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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 0988322
Sex: M
Age: 81
State: AZ

Vax Date: 02/03/2021
Onset Date:
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: COVID 19

Other Meds:

Current Illness:

ID: 0988323
Sex: F
Age: 64
State: CA

Vax Date: 01/08/2021
Onset Date: 01/16/2021
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: Sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: Severe rash on arm, near injection site, and extending to elbow. Very red, sore, and itchy. Lasted 3 days. No treatment.

Other Meds: Tymlos Vitamin D Calcium Magnesium

Current Illness:

ID: 0988324
Sex: F
Age: 58
State: NC

Vax Date: 01/05/2021
Onset Date: 01/19/2021
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: nkda

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

Symptoms: patient has terrible place on her arm where immunization was administered - bad skin reaction nearly one month later. still red with scabbing and itching.

Other Meds: levetiracetam

Current Illness: no

ID: 0988325
Sex: F
Age: 60
State: MI

Vax Date: 01/06/2021
Onset Date: 01/26/2021
Rec V Date: 01/30/2021
Hospital: Y

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

Lab Data:

Allergies: Codeine and morphine intolerance Sulfa antibiotics-prior hives seen on administration in her 20s

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Onset of Petechial/purpural rash along BLE starting in thighs B/L with spread to abdomen and BUE. Probable Type III Hypersensitivity vs vasculitis. Came to hospital 01/28/2021. Treated with PO steroids 60 mg PO prednisone with rapid improvement. Testing still pending.

Other Meds: Hydrochlorothiazide last taken 2 weeks prior to vaccine administration Levothyroxine Albuterol as needed Daily multivitamin

Current Illness: None.

ID: 0988326
Sex: F
Age: 51
State: MD

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: No

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

Symptoms: Red hot lumpy site painful sore , like a sunburn Bones ache , redness spreading

Other Meds: Vitamin D 2 50,000 Thyroid NP 1.5 GR 90 MG Bupropion xl 150 mg Atomoxetine 60 MG Losartan /HCTZ 50/12.5mg Estradiol .05 mg/day patch

Current Illness: None

ID: 0988327
Sex: F
Age: 69
State: NY

Vax Date: 01/20/2021
Onset Date: 01/25/2021
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: unknown

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

Symptoms: Moderna COVID-19 vaccine EUA- Patient came to the pharmacy on 1/30/21 at 9:15am. Her left arm was red, itchy and swollen. The red area extended 5.5" wide and 3.5" tall. Patient states that this began on Monday 1/25/21, 5 days after receiving the Moderna COVID-19 vaccine and was getting red and bigger each day. I marked the margins with pen and told her she needed to see her primary care doctor or go to an emergency care center as I was concerned about it being possible cellulitis or an allergic reaction. I also wrote her a note to have her doctor make a determination if she should receive the second vaccine if this was an allergic reaction, and if so, if she should have it in a hospital or doctors office better equipped to handle a severe allergic reaction if one was to occur. She was able to see a Nurse Practitioner at her doctors office. He prescribed Cephalexin 500mg three times a day and took pictures of her arm. NP told her he could not tell if it was cellulitis or an allergic reaction. The "clinical visit summary of today's visit diagnosis" was "cellulitis of left upper limb, adverse effect of vaccines and biological substances". NP was going to forward the picture and information to her primary doctor Dr. She was told that Dr. would be contacting her on Monday or Tuesday and would make a determination if she should receive the second dose in the Moderna series and if so, if she would have to have it in a hospital type setting.

Other Meds: unknown

Current Illness: unknown

ID: 0988328
Sex: F
Age: 38
State: VA

Vax Date: 01/28/2021
Onset Date: 01/30/2021
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: A cute allergic reaction with hives, sweating. Diarrhea, vomiting, hives.

Other Meds: Wellbutrin Tylenol Zinc supplement Vitamin D Vitamin E Multi vitamin B12

Current Illness: None

ID: 0988329
Sex: F
Age: 41
State: VA

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

Lab Data:

Allergies: Allergic to synthroid, penicillin, environmental allergies

Symptom List: Pharyngeal swelling

Symptoms: Swelling of eyelids, burning, hives on eyes face arms and legs. Fatigue joint aches. Started the morning after. My eyes lids are still swollen and burning but body hives have subsided. Fatigue and joint pain continue

Other Meds: Zyrtec Singulair Tirosint Liothyronine Prilosec

Current Illness: None

ID: 0988330
Sex: F
Age: 44
State: CO

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: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient was scheduled for the 2nd dose of the Moderna covid19 vaccine. However, the nurse administering the vaccine grabbed a Pfizer syringe instead. Patient inadvertently received the wrong vaccine for the second dose. Patient has not reported any additional symptoms.

Other Meds:

Current Illness:

ID: 0988331
Sex: F
Age: 67
State: CA

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

Lab Data:

Allergies: sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Swelling, redness hot to touch

Other Meds: actemra, zovirex, ambien, lamictal, D3, Calcium, rovastatin, well butrin

Current Illness:

ID: 0988332
Sex: F
Age: 69
State: MD

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: Phenagren

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

Symptoms: Gout like in left hand and in left knee around my TKR

Other Meds: Valsartan, Gabapentin, Aggrenox, Zetia, Hydrochlorothiazide, Lipitor, Potassium, Travatan, Symbicort, Rescue Inhaler, Nitrofurantoi Calcium, Multi-Vitamin, Cranberry, Magnesium, Fish Oil, Glucosamine, CQ10

Current Illness: None

ID: 0988333
Sex: F
Age: 23
State:

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

Lab Data:

Allergies: shellfish, aspirin, nuts

Symptom List: Rash, Urticaria

Symptoms: short of breath, throat itching,

Other Meds:

Current Illness:

ID: 0988334
Sex: F
Age: 62
State: VA

Vax Date: 12/23/2020
Onset Date: 01/09/2021
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: Tramadol

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

Symptoms: Approx 10 days after first vaccine developed red, mildly indurated, warm, itchy area approx 3 x 6 inches which took 8 days to resolve

Other Meds: Lisinopril np thyroid cytomel zyrtec vit d magnesium fish oil turmeric baby asa calcium diltiazem areds 2 vitamin

Current Illness: None

ID: 0988335
Sex: F
Age: 66
State: CA

Vax Date: 01/22/2021
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: lactose intolerant and bad reaction to sulfa antibiotics

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

Symptoms: swelling around where shot was given, red, itchy, grew to approximate of size of baseball under skin, hard to the touch, sore and kinda numb at the same time. Swelling, redness and itching first noticed Thursday, 1/28. Today, Saturday the swelling appears to be going down a bit, still sore and numb and itchy. I applied anti-itch cream and took Tylenol.

Other Meds: None

Current Illness: not to my knowledge

ID: 0988336
Sex: F
Age: 60
State: TX

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

Lab Data:

Allergies: NKA

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

Symptoms: Several hours later developed rash in lower neck area at clavicle region - 5.5" length and 2" height. Red and feel some burning sensation and slight itch.

Other Meds: Pravastatin, Spironolactone, NP Thyroid, Multi-vitamin, Claritin, Fish oil, Cosamin, escitalopram, Bupropion hydrochloride, vitamin D3, calcium

Current Illness: none

ID: 0988337
Sex: F
Age: 21
State: WI

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

Lab Data:

Allergies: n/a

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

Symptoms: Nausea, insomnia, abdominal pain, fatigue/exhaustion, fever, chills, overheating, dry eyes, muscle aches and joint pain (more/different than usual related to health condition)

Other Meds: Duloxetine 20 mg, Fluoxetine 20 mg, Bupropion Xl 300 mg, Gabapentin 300 mg, Celecoxib 200 mg, Cyclobenzaprine 5-10 mg, Propranolol ER 60 mg, Ivabradine 7.5 mg 2/day, Low-Dose Naltrexone 6 mg, magnesium, methylcellulose, chondroitin with MSM

Current Illness: n/a

ID: 0988338
Sex: F
Age: 65
State:

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

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

Symptoms: developed numbness/tingling of tongue, headache and also pain across chest, as well as high BP and HR. Given water, benadryl 50 mg IM with improvement of everything except chest pain. Sent to CSMC ER for further evaluation.

Other Meds:

Current Illness:

ID: 0988339
Sex: F
Age: 57
State: TX

Vax Date: 01/25/2021
Onset Date: 01/26/2021
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: Compazine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe body aches, malaise, nausea, chills, rash on chest.

Other Meds: Zonergan, viibryd, fosteum plus, vitamin d, Prilosec, hydroxyzine, gabapentin

Current Illness: Liver bleeding.

ID: 0988340
Sex: F
Age: 60
State: RI

Vax Date: 01/24/2021
Onset Date: 01/26/2021
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: sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Moderna COVID-19 Vaccine EUA 5 cm X 2 cm irregular macular erythematous rash starting about 3 cm below the injection site 2 days after vaccine with peak redness and extent on day 3 post vaccine. Slightly pruritic. Also seen after 1st dose, but not as large

Other Meds: ocrevus IV monthly, levothyroxine daily, biotin , CoQ10 daily MVI and Calcium with D twice weekly

Current Illness:

ID: 0988341
Sex: F
Age: 49
State: IL

Vax Date: 01/21/2021
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: None

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

Symptoms: Swelling,redness,increased warmth, hardness at injection site, itching,burning

Other Meds: Losartan and hydrochlorothiazide

Current Illness: None

ID: 0988342
Sex: F
Age: 38
State:

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: Nuts, Sulfate, Aspirin

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

Symptoms: PAIN AND REDNESS AT SITE OF INJECTION, HEADACHE, FEVER, FATIGUE, CHILLS, MUSCLE AND JOINT PAIN, THEETH AND MOUTH PAIN, VOMITING, BODY PAIN, LOSS OF APPETITE. TIME COURSE- WORST SYMPTOMS - TWO DAYS MILD SYMPTOMS- ONE DAY

Other Meds: Synthroid 125mg

Current Illness: Morbid Obesity, Hypothyroidism, Asthma

ID: 0988343
Sex: M
Age: 27
State: MI

Vax Date: 01/22/2021
Onset Date: 01/24/2021
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: Amoxicillin Penicillin azithromycin

Symptom List: Unevaluable event

Symptoms: Jaundice, abdominal pain, body aches. headache,nausea - started 1/24/21. HGB 6.8, low haptoglobin Pt has a had a history of hereditary stomatocytosis. When the patient had the shingles vaccine 5/2019,he had a similar reaction. Pt is requiring IV pain medications.

Other Meds: Albuterol Inh, Xanax 0.25 mg, Zytrec 10mg, Hibiclenz, vibramycin 100 mg, folic acid, ibuprofren, Airborne (not recently taken), MVI,sertraline

Current Illness: none listed

ID: 0988344
Sex: F
Age: 25
State:

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fever up to 101 F - began in early afternoon the day after vaccine was given. Improved by taking ibuprofen in evening and gone by morning. (Tried to report with vsafe, but ran into technical problems, so I am reporting here instead).

Other Meds: None

Current Illness: None

ID: 0988345
Sex: F
Age: 58
State: MO

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

Lab Data:

Allergies: Shellfish, Amoxicillin, Lidocaine

Symptom List: Injection site pain, Pain

Symptoms: On Monday, January 25th at 1:20pm I received my first dose of the Pfizer vaccine. On the afternoon 1/26 /21 around 2pm had mild back and shoulder pain on the left side which I though was a mild reaction to the vaccine so I took tylenol and it went away. On the evening of the 26th 2 bumps on my back on which I thought were zits. On 1/27 bumps/rash on my left side where my bra underwire would be on the side. I thought it was irritation from my bra. Put neosoprin on it the morning of the 28th and wore a sports bra. Did not have much change on the 29th yet when I went to bed it was itchy burning and my back hurt. I called and got an appointment at Urgent care on the 30th and was seen by staff at 10:30 am, who said it was Shingles and started me on a round of Valacyclovir 1gm for 7 days. I have never had Shingles before. She directed me to report this information to VAERS.

Other Meds: multi vitamin, b complex, C, D, Calcium, Turmeric, Zinc, melatonin, quercetin

Current Illness: None

ID: 0988347
Sex: F
Age: 67
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, muscle ache, severe chill, fever

Other Meds: Pravastatin, sertraline, levothyroxine, lisinopril

Current Illness:

ID: 0988348
Sex: F
Age: 77
State: CO

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

Lab Data:

Allergies: Kelflix

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

Symptoms: Dizziness, Chills, Diarrhea Nausea Weakness, Tiredness

Other Meds: Levothyroxine ,Lisinopril, Prednisone, Montelukast, Glipizide, Leflunomide, Potassium Chloride , Metoprol Tar, Metformin, Omeprazole, Atorvastatin, Aspirin 81mg, Calcium, Vit C.

Current Illness: None

ID: 0988349
Sex: M
Age: 58
State: NY

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: fever,chills,pain in the arm

Other Meds: Metropolol 50 mg

Current Illness:

ID: 0988350
Sex: F
Age: 41
State: IL

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: RA

Lab Data:

Allergies: Sulfa drugs

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Rash, itchy all over body, fever, chills, headache

Other Meds: None

Current Illness: None

ID: 0988351
Sex: F
Age: 36
State: OR

Vax Date: 01/22/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: PENICILLIN

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

Symptoms: HEADACHE, FEVER, FATIGUE, LOCALIZED SWELLING AND REDNESS AND PAIN IN LEFT ARM 6 DAYS POST VACCINE

Other Meds: NONE

Current Illness: NONE-HAD FEVER ONE WEEK PRIOR TO VACCINATION BUT WAS NEGATIVE FOR COVID, SO THEY PROCEEDED WITH VACCINE

ID: 0988352
Sex: F
Age: 26
State: KY

Vax Date: 01/16/2021
Onset Date: 01/16/2021
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: no known allergies

Symptom List: Nausea

Symptoms: Pfizer COVID- 19 Vaccine Pt received Pfizer COVID vaccine lot #EL3249. Pt sat for about 10 minutes, arm became itchy, gave diphenhydramine x 1 dose. Pt continued to sit for assessment for another 15 min. Pt stated she felt hot, but is typical for her to feel warm. No chest pain, SOB, blurred vision. Pt cleared to leave facility.

Other Meds:

Current Illness:

ID: 0988353
Sex: F
Age: 60
State: PA

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

Lab Data:

Allergies: Morphine, Tetracycline

Symptom List: Injection site pain

Symptoms: One week (1/29/21) after receiving vaccine the injection site got swollen, red and itchy. No issues with injection site following injection on 1/22/21.

Other Meds: Calcium with Vitamin D, Biotin, Colace

Current Illness: None

ID: 0988354
Sex: F
Age: 63
State: IN

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

Lab Data:

Allergies: No Known

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

Symptoms: Late evening after shot felt like was getting a cold, runny nose, tired. Next day had fever, high of 100.0 F, joint pain, headache, fatigue. Lasted about 24 hours, improved by second day after shot with minor fatigue for another day, by 3rd day felt normal.

Other Meds: Lipitor 20 mg daily Paroxetine 30 mg daily Hyzaar 50-12.5 daily Bupropion 150 mg daily One-a-Day Women 's 50+ daily Magnesium 500 mg daily Vitamin C 1000 mg daily Krill Oil 1000 mg daily

Current Illness: None

ID: 0988355
Sex: F
Age: 82
State: GA

Vax Date: 01/17/2021
Onset Date: 01/30/2021
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: none

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

Symptoms: patient stated that starting at the injection site and moving down her arm about halfway to elbow, the area is red and warm to the touch; she stated that she only noticed it today (1/30/2021).

Other Meds: unknown

Current Illness: unknown

ID: 0988356
Sex: F
Age: 75
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: 4:30 - 6:30 pm on 1/29/2021 nausea, chills, dry heaved, bowel purge (not diarrhea) No treatment -slept Fine after this event but tired

Other Meds: losartan, metoprolol, gabapentin, 81mg aspiring

Current Illness: none

ID: 0988357
Sex: F
Age: 37
State: ID

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

Lab Data:

Allergies: Monk fruit

Symptom List: Erythema, Pruritus

Symptoms: 01-28-2021 Hard to breath, wheezing and hyperventilating, finger, lips, and toes turned blue, severe headache and ringing tinnitus, fever up to 102, about 2in diameter red spot below injection site. All over body/muscle soreness and irritability to being touched by anything. Unable to sleep at all Took ibuprofen naproxen , benedryl 01-29-2021 Breathing returned to normal, fever 100-99 for entire day and all over body/muscle soreness and irritability to being touched by anything and red spot remains Took ibuprofen , naproxen , benedryl 1-30-2021 Fever gone, soreness mostly gone, red spot remains

Other Meds: Hydrochlorothiazide about 1hr prior

Current Illness: NA

ID: 0988358
Sex: F
Age: 73
State: CA

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

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

Symptoms: Patient arrived to observation room around 11am following vaccination with Moderna dose #1, no distress noted, sitting in back of room. Around 11:05am, patient was seen by observation RNs as putting head down into hands and started to wave for assistance. Per patient, she felt hot, light-headed and faint. Patient's lower extremities were elevated on adjacent chair and 10LPM 02 administered via bag mask. Vital signs measured: p64, R22, BP120/76, 02:99%. Patient stated she felt mild "scratchiness" in her throat, which dissipated in less than 5 minutes. No presence or reports of angioedema, wheezing, shortness of breath, hypotension, rash/redness. Benadryl was drawn up and prepared in case of need for administration, Epipen also nearby. After about 20 minutes of sitting with legs elevated and O2 flowing, client reports feeling better, no longer feeling "scratchy" throat. Patient states she was anxious to receive vaccine and thinks symptoms are due to anxiety. Patient's husband present and assisted patient to car around 11:30am. No further intervention needed.

Other Meds: Not available.

Current Illness: Not available.

ID: 0988359
Sex: M
Age: 65
State:

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: 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: injection site paid; fatigue; headache; muscle pain; fever; chills; joint pain; muscle cramps.

Other Meds:

Current Illness:

ID: 0988360
Sex: F
Age: 56
State: IN

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

Lab Data:

Allergies: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Extremely swollen and painful lymph glands located on L side collar bone. Same lymph glands became swollen 5 days after 1st injection and Dr. wanted to me to report them and I did. This time the morning after the injection the glands were extremely swollen so much so that my coworkers could see them on my collar bone. I also had with the 2nd vaccinatation fever, chills, headache and fatigue that I considered a normal reaction.

Other Meds: Wellbutrin, Losartan, Potassium, Singulair, Chlortalidone, Baby Aspirin, Meloxicam, Prilosec

Current Illness: N/A

ID: 0988361
Sex: M
Age: 72
State: IN

Vax Date: 01/28/2021
Onset Date: 01/30/2021
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:

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

Symptoms: Severe flu-like symptoms Dizziness Vomiting Weakness

Other Meds:

Current Illness:

ID: 0988362
Sex: F
Age: 54
State: IA

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

Lab Data:

Allergies:

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

Symptoms: Woke up 11 hours after dose with upset stomach, body aches. By next morning around 9:00 am had high fever (103 degrees) as well, called in sick to work x2 days.

Other Meds:

Current Illness:

ID: 0988363
Sex: F
Age: 69
State: DE

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

Lab Data:

Allergies: Durazol, erythromycin

Symptom List: Pain in extremity

Symptoms: Reddened, itchy, circular patch on injected deltoid area approx 3 1/2" diameter

Other Meds: atorvastatin, hydrochlorothiazide, amlodipine, levothyroxin

Current Illness: none

ID: 0988364
Sex: M
Age: 47
State: NC

Vax Date: 01/06/2021
Onset Date: 01/22/2021
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: None

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

Symptoms: Red raised rash at injection site next day. Sore right arm for several days. January 22 sneezing, congestion and cough started. Then joint pain and body aches. January 25 extreme fatigue and nausea and had to leave work. Coughing worsened and lead to shortness of breath for three days. Developed red raised rash on my face January 28. January 29 cough, congestion, muscle pain and fatigue gone, continue with joint pain and rash.

Other Meds: None

Current Illness: None

ID: 0988365
Sex: F
Age: 26
State: WA

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

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

Symptoms: My first dose went well. I just had a sore arm. 8 days prior to my second dose I was covered in thick hives head to toe. I went to and urgent care, the ER, saw my PCP, and got established with a dermatologist within those eight days who put me on predisone and Pepcid. Nothing was helping and the day of my second dose I still had hives all over my body, but about three hours after my shot, they were almost completely gone. Not sure if the vaccine had something to do with that or if it was a coincidence. Other than that I felt fantastic after my second dose.

Other Meds: Prednisone, and pepcid

Current Illness: Hives for 8 days prior to getting my second dose of vaccine.

ID: 0988366
Sex: F
Age: 65
State: NJ

Vax Date: 01/20/2021
Onset Date: 01/27/2021
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: One week after shot experiencing severe joint pain, especially in my wrists and fingers

Other Meds: Sertraline, Buspirone, Lipitor, Caltrate +D; Restasis, Align

Current Illness: Sjogrens

ID: 0988367
Sex: F
Age: 52
State: RI

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Headache fever , temp 102 at 3 AM and hallucinations, red raised rash surrounding injection site, on 1/30 night sweats, sore throat

Other Meds: Triamterene Breo Albuterol

Current Illness: Positive for Covid on 1/4 Negative for Covid on 1/12

Date Died: 01/22/2021

ID: 0988369
Sex: M
Age: 82
State: IL

Vax Date: 01/19/2021
Onset Date: 01/21/2021
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: Penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: aspiration pneumonia/death

Other Meds: Carvedilol Citalopram Phenytion Olanzapine

Current Illness:

ID: 0988370
Sex: F
Age: 57
State: MA

Vax Date: 01/04/2021
Onset Date: 01/11/2021
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: None

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

Symptoms: Developed red warm raised rash around injection site 1 week after injection. Site itchy and irritated for three days

Other Meds: Multi vitamin, Climara patch

Current Illness: None

ID: 0988371
Sex: F
Age: 60
State: RI

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

Lab Data:

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: None stated.

Other Meds: Calcium Women's 50 plus daily vitamin

Current Illness: none

ID: 0988372
Sex: F
Age: 64
State: KY

Vax Date: 01/16/2021
Onset Date: 01/16/2021
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: antihistamines - reaction listed as 'other', 7/12/2012

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

Symptoms: COVID- 19 Vaccine. She was experiencing chest tightness, SOB, and dizziness. 50mg of Benadryl and 20mg of famotidine was administered around 1410. Patient was still experiencing chest tightness and was having difficulty breathing. 0.3mg of epinephrine was administered at 1420. EMS was called. Breathing improved. Pulse ox 100%, HR 68, BP 130/89. EMS arrived and assumed patient care. Pt seen in Emergency Room 1/16/2021 1513 CHIEF COMPLAINT: reaction to COVID vaccine HISTORY OF PRESENT ILLNESS: Patient is a 64y F with PMHx significant for Myopericarditis, Anxiety and HTN who presents to ER after developing tongue swelling, wheezing, tunneled vision and shortness of breath. Patient states that she was getting first shot of COVID19 Pfizer vaccine at 2:00 pm. After getting vaccine she waited 15 minutes like she was told and recalls room getting very hot at approximately 6 minutes after getting vaccine. She also states that her tongue felt swollen. She then noticed her vision started to turn dark and then she felt dizzy. She told pharmacist about symptoms and then she was given one pill of Benadryl. This did not help and actually made her symptoms worse. She recalls wheezing. She was given another pill of what she believes was Benadryl. She also recalls pharmacist measured her BP and her husband, who was present, reported that her blood pressure was in the 140s This did not improve so she was given 0.3mg IM epinephrine shot. This significantly improved her symptoms. However, she was sent to ER. She denies any hx of recent UTI or GI infection. She denies fevers, chills, nausea, diarrhea, chest pain, generalized itching, vomiting, abdominal pain, generalized swelling, headache or syncopal episode. She denies any past reactions to vaccines. She denies current SOB and feels like her symptoms resolved. Denies hx of COPD or asthma. Physical exam did not show any recurrent signs of wheezing or tongue edema. Her SaO2 was 100% on RA and BP was within baseline 140-160s. Given episode, we decided to obtain tryptase levels. We also observe patient to ensure she did not have any recurrence of symptoms. She remained hemodynamically stable and SaO2 remained in mid 90s to 100. She was given a rx for epinephrine pen should symptoms recur though this is highly unlikely as she remained stable throughout ER stay. She was also given instructions to pick up OTC Benadryl and Pepcid. She does have antihistamines listed as an allergy but patient states that she gets tachycardic upon taking tabs, so this could just be a side effect. We will follow up with tryptase levels but even if tryptase levels return as normal, it does not mean she did not have an anaphylactic reaction to vaccine. Her clinical picture puts this diagnosis high in the differential. Teaching and instructions were given to patient and her husband. She was advised to return to ER if symptoms recur. IMPRESSION: Anaphylaxis Anxiety attack

Other Meds:

Current Illness:

ID: 0988373
Sex: M
Age: 31
State: IN

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/30/2021
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: Metformin, Cipro, Levaquin, Milk, Eggs

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

Symptoms: High blood sugar, fever, headache, body aches

Other Meds: Lisinopril, metoprolol, pravastatin, amlodipine, Lyrica, insulin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm