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: 0991511
Sex: F
Age: 95
State: AZ

Vax Date: 01/20/2021
Onset Date: 01/25/2021
Rec V Date: 02/01/2021
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: Systemic: Chills-Medium, Systemic: Generalized Body Aches -Severe, Systemic: Joint Pain-Severe, Systemic: Diarrhea-Severe, Systemic: Fainting-Severe

Other Meds:

Current Illness:

ID: 0991512
Sex: F
Age: 36
State: NE

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 02/01/2021
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: Penicillin, sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: Starting at 11:30pm and lasting for 48 hours- nausea, headaches, chills, fatigue, runny nose, severe muscle aches. After 48 hours and still happening headaches, brain fog, fatigue

Other Meds: Vitamin C Vitamin D multivitamin

Current Illness:

ID: 0991513
Sex: F
Age: 74
State: NY

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
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: Achromycin, Alirocumab, Clindamycin, /corticosteriods, /gabapentin, Hydrocodone, Iodine, Mprphine, Nambumetone, Oxycodone, Penicillins, Piroxicam, Sulfas, Tetracycline, Almond, Fentanyl, Iodine, Ramipril, Niacin.

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

Symptoms: Pt has a history of asthma. Pt states after she recieved the vaccine she started coughing. Pt states she used her albuterol inhaler. Pt states she also took 50MG of benadryl. Pt states her symptoms are gone at this time. Pt's vitals are stable. Pt refused transport to hospital.

Other Meds: Allopurinol, ambien, ASA, Benadryl, Bisacodyl, Bupropion, Docusate Sodium, Fluticasone propionate, Lisinopril, Meclizine, Naproxen, Omeprazole, /rosuvastatin, Ther-M.

Current Illness: None

ID: 0991514
Sex: M
Age: 46
State:

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: "Wednesday January 20th I received my second COVID vaccine, returning to work the next day. I felt some fatigue and chills through Friday, but woke up Saturday the 23rd feeling normal, except for a rash developing on my neck and the left side of my head. By Sunday, it spread, so I made a virtual appointment. Yesterday, it got worse, so I made an appointment with my primary care and saw him in the afternoon. Apparently, I was his second patient yesterday with the same diagnosis: shingles trigglered by the COVID - 19 vaccine."

Other Meds:

Current Illness:

ID: 0991516
Sex: F
Age: 38
State: VA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Headache, arm swollen/sore, body aches, back ache, runny nose, hands swollen, unable to sleep

Other Meds:

Current Illness:

ID: 0991517
Sex: F
Age: 40
State: MD

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
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: amoxicillin

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

Symptoms: "COVID Arm" itching, rash on upper left arm where vaccine was given

Other Meds: vyvanse lexapro wellbutrin vitamin E

Current Illness:

ID: 0991518
Sex: F
Age: 78
State: NY

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
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: Sulfa

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Upon going to bed, within a matter of a few minutes, I started to get the chills real bad. Then my muscles and joints started to hurt. I could not even turn over in bed without my whole body hurting. I don?t know if I had a fever or not. I was so tired, but shaking with chills and body hurting I couldn?t go to sleep. Put more blankets on and took 2 Tylenol. I was able to eventually go to sleep. I felt better in the morning but was very tired during the day. It felt like I had covid again. I had the same symptoms then. I tested positive for covid November 27 at a rehab/nursing home where I was sent after foot surgery.

Other Meds: Pantoprazole and Levothyroxine

Current Illness:

ID: 0991519
Sex: F
Age: 74
State: CO

Vax Date: 01/13/2021
Onset Date: 01/21/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Diflucan

Symptom List: Pharyngeal swelling

Symptoms: Right arm at site started itching, was red and had slight swelling - this lasted 24 hours.

Other Meds: Fluticasone spray, Flonase spray, Atorvastatin, Monteleukast, Ramipril, Methimazole, Levothyroxine, Pepcid, Xyzal, Vitamin D3 tablet.

Current Illness: None

ID: 0991520
Sex: F
Age: 40
State: ME

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 02/01/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Diarrhea, 1 1/2 hour after vaccination. Resolved without treatment. Sore arm started about 8 hours after vaccination. Treated with ibuprofen following morning.

Other Meds: Levothyroxine, Ferrous Sulfate, Docusate Sodium

Current Illness: None

ID: 0991521
Sex: F
Age: 39
State: KY

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Rash to entire arm that vaccine was administered in

Other Meds:

Current Illness:

ID: 0991522
Sex: F
Age: 78
State: NC

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Latex

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

Symptoms: Intense headaches starting night of injection, lasted for days. I felt weak, pains in my legs ankles and arches. Stomach pain, and feeling lethargic. I took Tylenol but i think that disturbed my stomach. Still having soreness in my legs and ankles and still don't have energy today.

Other Meds: Triamterene, turmeric, allergy pill , red yeast rice, multivitamin, vitamin D

Current Illness:

ID: 0991523
Sex: F
Age: 15
State: GA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient had Rash appear all over body. Patient was treated with Benadryl and anti-itch cream and symptoms resolved over the next few days

Other Meds:

Current Illness:

ID: 0991524
Sex: F
Age: 45
State: MO

Vax Date: 01/21/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: horses

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

Symptoms: large bundle of lymphadenopathy in the left axilla on 01/22/2021 and I developed a Covid rash last eve. 01/31/2021

Other Meds:

Current Illness:

ID: 0991525
Sex: F
Age: 90
State: WI

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Family member reported that after receving first injection patient went home and a few hours later became lethargic to the point where she did not know she had an injection, could not answer questions and could not feed herself. Patient had extreme lethargy and did fall once. This lasted 24 hours.

Other Meds:

Current Illness: Diabetes, has a pacemaker

ID: 0991526
Sex: M
Age: 64
State: MN

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/01/2021
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: Moderna COVID-19 Vaccine EUA Reddish Blotch @ 2-3" in Diameter at Site of Vaccine-appeared 2 days after vaccine Swelling at the same area -continues as this is day 11- area not warm to touch or causing any pain just swollen

Other Meds: Atenolol 50mg Nature Made Triple Flex dietary supplement

Current Illness: none

ID: 0991527
Sex: M
Age: 32
State: CA

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Fever, chills , sore throat, fatigue.

Other Meds:

Current Illness:

ID: 0991528
Sex: F
Age: 119
State: VA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/01/2021
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: Fever, chills, body aches, exhausted, nausea

Other Meds:

Current Illness:

ID: 0991529
Sex: U
Age: 76
State: NY

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: nome

Symptom List: Ear pain, Hypoaesthesia

Symptoms: We are useing the Drive thru method at Airport. Client recieved COViD 19 vaccine and after getting it drove to Recovery Room. Client stated in Recovery Room she felt a little N/. She wanted to stand uo, so she did and then drank some water. She felt better and we made her sit in the 30 minute line. After the 30 min, were over, she felt better and went home. Told her if she had any othr problems to call her Dr.

Other Meds: vitamins Ca Tables

Current Illness: nome

ID: 0991530
Sex: F
Age: 58
State: MN

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient received the Pfizer COVID vaccine dose #1 on 1/14/2021 and within 5 minutes of administration the patient developed itching and a flushed feeling, tingling lips, racing heart rate, and headache. Patient reports these symptoms lasted several hours and then resolved.

Other Meds:

Current Illness:

ID: 0991531
Sex: M
Age: 35
State: AK

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Nickel

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

Symptoms: 35 yo M w/PMH of asthma, allergies, w/acute onset of lower chest/epigastric pain, nausea, cough, and feeling flushed within 30 minutes of Pfizer dose #1. T: 98.3 F, BP: 139/105, HR : 89, Ox 98% RA. CO is well appearing, not diaphoretic, w/clear lungs and normal heart sounds. No rash. PO Benadryl given at 13:07 PM d/t cough and CO observed until 13:24 w/resolution of chest discomfort and throat irritation. Tolerating sips of water. ER precautions discussed.

Other Meds:

Current Illness:

ID: 0991532
Sex: M
Age: 43
State: AL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
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: Fish

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

Symptoms: 101.6 Degree Temperature/ Chills/ Severe Muscle Aches and Pain/ Headache/ Redness and Swelling at Site of Shot/ Tiredness.

Other Meds: Suboxone 8mg, Adderall 30mg

Current Illness: N/A

ID: 0991533
Sex: F
Age: 42
State: VA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: fish, shellfish, celery

Symptom List: Unevaluable event

Symptoms: Intense thirst lasting 24 hours, abnormal bowel evacuation, mild loss of sensitivity to smells and tastes

Other Meds: Paxil, Protonix, Multivitamins, calcium, vitamin d, vitamin b12, allergy OTC

Current Illness: psoriasis, lichen planus

ID: 0991534
Sex: F
Age: 79
State: NC

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/01/2021
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: Dizzy and light headed, mild nausea, weak and tired with occasional shortness of breath. Elevated blood pressure causing headaches. I have been unable to send this via the phone/text. I am exhausted from this continued distress. Normally very active and healthy.

Other Meds: Amlodipine, D3, Calcium 600mg +400 D3, .81 aspirin every other day

Current Illness: none

ID: 0991535
Sex: M
Age: 34
State: PA

Vax Date: 01/13/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Pain

Symptoms: Fever, rapid heart rate, and flu like symptoms within 6 hours of receiving vaccine. Extreme abdominal pain coupled with fever began again in the night of 01/26-01/28/2021. Extreme abdominal pain continued and I had to have emergency appendectomy on 01/30/2021.

Other Meds: N/A

Current Illness: N/A

ID: 0991536
Sex: F
Age: 57
State: LA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Demerol, Vicodin, Norco,

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient states felt hot flashes following injection in waiting room went home became lethargic that evening having difficulty answering questions at night patient states she became apneic and husband had to watch her breathe. Did not go to the ER. Patient states fully recover the next day and fully recovered 5 days later. No rashes fever generalized weakness that resolved.

Other Meds: vit D3, atorvastatin, hydrocholorthiazide, losartan, metformin, jardiance, soliqua, aspirin, biotin,

Current Illness: COVID + on 1/12/2021

ID: 0991537
Sex: F
Age: 42
State: VA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Body aches, fever = 101.5, swelling in arm, soreness in arm

Other Meds:

Current Illness:

ID: 0991538
Sex: F
Age: 47
State: GA

Vax Date: 01/21/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
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: Environmental allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Even though I received the vaccine on 1/21/2021, I noticed a slight knot on my shoulder on 1/31/2021. There is no pain but I do feel it. I only felt slight discomfort after the shot but nothing noticeable. I put some ointment and ice on it and it has went down some. I am scheduled for my 2nd does on 2/18/2021.

Other Meds: Spironolactone, Xyzal, Multivitamin, Vitamin D, Turmeric, Cinnamon

Current Illness: None

ID: 0991539
Sex: M
Age: 86
State: TN

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient experienced audible crackles and low oxygen levels starting around 5:30pm the date of the vaccine. His heart rate spiked to 112bpm and he was given oxygen and Lasix 40mg. He was sent to the hospital and diagnosed with acute systolic CHF

Other Meds: unknown

Current Illness:

ID: 0991540
Sex: F
Age: 89
State: AZ

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/01/2021
Hospital: Y

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

Symptoms: Systemic: Vomiting-Medium, Systemic: Other- low blood pressure-Medium

Other Meds:

Current Illness:

ID: 0991541
Sex: F
Age: 38
State: PA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: After receiving the Covid-19 Moderna vaccine, patient was able to walk to the observation area. after few minutes reported throat tightness and dizziness. Lower extremities were elevated. BP 122/80, P-104, pulse ox 99%. Did report tingling in lips and throat. 122/90, HR 119, Resp 18. pulse ox 99%. Administered 50 mg liquid diphenhydramine, per standing order. 18 min later- VS improved. 124/80, HR-81, pulseox 99%, dizziness resolved, throat tightness resolved

Other Meds:

Current Illness:

ID: 0991542
Sex: F
Age: 50
State: WA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Penicllin, bee venom

Symptom List: Injection site pain

Symptoms: Soreness/swelling at injection site, fever 102 degrees Fahrenheit for 24 hours, severe chills at times, headache, mental fogginess/forgetfulness, generalized aches.

Other Meds: Multivitamin, Vit D3 -2000 iu, Vit B6, Vit B12, Magnesium -100mg, GABA -500mg, Omega 3

Current Illness: N/A

ID: 0991543
Sex: F
Age: 65
State: TX

Vax Date: 01/23/2021
Onset Date: 01/30/1921
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Sulfa drugs Erythromycin

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

Symptoms: A week later had some itching and an area of redness around injection site.. Had soreness after injection. No redness. Some ticking on and off after injection.

Other Meds: Vitamin c zinc.lysine.b complex.cinnamon..Zyrtec 5 mg

Current Illness: Seasonal allergies

ID: 0991544
Sex: F
Age: 40
State: VA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
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: Fever, HA, body aches

Other Meds:

Current Illness:

ID: 0991545
Sex: F
Age: 40
State: GA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
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: 102 Fever, headache, body aches, chills, sweats

Other Meds:

Current Illness:

ID: 0991546
Sex: F
Age: 98
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
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: dizziness upon awakening 2 days after receiving vaccine. Has not experienced an episode like this prior to the vaccine

Other Meds:

Current Illness:

ID: 0991547
Sex: F
Age: 59
State: WI

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
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: N/A

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

Symptoms: Patient developed pruritis on arms/back and felt some minor throat tightness. Minutes later, itching had spread but no tightness in airway. Patient was sent to ER for further evaluation and discharged without complication after brief observation.

Other Meds: Albuterol, fluticasone nasal , levothyroxine , fluticasone/salmeterol , olopatadine

Current Illness: N/A

ID: 0991548
Sex: F
Age: 27
State:

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Gluten

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

Symptoms: 1/27 , 13 hours after vaccination (dose #2), 2:30am- strong rigors. Temp 102 1/27-1/28 SEVERE pain on the top and back of head, neck pain, and back pain. Pain untouched by consistent 1000mg tylenol and 600mg iburpofen. Also, generalized joint and muscle pain + weakness. I was unable to sit up these days. 1/27-1/29 Fevers for 3 days straight. Unable to get temperature below 99.8 even with Tylenol. Alternated 600mg Ibuprofen and 1000mg Tylenol. 1/28-1/29 Diarrhea - 5-6 bowel movements

Other Meds: NONE

Current Illness:

ID: 0991549
Sex: F
Age: 62
State: ME

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/01/2021
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: PCN

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore arm at injection site for 12 hours; no treatment, resolved over time

Other Meds: none

Current Illness: N/A

ID: 0991550
Sex: F
Age: 60
State: CO

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Cellulitis left arm requiring antibiotics to treat

Other Meds: Diovan

Current Illness: None

ID: 0991551
Sex: M
Age: 40
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Rash about 4 inches wide around the injection site. It is hard and hot to the touch. The rash is very itchy.

Other Meds: None

Current Illness: None

ID: 0991552
Sex: F
Age: 67
State: GA

Vax Date: 01/23/2021
Onset Date: 01/26/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Soy, Lactose

Symptom List: Pain in extremity

Symptoms: I received the 1st shot of the Moderna's Covid-19 vaccine on 1/23/21 at the Pharmacy. Three days later I started experiencing sharp abdominal cramps with gas that I couldn't expel and abdominal bloating. I am still experiencing this 6 days later from when it started. I feel better when laying down but when I stand up I have this really heavy feeling in my lower abdomen. I also experience abdominal cramps not long after eating. I am not constipated. In fact, I've been having a lot more bowel movements which is not normal for me. Also, on Sunday, 1/31, eight days after injection, I developed a red patch that was very warm on my left arm where I received the injection and a headache. The red patch is still there. I'm concerned about this and wonder if this may be related to one of the ingredients in the vaccine, i.e., polyethylene glycol. I have reported this to my M.D. this morning and they are asking me to come in.

Other Meds: Bupropion 100 mg, Escitalopram 10mg, Centrum, Caltrate, Folic Acid 400 mcg

Current Illness: None

ID: 0991553
Sex: F
Age: 59
State: NY

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: extreme arm pain---goes down to fingers. Also a general feeling of being "off" and dizzy spell/vertigo post vaccination day 5.

Other Meds:

Current Illness:

ID: 0991554
Sex: F
Age: 119
State: VA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
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: Hives starting 2 hours after vaccine administration, itchy, unable to sleep, fatigue, tiredness Allergy medication provided temporary relief

Other Meds:

Current Illness:

ID: 0991555
Sex: F
Age: 65
State: NY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Lisinopril Latex

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

Symptoms: Paresthesias of left hand, general malaise, fatigue, ? HTN urgency ? however missed HTN med doses at the time of evaluation

Other Meds: acetaminophen 325 MG Oral tablet aspirin 81 MG Oral EC tablet atorvastatin 40 MG Oral tablet metoprolol succinate 50 mg 24 hr ER

Current Illness: None

ID: 0991556
Sex: F
Age: 41
State: VA

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 02/01/2021
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: Penicillin

Symptom List: Vomiting

Symptoms: Visible rash on left arm forearm, appeared approx. 1 week after second injection. Not relieved with OTC Zyrtec or Benadryl cream

Other Meds: Multivitamin

Current Illness: None

ID: 0991557
Sex: M
Age: 66
State: NC

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 1/26/21- Tuesday. 5:00PM Received vaccine in upper right arm. Monitored at site for 30 minutes, no adverse reactions. Released. Drove home about 20 minutes from site. 7:00PM to 10:00PM ? Had dinner, began to feel soreness at injection site. Soreness continued to increase throughout the evening. 10:00PM Went to bed at 10PM, had difficulty going to sleep due to injection site soreness. Restless. 11:00PM ? 1:45AM Began to get more intense chills, numbness in legs, some sweating, shaking. Could not get warm. Could not sleep. Very uncomfortable. Continued to escalate. 2:00AM Woke up my girlfriend (partner) in bed next to me and she observed the following. Sat up in bed. Complaining of feeling flush, sweating, nauseated. She said I seemed to ?black out?, starting at her, breathing loudly. She had to ?shake me? to get me to respond back to consciousness. She told me I felt very clammy, and pale ? felt quite warm, I complained of a headache. Event last around 30 minutes then I began to get more chills. I took some Ibuprofen for the headache. Eventually was able to go back to sleep, but some not a restful evening. 1/27/21 ? Wednesday Awoke around 7:30AM ? Still a little pale, lethargic, drained with headache most of the day. Ate normal meals. Injection site soreness continued for 2 more days. Subsided 1/29/21. 1/29/21 ? 1/31/21 Continued to improve. No more adverse reactions, no headache, no chills, no elevated temperature. 2/1/2021 Back to normal.

Other Meds: fluoxetine hcl, 10 mg. once daily omeprazole dr 20mg, once daily

Current Illness: none

ID: 0991558
Sex: F
Age: 46
State: TX

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 02/01/2021
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: contrast dye, dust, trees

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

Symptoms: redness to insertion site 2inx2.5in, soreness and cough

Other Meds: zyrtec, vitamins

Current Illness: none

ID: 0991559
Sex: F
Age: 93
State: NY

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
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: Pt states that at 11:13 her right hand started feeling tight. Pt stated she had the vaccine administered in her left arm. Pt's Vitals are stable. Stroke scale negative. Positive CMS in extremities. Pt was cleared to go home by onsite Doctor.

Other Meds: Toresimide, Crestor, Potassium, Lavoxel, Alpurinol. Paxel, Baby ASA.

Current Illness: None

ID: 0991560
Sex: F
Age: 46
State:

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Redness, swelling and heat at injection site 3 days after injection, 4?x 3?

Other Meds:

Current Illness:

ID: 0991561
Sex: F
Age: 40
State: ME

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/01/2021
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: Sore arm began evening of vaccination (not as sore as with first dose in series). Did not treat. Mild headache began evening of vaccination, advanced to severe headache throughout the next day. Treated with Ibuprofen 24 hours after vaccination. Pelvic/lower back/neck aches began evening of vaccination, around 10pm. Pain was significant enough to cause insomnia during the night and did not improve during the day after vaccination. Pain improved considerably after dose of ibuprofen mentioned above.

Other Meds: Levothyroxine, Ferrous Sulfate, Docusate Sodium

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm