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: 1001065
Sex: F
Age: 74
State: FL

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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: Within 15-minutes of vaccination, the patient reported pruritus at site of injection. EMS managed the patient's condition on-site.

Other Meds:

Current Illness:

ID: 1001066
Sex: F
Age: 49
State: KY

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: n/a

Symptom List: Anxiety, Dyspnoea

Symptoms: Redden area area to touch at injection site that appeared 1 week post injection.

Other Meds: n/a

Current Illness: n/a

ID: 1001067
Sex: M
Age: 67
State: PA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: None

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

Symptoms: Shingles - shoulder, under arm on opposite side of vaccination

Other Meds: None

Current Illness: None

ID: 1001068
Sex: M
Age: 27
State: NJ

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Skin rash, seems to get worse and worse with time. it looks like red pimples all over my body.

Other Meds: none

Current Illness: none

ID: 1001069
Sex: F
Age: 45
State: MA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: PCN, Sulfa

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

Symptoms: Throat tightening, rash, flush.

Other Meds: ASA, Lipitor, Klonopin, Vit. B12, Prozac, Linzess, Provigil, MVI, Nurtec, Aldactone

Current Illness:

ID: 1001070
Sex: F
Age: 82
State: FL

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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: aleve, codeine, garlic

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

Symptoms: pt states arm was itchy and sore after the injection. On 2/3/2021 she had severe chills and fatigue. Pt states she is feeling better today 2/3/2021 and has a regular appt w/ her PCP on 2/5/2021 and will discuss her symptoms.

Other Meds: Nexium

Current Illness: no

ID: 1001071
Sex: M
Age: 45
State: CO

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
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: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Approximately 12 hours after my 2nd injection of the Moderna COVID19 vaccine, I experienced severe nausea and ended up having an episode of syncope where I passed out on the stairs in my home.

Other Meds: Livalo 4mg, Benicar 20mg, Vitamin D3 4000 units, Asprin 81mg, Novolog

Current Illness: N/A

ID: 1001072
Sex: F
Age: 89
State: MD

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: About 10 minutes after vaccination she experienced chest pain. This lasted for several minutes and then subsided, but she was transported to the ED for evaluation.

Other Meds:

Current Illness:

ID: 1001073
Sex: F
Age: 59
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: na

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: severe redness and cellulitis from the shoulder down to mid bicep and going around the whole arm area. It is very hard to the touch with fever and very itchy.

Other Meds: protonix

Current Illness: diabetes

ID: 1001074
Sex: F
Age: 63
State:

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: Day 3 started with rash over trunk, arms, upper legs

Other Meds:

Current Illness:

ID: 1001076
Sex: F
Age: 66
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Extreme fatigue, muscle pain all over even hair follicles hurt, Entirely snuffed up nose

Other Meds: hydrocholithiazide, Lipitor, fish oil, folic acid,

Current Illness: COVID-19

ID: 1001077
Sex: M
Age: 52
State: NJ

Vax Date: 01/13/2021
Onset Date: 01/25/2021
Rec V Date: 02/04/2021
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: No

Symptom List: Rash, Urticaria

Symptoms: Numbness and twitching to ride side of facial area below eye

Other Meds: Vitamin C / Vitamin B-12 / Vitamin D Metformin/ Lantus/ Hyzar / Glyburide / Victoza / baby ASP / Cholosterol Med

Current Illness: No

ID: 1001078
Sex: F
Age: 23
State: TX

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Fever to 101 and headache beginning this morning. No treatment given. States symptoms are beginning to improve.

Other Meds:

Current Illness:

ID: 1001079
Sex: F
Age: 44
State: CO

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/04/2021
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: None

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

Symptoms: Fever 101F 6pm 1/28/21 Headache same - Ibuprofren resolved 1/29/21 - Sore arm lasting 2 days 1/30/21 - developed sollen/red/hot spot across upper arm, but below deltoid. This was hot to touch and sore, it resolved in 3 days with last day being itchy.

Other Meds: Synthroid, Liothyronine, Vit C, Fish Oil, Vit, D, Magnesium, Zinc, Multi Vitamin

Current Illness: None

ID: 1001080
Sex: F
Age: 55
State: NY

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 02/04/2021
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: Penicillin,peanuts,dust,mold and cat

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

Symptoms: Patient received Pfizer #1 on 1/6/21 and developed muscle cramps and tinnitus and was evaluated by ENT, TMJ specialist,allergist and her PCP. Hearing test revealed mild hearing loss in high frequency. 1/27/21 received the second dose of the vaccine. The following day she developed flu-like symptoms, including fever, chills, headache and fatigue and worsening of Tinnitus. Received Dupixent two weeks prior to the vaccine.

Other Meds:

Current Illness: Asthama,Graves disease.

ID: 1001081
Sex: F
Age: 23
State: FL

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/04/2021
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: Fish - facial swelling

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

Symptoms: About 15 minutes after injection, head felt heavy and she felt weak and throat was closing. She received Benadryl and her symptoms resolved before she left vaccine clinic. Recommended not to take #2 dose until she sees an allergist and gets their opinion.

Other Meds: None

Current Illness: None

ID: 1001082
Sex: F
Age: 67
State: IL

Vax Date: 01/14/2021
Onset Date: 01/16/2021
Rec V Date: 02/04/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

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

Symptoms: 48 hours after injection , site turned bright red approx 2? diameter redness, itchy and painful. Applied neosporin and symptoms subsided within 8 hours. BUT THEN ON JAN 23 I FELT A SMALL GRAPE SIZE MOVEABLE LUMP ON MY LEFT CLAVICLE, VACCINE GIVEN IN LEFT ARM. I MADE AN APPT WITH MY INTERNIST WHO ORDERED MULTIPLE TESTS LISTED BELOW

Other Meds: Crestor 5mg q hs Naproxen 500mg bid Vitamin d OTC

Current Illness: None

ID: 1001083
Sex: M
Age: 39
State: MA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: On 2/2/2021, patient came in to clinic before scheduled appt. Patient did not have his vaccination card so received new card at check-in with 2nd dose of Moderna written in the 1st dose section was provided. Nurse inquired to patient when was 1st dose so nurse can write down the information on the card. Patient did not know. "2nd" dose of Moderna was administered in right deltoid. Upon documentation, it was found that patient received the 2nd dose of Moderna vaccine at day 15 by nurse. Patient received 1st dose of Moderna 1/21/21.

Other Meds: None

Current Illness:

ID: 1001084
Sex: F
Age: 69
State: WA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: PT complaining of Headache and Dizziness post vaccination. After Evaluation PT states symptoms have resolved and refused treatment or transport.

Other Meds:

Current Illness:

ID: 1001085
Sex: F
Age: 38
State:

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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: Very sore arm starting about 1 hour post injection. Severe arm pain lasted about 48 hours then lessened to mild pain. Chills started about 10 hours after the injection. Fever spiked to 101.1 the afternoon following the injection. Fever lasted about 18 hours. All symptoms except sore arm were gone 48 hours after the injection.

Other Meds: Vitamin D3 (2000 iu) daily

Current Illness: None

ID: 1001086
Sex: F
Age: 72
State: NY

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
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: sulphur mold pollen

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

Symptoms: itchy red rash oval shape 3 inches long

Other Meds: synthroid vitamin C and D

Current Illness: cold

ID: 1001087
Sex: F
Age: 74
State: WV

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Unevaluable event

Symptoms: Trouble swallowing, expelling mucus, tongue swelling, shortness of breath. Epi administered IM in right thigh. Patient sent via ambulance to hopsital.

Other Meds: Unknown

Current Illness: Unknown

ID: 1001088
Sex: F
Age: 78
State: FL

Vax Date: 01/19/2021
Onset Date: 01/23/2021
Rec V Date: 02/04/2021
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: Sulfa and Novacaine.

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

Symptoms: Got the vaccine, had sore arm immediately. Thought she was fine. Husband had the same vaccine, and had the splotch and soreness, but then around 1/23/21. The shoulder started to hurt after about 3 days, and put a heating pad on it, and finally the pain and discomfort gradually subsided. She is not having any problems now.

Other Meds: Pravachol and aspirin. Centrum, caltrate, vitamin C, zinc, B12, Preservision red.

Current Illness: None.

ID: 1001089
Sex: M
Age: 42
State: NJ

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: On 2/4, I had discomfort near my armpit under the left arm. There also was some swelling.

Other Meds: Hydrocholorthiazide Amlopidine besylate

Current Illness: N/a

ID: 1001090
Sex: F
Age: 65
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: 102.2 temperature for 2 days chills headache arm very sore, more sore than most injections

Other Meds: Lisinopril, Levothyroxine, Avastin, Tramadol, Gabapentin, Methacobomol

Current Illness: none

ID: 1001091
Sex: F
Age: 28
State: NV

Vax Date: 12/24/2020
Onset Date: 12/31/2020
Rec V Date: 02/04/2021
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: unk

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

Symptoms: Developed severe erythematous macular rash on arm near rash site.

Other Meds: unk

Current Illness: none

ID: 1001092
Sex: F
Age: 33
State: IL

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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 that I know of

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: In the middle of the night, Wednesday morning, my eyelids were swollen. Left eyelid more than right eyelid. Then waking up at 11:30am Wednesday, the swelling was still there, right eyelid more than left eyelid. I took a tablet of Cetrizin antihistamine at around 12:30pm. Around 4pm, the swelling was still there, now left eyelid more than right eyelid. I took Benedryl at around 11pm, but upon awakening in the morning (Thursday), the swelling is still present, still left eyelid more than right eyelid. No pain, but there is tenderness of the left eyelid. I had mild fever, chills, muscle pain, fatigue, headache in the middle of the night after receiving the second dose of the vaccine on Tuesday. This has subsided. Mild headache still remains.

Other Meds: Airborne tablet in the morning

Current Illness: none

ID: 1001093
Sex: M
Age: 70
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: first was fever 100.9 and chills. injection site was sore and soon left elbow area was aching. ftemp stayed at 100.9 during the night along with a headache and sleep was restless. by morning temp had lowered to 99.9 and some of the body aches were dissapating.. after several more hours the temp has returned to normal and all that is left is a headache. total time of issues was about 17 hours.

Other Meds: atorvastatin, clopidogrel, ramipril, metoprolol, ropinrole, tramidol

Current Illness: NONE

ID: 1001094
Sex: F
Age: 78
State: TX

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 02/04/2021
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: seasonal allergies

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

Symptoms: 12/28 Vaccination Later that evening, muscle aches and HA. 12/29 Joint pain, HA, and mild cough 12/31 Severe cough, lost voice, unable to sleep 1/2021 Urgent care; COVID test; Positive Bamlanivimab; treatment/infusion; 3 hours 15 days isolation 1/18/2021

Other Meds: Cintroid, lipitor

Current Illness: n/a

ID: 1001095
Sex: F
Age: 39
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Nausea

Symptoms: Anosmia, fatigue, congestion, soreness as injection site

Other Meds: None

Current Illness: None

ID: 1001096
Sex: M
Age: 71
State: OH

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: CIPRO

Symptom List: Injection site pain

Symptoms: 2-2-21 @ 12:45PM WIFE STATES CLIENT IS NOT FEELING WELL. CLIENT UNRESPONSIVE, COLOR PALE, SKIN CLAMMY, PULSE WEAK AND SLOW WITH SNORING RESP-EPISODE APOX 90 SEC. AIRWAY MAINTAINED WITH JAW THRUST, PLACED ON COT AND CLIENT BECAME RESPONSIVE. STATED HE STILL FELT UNWELL. TRANSPORTED TO ER PER SQUAD @ 1:10PM. COLOR IMPROVED, SKIND W/D, A/O X3. BP 122/90 NOW. WIFE FOLLOWING IN PRIVATE AUTO. 2-3-21 @ 08:37AM WIFE STATES ALL SYMPTOMS RESOLVED ON 2-2-21 AND WAS RELEASED SAME DAY AND HE IS "BACK TO NORMAL". ADVISED TO LAY DOWN FOR NEXT VACCINE AND FOR AFTER CARE PERIOD.

Other Meds:

Current Illness:

ID: 1001097
Sex: F
Age: 42
State: WI

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Dizziness, sore arm

Other Meds: Birth control

Current Illness: None

ID: 1001098
Sex: F
Age: 37
State: NY

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: Latex, Shellfish, compazine, reglan

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

Symptoms: I had sudden onset severe lower abdominal pain starting 8 hours after my second dose of the Moderna vaccine and it lasted 5 hours without any relief despite being medicated with narcotics.

Other Meds: Omeprazole 20 mg BID, Benadryl 50 mg QHS

Current Illness: None

ID: 1001099
Sex: F
Age: 70
State: NJ

Vax Date: 01/25/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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: Sulfur drugs, Diovan, PPE in permanent Hair Dye, Seasonal

Symptom List: Tremor

Symptoms: One week after shot a rash appeared around injection site on upper left arm about 4 inches in diameter. "Covid Arm".

Other Meds: Vitamins C, Vitamin D, Calcium, Zinc, Magnesium

Current Illness: None

ID: 1001100
Sex: F
Age: 33
State: TN

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 02/04/2021
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: Vaccine at 11:00 on 1/4 Slight headache that went away with tylenol at 15:00. Woke up at 02:00 on 1/5 with extreme headache. nausea, muscle pain, joint pain, and high blood glucose of 270. Took a tylenol at 02:00 and did not help. Was in so much pain went to ER. Was seen and sent home. went to sleep at 09:00 and when I woke at 14:00 I felt fine. Had headache, site injection pain and swelling for a few more days after.

Other Meds: Novolog-insulin pump

Current Illness: Cough/cold- COVID negative

ID: 1001101
Sex: F
Age: 46
State:

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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:

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

Symptoms: C/O SOA, WHEEZING AFTER RECEIVING COVID VACCINE YESTERDAY; PT STATES NO RELIEF FROM ALBUTEROL INH

Other Meds:

Current Illness:

ID: 1001102
Sex: F
Age: 52
State: AR

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: Muscle Cramps, nausea, low grade temp 101.4, severe headache, right side of face tingling.

Other Meds: Levithyroxin 75 MCG once a day

Current Illness: gallbladder removal on 1/27/21

ID: 1001103
Sex: F
Age: 45
State: MO

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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: The evening after the shot could not sleep and was nauseous. The next day had body aches, fatigue and chills. Back really hurt. The next day felt lots better.

Other Meds: Humira, Amlodine, Celexa, birth control, multi vitamin, Vitamin D

Current Illness: n/a

ID: 1001104
Sex: M
Age: 78
State: IN

Vax Date: 02/01/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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: Large pink area around vaccination site

Other Meds: Levothyroxine,metoprolol,lisinopril,levetiracetam,clopidogrel,atorvastatin,cholestyramine,omeprazole,vitamin D3,Fish oil

Current Illness: None

ID: 1001106
Sex: F
Age: 79
State: OK

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 02/04/2021
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: simvastatin, sulfa

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

Symptoms: This vaccine clinic was held at the Center in on 1/23/21 and hosted by the Hospital.. Vaccine administered at 1340 by LPN. Patient with immediate c/o of feeling light headed, hot all over, flushed. Patient stated she felt better but at 1357 c/o of itching all over body and tongue swelling. Epinephrine pen administered at 1358 by LPN. Emergency services contacted. Patient transported to ER at approximately 1410.

Other Meds: multi-vitamin, atorvastatin, carvedilol, divalproex, levothyroxine

Current Illness:

ID: 1001107
Sex: F
Age: 54
State: IN

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Pain in extremity

Symptoms: Headache, myalgias staring within 6-7 hours post vaccine dose #2, lasting for almost 36-38 hours. Right upper arm soreness lasted for almost a day. Still have a large macular rash at the site of injection.

Other Meds: None

Current Illness: None

ID: 1001109
Sex: F
Age: 21
State: KY

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Sulfa-hives

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

Symptoms: Shortly after vaccination patient started to experience rash on her torso and arms.

Other Meds:

Current Illness:

ID: 1001110
Sex: M
Age: 63
State: MO

Vax Date: 01/28/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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: Approximately 5 days after receiving 1st dose of vaccine, patient woke up from nighttime sleep feeling 'itchy' all over body. Found approximately 10 red, raised spots or 'welts' on skin that he had never seen before. They were sporadic, NOT clustered. He described as not quite hives. He checked bed for 'bugs' but didn't find anything. He had taken metaxolone for only the second time in his life before bed. Prior use did not elicit any type of 'rash' as described. He applied no topical nor ingested any oral medication at this time. He mentioned he has IBS and also had 1 instance of diarrhea. He then took 1 imodium. He was able to eventually fall back asleep. When he awoke the next morning, all but 1 spot were gone and no indication this had ever happened. He has experienced a mild headache off and off since injection, but nothing significant that keeps him from his normal business.

Other Meds: metaxolone, ibuprofen

Current Illness:

ID: 1001111
Sex: F
Age: 63
State: TN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
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 known

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

Symptoms: Nausea, headache, chills, fever, fatigue, body aches. Symptoms were severe lasting 48 hours. Treated with Tylenol and rest.

Other Meds: EstraNoreth, Myrbetrig Vitamin D3, B Complex, Calcium, Fish Oil, C and MultiVitamin

Current Illness: No. However, Covid positive end of September.

ID: 1001112
Sex: F
Age: 35
State: NC

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
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: Seafood allergy

Symptom List: Vomiting

Symptoms: According to provider note: "Patient complained of nasal congestion, chest tightness, and diaphoresis approximately 20 mins after 2nd COVID vaccine. Patient has allergy to seafood and states this is what it feels like when she has an allergic reaction." Patient received Benadryl 50 mg IV x 1 dose famotidine 20 mg IV x 1 dose Solumedrol 125 mg IV x 1 dose Zofran 4 mg IV x 1 dose---patient because nauseated after receiving Benadryl Normal saline 500ml bolus x 1 dose Patient improved after receiving medication

Other Meds:

Current Illness:

ID: 1001113
Sex: F
Age: 68
State: MO

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
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: Bee stings strawberries wheat sutures

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Hives arm soreness and a headache

Other Meds: Lisinopril HTCZ Dicyclomine Omperprazole Fluoxetine Euthyrox Tylenol Calcium Fiber gummy Multivites Probiotic

Current Illness:

ID: 1001114
Sex: F
Age: 50
State: IL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: About 4:00 p.m. symptoms began-extreme fatigue but couldn't sleep, low fever: 98.8 temperature, chills, achiness, and upper arm pain. Took Aleeve at 8:00 a.m. and 6:30 p.m. on 2/3/21, and 8:00 a.m. on 2/4/21. By 4:00 a.m. all symptoms but arm pain were gone.

Other Meds: Synthroid Atorvastatin Birth Control

Current Illness: None

ID: 1001115
Sex: M
Age: 59
State: IN

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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: Had all the symptoms of a bad case of the flu. 9 hours after the vaccine, started getting light-headed, very tired (went to bed), woke up 3 hours later with extreme chills, followed by a fever for a few hours. Slept through the night. Woke up and muscles were sore all over. Continued to be very tired and light headed. By 5:00 PM, the symptoms had subsided. I woke up 2 days after the vaccine injection and felt 100%.

Other Meds: Vitamin D

Current Illness: None

ID: 1001116
Sex: F
Age: 91
State: MN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Amlodipine, Codeine, Morphine

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

Symptoms: Nausea

Other Meds: Losartan, Triamterene-hydrochlorothiazide, Vitamin B12 injection, Sennosides-docusate sodium, Estrace, Humalog, Levemir, acetaminophen, and Seroquel

Current Illness: Parkinson's, Dementia, Type 2 diabetes mellitus, Hypertensive chronic kidney disease, and dysphagia.

ID: 1001117
Sex: F
Age: 24
State: OH

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 02/04/2021
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: Scattered areas of urticaria (hives) spreading diffusely over body. Some areas of vasculitis on arms and legs. Symptoms began within 24 hours of vaccine and have continued until present date. Prednisone prescription given on February 18th and taken for 9 days as prescribed (20MG- 3 tabs x 3 days, 2 tabs x 3 days, 1 tab x 3 days) taken with Benadryl as advised. Symptoms continued. Urgent care visit on February 3rd. Treated with methylPREDNISolone sod suc(PF) (SOLU-medrol) Injection 125 mg and prescribed predniSONE (DELTASONE) 20 MG tablet and famotidine (PEPCID) 40 MG tablet. Following injection skin is moderately less irritated.

Other Meds: Oral contraceptive

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm