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: 0995963
Sex: M
Age: 60
State: NY

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 02/02/2021
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: Oval bright red, lesion immediately adjacent to injection site over left deltoid with mild to moderate swelling. Started app. 3"x1", over 3.5 days grew to app. 7"x2.5". Extremely severely itchy, not relieved by Benadryl cream or hydrocortisone ointment. Very temporarily relieved by applying ice. On day 4 lesion has mostly faded, swelling is reduced and itching is now mild and intermittent.

Other Meds:

Current Illness:

ID: 0995964
Sex: M
Age: 56
State: CA

Vax Date: 01/14/2021
Onset Date: 01/31/2021
Rec V Date: 02/02/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Bells Palsy occurred on 1-31-2021 after receiving the shot on 1-14-2021. No other issues or illness before or after getting the vaccine which would explain getting Bells Palsy. Have not been ill or seen doctor except for regular check-ups as necessary.

Other Meds: Losartan Pot/Hydrochlor Othiazide Tab 100-25MG Atorvastatin Calcium Tab 40MG

Current Illness: None

ID: 0995965
Sex: F
Age: 71
State: CA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 02/02/2021
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: Cannot take Stadol or penicillin.

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

Symptoms: It turned red at the time of the vaccine up to the shoulder, red. She went to the doctor who did not feel that it was the shot, but injection given wrong but was concerned that it might be infected. Was nauseated, felt sick, chills. Her energy level is still not there, and the entire arm hurts.

Other Meds: Synthroid, Amlodipine, Hydrochlorathiazide, potassium chloride.

Current Illness: None.

ID: 0995966
Sex: F
Age: 78
State: NM

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

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

Lab Data:

Allergies: None known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Developed a small red spot on skin near the injection site. It has continued to expand where it covers a much larger area and has expanded around my arm to the under side. It is not painful, but uncomfortable. Continues to expand, not decrease.

Other Meds: Bisoprolol Fumarate 10MG - one per day Valsartan/HCTZ 160MG/125MG One per day Ibuprofen - 400mg (dental work) Occasionally as needed Also I took 1 Excedrin during this time for a headache Take Centrum Silver & Caltrate daily

Current Illness: Only a tooth extraction with antibiotic & ibuprofen & tylenol

ID: 0995967
Sex: F
Age: 54
State:

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 02/02/2021
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: Fever X24 hours at 100.0, pain at site 48 hours, headache 24 hours, muscle aches X 48 hours and fatigue X 48 hours

Other Meds:

Current Illness:

ID: 0995968
Sex: F
Age: 76
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/02/2021
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: Sulfa antibiotics; Macrolides/Ketolides

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

Symptoms: Patient developed chills about 9pm the night of the vaccine. She ran 101 temperature, and ached all night. She took some Tylenol when the chills started and again in the morning. She said she ran fever till about noon, and then later took some Ibuprofen. She is feeling better, but just fatigued.

Other Meds: Montelukast 10mg; Meloxicam 15mg.; Azelastine 0.1%

Current Illness:

ID: 0995969
Sex: M
Age: 75
State: CA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/02/2021
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: Maybe fosinopril,

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Rash on stomach, leg, arm. Very short feeling in throat. Have esophagus issues so do not know if that was from that. Do not think so. Rash has come and gone over few days.

Other Meds: Metoprolol, Flecainide, Hydrochlorothiazide, Fosinopril, Allopurinol, Omeprazole, Eliquis, Vitamin B Complex Vegan, Vitamin D3, BP8 Probotics, Tamsulosin

Current Illness: High Blood Pressure, Bigeminy, Atrial Fibbulation

ID: 0995970
Sex: F
Age: 24
State:

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/02/2021
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: Developed chills and body aches by 5:30 pm of the day of vaccine. Fever with a max of 101.1 orally by that evening. All symptoms resolved 24 hours after they began.

Other Meds: Levothyroxine, fluoxetine, magnesium 500 mg OTC, vitamin d OTC, probiotic

Current Illness: None

ID: 0995971
Sex: F
Age: 36
State: MA

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 02/02/2021
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: received the Moderna Covid-19 vaccine 8 days ago (Friday 1/8/21) and yesterday (Friday 1/15/21) developed itching and hives at the site. No other symptoms and I otherwise feel well.

Other Meds:

Current Illness:

ID: 0995972
Sex: M
Age: 81
State: CA

Vax Date: 01/19/2021
Onset Date: 01/26/2021
Rec V Date: 02/02/2021
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: Redness at shot location Swelling Hot to the touch Rx ( antibiotic was prescribed by doctor It happened a week after the shot.

Other Meds:

Current Illness:

ID: 0995973
Sex: F
Age: 34
State: CT

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: Muscle aches, fever, chills

Other Meds: Bupropion Methylphenidate OCP

Current Illness: None

ID: 0995974
Sex: M
Age: 56
State: MA

Vax Date: 01/23/2021
Onset Date: 01/26/2021
Rec V Date: 02/02/2021
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: Severe long term headache

Other Meds: Losartan Venlafaxine Baby Aspirin

Current Illness:

ID: 0995975
Sex: M
Age: 71
State: GA

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 02/02/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Received Moderna COVID-19 vaccine on 01/14/2021. Called on 01/22/2021 to report redness and itching to vaccine site which patient noticed on 01/21/2021.

Other Meds:

Current Illness: unknown

ID: 0995976
Sex: F
Age: 32
State:

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/02/2021
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: Morphine

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

Symptoms: Nausea, warm with symptoms worsening with time Pt went to urgent care.

Other Meds:

Current Illness:

Date Died: 01/27/2021

ID: 0995977
Sex: M
Age: 51
State: VA

Vax Date: 01/19/2021
Onset Date: 01/25/2021
Rec V Date: 02/02/2021
Hospital: Y

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

Lab Data:

Allergies: Aspirin, NSAIDs.

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

Symptoms: Lethargy/altered level of consciousness lead to hospital admission. Multiple interventions during hospitalization. Final hospital diagnoses: Acute respiratory failure with hypercapnia, acute pansinusitis.

Other Meds: Latest medication list available to us 12/18/19, due to record being deleted after death: CORN STARCH POWDER RED AREA BETWEEN 3RD AND 4TH FINGER RIGHT HAND - APPLY CORN STARCH FOUR TIMES DAILY - FACILITY TO SUPPLY ACYCLOVIR 200MG CAPSULE 1

Current Illness: N/A

ID: 0995978
Sex: F
Age: 54
State: NY

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

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

Lab Data:

Allergies: NKDA at the time

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

Symptoms: Patient with a subjective complaint after first covid vaccine where patient felt a hot flushed feeling across chest and throat and face of which patient did not self medicate nor seek treatment. Patient was given Benadryl 25mg IM pre vaccination at 12:39pm, vaccine given at 1:00pm and while being observed by vaccination team, patient become diaphoretic, pale, "throat tightness" that was appreciated to be swollen, and difficulty swallowing at 1:11pm at which point Epinephrine 0.3mg was given IM to L anterior thigh. Patient's vitals were the following: BP 148/86, HR 124 bpm. After epinephrine, patient's throat swelling and breathing much improved, and able to swallow. Patient was then transported to ED in wheelchair via wheelchair. Patient was given Dexamethasone 10mg IV, Pepcid 20mg IV, and Benadryl 25mg IV. Only complaint that patient had during ED visit was palpitations of which HR did regulate to 86 bpm, BP 149/70. Patient was discharged on 1/29/2021 at around 4:50pm as patient was fully asymptomatic and able to ambulate on own. Sent home with prednisone 40mg po daily x 7 days, pepcid and benadryl otc. Advised to f/u with PCP in 1-2 days and suggested possible allergy testing.

Other Meds: Benadryl 25mg IM

Current Illness: 1/11/2021 Chest Pain r/o CAD 1/21/2021 GERD, Constipation

ID: 0995979
Sex: M
Age: 63
State: NY

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

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

Symptoms: Began experiencing severe chills, headache, joint ache, fatigue, muscle ache, fever 12 hours after injection. Symptoms continued for additional 48 hours. Unable to report to work for that time.

Other Meds: Finasteride 5mg, Alfuzosin 10mg

Current Illness: None

ID: 0995980
Sex: F
Age: 39
State: GA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/02/2021
Hospital:

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

Lab Data:

Allergies: codeine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Starting around 12AM, fever 100-102 w/ Tylenol. Body aches, fatigue, chills, tightness in chest, feels like flu. Ended around noon the following day. Fatigue until 1/27/2021.

Other Meds: Synthroid, Effexor, Vitamin D, B complex, Flonase

Current Illness: none

ID: 0995981
Sex: F
Age: 29
State: MA

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

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

Lab Data:

Allergies: n/a

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Was accidentally given a different second dose for the COVID-19 vaccine than the first dose by the nurse.

Other Meds: Aderrele 15 mg/ daily FLUOXETINE 20 mg / daily

Current Illness: n/a

ID: 0995982
Sex: F
Age: 26
State: IL

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

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

Lab Data:

Allergies: Ferrous sulfate

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

Symptoms: Shortness of breath, chills. tingling, metallic taste, nausea, headache

Other Meds: Metoprolol, lo lost in, albuterol, dulera

Current Illness: None

ID: 0995983
Sex: F
Age: 66
State: FL

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

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

Symptoms: extreme tiredness, Malaise with body and joint aches, asthma minor flare up, wheezing that woke me up during the night. Sore L upper arm

Other Meds: Sertraline 100mg Prilosec 40mg Gabapentin 100mg / 2caps Xanax 1mg at night only. Benadryl 25mg at night only Cetirizine 10mg a day Multivitamins Calcium Vita D3 5000 units Glucosamine Chondroitin Vitamin C 1000 mg a day Advair Inhaler

Current Illness: None

ID: 0995984
Sex: F
Age: 0
State:

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

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

Lab Data:

Allergies: Morphine

Symptom List: Unevaluable event

Symptoms: Patient had tenderness and pain at the time of the vaccine on 1/31/21. On 2/1/21, patient woke with severe headache in morning which persisted throughout the day; also had fatigue and body aches, found it hard to move arm , the site was inflamed and swollen . Patient napped all day. Today, 2/2/21 patient's left arm pain is mild and getting much better; headache, body aches, and fatigue have gone away.

Other Meds: Anti depressants, but has not taken any for a month

Current Illness: No

ID: 0995985
Sex: F
Age: 63
State:

Vax Date: 01/28/2021
Onset Date: 02/01/2021
Rec V Date: 02/02/2021
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: Moderate muscle aches, fatigue, headache and nausea

Other Meds:

Current Illness:

ID: 0995986
Sex: M
Age: 73
State:

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/02/2021
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: rosuvastatin amlodipine Ezetimibe pravastatin

Symptom List: Injection site pain, Pain

Symptoms: The patient developed shortness of breath 5 hours after receiving the Covid 19 vaccine on 1/29/21.He had "heavy wheezing " and finally went to the local ER the next day around 6 pm. He was treated with prednisone oral and felt immediate relief.

Other Meds: metformin,amlodipine,lisinopril,atenolol,aspirin

Current Illness:

ID: 0995987
Sex: F
Age: 19
State: KS

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 02/02/2021
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: Patient experienced slight throat tightening shortly after receiving vaccine.

Other Meds:

Current Illness:

ID: 0995988
Sex: F
Age: 36
State: OR

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

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

Symptoms: Numbness and pain in left arm 45 mins after injection, headache Numbness in left arm and hand everyday since injection Numbness in right arm, hand, foot day after injection and intermittent since then. Consistent Numbness in right side face, right arm, right leg and right foot on day 4 after injection , went to emergency department

Other Meds: armour thyroid 60 mg

Current Illness:

ID: 0995989
Sex: F
Age: 67
State: AK

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/02/2021
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: cephalexin - anaphylaxis, rosuvastatin - "pain", penicillin - hives

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient reported to vaccine clinic to receive first dose of Pfizer Covid Vaccine. After receiving vaccine patient was sitting in observation area. Patient asked RN who was in observation area if it was normal to feel chest pressure after the vaccination. RN took patient to ER for full workup for chest pain. All labs within normal limits. Cardiology was consulted. Awaiting consult notes

Other Meds: Unknown

Current Illness: Unknown

ID: 0995990
Sex: F
Age: 87
State: OH

Vax Date: 01/21/2021
Onset Date: 01/27/2021
Rec V Date: 02/02/2021
Hospital:

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

Lab Data:

Allergies: fentanyl, morphine, Percocet

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: pt states she has swelling under the skin around the injection site. The spot is 3 x 2 1/2" in size and it red and itching. Pt has not contacted her PCP at this time.

Other Meds: sertraline HCL 50 mg x1, amlodipine besylate 10 mg, a Synthroid 150mcg x 1, baby aspirin 81 mg, multivitamin, fish oil, rosuvastatin calcium 500 mg x 3 times weekly, calcium chews 650 mg. Vitamin D

Current Illness: none

ID: 0995991
Sex: F
Age: 44
State: TX

Vax Date: 12/29/2020
Onset Date: 01/01/2021
Rec V Date: 02/02/2021
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: A couple days the vaccination I started having throat pains but it diminished on its own. On 1/2 I felt totally normal but on 1/3 about 7:30am I woke up with major pain in my throat but after 20 min it faded away on its own also. But about 3pm my throat got scratchy but faded away away. About 6pm I got a dry cough and by 9pm my enitre body was hurting so bad, I had a fever of 100.8. I went to the night clinic the next night and still had a fever of 101.4. On 1/4 I still had a 100.8 fever and had a lot of nasal congestion causing me to have to breathe with my mouth open. I felt so stuffy and still had the body aches and a slight cough so by that Tues 1/5 I returned back to the Clinic with a temp of 100.4 and body aches so I was given COVID test which then came back positive.

Other Meds: no

Current Illness: no

ID: 0995992
Sex: F
Age: 37
State: AL

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 02/02/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Neomycin, Penicillins, Sulfa drugs

Symptom List: Nausea

Symptoms: Pt received covid vaccine #1 on 11JAN2021 in left deltoid. 48-72hrs later pt reports noticing a small spot or bump on her left arm. The size increased to the size of a dollar bill. Pt denies any fever. Pt developed an irregular urticarial rash that was raised, mildly erythematous to her left deltoid.

Other Meds: Zofran, Multivitamin, Prilosec, Loratadine, Tylenol, Chlorthalidone, Fluoxetine

Current Illness: Obesity (MDD, GAD), HTN, Preeclampsia, gastric sleeve. GERD, High Cholesterol, PCOS, Infertility hx of clomid, HSG 2009

ID: 0995993
Sex: F
Age: 91
State: OK

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

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

Lab Data:

Allergies: NKA

Symptom List: Injection site pain

Symptoms: FIRST THING WHEN GETTING UP IN THE MORNING, FELT DIZZY, NAUSEA AND VOMITED 3-4 TIMES, Increase in Blood Pressure; Treated with Phenergan for N & V; and rest, fluids. Lasted just this day, but wasn't back to normal for 2 days.

Other Meds: Potassium; Mobic; Plavix; Toprol; Lipitor; I-CAPS; B12; Vitamin D; Fish Oil; Meclizine;

Current Illness:

ID: 0995994
Sex: F
Age: 67
State: CA

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

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

Lab Data:

Allergies: Seclor

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

Symptoms: A 2" in diameter red rash formed at the vaccination site. Rash is red, slightly hard and slightly warm. We have not treated it.

Other Meds: Estra 0>%mg/noreth0.1mgTb Low Ttr, Advil (after the vaccine)

Current Illness:

ID: 0995995
Sex: M
Age: 51
State: VA

Vax Date: 01/21/2021
Onset Date: 01/27/2021
Rec V Date: 02/02/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Listed in record as: Anafranil, Benadryl, Haldol, Lamictal, penicillin, Risperdal, Zithromax, Keppra, Tegretol, polymyxin-B sulfate.

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

Symptoms: Fever. Hypoxia. SOB. Hospital admission diagnoses: Aspiration, right lower lobe pneumonia, hyponatremia.

Other Meds: ACETAMINOPHEN OUTER UD 650MG/20.3ML SOLUTION 20.3 ML (650MG = ONE DOSE CUP) VIA GAST-TUBE EVERY 6 HOURS AS NEEDED FOR PAIN OR FEVER - MAX ACETAMINOPHEN 3-4GM DAILY - CHECK DAILY TOTAL 650MG/20.3ML SOLUTION 7/31/2020 ACETAMINOPHEN OUTER

Current Illness: Upper respiratory congestion 1/11/2021.

ID: 0995996
Sex: F
Age: 17
State: MA

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

Symptom List: Tremor

Symptoms: COVID-19 Moderna Vaccine clinic held at facility for adults with autism and developmental disablities. Client getting vaccine came in with PCA (who was also a family member). There were several appointment no-shows due to a snow storm and when PCA and family asked about getting a vaccine and were offered one by registration team. The registration team and nurse administering the vaccine did not realize the PCA was not yet 18 (was 17 years and 6 months). When error was realized the next day the family was notified and they called their primary care doctor. No adverse outcomes noted at this time.

Other Meds: unknown

Current Illness: none

ID: 0995997
Sex: M
Age: 65
State: VA

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/02/2021
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: Erythema, Pruritus

Symptoms: injection site pain, headache, muscle pain, chills, joint pain, and nausea. Started 0300 02 Feb 21, ended 1000 02 Feb 21.

Other Meds: N/A

Current Illness: None

ID: 0995998
Sex: F
Age: 49
State: CA

Vax Date: 01/06/2021
Onset Date: 01/12/2021
Rec V Date: 02/02/2021
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: sulfa medication doxycycline upsets my stomach

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

Symptoms: itchy/painful welt patch about 3 inches in circumference around injection site. delayed onset, appeared about 5 or so days after the first vaccine. had typical soreness for about three days, but this patch came after the soreness had disappeared. I have read from the news stories that this is referred to as "COVID Arm" and it appeared to be similar to the picture featured in the article

Other Meds: birth control pill

Current Illness: none

ID: 0995999
Sex: F
Age: 52
State: GA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/02/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Received 2nd dose of Moderna COVID-19 vaccine on 01/27/2021 at 0800 am. Called on 01/28/2021 to report dry mouth, nausea/vomiting, body aches, weakness and chest tightness that began after lunch on same day. by 5:00 PM she began to run fever and pulse 120. Reports symptoms resolved in 24 hours.

Other Meds:

Current Illness: unknown

ID: 0996000
Sex: F
Age: 74
State: IL

Vax Date: 01/15/2021
Onset Date: 01/24/2021
Rec V Date: 02/02/2021
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: Penicillin, sulfa, tetracycline, macrobid, floxin, plaquinil, Pneumonicocal vaccine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Hives on inner elbows, both arms

Other Meds: Lexapro, Xanax, methenamine Hippurate, atorvastatin

Current Illness: None

ID: 0996001
Sex: F
Age: 47
State: WI

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 02/02/2021
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: Client stated she developed some itching and a flat rash on the vaccinated arm about one week after the injection. She did not contact a medical provider as she does currently not have one. She denied taking any medications to treat the symptoms.

Other Meds: None

Current Illness: None

ID: 0996002
Sex: F
Age: 31
State: CA

Vax Date: 12/23/2020
Onset Date: 01/05/2021
Rec V Date: 02/02/2021
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: Sore left arm with tenderness both series for 2 days . Two weeks after first vaccine, right-sided eachaches with mild headaches on right began. Prescribed ofloxacin 0.3% otic solution for a week. However, after this and my 2nd vaccine it progressively worsened with pain radiating to right jaw, more persistent and sharp right-sided headaches, blockage of hearing out of my right ear, hearing a pulsatile artery near my right ear mainly at night, and worsening earaches. Self-removed ear wax with an Asian ear pick, and the sharp headaches became intermittent mild headaches and earaches more mild. I was able to hear better but after a few hours my hearing was blocked again. I removed more wax again, but hearing was blocked again after a few hours, but this time, jaw pain went away. Went to see an ENT MD. He removed more right earwax and prescribed me "Neomycin and Polymyxin B Sulfates and Hydrocortisone 1% Otic suspension" for 10 days and sulfameth/trimethoprim 800/160MG TB (10 tablets) over 5 days. After a few days, I was completely relieved of all my symptoms. He then prescribed me another ear solution for the yeast in my ears, which I haven't started yet. Additionally, after my second vaccine, I had a cramp in my upper mid back for a day and weakness/fatigue for 2 days.

Other Meds: Triamcinolone acetonide 0.1%

Current Illness:

ID: 0996003
Sex: F
Age: 65
State:

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

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

Lab Data:

Allergies: avocado, mango, various OTC eye creams (no brand identified)

Symptom List: Pain in extremity

Symptoms: Approximately 30 minutes after being vaccinated, client noted tongue felt thick and slight throat sensation of feeling thick. Color good, no difficulty breathing. Given Benadryl 50 mg while at clinic, assessed by EMS and recommended being evaluated at hospital. While at hospital symptoms did not worsen but was given IV Pepcid and Prednisone. Given prescriptions for oral Prednisone and Pepcid to take at home. Also given a prescription for an EpiPen. Sent home. Reports that 30 hours after first reaction noted return of symptoms tho not as intense as originally. After two hours was feeling normal and has had no reoccurence of symptoms.

Other Meds: None

Current Illness: none

ID: 0996004
Sex: F
Age: 46
State: OH

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/02/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: The vaccine was administered incorrectly. The IM injection was given too high on the left arm. The injection immediately caused significant pain in the left shoulder which worsened throughout the day and into the following day. The significant pain in the left shoulder has persisted and is accompanied by decreased AROM, decreased strength, and sleep disruption. Treated with Ibuprofen 800mg q8h and ice with minimal benefit. Saw PCP on 01/29/2021 who recommended continuation of same and ordered a PT referral. Was unable to work for 3 days due to this complication.

Other Meds: Sumatriptan 100mg daily PRN Fluoxetine 20mg daily

Current Illness: None

ID: 0996005
Sex: M
Age: 24
State: MA

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 02/02/2021
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: had an allergy to amoxicillian as a child and severe environmental allergies

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

Symptoms: next day through the following week List of symptoms includes: headache, temp 102.5 - 101. for 5 days , nausea, fatigue, body aches

Other Meds: none

Current Illness: dx with COVID-19 on 12/24/2020

ID: 0996006
Sex: M
Age: 74
State: TX

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 02/02/2021
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: sore arm, fever 100.5 degrees, fatigue. Took Tylenol. Symptoms gone after second day

Other Meds: none

Current Illness: none

ID: 0996007
Sex: F
Age: 68
State: MI

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/02/2021
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: "Moderna- Covid-19 Vaccine EUA". I waited the 15 minutes after the shot. I arrived home and started watching tv. I became extremely tired around 1:15. (Received shot at 11:55). I slept for about an hour. My arm is a little sore.

Other Meds: VITAMIN D3, E, ONE A DAY FOR SENIORS METOPROLOL

Current Illness: NONE

ID: 0996008
Sex: F
Age: 61
State:

Vax Date: 01/12/2021
Onset Date: 02/01/2021
Rec V Date: 02/02/2021
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: Redness and itchy hands a few days after vaccination.

Other Meds:

Current Illness:

ID: 0996009
Sex: F
Age: 57
State: MO

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

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

Symptoms: First dose - no side affects at all could not even tell I had a vaccine. 2nd dose - by mid-afternoon my arm was getting sore, headache and scratchy throat. Arm progressively got worse. Took Tylenol and headache improved. Went to bed abut 10:30 pm was doing ok except for arm pain. Woke up at 2:40 AM with the chills (shaking really bad and very cold) got another comforter and went back to sleep woke up about 4:15 am a little better but just kind of sore all over. Laid in bed but couldn't sleep, got up and tried to log on about 8:45am for work. Felt completely drained and couldn't concentrate, took PTO. Took more tylenol and went back to bed, fell asleep about 11:00 am and slept until 2:00 PM. Felt much better when I got up just still kind of drained. By 8:00 PM that night (wednesday the 27th) my arm didn't hurt any more and I was basically back to normally. Have had a mild sore throat off and on since then but really nothing more than an irritation.

Other Meds: Synthroid .175 mcg, Bio-Identical Hormone Replacement Therapy, Vitamin D

Current Illness: None

ID: 0996010
Sex: F
Age: 81
State: OH

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient states she just noticed today, 2/2/21, that there is a red mark on her arm, 2 inches long, 1 inch wide, where she received the vaccine. No other symptoms.

Other Meds:

Current Illness:

ID: 0996011
Sex: F
Age: 68
State: IL

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/02/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: MY HEART STARTED BEATING IRREGULARLY LAASTED ON AND OFF ALL DAY

Other Meds: CENTRUM MULTI VITAMIN VITAMIN D 1000 MG SIMVASTATIN 20 MG ANASTROZOLE 1 MG

Current Illness: NONE

ID: 0996012
Sex: M
Age: 16
State: NJ

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

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

Symptoms: It was not determined that the patient was under 18 until after it was administered

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm