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

Incidents per State

State Total
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 0917364
Sex: F
Age: 37
State: PA

Vax Date: 12/23/2020
Onset Date: 12/28/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Redness, warmth, itching, swelling

Other Meds: Metformin Azithromycin Spironolactone

Current Illness:

ID: 0917365
Sex: F
Age: 44
State: WI

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: At injection site, at 1202, redness, rash, itchiness, and warmth. Then at 1206 head itchiness. Cold Compress applied to injection site. Later patient reported whole body itchiness and rash that was not raised. Patient is an NP and took prednisone.

Other Meds: unknown

Current Illness: unknown

ID: 0917366
Sex: M
Age: 36
State: CT

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: I performed a mild workout 30 minutes prior to the start of symptoms. I started to feel moderate body aches in my back and sides, felt flush and very tired and heavy. Temperature rose to 99.3. Symptoms began to subside after about 4 hours and temperature came down to a normal 98.3.

Other Meds: N/A

Current Illness: N/A

ID: 0917367
Sex: F
Age: 47
State: VT

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: shellfish- anaphylaxis, sudafed, pineapple-anaphylaxis

Symptom List:

Symptoms: Erythematous plaques/rash starting one day after vaccine that worsened at day 7 to eyelid swelling

Other Meds:

Current Illness:

ID: 0917368
Sex: F
Age: 82
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: Norvasc, Toprol, Lopid, Advil, Synthroid, cholesterol

Current Illness: None

ID: 0917369
Sex: M
Age: 98
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us by the agency. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and regulatory authority website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call from the agency that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: Aspirin, "blood pressure pill"

Current Illness: None

ID: 0917371
Sex: F
Age: 28
State: NH

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: Appeared to have a vasovagal reaction with nausea and dizziness lasting approximately 5 minutes. Did not pass out. Symptoms self resolved and patient refused EMS services.

Other Meds: none

Current Illness: n/a

ID: 0917372
Sex: F
Age: 66
State: CT

Vax Date: 11/13/2020
Onset Date: 11/13/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received 3rd dose of Shingrix and 2nd flu shot on 11/13/20. She had no adverse reactions.

Other Meds:

Current Illness:

ID: 0917373
Sex: M
Age: 91
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us by National Guard. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call from National Guard that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: "blood pressure pill", Metformin, Xanax, Hydrocodone

Current Illness: None

ID: 0917374
Sex: F
Age: 80
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: PCN

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: Synthroid, Amiodarone, Eliquis, Losartan

Current Illness: None

ID: 0917375
Sex: F
Age: 60
State: CA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: environmental allergies

Symptom List:

Symptoms: Within 5 minutes of the vaccine, patient had wheezing, shortness of breath and chest pain. patient given epi x 4, decadron, fluids with some improvement and then hospitalized. IN the hospital, patient continued to have chest pain and satting well but with protracted course and is still in the hospital.

Other Meds: none

Current Illness: none

ID: 0917376
Sex: M
Age: 81
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: Synthroid, Omeprazole

Current Illness: None

ID: 0917377
Sex: F
Age: 20
State: CA

Vax Date: 12/24/2020
Onset Date: 01/01/2021
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: redness, heat, and swelling at the injection site. three and a half inches by 5 inches and expanding. went to the urgent care and the provider prescribed antibiotics, taking the antibiotics if the symptoms worsen in the next 24 hours.

Other Meds: N/A

Current Illness: N/A

ID: 0917378
Sex: F
Age: 19
State: FL

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Bactrim

Symptom List:

Symptoms: The patient sat down for 15 minutes to be observed for any reactions and told us that she had numbness on the right side of her face and right arm as well. She then told us that the numbness was spreading to her neck and right leg as well. EMS was called and took her to the hospital.

Other Meds:

Current Illness:

ID: 0917379
Sex: F
Age: 36
State: GA

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: I HAVE SEVER ASTHMA AND BRONCHITIS AND GET PNEUMONIA 2 OR 3 TIMES A YEAR. I HAVE TROUBLE TAKING A DEEP BREATH AND CONSTANTLY TAKING MY INHALERS DAILY TO BREATH, I ALSO TAKE STEROIDS. I TOOK THE VACCINE AFTER GETTING OFF WORK ON 12/31/2020. THE NEXT DAY ON 1/1/2021 AND WOKE UP BEING ABLE TO TAKE A DEEP BREATH WITH NO PROBLEMS AND NO CHEST PAINS OR COUGHING. IT IS 1/2/2021 AND I HAVEN'T TOOK NONE OF MY INHALERS OR STEROIDS SINCE I TOOK THE VACCINE. IT IS AN AMAZING FEELING TO BREATH WITHOUT PAIN OR TAKING ANYTHING.

Other Meds: 1 - INHALER TWICE A DAY (MORNING AND NIGHT) 2 - INHALER AS NEEDED THROUGHOUT THE DAY

Current Illness: SEVEDR ASTHMA AND BRONCHITIS

ID: 0917380
Sex: F
Age: 63
State: NY

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: Temperature of 101, severe body aches and severe headache. Lethargic and in bed all day.

Other Meds: none

Current Illness: no

ID: 0917381
Sex: M
Age: 81
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us by National Guard. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call from National Guard that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: "blood pressure pill"

Current Illness: None

ID: 0917382
Sex: M
Age: 25
State: IN

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Approximately 12 hours after injection, I experienced hot flashes, chills, and a severe headache. The next morning I experienced a less severe headache but experienced noticeable shortness of breath especially on exertion. Tylenol P.O. helped my headache that morning, no known fever. Approx 2 days after injection I also experienced a noticeable reduction in the ability to smell or taste. This Stayed for at least another day or so.

Other Meds: None

Current Illness: None

ID: 0917383
Sex: M
Age: 87
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: "Blood pressure pill, cholesterol pill"

Current Illness: None

ID: 0917384
Sex: F
Age: 36
State: CA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Na

Symptom List:

Symptoms: Tingly face, lips, and tongue

Other Meds: Na

Current Illness: Na

ID: 0917385
Sex: M
Age: 80
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: Finasteride 5mg daily, Isosorbide Mononitrate 30mg daily, Lisinopril 10mg daily, Metoprolol Succinate 25mg daily, Plavix 75mg daily, Rosuvastatin 20mg daily, Ramsulosin 0.4mg daily, Folic acid 1mg daily

Current Illness: None

ID: 0917386
Sex: F
Age: 55
State: MA

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Rash; localized to injection site. Patient reports possible itchiness.

Other Meds: N/A

Current Illness:

ID: 0917387
Sex: F
Age: 24
State: IL

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Stiffness and pain in neck and right upper back for 3 days unresolved by OTC NSAIDs (Aleve & Ibuprofen). Pain around right scapular area. Pain radiating to right upper arm on third day. Unable to move neck and back, sleep, carry on with normal activities. Pain is a burning and pulsating sensation that keeps me up at night. Unable to take a deep breath.

Other Meds: Iron 65mg

Current Illness: Iron deficiency anemia

ID: 0917388
Sex: F
Age: 62
State: OH

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: N/a

Symptom List:

Symptoms: Headache

Other Meds: n/a

Current Illness: N/a

ID: 0917389
Sex: F
Age: 83
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: PCN, Sulfur

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us by the agency. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and regulatory authority website for the Moderna vaccine. Instead, the medication in the vial was actually COVID-19 antibodies meant for hospital use. After administration for 44 individuals, we received call from the agency that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: Amlodipine, Cymbalta, Metorpolol, Atorvastatin, Claritin

Current Illness: None

ID: 0917390
Sex: F
Age: 56
State: NJ

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: A rash on the right check

Other Meds: none

Current Illness: none

ID: 0917391
Sex: F
Age: 81
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: Metformin, "blood pressure pill", "sugar pill"

Current Illness: None

ID: 0917392
Sex: F
Age: 38
State:

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: No known Drug Allergies, but advised not to take Decadron (oral steroid) No other Allergies

Symptom List:

Symptoms: In addition to a scratchy throat and body aches, I experienced mild mental fogginess. It's the same mental fogginess I experience when I have a head cold.

Other Meds: Trazadone 50 mg Adderall 10 mg Effexor XR 150 mg Cyclafem 1/35 EQ 1 mg Crestor 40 mg Nitrofurantoin 50 mg Aleve 440 mg

Current Illness: Anxiety Depression Insomnia Hyperlipidemia Sickle Cell Trait Persistent UTIs Chronic Back Pain

ID: 0917393
Sex: F
Age: 66
State: FL

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: Elevated blood pressure and heart rate. 163/116 HR 125. I got up at 9:00 am with elevated BP and HR. I had missed a dose of Metoprolol the previous evening. I felt shaky/jittery and checked my BP and HR. Called the doctor on call at my PCP's office and he stated it is probably rebound hypertension and elevated HR due to missing the dose of Metoprolol last night. His direction was to check in two hours, and if still elevated, take 1/2 tablet Metoprolol. Current readings at 2:00 pm are 129/97 HR 99. Unsure if related to Covid vaccine. MD recommended reporting to CDC

Other Meds: Losartan/HCTZ, Metoprolol, Amlodipine, Anastrozole, Venlafaxine, pepcid, Vitamin D, B12

Current Illness: none

ID: 0917394
Sex: M
Age: 54
State: TN

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: stadol

Symptom List:

Symptoms: Chest tightness and squeezing sensation; SOB; chills; low grade fever; quivering of legs;

Other Meds: metoprolol, lisinopril, paxil, zocor

Current Illness: none

ID: 0917395
Sex: F
Age: 80
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: Aspirin 325 daily, Cardizem 360mg daily, Lopressor 100mg BID, Midodrin 5mg BID, Vasipa 1000mg QID, Myrbetriq 50mg daily, Zetia 10mg daily, Torsemide 40mg daily, Digoxin 125mcg daily, Singulair 10mg daily, Trazodone 100mg daily, Fenobrita 16

Current Illness: None

ID: 0917396
Sex: F
Age: 87
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and CDC website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: "blood pressure medication, acid reflux medication"

Current Illness: None

ID: 0917397
Sex: F
Age: 38
State: LA

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: cats, pineapples

Symptom List:

Symptoms: woke up and all of a sudden felt like I had pulled several muscles the left side of my neck and shoulder. But I hadn't done anything. Pain progressed as did stiffness within an hour to the point that I can barely move my neck without significant pain to neck and down into shoulder. It has been like this for almost 5 hours now and has not improved. Prior to this - the day and night i got vaccinated I felt fine. the following day I had a pretty bad headache. And then this morning this new thing happened. I am not worried about the headache as that is normal. I am worried about this severe pain and stiffness that is localized in one part of my body and is not going away.

Other Meds: no

Current Illness: none

ID: 0917398
Sex: M
Age: 81
State: WV

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
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Allergies: None

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Symptoms: No adverse event. We picked up what was supposed to be COVID-19 Moderna vaccine. Lot numbers and expiration date matched tracking sheet given to us by the agency. Color of medication also matched what was stated on Fact Sheet for Healthcare Providers and regulatory authority website for the Moderna vaccine. Instead, the medication in the vial was actually COVID -19 antibodies meant for hospital use. After administration for 44 individuals, we received call from the agency that the medications had been mixed up. The vials and box that medication came in had no identifying factors to indicate it was not the Moderna vaccine.

Other Meds: None

Current Illness: None

ID: 0917399
Sex: M
Age: 65
State: FL

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
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Allergies: Peanuts, shellfish

Symptom List:

Symptoms: Dizziness, nausea, fever, headache, abdominal pain

Other Meds: Prescription Flomax, finestride Supplement Alpha lipoic acid, noni

Current Illness:

ID: 0917400
Sex: F
Age: 32
State: KS

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/02/2021
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Symptoms: Injection site red, swollen, warm to the touch.

Other Meds:

Current Illness:

ID: 0917401
Sex: F
Age: 36
State: UT

Vax Date: 12/18/2020
Onset Date: 12/26/2020
Rec V Date: 01/02/2021
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Allergies: Nuva ring, cipro

Symptom List:

Symptoms: Tennis ball size hive that was itching and warm to the touch. This hive came and went 2-3 times over the course of 1 week, each time it got bigger and hotter and more itchy.

Other Meds:

Current Illness: Congestion

ID: 0917402
Sex: F
Age: 60
State: IA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
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Allergies: sulfa meds, rash to ampicillin, eggs, potatoes, chocolate, milk products, molds, dust mites

Symptom List:

Symptoms: increase warmth, pain at injection site, aching of entire left arm, then aching of neck, shoulders, back, hips, legs, headache by 7pm same day of injection. By 10pm, shaking chills, severe aching all over body, bad headache. Had taken aleve and omeprazole by 7pm with supper as per usual routine. At 10pm I took tylenol 650mg and cyclobenzaprine 2.5mg and crawled into bed. Slept 2 hours, woke without shaking but head throbbing, nose congested more, body still very achey, and heart pounding. This went on rest of night and all next am. temp at 10am 1/2/21 100.8 orally. Had not taken it before that. Took 2 aleve, drank glass water & ate toast. Slept til around 2pm. temp then 100.4. less achey in back, legs but arm still very sore and headache, hips hurt and neck hurt. Slowly better overnight to 2/2/21 but still not over headache, arm pain, neck ache and hip pain. All are less, however.

Other Meds: omeprazole, aleve, effexor, premarin, vit b complex, vit d3, atorvastatin, cyclobenzaprine, fluticasone, tylenol.

Current Illness: head cold with nasal congestion, postnasal drainage

ID: 0917403
Sex: F
Age: 61
State: WI

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
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Symptoms: Fever up to 104 x 2 days, chills, severe arm pain

Other Meds:

Current Illness:

ID: 0917404
Sex: M
Age: 32
State: IL

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 01/02/2021
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Allergies: none

Symptom List:

Symptoms: Sx onset 1/1/2021 Chills, (no fever), aches, fatigue, Pain at injection site

Other Meds: none

Current Illness: none

ID: 0917405
Sex: F
Age: 35
State: PA

Vax Date: 12/19/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
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Allergies: Augmentin shellfish

Symptom List:

Symptoms: Facial itiching with hypersensitive skin started a 2-3 days after injection. Swelling of face and eyes and blotchy facial skin 13 days after injection. Seen by ED physician for steroids and benadryl. Slight decrease in swelling 24-36 hrs post start of steroid regimen.

Other Meds: Iron 65mg BID

Current Illness:

ID: 0917406
Sex: F
Age: 46
State: MT

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
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Allergies: Pyridium Seasonal allergies

Symptom List:

Symptoms: Fatigue. Body aches. Nausea. Heart racing. Chills Nausea.

Other Meds: Thyroid medicine Aspirin

Current Illness: None

ID: 0917407
Sex: F
Age: 73
State: FL

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
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Allergies: Penicillin

Symptom List:

Symptoms: 12/31/2020 very dizzy 1/1/2021 not as dizzy but still dizzy 1/2/2021 still dizzy

Other Meds: Tylenol PM 1/2 pill Vitamin E COQ10 Simvastatin 20mg Thyroxine 40mg Biotin Glucosamine Chondroitin Prilosec

Current Illness:

ID: 0917408
Sex: F
Age: 70
State: MD

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
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Allergies: Cardiezem, percocet

Symptom List:

Symptoms: First and second doses-sore arm and redness around injection site Second dose-severe headache, fatigue, and weakness for 3 days following vaccination

Other Meds: Metoprolol, Armour thyroid, verapamil, Crestor, 81mg aspirin, vitamin D, vitamin C

Current Illness: N/A

ID: 0917409
Sex: F
Age: 38
State: OH

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
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Allergies: unknown

Symptom List:

Symptoms: Pt reports having arm/shoulder pain after receiving Covid vaccine injection. States the injection "felt high" and was more painful than typical IM vaccines she has had. Pt concerned about SIRVA.

Other Meds: unknown

Current Illness:

ID: 0917410
Sex: F
Age: 23
State: PA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/02/2021
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Allergies: Allergies to tree nuts

Symptom List:

Symptoms: I received the vaccine at 11:30am. About a half hour after receiving the vaccine, I felt dizziness and very slight chest tightness. I took benadryl, and was relieved of these symptoms. Then, around 9pm that night, I developed a fever. The highest temperature I recorded was 101.9. I took Ibuprofen around 11pm, and was afebrile by 3am. I have not had any fevers since, and I did have to call off work New Year's day. I have had an intermittent, mild headache since receiving the vaccine as well, but overall I feel fine.

Other Meds: None

Current Illness: None

ID: 0917411
Sex: M
Age: 23
State: TX

Vax Date: 12/22/2020
Onset Date: 01/02/2021
Rec V Date: 01/02/2021
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Allergies: None

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Symptoms: I spiked a fever and became symptomatic and then tested positive via a rapid viral test.

Other Meds: None

Current Illness: None

ID: 0917412
Sex: F
Age: 34
State: CT

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/02/2021
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Allergies: None

Symptom List:

Symptoms: Whole body muscle aches, starting about 12 hours after the first injection, worsening for about 3 hours, then improving after about 20-24 hours, ending by 36 hours.

Other Meds: Bupropion, methylphenidate, oral contraceptives

Current Illness: None

ID: 0917413
Sex: F
Age: 22
State:

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/02/2021
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Allergies: None

Symptom List:

Symptoms: Extreme fatigue, hard to get out of bed, high fever, chills, headache, and extreme arm soreness that radiated all the way underneath my armpit and towards the back of my scapula

Other Meds: Lexapro

Current Illness: Slightly scratchy throat

ID: 0917414
Sex: F
Age: 57
State: FL

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/02/2021
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Allergies: Sulfonamides (Rash to Septra DS)

Symptom List:

Symptoms: Experienced extreme dry mouth immediately after receiving the Moderna Covid vaccine. Symptom relieved by water provided by hospital team observing patients after vaccination. Further relief obtained by consuming cool grapes. Reaction completely resolved within 15-30 minutes. I did not feel that medical attention was needed.

Other Meds: Metoprolol 12.5mg daily (4 years) Diltiazem CD 120mg daily (4 years) Vitamin D 50 mcg daily Zinc 50 mg daily Vitamin B Complex (Super) Nature Made daily

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm