptoms: Thursday evening, after the vaccine, she said she started itching all over her body and developed hives/ increased itching in places that she sweated more. She took scheduled Benadryl the rest of the night and the next day. On Friday, she received a shot of Novocain at the dermatologist's office. Friday night at approximately 9:30 pm, her husband woke her up for the next dose of Benadryl and saw that her bottom lip was extremely swollen. They went straight to the ER for treatment.

Other Meds: Magnesium, Vitamin D3, B12 complex, Red Yeast Rice

Current Illness: None

ID: 0987954
Sex: F
Age: 39
State: MD

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/30/2021
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: PCN, latex, Bactrim, adhesive, dairy, gluten, IV contrasr

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: hoarseness, cough, pruritus, treated with IV solumedrol and diphenhydramine

Other Meds: Unknown

Current Illness: None

ID: 0987955
Sex: F
Age: 50
State: IA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/30/2021
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, glycerin

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

Symptoms: 101.8, at 5 am, took ibuprofen 400 mg, fever rose to 103.5 by 11:00, took acetaminophen 1000 mg. Continued Fever rise at 4 pm 104.2 with onset of controlled diarrhea. Took ibuprofen 800 mg, 10 mg cetirizine and sat outside in winter weather for 10 minutes. Fever reduced to 102 remainder of the afternoon and evening with another dose of acetaminophen 1000 mg, followed by 400 mg ibuprofen at bedtime. No fever the following morning, persistent loose stools and headache relieved by ibuprofen 400 mg TID. Headache and intermittent loose stool still present on 1/30/21

Other Meds: None

Current Illness: None

ID: 0987956
Sex: F
Age: 38
State: FL

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/30/2021
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: Allergic reaction to neosporine and preparation H Alllergic reaction to poison Ivy Seasonal allergies Dust

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 3 hours after vaccine I got diarrhea one time only. maybe about 8 hours later injection site was very mild discomfort. Next day I was tired all day. All symptoms were over after 2 days.

Other Meds: Elderberry Multi vitamin

Current Illness:

ID: 0987957
Sex: F
Age: 77
State: NC

Vax Date: 01/21/2021
Onset Date: 01/28/2021
Rec V Date: 01/30/2021
Hospital:

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

Lab Data:

Allergies: Pineapple

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

Symptoms: Unusual delayed dermal event. Erythematous rash several cm in diameter surrounding injection site. The rash is not painful. Rash occurred about 7-8 days post injection but was not visible before. Cocern about mild Arthus type reaction in skin. Has this been reported previously??

Other Meds: routine anti hypertensives

Current Illness: none

ID: 0987958
Sex: F
Age: 45
State: WA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/30/2021
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: Amoxicillin, dust, cedar, grass, bee stings, white fish

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

Symptoms: Fatigue, fever, achy joints, itchy skin, hot arm, Covid arm rash (2 weeks later)

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm