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: 1003488
Sex: F
Age: 68
State: FL

Vax Date: 01/25/2021
Onset Date: 01/31/2021
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: NSAIDS, IVOP dye, kiwi fruit

Symptom List: Dysphagia, Epiglottitis

Symptoms: On the seventh night after vaccination, somewhat suddenly, I could not move my left arm without pain, pain radiated to left side of neck, two red swollen splotches near injection site, which were hot to touch, appeared & I had some itchiness at the site . Pain & arm movement fully resolved on its own within about 10- 12 hours, With intermittent ice applications, swelling resolved within 10 hours. As of today, four days after the reaction started, I still have splotches, but they are a lighter color, & a bit of soreness in that area.

Other Meds: Acyclovir, Atorvastatin, Transdermal Verapamil M3 15%, gel, Estradiol vaginal cream .01%; Lutein & Zeaxanthin 25 mg, CO Q10, 300 mg, Omega 3 fish oil, probiotic, D# 1000IU, Magnesium glycinate 400 mg, Calcium citrate 650 mg dissolved in

Current Illness:

ID: 1003489
Sex: M
Age: 42
State: TX

Vax Date: 02/01/2021
Onset Date: 02/02/2021
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: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Extreme nausea and vomiting for 3 days, muscle pain, 100.9 temperature

Other Meds: Biktarvy, gabapentin, ibuprofen, Tylenol, nexium.

Current Illness: N/A

ID: 1003490
Sex: F
Age: 46
State: VA

Vax Date: 01/27/2021
Onset Date: 02/01/2021
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: Expected pain, swelling, and redness for approximately 3 days after the vaccine (including the day of). The site was also "knotty" under the skin. Side effects decreased and subsided during the 4th and 5th day after vaccination. Beginning with the 6th day, mild soreness resumed, along with increased redness, increased "knottiness," warm to the touch, and itchiness. These side effects continued and somewhat worsened into the 7th and 8th days. On the 8th day, my school nurse recommended I visit a doctor. I spoke with a nurse practitioner over the phone, and then visited her in person. Upon examination, she determined I had cellulitis. She prescribed an antibiotic (Keflex). (Today is the 8th day - 2-4-21.)

Other Meds: Xyzal (one 5mg pill taken 2-3 times a week)

Current Illness: None

ID: 1003491
Sex: M
Age: 68
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Severe headache for 24 hours. No treatment.

Other Meds: Omega 3 One-a-day vitamin Ocuvite Rosuvastatin

Current Illness: None

ID: 1003492
Sex: M
Age: 71
State: CA

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

Lab Data:

Allergies: None known

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

Symptoms: None stated.

Other Meds: Multiple

Current Illness: None

ID: 1003493
Sex: F
Age: 48
State: MI

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: Strawberries and tree nuts

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

Symptoms: Rash chest and face. Face and throat swelling. Difficulty swallowing. Taken to ER and given steroid, benadryl, and pepcid. Systemic affects x3 days. Medications given for a total of 5 days.

Other Meds: Adipex

Current Illness: None

Date Died: 01/27/2021

ID: 1003494
Sex: M
Age: 81
State: IL

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Possible transverse myelitis developing 2 days after vaccine injection. Death on day 9 after vaccination

Other Meds: acetaminophen, 650 mg= 2 tab, Oral, q6hr, PRN amLODIPine, 10 mg= 2 tab, Oral, Daily aspirin, 81 mg= 1 tab, Chewed, Daily atorvastatin, 40 mg= 1 tab, Oral, Q Bedtime Keppra, 1000 mg= 2 tab, Oral, every 12 hr levothyroxine, 75 mcg= 1 tab

Current Illness: Recent hemorrhagic stroke

ID: 1003495
Sex: F
Age: 60
State: CA

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: OPIOIDS - MILD RASH

Symptom List: Pharyngeal swelling

Symptoms: PATIENT REPORTS HAVING MODERATE PRURITIS OF THE SKIN FOR 1 NIGHT OF 02/02/2021. NO REACTIONS NOTED.

Other Meds: LISINOPRIL, LORAZEPAM, AMLODIPINE, GABAPENTIN, ATORVASTATIN, METFORMIN, AND XERALTO

Current Illness: NO SICK OR COLD SYMPTOMS.

ID: 1003496
Sex: F
Age: 37
State: CA

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Sudden Chills and Dizziness lasted for 15 minutes. Symptoms went away after drinking some warm water and rested.

Other Meds: No.

Current Illness: None

ID: 1003497
Sex: F
Age: 36
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Macrobid; realpax, surgical glue; iv contrast dye

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Swelling, Red rash, at injection site. Pain and itching. Size of swelling has grown over time.

Other Meds: Vyvanse; Super C vitamin with vitamin A, C, D3, E, and Zinc; Vitamin B12; Ibuprofen

Current Illness: None

ID: 1003498
Sex: F
Age: 34
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:
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: Body aches and soreness. Started in am and progresses as day went on. A headache. Took Tylenol extra strength 2 times. Q 6 hrs.

Other Meds: Tylenol extra strength

Current Illness: None

ID: 1003499
Sex: F
Age: 73
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: A couple of hours after receiving the shot, I became dizzy, sick to my stomach and nauseous. For the next few hours, I suffered from diarrhea, bad stomach pains, vomiting and was very chilled. I felt like I was going to pass out numerous times. Once the above subsided, I slept on and off. The symptoms never were that bad again. By morning I was feeling better, just weak and chilled. That feeling has stayed for the past two days.

Other Meds: Carbidopa-Levodopa Ropinirole Atorvastatin,

Current Illness:

ID: 1003500
Sex: F
Age: 69
State: NJ

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

Lab Data:

Allergies: Codeine

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

Symptoms: Vertigo and diarrhea

Other Meds:

Current Illness: None

ID: 1003501
Sex: F
Age: 84
State: CA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: next day after vaccine face is swollen

Other Meds: Took Cough medicine next day after vaccination

Current Illness: Cough 2 months lasting

ID: 1003502
Sex: F
Age: 55
State: CA

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Light headed, feeling faint.

Other Meds:

Current Illness:

ID: 1003503
Sex: F
Age: 16
State: PA

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

Lab Data:

Allergies:

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

Symptoms: Approximately 20 hours after vaccination patient felt faint, lost all color and fainted. She was in and out of responsiveness. Patient was transported to the ER. Patient was treated with fluids and discharged after observation. According to patient's mom the EKG and lab work were unremarkable. Patient has fully recovered.

Other Meds:

Current Illness:

ID: 1003504
Sex: F
Age: 55
State: NC

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: Sulfa Drugs, Penicillin (Hives),

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

Symptoms: About 10 minutes after I received the vaccine I felt my heart flutter. At the time I didn't think anything of it but the flutter continued and felt like my heart was skipping a beat. This continued the next day (Friday) so I reached out to my doctor. She placed me on a Beta Blocker which reduced the number of palpitations. Today is 4 weeks since I had my first dose of the vaccine and I am still feeling my heart flutter.

Other Meds: Vitamin C, D3, Elderberry, Multivitamin, Magnesium Citrate, Fish Oil , Allegra, Primrose Oil Atorvastatin 10 mg, omeprazole 20 mg, Flonase 50 mcg,

Current Illness: GERD

ID: 1003505
Sex: F
Age: 52
State: AK

Vax Date: 01/12/2021
Onset Date: 02/03/2021
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: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: On 1/25/2021 patient reports experiencing vertigo and required a procedure at physical therapy to resolve. On 01/27/2021 patient experienced tachycardia of 175 and was sent to emergency room. ECG showed SVT

Other Meds: Synthroid

Current Illness:

ID: 1003506
Sex: F
Age: 44
State: MI

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: Cleocin & reglan

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Light headache & injection area soreness at 2pm 10pm started to notice some aches. Midnight (14 hours post injection) awakened by intense headache, severe body aches, sweating, hot and cold. Extreme fatigue. In bed & slept all day. 8:30pm still have headache, fatigue & light body aches.

Other Meds: Zoloft 100mg Daily multivitamin

Current Illness: None

ID: 1003507
Sex: F
Age: 80
State: DC

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: metformin: GI upset, wellbutrin: vomit, Aspir-81: GI upset.

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

Symptoms: Pt fainted, and fell forward out of her chair onto the floor during post vaccination observation.

Other Meds: Taking Januvia 25 MG Tablet as directed Orally Once a day for diabetes, Taking Levothyroxine Sodium 100 MCG Tablet TAKE 1 TABLET EVERY MORNING ON AN EMPTY STOMACH ONCE A DAY ORALLY , Taking Clopidogrel Bisulfate 75 MG Tablet TAKE 1 TABLET O

Current Illness:

ID: 1003508
Sex: F
Age: 54
State: OR

Vax Date: 01/09/2021
Onset Date: 01/25/2021
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: sunscreen (?) - rash

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

Symptoms: Jan. 25, 2021 - Day17 post vaccination- around 1 am noticed itchy ankles. In the morning I noticed some small papules on the anterior ankles. I donated blood later that day and definitely did not have any rash on my arms. The following morning (Jan. 26, Day 18) I noticed 1 mm papules on my right wrist that were itchy. Over the course of the day I had some increase in papules on the left wrist and also developed some on the right. Are used triamcinolone cream and gold bond anti-itch cream. Over the next two days the rash continued to spread over the dorsum of both hands and feet and up the volar and posterior surfaces of the forearms to the elbows, as well as up the inner lower legs to the knees. I ended up taking three days of 10 mg prednisone until the itch was controlled. Today, day 26 there is no itch and the rash has almost completely faded. There was no rash on palms or souls, no rash in the web spaces, no rash on the torso, no other symptoms. Each papule was 1 to 2 mm and skin colored when I was cool, but red and itchy when I was hot.

Other Meds: vitamin D, Vitamin B complex, iron aspartame, DHEA, docusate sodium, Natural Calm (magnesium)

Current Illness: none

ID: 1003509
Sex: F
Age: 42
State: WI

Vax Date: 01/27/2021
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: skin sensitivity to certain tape adhesives

Symptom List: Unevaluable event

Symptoms: On day 8, injection site became hard and swollen. Skin around injection site developed rash and it became itchy.

Other Meds: birth control pills, fiber supplements, multivitamen

Current Illness: none

ID: 1003510
Sex: F
Age: 46
State: NY

Vax Date: 01/21/2021
Onset Date: 01/24/2021
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:

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

Symptoms: Dizziness, nausea that has been ongoing for 2 weeks with no resolution still; going to doctor tomorrow to start bloodwork.

Other Meds:

Current Illness:

ID: 1003511
Sex: F
Age: 55
State: OR

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

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: Woke day after vaccination with slightly red right eye. Woke 2nd day with very red right eye. Little watery but no pain.

Other Meds: Floxitine Vit D CoQ10

Current Illness:

ID: 1003512
Sex: F
Age: 66
State: IL

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

Lab Data:

Allergies: Sulfa, Vioxx, Bextra, Celebrex, Aspirin, Sulfites, Dairy, Nitrates

Symptom List: Injection site pain, Menorrhagia

Symptoms: Lip swelling bottom lip & numbess, Rash on stomach Dizzy, Weak, Intermitrent Chest pains, lowered Oxy Sat to 93 & 92. In addition to the more normal symptoms of vomiting, Diarhhea, headache, fatigue, cold & alternating sweats GI pain,

Other Meds: Armour Thyroid Medication 60 mgs.

Current Illness: Pnuemonia had resolved 4 wks prior to yhe vaccination was given the go ahead by my PCP. Negative Covid test and Chest Xray showed no classic Covid signs also.

ID: 1003513
Sex: F
Age: 48
State: CA

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

Lab Data:

Allergies:

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

Symptoms: Immediate tingling in chest, throat tightness and felt as if phlegm but had no phlegm, then ears clogged, then vocal changes sounding like frog in throat. BP went from 155/88 to 169/93. 96% RA At 1628--Gave albuterol 2 puffs, symptoms improved. Then at 1655, pt c/o difficulty breathing, BP 161/100, EPI PEN 0.3mg given at 1658 and 911 called. BP 170/104, 78% o2sat on oxygen mask on 10L. Chest felt tight. EMS took pt to ER at 1715.

Other Meds:

Current Illness:

ID: 1003514
Sex: F
Age: 59
State: MD

Vax Date: 01/04/2021
Onset Date: 02/01/2021
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: PCN

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 1st dose really sore at injection site 2nd dose: 3-4 hours after receiving shot felt lightheaded for a few minutes, 8 hours later left arm, shoulder and face was very sore and stiff, chills but no fever, body aches, joint pains, lethargic for 2-3 days after the shot.

Other Meds: Amlodipine 5mg PO Daily, Tums 2000mg PO Daily, COQ10 1 capsule PO daily, Vitamin D PO daily, MVI

Current Illness:

ID: 1003515
Sex: F
Age: 64
State: WY

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 01/14/2021-approximately 4pm, approximately 5 hrs. post vaccination, Ct started experiencing a 'vibration sensation' inside legs and hips. Ct was driving at the time, thought something was wrong with her car got out and realized it was her body. By 6pm she had 'internal tremors' throughout whole body. Described vibrations at bedtime as quite violent. Reported to Heath Department via V-safe. Was going to go to the ER but didn't, next morning, 9am, tremors started to subside and were gone within 24 hrs. of the vaccine.

Other Meds: Corzaar 50mg/day, supplements-Vit D, Calium, Magnesium

Current Illness: none

ID: 1003516
Sex: F
Age: 31
State: MO

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: RA

Lab Data:

Allergies: None

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

Symptoms: Swelling and tenderness of dermal filler (chin) after the 2nd Moderna vaccine

Other Meds: None

Current Illness: None

ID: 1003517
Sex: F
Age: 36
State: AZ

Vax Date: 01/19/2021
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: none

Symptom List: Nausea

Symptoms: very lethargic on Sunday. Felt hot (no fever) all day Monday, with headache, also lethargic. In the evening I was changing my shirt and I noticed there was a large raised, hot welt on my left arm around the injection site. Called a family member who is a nurse and they told me to go to Urgent care. Went to Urgent care that night around 5:30pm, the Physicians Assistant (did not get her name) told me it looked like a delayed reaction to the covid 19 vaccine and she told me not to get the second shot. She also told me to report the side affect.

Other Meds: fluoxetine, buspirone, womens vitamin

Current Illness: none

ID: 1003518
Sex: F
Age: 45
State: OK

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

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

Lab Data:

Allergies: Shellfish Latex

Symptom List: Injection site pain

Symptoms: Patient waited approximately 20 minutes after receiving vaccine as is standard. Patient began to drive home when she started to notice tingling in her lips, feeling flushed, and then as though her throat was closing. She contacted 911 and they responded road side. Patient was initially being monitored only, then her BP dropped. Decision was made to transport patient to ED. En route she received epinephrine and was placed on O2 by way of non-rebreather mask. Upon arrival to the ED patient continued to be dyspneic. She was given solumedrol, benadryl, Pepcid, and mag. Patient was stabilized and no additional epi was required. Patient was admitted to hospital in observation status. She was stable overnight. She did have one episode of itching and nausea, she was given diphenhydramine and Zofran and these symptoms resolved. Patient was monitored until around 1PM the day after event and was released to home in stable condition.

Other Meds: Albuterol

Current Illness: None

ID: 1003519
Sex: M
Age: 37
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Banana

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

Symptoms: I began having what felt like was nerve and joint pain along my left side of my face and arm. I developed a headache and was also nauseous. It went away after about 48 hours.

Other Meds: Hydrochloride, daily men?s vitamins

Current Illness: None

ID: 1003520
Sex: F
Age: 39
State: OR

Vax Date: 01/26/2021
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: N/A

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

Symptoms: 4 inch round area with swelling, redness, itching around injection site. Began at 1300 on 2/3/2021 continues today.

Other Meds: N/A

Current Illness: N/A

ID: 1003521
Sex: M
Age: 68
State: IN

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Extreme fatigue Fevers of up to 103.5F Could not get warm Body/joint aches (even knuckles on both hands)

Other Meds: Tamsulosin Atorvastatin

Current Illness:

ID: 1003522
Sex: M
Age: 41
State: MA

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

Lab Data:

Allergies: N/A

Symptom List: Erythema, Pruritus

Symptoms: Right Arm rash, hard, warm-to-touch, 2-3cm below injection site, area enlarged each day (two days)

Other Meds: Lexapro 20mg, Prevacid 30mg, Multi-Vitamin, Zrytec, Probiotic

Current Illness: N/A

ID: 1003523
Sex: M
Age: 45
State: WA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
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: No

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

Symptoms: Body pain Fever Chills Fatigue Abdominal bloating

Other Meds: No

Current Illness: No

ID: 1003524
Sex: F
Age: 70
State:

Vax Date: 01/26/2021
Onset Date: 02/02/2021
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: Sulfa

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

Symptoms: Rash presenting one week later at injection site, approximately 4 inches by 5 inches. Red, itchy, hard.

Other Meds: None

Current Illness: None

ID: 1003525
Sex: F
Age: 42
State: PA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
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: Amoxicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore arm, gi upset, diarrhea, head ache

Other Meds: Topamax

Current Illness: Headaches Depression (past) Seizures (none in over 2 years)

ID: 1003526
Sex: F
Age: 48
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Shellfish

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

Symptoms: Allergic Reaction had to be taken to The ER. Treatment Benadryl IV and monitored

Other Meds: No

Current Illness: No

ID: 1003527
Sex: F
Age: 46
State: IN

Vax Date: 01/13/2021
Onset Date: 01/17/2021
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: None

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

Symptoms: 4 days post 2nd vaccine I started vaginal bleeding. Lasted 2 weeks. Bleeding stopped for a few days then I started my regular period on my regular schedule

Other Meds: Cymbalta Singulair imitrex vitamin D Lmethylfolate Topamax

Current Illness: None

ID: 1003528
Sex: F
Age: 75
State: LA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
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: Pain in extremity

Symptoms: PATIENT EXPERIENCED HIVES ON TORSO, ARMS AND LEGS; CHILLS

Other Meds:

Current Illness:

ID: 1003529
Sex: F
Age: 72
State: CA

Vax Date: 01/20/2021
Onset Date: 01/22/2021
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: none

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

Symptoms: two days after initial shot, red and swollen arm at site. 3 days after, cold and flu feeling aches for 1 day, 7 days after itching all over body 20 days later flu feeing aches

Other Meds: none

Current Illness: none

ID: 1003530
Sex: F
Age: 43
State: NY

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

Lab Data:

Allergies: Bees, wasps -anaphyaltic

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

Symptoms: Dose 1: Light headed, asthmatic light breathing after 10 mins. mild headache within 1 hour. Extreme Headache lasted 4 days intensified after first full day, arm tenderness 5 days Dose 2: Light headed, extreme nausea, heat flush, redness in face within 5-15 mins of shot. Continuous nausea, no appetite for 18 hours; first evening sever fatigue full body aches, low mobility in legs, serve chills and extreme headache; second day nausea improved, fatigue, body aches, chest tightening, intermittent headache - treated with Advil. Evening fatigue, chest tightening, chills

Other Meds: 150mcg Synthroid 2000 units Vit D

Current Illness: Thyroid disease, hypothyroidism

ID: 1003531
Sex: F
Age: 88
State: CA

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

Lab Data:

Allergies: Not aware

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

Symptoms: Sleepy on the evening of shot, sleepy and weakened arm and leg strength , slurred speech, complains of headache and dizziness (difficult to validate)

Other Meds: Simply 12.5mg hydrochlorothiazide , omeprazole and vitamins

Current Illness: Recovered from Covid and released from ?watch?

ID: 1003532
Sex: F
Age: 29
State: NV

Vax Date: 01/21/2021
Onset Date: 01/24/2021
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: Latex, mango, various skin products, fragrances, adhesives

Symptom List: Vomiting

Symptoms: Mid to low grade fever (99.5-101) from 3 days to 2 weeks following vaccine, nausea from 3 days to ~12 days after vaccine

Other Meds: Multivitamin, vitamin d, loratadine

Current Illness: N/A

ID: 1003533
Sex: F
Age: 65
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Tetracycline

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever, tired, loss of appetite, sleepy, achey

Other Meds: Citalopram, levothyroxine, rusivastatin, metformin, vitamin, d3, fiber gummies,

Current Illness:

ID: 1003534
Sex: M
Age: 65
State:

Vax Date: 02/03/2021
Onset Date: 02/04/2021
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: n.a.

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

Symptoms: About 12 hours after the vaccination I had diarrhea and then again about 3 hours later.

Other Meds: lisinopril, hctz, metoprolol, eliquis, lipitor, amlodipine, predisone

Current Illness: diverticulitis

ID: 1003535
Sex: F
Age: 73
State: AK

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: IM
Vax Site: LA

Lab Data:

Allergies: Advil, Robitussin, Naprosyn, Paroxetine, Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Generalized itching, runny nose since time of injection. On day 6 develop raised warm area over site of injection, 8 cm, 4 cm x 1 mm

Other Meds: None

Current Illness: None

ID: 1003536
Sex: F
Age: 66
State: CA

Vax Date: 01/26/2021
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: Penicillin Nitroglycerin Bee stings

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

Symptoms: Red swollen itchy patch or hive at injection site starting on day 8 after the first dose

Other Meds: Calcium tablet Vitamins B-12, C, D3 Biotin

Current Illness: None

ID: 1003537
Sex: F
Age: 63
State: OH

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Extreme muscle pain at injection site within three hours of inoculation, headache within seven hours and general achiness all over body and fever of 101 x 6 p.m.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm