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: 0988268
Sex: F
Age: 54
State: CO

Vax Date: 01/21/2021
Onset Date: 01/23/2021
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: Patient recieved second Covid Vaccine on 1/21, Moderna Lot 029L20A. Experienced headache, fever, chills, muscle aches, joint pains for 3 days, now resolved. Arm at injection site noted to be red on second day. Continued to be more sore, red, swollen, and hot to touch. Small bruise at injection site. Site symptoms not resolving, contacted Occupational health and was referred to PCP. Telehealth visit with doctor resulted in antibiotics for possible cellulitis at site.

Other Meds:

Current Illness:

ID: 0988269
Sex: F
Age: 41
State: CA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
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: MSO4 Ketoralac Tromethamine Vicodin Ferrous Fumarate-DSS Latex

Symptom List: Anxiety, Dyspnoea

Symptoms: Elevated blood pressure, fever, malaise, headache, dizziness, loss of appetite, abdominal pain. all of these symptoms came on gradually and worsened 20 hrs after vaccination. symptoms lasted a full 48hrs for me and slowly dissipated over the following days. Itching at injection site started 72hrs after and has now ceased

Other Meds: Namenda 10mg Vitamin B3 Evening Primrose oil Tylenol 500mg

Current Illness: Migraine headache

Date Died: 01/14/2021

ID: 0988270
Sex: M
Age: 90
State: TN

Vax Date: 12/28/2020
Onset Date: 01/14/2021
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: Narrative: Symptoms: & death Treatment:

Other Meds:

Current Illness:

ID: 0988271
Sex: M
Age: 35
State: KY

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

Lab Data:

Allergies: Penicillin, Agave

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Had body aches, low grade fever, and developed a dry mouth and tickle in my throat, which cause me to keep coughing for 3 days.

Other Meds: Tramadol, gabapentin, metoprolol, CBD, Protonix, Vitamin-D, Fexofenadine, Cetirizine

Current Illness:

ID: 0988272
Sex: M
Age: 59
State: MA

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

Lab Data:

Allergies: tegretol

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

Symptoms: pt presented to group home with fever of 102.0 on 1/29/21 in the evening - pot was taken to ED for further evaluation, At ED INR was drawn and found to be decreased from last draw (1/26/21 = 2.4). After a "complete workup" PT was other wise healthy and discharge back to home. Pt PCP was notified and pt has been closely monitored for any further reaction.

Other Meds: famotidine, omeprazole, divalproex sodium er 500 and 250, furosemide, lamotrigine, lorazepam, paroxetine, Risperdal., Tamsulosin, zonisamide, coumadin (2.5mg t/h 5mg all other days last inr 2.4 on 1/26/21)

Current Illness: after vaccination it was reported pt was covid 19 positive and hospitalized for 10 days on 11/10/20, pt had been discharge to home

ID: 0988273
Sex: F
Age: 63
State: CA

Vax Date: 01/22/2021
Onset Date: 01/29/2021
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: No

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

Symptoms: Week 2 - minor headache, sniffing, sinuses running

Other Meds: Allergy meds

Current Illness: None

ID: 0988274
Sex: F
Age: 29
State:

Vax Date: 01/11/2021
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: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Henoch-Sch?nlein purpura flare up in arms and legs. Haven?t had a previous flare up in years. Seeking in joints and feet.

Other Meds: Lisinopril, levothyroxine

Current Illness: None

ID: 0988275
Sex: F
Age: 33
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Chills, cramps, diarrhea. Lasted about 2 hours

Other Meds: Gummie multi vitamins

Current Illness: None

ID: 0988276
Sex: F
Age: 19
State: MA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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: allergy to peanuts

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient reported feeling swelling in her tongue and itchiness in her throat. No rash, shortness of breath, noticeable swelling. Administered oral diphenhydramine 50mg and monitored 30 min. Patient reported feeling drowsy, but that symptoms had lessened significantly. Patient was driven home.

Other Meds:

Current Illness:

ID: 0988277
Sex: M
Age: 34
State: NY

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I had pretty intense chills and sweats in addition to significant pain in my left arm. These started a few hours after the injection, peaked at about 8 hours after the injection, and I was fine the next day

Other Meds: None

Current Illness: Common cold 12/31 (tested negative for COVID-19)

ID: 0988278
Sex: F
Age: 23
State: MA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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: None

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

Symptoms: Hives all over body, particularly on the legs and stomach.

Other Meds: Januvia, Metformin, Trintillex, Lantus, Humalog

Current Illness: None

ID: 0988279
Sex: F
Age: 70
State: IN

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Sulfa

Symptom List: Rash, Urticaria

Symptoms: Left Big toe and two next to it became very itchy and red and painful . Toes were much hotter than the other foot.

Other Meds: Maxide Synthroid Lisinopril

Current Illness: None

ID: 0988280
Sex: M
Age: 77
State:

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

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

Symptoms: SOB, Fatigue, weakness Narrative: F: Telephone call: Pt's wife called and said that patient is in the hospital- He went into hospital on 1/24/21. He had the Covid injection here at facility on 1/22/21@0945. He was feeling fine till approximately 1800 that night. His symptoms included the following: chills- fever of 102- he took Motrin 11PM on 1/22. On 1/23- @0200 fever was 99 on 1/23- he was fatigued feverish was back @ 101 degrees. He had no appetite all day. He was tired- weak- trouble breathing with SOB- Call was made to to this facility at 0230 but there was no answer. On 1/24/21- 0230AM patient could not breath and 911 was called. The EMT came- Sao2 was 65 %- couldn't walk- very short of breath. He was taken to hospital where he has been since. He was Dx with Pneu and placed on IV/ABT. Covid test was done and was negative at hospital. He has been on Oxygen since. His wife was very tearful. Family says that he may need O2 at home and a HHA.

Other Meds:

Current Illness:

ID: 0988281
Sex: M
Age: 51
State: TX

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

Lab Data:

Allergies: NKA

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

Symptoms: Moderna COVID-19 Vaccine EUA fever (99.9-101), chills, joint pain, body aches, fatigue, malaise, nausea, frequent urination - lasted about 14 hours; day 2 was just fatigue and some body aches later in day; day 3 no issues

Other Meds: aspirin 81mg, fiber supplement, glucosamine/chondriontin, culturele, naproxen 500mg, vitamin D 50,000, pantoprazole

Current Illness: none

ID: 0988282
Sex: F
Age: 59
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: 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: 8 hours after receiving the shot, I had fever, chills, shaking, fatigue & headache. Stayed in bed 24 hours.

Other Meds: citalopram, zyrtec

Current Illness: None

ID: 0988283
Sex: M
Age: 76
State: FL

Vax Date: 01/25/2021
Onset Date: 01/30/2021
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: None

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

Symptoms: Elevation of BP with mild dizzinessd

Other Meds: Amlodipine Losartan Tamsulisin Finasteride Omeprazole

Current Illness: None

ID: 0988284
Sex: M
Age: 69
State: CA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
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: None

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

Symptoms: Mild facial numbness, left cheek, left lower jawline, left lower lip

Other Meds: None

Current Illness: None

ID: 0988285
Sex: M
Age: 88
State: NV

Vax Date: 01/21/2021
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: First blotchy rash, then next day solid red rash from injection site to right above elbow. Itches.

Other Meds: 20mg Omeprazole

Current Illness: None

ID: 0988287
Sex: F
Age: 23
State: IL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: No allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I received my second dose of the Moderna COVID vaccine at approx. 10:40 AM on Friday, January 29 at clinic. By 12:00 PM, I noticed that I developed facial swelling, which was most significant around my eyes, and I felt lethargic. Between 12:00 PM and 2:00 PM, I developed hives on my neck, chest, stomach, and arms, which prompted me to take 1/2 of a dose of 25mg Benadryl. Nonetheless, the symptoms persisted and I began to experience dizziness and tightness in my throat around 4-5 PM, which was when I was advised by a nurse to go to the emergency room for treatment. I arrived at Hospital's Emergency Department around 6:00 PM and I was treated for "Possible Allergic Reaction Major." I received diphenhydrAMINE (BENADRYL) injection 50 mg, famotidine (PF) (PEPCID) injection 20 mg, methylPREDNISolone sodium succinate (PF) (SOLU-MEDROL) injection 125 mg, sodium chloride 0.9 % iv bolus, and acetaminophen (TYLENOL) tablet 650 mg. I was discharged after 10:00 PM and sent home with a prescription for predniSONE 20 mg and famotidine 20 mg. My facial swelling and hives have gone down but neither have completely resolved since being discharged. I am also experiencing full body aches and fatigue at this time (3 PM on Saturday, January 30).

Other Meds: Vyvanse (ADHD), doxycycline (acne)

Current Illness: None

ID: 0988288
Sex: F
Age: 76
State: CA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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: Adhesive Tape, Cephalosporins, Cipro, Iodine, PCN Class, Bactrim, Pneumococcal

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

Symptoms: Patient With numbness and tingling of her lips, tongue, palate. Increased BP Clammy sweating

Other Meds: Zocor, Macrobid

Current Illness: N/A

ID: 0988289
Sex: F
Age: 48
State: SC

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: 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: - several hours post injection, extreme fatigue. Good next day - a few days post injection, a lump/nodule with pain when touched was discovered front left/top shoulder about a finger distance away from injection site. Today 10 days later, nodule still exists and still sensitive to touch. Hard and pea like in size

Other Meds: None

Current Illness: None

ID: 0988290
Sex: F
Age: 44
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: Famotidine Topiramate

Symptom List: Unevaluable event

Symptoms: At injection site, redness measuring 5cm at widest part and swelling measuring 8cm diameter surrounding injection site. Pain and difficulty lifting arm

Other Meds: Hydroxychloroquine 200mg daily Bupropion XL 300mg daily Pantoprazole 20mg daily Lisinopril 10mg Vitamin D3 2000 IU Multivitamin Ibuprofen 600mg two hours prior Tylenol 1000mg two hours prior

Current Illness: None

ID: 0988291
Sex: F
Age: 51
State: CO

Vax Date: 01/22/2021
Onset Date: 01/23/2021
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:

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

Symptoms: Patient received 2nd Moderna Covid Vaccine dose on Friday, January 22nd at 5:50 pm. On Saturday, January 23rd at 10:00 am they started having severe body aches which lasted until Monday morning. On Sunday morning the patient noticed a red rash over their entire body except legs which lasted until Tuesday morning despite taking Allegra. Additionally, patient felt dizzy and weak for 2 days following the vaccination.

Other Meds:

Current Illness:

ID: 0988292
Sex: F
Age: 37
State: NC

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

Lab Data:

Allergies: Sulfa medications

Symptom List: Injection site pain, Pain

Symptoms: Itching at injection site after 15 minutes post injection which progressed to itching and rash of the flanks and neck. She did report itching in her throat. At no time did the individual develop any raised rash (no wheal) or respiratory / cardiac distress. No pulmonary distress or wheezing occurred. Her vital signs remained stable. She responded well to diphenhydramine 25 mg po x one dose and famotadine 20 mg po x one dose. She was observed for 3 + hours while her spouse drove to pick her up as she was advised not to perate a vehicle due to her Benadryl dose.

Other Meds: denied

Current Illness:

ID: 0988294
Sex: F
Age: 50
State: VA

Vax Date: 01/18/2021
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: None known

Symptom List: Injection site pain, Menorrhagia

Symptoms: Moderna COVID-19 Vaccine EUA After receiving the vaccine on January 18, my arm hurt for the first couple of days, similar to what I have experienced when receiving a flu shot in the past. I first noticed a red spot (almost like an 8-shape) on my arm around the injection site on the morning of Wednesday, January 27. The area felt warm and was about 4 x 2 inches big. I didn't/don't feel any pain, tenderness, or itching, and there was/is no swelling. Since then, the center area has lost some of its red color, but overall the red area is larger now (about 6 1/2 x 3 inches as of January 30). The area does not feel warm anymore and I don't have any other symptoms besides the discoloration. I have not gone to see a medical professional as I feel totally fine. I would like to note that I had a similar reaction (skin turning red, raised, and warm) 6 days after having had surgery under my arm to remove a cyst in 2019. Back then, the symptoms disappeared within a day or two.

Other Meds: Levothyroxine 150 mcg Prebiotic fiber supplement

Current Illness: N/A

ID: 0988295
Sex: M
Age: 88
State: VA

Vax Date: 01/25/2021
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: oxycodone

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

Symptoms: Upon leaving the site my husband had great difficulty walking. Upon arrival home he seemed unusually confused and over the course of the next 15 hrs had bouts of incontinence. He was up 6 times during the night (usually only 1-2x) and unable to get himself out of bed without assistance. Walking continued to be very unsteady. I thought perhaps he had a mini-stroke. I relayed this to his PCP but he didn't think it was vaccine related

Other Meds: 50 mg metoprolol 40mg atorvastatin 2000IU Vit D 81mg aspirin

Current Illness:

ID: 0988296
Sex: F
Age: 50
State: PA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: This is a female with a history of breast cancer on tamoxifen, hypertension, asthma who apparently received her second dose of Covid Pfizer vaccine 10 to 15 minutes prior to presentation who presented in ED with complaints of shortness of breath and tingling sensation over her face and neck. Apparently had rash over the first dose and now presented with shortness of breath. She denies any fever chills. No chest pain. EPINEPHrine (EPIPEN) injection syringe 0.3 mg (0.3 mg intramuscular Given 1/26/21 1547) sodium chloride 0.9 % bolus 1,000 mL (1,000 mL intravenous New Bag 1/26/21 1555) dexAMETHasone (DECADRON) vial 6 mg (6 mg intravenous Given 1/26/21 1548) diphenhydrAMINE (BENADRYL) injection 25 mg (25 mg intravenous Given 1/26/21 1548) famotidine (PEPCID) injection 20 mg (20 mg intravenous Given 1/26/21 1548)

Other Meds: Dexilant lisinopril famotidine fluticasone tamoxifen venlafaxine vitamin E Tylenol as needed

Current Illness: none

ID: 0988297
Sex: F
Age: 72
State: TX

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Area extends about 4" from and below vaccination site. Two days ago (8 days from receiving vaccine), area began to itch, discovered small irregular lumps under skin. Today the area is very red and small lumps seem to have diminished into a hardness; arm is still sore to the touch.

Other Meds: none

Current Illness: month prior: sinus congestion, most likely cedar allergy

ID: 0988298
Sex: F
Age: 32
State: KY

Vax Date: 01/07/2021
Onset Date: 01/15/2021
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: no allergies

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

Symptoms: ?Moderna COVID- 19 Vaccine EUA Received Moderna vaccine on 1/7/2021 on right arm. Experienced pain and tingling sensation afterwards on vaccinated arm. No adverse events noted during observation time. Pain provoked with laying on unvaccinated arm and alleviated with shaking and moving vaccinated arm. No systemic symptoms, no warmth noted on right deltoid, no erythema, no swelling or effusion, no weakness. Physical and neurological exam unremarkable. Medrol dose pack and Voltarene gel scripts given. Return to clinic for follow up as needed if no improvement after steroid course. Moderna Lot 012L20A IM injection Right arm

Other Meds:

Current Illness:

ID: 0988299
Sex: M
Age: 71
State: IN

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: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: low to high fever. night sweats. uncontrollable chills. body aches. headache. similar symptoms as the virus

Other Meds: lisinopril. allupurinol

Current Illness: none

ID: 0988300
Sex: F
Age: 38
State: OK

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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: Fish

Symptom List: Injection site pain

Symptoms: Itching at injection site which spread to bilateral arms, legs and abdomen 4 minutes following injection. 50mg Benadryl PO administered to patient by co-workers in LTC facility. HR 108, SaO2 98%, 5 min following injection. Dizziness began 11 minutes following vaccine injection. Patient laid in bed with elevated head. HR 80, SaO2 98% 15 minutes following injection. Tingling in lips mouth area began 30 minutes following vaccine injection. 911 called within 2 minutes of this and EpiPen 0.3mg dose administered at same time in left thigh. HR 94, SaO2 98% 32 minutes following vaccine injection. Ambulance arrived and patient stable, stating reduction in tingling of lip/mouth area and reduction in overall body itching. Patient taken to ER, based on history of allergy to fish, and patient's agreement to be seen in ER.

Other Meds: Birth control pill, escitalapram

Current Illness:

ID: 0988301
Sex: F
Age: 31
State: MO

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

Lab Data:

Allergies: allergy to Rocephin

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

Symptoms: High fever up to 101 (my normal temp is around 96.5), the highest temp I got with influenza was 99.0 so this was very high for me. Chills, shaking, dizziness, nausea, and vomiting. At about 24 hours I developed a terrible migraine. My fevers persisted despite taking ibuprofen. At about 48 hours I was finally able to keep fevers down and am now feeling better. The dizziness was so bad my husband had to walk me to the bathroom to throw up. The fever and chills were so bad I couldn't rest for longer than 5-15 minute increments.

Other Meds: prenatal vitamins

Current Illness: N/A

ID: 0988302
Sex: F
Age: 41
State: TX

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

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

Symptoms: Very heavy period. Passed multiple golf ball sized clots for several hours.

Other Meds: Stelara

Current Illness:

ID: 0988303
Sex: M
Age: 31
State: TX

Vax Date: 01/25/2021
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: Tremor

Symptoms: I received it at 10am and around 2am that night I started to have a bad headache and body aches. I would fall asleep for a bit but then at 4am I woke up with the worst headache of my life. It was so unbearable that I would clinch my eyes shut. Bones and muscle pains all over. Violent hot/cold flashes. I would feel hot all over and after a minute or so of placing a cold pack on my head I began to shiver despite sweating. Around 5am I was looking at my phone wondering if I should go to the ER because I legitimately felt like I was in danger. The unbearable headache lasted a total of 14 hours from its onset. No OTC medications were taken. Around 6pm on day 2 from the dose the intensity of the headache began to subside VERY slowly. I woke up on day 3 completely fine as if nothing happened.

Other Meds: Testosterone Cypionate, Men's multi vitamin.

Current Illness:

ID: 0988304
Sex: F
Age: 67
State: MI

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: SLIGHT HEADACHE STARTING AT 2330 ON FRIDAY 1/29/21. SHAKING AND COLD WITH SEVERE MUSCLE PAIN FOR APPROXIMATELY 4 HOURS PER PATIENT STATEMENT.

Other Meds:

Current Illness:

ID: 0988306
Sex: F
Age: 69
State: TX

Vax Date: 01/15/2021
Onset Date: 01/22/2021
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: allergy to bee stings, possibly Macrobid

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

Symptoms: 1 week after receiving the 1st Moderna dose, an intense itch started on right arm at injection site. Cortizone-10 cream was applied to calm the itch. Approximately an additional 1 week later, a large spotty rash appeared on the upper arm. Both symptoms seem to be improving as of 1/30/21 today.

Other Meds: eye vitamins, collagen powder

Current Illness: none

ID: 0988307
Sex: M
Age: 88
State: AZ

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: 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: There were no side affects after the first vaccine Lot# EK5730. Following the second vaccine on 1/28/21 I started feeling fatigued that evening but felt better the next morning. The following day on the 29th around 7pm I started feeling severe nausea at first and then had severe vommiting so I called 911, they took my vitals and said they were in a safe range, I did not go to the hospital and then today around 7a.m. I started feeling better and the nausea stopped.

Other Meds: Losartin Tamsulosin Areas2 Finasteride Symbicort Vitamin D3

Current Illness: COPD

ID: 0988308
Sex: F
Age: 66
State: FL

Vax Date: 01/04/2021
Onset Date: 01/08/2021
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, isothiazolinone, colophony

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Rash/hives and itching on arm next to vaccine site that eventually (after about 1 week) bruised and went away.

Other Meds: Prolia, Metformin, Crestor, Esomeprozol, l-theanine

Current Illness: None

ID: 0988309
Sex: F
Age: 52
State: KS

Vax Date: 01/08/2021
Onset Date: 01/08/2021
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: "azole" drugs like Flagyl, vermox, Bactrim Shrimp, shellfish Anaphylactic reaction to Thiabendazole 18 years ago with administration of Epi

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

Symptoms: Heart racing, facial redness/ flushing 7-8 hours after Vaccine given. Severe allergic reaction 10 days after vaccine given with redness of face, itching in face and arms, hives on arms, tightness in chest, felt SOA. Taken to ER by friend, given IV Benadryl, Provide and solumedrol with some relief. Then IM Epi given. Then RX of Provide, Prednisone, and Benadryl. Symptoms slowly improving over 10 days.

Other Meds: Claritin 10 mg daily MVI Elderberry gummy

Current Illness: 2.5 weeks before felt tired after travelling with runny nose. Covid PCR negative. 2 days before vaccination, Covid 19 IGM and IGG antibodies negative

ID: 0988310
Sex: F
Age: 27
State: MD

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin

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

Symptoms: Moderna COVID-19 Vaccine EUA I had a headache from shortly after injection until around 9PM. At 9PM I noticed a rash on my neck and chest and had minor throat swelling. I went to Patient First and received 20mg Prednisone and 25 mg Hydroxyzine. I woke up in the morning and the rash was much worse, covering my face and the rest of my body in addition to my neck and chest.

Other Meds: mirena, bactrium, women's multivitamin, B12, D3, boitin, elderberry

Current Illness: minor infection in finger- treated through bactrium. Began 1/21/21

ID: 0988311
Sex: F
Age: 50
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Extensive, painful swelling and redness radiating from injection site. Multiple bumps below injection site.

Other Meds:

Current Illness:

ID: 0988312
Sex: F
Age: 39
State: NY

Vax Date: 01/28/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Citrus, lobster, cinnamon, banana, avocado

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

Symptoms: 12:20 given vaccine on 1/27/21 12:29 began to leave, felt dizzy 12:30 parked in vehicle at vaccination location I had sharp pain in center of chest, heart was racing, I saw hives on my chest, neck, throat and up to my mouth. My lips were getting numb. I was confused and unable to participate in a work phone call I answered. 12:45 I began driving as I felt a little better. Drove 2 miles and pulled over to park and wait it out. Heart still racing, hives still present, chest pains still there and could not inhale deeply. 12:50 I drove the rest of the way home. I took a double dose of liquid Benadryl and laid down waiting for symptoms to pass. They slowly resolved over the next 6 hours. It is now 1/30/21 and I still feel like crap, but not allergy wise. More like the flu.

Other Meds: Wellbutrin Xr Lactose defense probiotic Bariatric vitamin Ferrous fumarate Zyrtec Benadryl

Current Illness: None

ID: 0988313
Sex: F
Age: 70
State: FL

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: N/A

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

Symptoms: Injection site sore and swollen -- started after injection and still continues today. Eighteen hours after injection the following side effects came almost simultaneously--nausea, headache, sore throat, swollen glands, chills and very cold feet (these were the two worst side effects), flushed face, body aches and pains, very fatigued.

Other Meds: Bromocriptine, Omerprazole, 81 mg Aspirin, Centrum Silver, Caltrate + D, and Vitamin D

Current Illness:

ID: 0988314
Sex: F
Age: 70
State: AL

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: none

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

Symptoms: Higher fever than expected, malaise, muscle aches, headache lasting from next day morning for 36 hours. weakness

Other Meds: tylenol

Current Illness: none

ID: 0988315
Sex: F
Age: 71
State: MS

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

Lab Data:

Allergies: Sulpha Tetracycline Morphine

Symptom List: Vomiting

Symptoms: Tingling lips, tongue, face. Tongue numbness and burning sensation

Other Meds: Lamictal Estradiol Losartan

Current Illness: None

ID: 0988317
Sex: F
Age: 63
State: CO

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received 2nd Moderna vaccine Thursday Jan 21st at 1610. Patient checked injection site and arm Friday Jan 22nd with no issues. On Sun Jan 24th, patient noticed redness of arm below injection site and warm to touch. Per patient, the area of redness was very large, achy to touch, and very itchy.

Other Meds:

Current Illness:

ID: 0988318
Sex: F
Age: 31
State: KY

Vax Date: 01/06/2021
Onset Date: 01/15/2021
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:

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

Symptoms: Moderna COVID- 19 Vaccine EUA Moderna Lot 012L20A Left arm IM injection Staff received First dose Moderna COVID vaccine 01/06/2021 at facility. No adverse reactions noted during observations. Yesterday pt reports redness, mild warmth and itching on vaccinated site. Today, no warmth, erythema improved, itching resolved. Hydrocortisone and topical Benadryl given. Monitor for worsening symptoms and follow up in clinic if no improvement in 3-5 days

Other Meds:

Current Illness:

ID: 0988319
Sex: F
Age: 41
State: SD

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

Lab Data:

Allergies: Corn, kiwi, gluten

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Started within 2 hours of vaccination. Chills, fever, dizziness, nausea, widespread itching,/rash, swollen arm, joint pain, abdominal pain, diarrhea, tingling in arms and legs, tongue.

Other Meds: Lamotrigine, vraylar, magnesium, levothyroxine, spironolactone, Wellbutrin, baby aspirin, vitamin D, benedryl, Dramamine

Current Illness:

ID: 0988320
Sex: F
Age: 23
State: MS

Vax Date: 01/29/2021
Onset Date: 01/30/2021
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: Codeine, Sulfa

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

Symptoms: Patient report that she received her 1st covid-19 vaccine yesterday (1/29). Today (1/30) having congestion, loss of taste, chills, headache. Denies fever.

Other Meds: Minastrin 24 Fe

Current Illness: none

ID: 0988321
Sex: F
Age: 77
State: NV

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

Lab Data:

Allergies: none

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

Symptoms: On day 7 after vaccine a red rash ( dotted spots like pimples) developed at vaccine site covering Approx 4" in diameter. The next day the whole area turned into one large red spot approx. 4" in diameter. There is an itch and slight swelling with slight pain. Also warm to the touch.

Other Meds: synthroid

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm