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: 1006989
Sex: M
Age: 85
State: WA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Fever at 100.3 and was resolved the same day

Other Meds:

Current Illness:

ID: 1006990
Sex: F
Age: 19
State: MA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Student received second dose Moderna yesterday (2/4), today (2/5) developed nausea and lightheadedness and had a syncopal episode. Seen and evaluated at clinic. Recovered and no further concerns.

Other Meds: None

Current Illness: None

ID: 1006991
Sex: F
Age: 22
State: MA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: Strawberries

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

Symptoms: About 2m after second COVID shot patient began feeling burning eyes and slight difficulty breathing. Paramedic onsite immediately listened to lungs and heard diffuse wheezing bilaterally. Within 1m minute patient felt throat tickling and then tightening and breathing was more difficult. Paramedic gave patient EpiPen with resolution of symptoms in less than 1-2 minutes. Ambulance called and arrived very quickly. Patient was transported to hospital. As way to hospital patient felt breathing getting worse again and was given solumedrol and benadryl IV and a second EpiPen. Don't yet know what happened beyond this.

Other Meds: unknown

Current Illness: None

ID: 1006992
Sex: M
Age: 56
State: AK

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Migraine, felt sick to his stomach and dizziness

Other Meds:

Current Illness:

ID: 1006993
Sex: M
Age: 67
State: WA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Chills after 6hrs Fever 102F after 24hrs Body pain radiating in right arm and leg n thymus area

Other Meds: Oncet CF

Current Illness: Sore throat

Date Died: 01/26/2021

ID: 1006994
Sex: F
Age: 75
State: WV

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/05/2021
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: penicillin and sulfa

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

Symptoms: Patient had one occurrence of thrombotic thrombocytopenic purpura in 1996 for which she had plasma exchange therapy in 1996. No other occurrence since 1996 until she received her first dose of the Pfizer covid vaccine.

Other Meds: atorvastatin Excedrin Extra Strength gabapentin lansoprazole Lantus Solostar U-100 Insulin lisinopril Ozempic phenazopyridine Prelief Vitamin B-12 vitamin D3-vitamin K2 (MK4) zolpidem

Current Illness:

ID: 1006995
Sex: F
Age: 48
State: ID

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Nuts; sulfa; penicillin, doxycycline; latex; tegretol

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fever, chills, muscle aches, abdominal pain, fever; lethargy

Other Meds: Wellbutrin; Lexapro; gabapentin; DHEA; aderrall; bi-est;

Current Illness: Sinus infection

ID: 1006996
Sex: F
Age: 31
State: NY

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Almost 12 hours after receiving the injection I woke up from sleep with chills and a fever. This didn't last long - maybe a couple hours. I fell asleep without an issue and woke up in the morning with SEVERE arm pain as well as fatigue and like generalized weakness - I essentially felt like I was getting sick with a cold or something. This lasted a couple days but the arm pain was terrible. It felt like someone had taken a baseball bat to my upper arm - I had very limited range of motion and felt severe pain in the region of my joint capsule. This eventually went away, but I still feel like my arm is a little stiffer than it was previously - it cracks and pops when I do yoga and such and it never did this before.

Other Meds: None

Current Illness: None

ID: 1006997
Sex: F
Age: 55
State: TN

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt stated she could not swallow as well as she normally does. Pt did not complain of SOB.

Other Meds:

Current Illness:

ID: 1006998
Sex: F
Age: 46
State: MN

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Body aches beginning the evening of the day of injection and continue

Other Meds:

Current Illness:

ID: 1006999
Sex: M
Age: 64
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Elevated Temp 100.0

Other Meds:

Current Illness:

ID: 1007000
Sex: F
Age: 51
State: RI

Vax Date: 12/31/2020
Onset Date: 01/15/2021
Rec V Date: 02/05/2021
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: penicillin, amoxicillin, bactrim

Symptom List: Rash, Urticaria

Symptoms: approximately 2 weeks after vaccine injection patient developed macular-papular, pruritic rash on feet. no other new medications taken by patient or allergens applied to area.

Other Meds: vit d3 1000 units daily senna-docusate prn

Current Illness: n/a

ID: 1007001
Sex: F
Age: 62
State: AZ

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Numbness in the left arm and left hand for about 2.5 days. Severity lessened as days progressed

Other Meds: Calcium 600mg daily

Current Illness: None

ID: 1007002
Sex: F
Age: 71
State: PA

Vax Date: 01/23/2021
Onset Date: 01/30/2021
Rec V Date: 02/05/2021
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: tetracyclinic, ASA/ NSAIDs ,codeine, roboxin

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

Symptoms: 8 days after the first injection got hives (painful, itchy, and very red) on the trunk, chest, back, and some on arms

Other Meds: Buproprion 200mg, Gabapentin 300 ER Magnesium 400 mg ADK Glucosamine chondroitin probiotic

Current Illness: None

ID: 1007003
Sex: F
Age: 31
State: TX

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 02/05/2021
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: I was feeling SOB at work, but by the end of the day I would have to sit down and catch my breath. I didn't feel like I was getting enough oxygen. I was light headed. Removing my scrub top was enough to make me pass out. My boyfriend called 911 and after monitoring me for 45 min, they determined that it was best to go to ER. Heart rate was in 160s, Respiration was in the 60s, Carbon Dioxide was 11 and pulse ox was around 7%. They did EKG , CT Scan and they gave you oral Benzo. They told me that I probably got the vaccine too soon after COVID diagnosis, which I had in Dec.

Other Meds: Prenatal vitamins Adderall

Current Illness: Tested positive for COVID on DEC 28th.

ID: 1007004
Sex: M
Age: 64
State: CO

Vax Date: 12/20/2020
Onset Date: 12/29/2020
Rec V Date: 02/05/2021
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: NKA

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

Symptoms: lymphopenia noted on metabolic monitoring labs/depression evaluation

Other Meds: sertraline

Current Illness:

ID: 1007005
Sex: F
Age: 21
State: MO

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 02/05/2021
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: NA

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

Symptoms: headache (constant, more intense in AM/PM), 2 capsules in morning and at night, dampened but didn't completely remove nausea (constant, worsened with food) night sweats (only for first four nights post vaccine) fatigue (constant since vaccine)

Other Meds: spiranolactone 100mg zyrtec 10 mg

Current Illness: NA

ID: 1007006
Sex: F
Age: 79
State: IN

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Elevated Temp 100.8

Other Meds:

Current Illness:

ID: 1007007
Sex: F
Age: 49
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Immediate rash and swelling. Was given 50ml Benadryl I he injection in same arm. Rash continues to spread. Very itchy. All over. Legs back stomach neck chest arms hips buttocks. Still spreading and uncontrollably itchy. Have seen PCP and was given steroid ointment. Doesn?t help at all. Seeing doctor again next Monday

Other Meds: None

Current Illness: None

ID: 1007008
Sex: F
Age: 66
State: TX

Vax Date: 01/16/2021
Onset Date: 01/26/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: Ceftin, Excedrin, Neosporin

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

Symptoms: 10 days after receiving the vaccine, presented with rash on lower legs, fever, chills, night sweats, muscle & joint pain. ER treated me for cellulitis although results of blood work, etc which came back after diagnosis did not show anything wrong. IV steroids, antibiotics, Tylenol at ER & oral steroids/antibiotics 5 days following. Rash gone the next day and fever broke that night. Symptoms except rash returned immediately once discontinued medication 5 days later and have persisted for the past 5 days with fever as high as 104.8. Re-read my Moderna material wondering if anything in the vaccine could be causing it and was told adverse reaction can appear as much as 3 weeks later and that symptoms I had were common.

Other Meds: Zyrtec, Singular, Acyclovir, Vitamin D, Calcium

Current Illness: None

ID: 1007009
Sex: F
Age:
State: AR

Vax Date:
Onset Date:
Rec V Date: 02/05/2021
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: Sulfa drugs talwin shots

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

Symptoms: Headache Muscle and joint aches fatigue Jan 21 2021 until present Feb. 5. Doctor visit Feb 4

Other Meds: Yes

Current Illness: No

ID: 1007010
Sex: F
Age: 58
State:

Vax Date: 01/15/2021
Onset Date: 02/01/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: Sulfa-rash Keflex/ hives Indomethacin and imitrex chest tightness

Symptom List: Unevaluable event

Symptoms: 2/1 awakened with multiple fingers swollen and painful middle joints only. Sausage fingers. This increased in severity I took nsaids topical steroids Saw rheumatologist who ordered prednisone snd multiple lab tests. Suspect autoimmune reaction triggered by vaccine in some way. Also have migraine

Other Meds: Synthroid Amoxicillin Valtrex Estradiol Citrucell Vitamin d

Current Illness: None

ID: 1007011
Sex: F
Age: 70
State: AZ

Vax Date: 01/27/2020
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: reported delayed reaction occuring 7 days after vaccine. Rash all over body and in between fingers.

Other Meds: pravastatin 10 mg; Vit D2 1,250mcg , chlorthalidone 25mg tablet

Current Illness: none

ID: 1007012
Sex: F
Age: 64
State: OR

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/05/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: slightly sore and stiff arm ( similar to tetnis shot) about 5 hours after; restless, tired, & general feeling "unwell" about 7 hours; fever at 10 hours. Fever of 101.7 sustained from 2 AM through the day until 8 PM when it dropped to 99.8. By 10 PM fever resolved & was asymptomatic. Treatment was Tylenol, hot shower, hot bath, hydration, & rest.

Other Meds: Tylenol, Vitamin D, Krill oil, low does aspirin, multi vitamin, bupropian SR

Current Illness: none

ID: 1007013
Sex: F
Age: 61
State: CO

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Red itchy painful rash below injection site

Other Meds: Progesterone finastride raberprazole Vit D as needed zolpidem maxalt. Testosterone cream

Current Illness: None

ID: 1007014
Sex: F
Age: 36
State: MN

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Woke up with chills, sore arm, body aches, coughing, and headache

Other Meds:

Current Illness:

ID: 1007015
Sex: F
Age:
State: CA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: About hour after Injection lightheaded, next day fatigued.

Other Meds:

Current Illness:

ID: 1007016
Sex: F
Age: 74
State: MI

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Day following first Moderna vaccine, started getting a very itchy rash which covered much of upper half of back. Looked more like red blotches than smaller rash. Just placed powder etc. on it myself for a few days until I saw Doctor 2/2/2021 for previously scheduled wellness check. Doctor prescribed a Prednisone pack ( 21 pills over six days) to address the itching/rash.

Other Meds: Levothyroxine Atorvastatin 10mg tab. pm; Levothyroxine 125 mg am; Super B-Complex; CoQ10 100 mg 2/day; D3 50mcg (2000 IU) 2/day; Magnesium 400 mg. once/day; Multple Vitamin 1xday; PreserVision Areds 2 one/day.

Current Illness: Immune Thrombocytic Purpura (dx'd 8/20) ..... on no meds for this.

ID: 1007017
Sex: F
Age: 36
State: AK

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: No known allergies

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

Symptoms: Approximately one hour after the injection, patient reported difficulty swallowing, throat swelling/tingling, tongue thickness

Other Meds: no

Current Illness: none

ID: 1007018
Sex: F
Age: 69
State: TX

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: at one point had a reaction Sulfa drugs. No other allergies known.

Symptom List: Nausea

Symptoms: Flu like symptoms, low grade fever, aching and fatigued

Other Meds: Myrbetriq 50 mg 3 times/week Loratadine 10 mg/daily Fluticasone Propionate Nasal spray CoQ-10 100 mg/daily Melatonin 10 mg OR 1/2 tab Unisom/ daily Multivitamin Fish Oil 1200 mg + 360 mg Omega-3/daily Vitamin D3 50 mcg/daily Vitamin E

Current Illness: none

ID: 1007019
Sex: F
Age: 45
State: FL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: PT COMPLAINED OF ITCHING AT INJECTION SITE. DEFERRED IMMEDIATE TREATMENT. STATED SHE WOULD TAKE A BENEDRYL WHEN SHE GOT HOME. ADVISED TO SEEK ADDITIONAL MEDICAL HELP IF SYMPTOMS WORSENED BY RN.

Other Meds: EFFEXOR

Current Illness: UNKOWN

ID: 1007020
Sex: F
Age: 54
State: CA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: First on a rash below the vaccine site. Second Rash around vaccine site, fever, chills, arm very sore, fatigue and had to call into work.

Other Meds:

Current Illness:

ID: 1007021
Sex: F
Age: 96
State: IN

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Elevated temp 99.6

Other Meds:

Current Illness:

ID: 1007022
Sex: F
Age: 29
State: SD

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: Sulfa is listed as allergy because her mother has a severe allergic reaction to sulfa. Patient denies any known allergy to sulfa.

Symptom List: Tremor

Symptoms: Patient arrived to vaccine clinic for her 1st Pfizer vaccine. She received her vaccine at 1606. She was then walked out to the waiting room to wait her 15-20 minutes that is strongly recommended after receiving the vaccine. Approximately 5 minutes later, she alerted the reception staff that she was having some sort of reaction. I was then notified immediately and patient was brought back to a private exam area. Patient complained of chest tightness, numbness in fingers and a racing heartbeat. She also felt that she was having difficulty breathing. Vital signs at that time were 96.3 temperature, RR 36, blood pressure 170/100 and a heart rate of 174. Patient received (1) epipen and 911 was simultaneously notified. 2 liters of oxygen via nasal cannula were applied. Shortly after epipen was given and oxygen applied, patients heartrate decreased into the 130s. Oxygen remained stable at 99-100% on 2 liters nasal cannula. Ice pack applied to base of neck for comfort. EMS arrived and report given as patient will be taken to the emergency department for further evaluation.

Other Meds: Sertraline 50 mg table once daily by mouth Prenatal vitamin 1 tablet daily

Current Illness: None to report.

ID: 1007023
Sex: F
Age: 57
State: OR

Vax Date: 01/22/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
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: Gluten, Corn, Soy, Dairy Strawberries, Pineapple, Apple Vicoden, Contrast Dye

Symptom List: Erythema, Pruritus

Symptoms: a small knot that is still a little swollen and red.

Other Meds: Lisinopril, Chlorthaladone, Metropolol, Warfarin

Current Illness: None

ID: 1007024
Sex: F
Age: 84
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: N/A

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

Symptoms: DIZZINESS, W EAKNESS

Other Meds: N/A

Current Illness: N/A

ID: 1007025
Sex: F
Age: 73
State: IL

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 02/05/2021
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, Penicillin, fragrances

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

Symptoms: Headache A severe feeling of burning on my facial skin and a flushing of the skin My forehead felt as though I had a severe sunburn A slightly elevated temperature: normal is 97.3 elevated 98.6 All day 02/01, Partial day 02/02, Redness gone and feeling of burning less severe 02/03 and 02/04. 02/05 a couple of episodes of sensation of facial burning and slightly elevated temp

Other Meds: Amlodipine, Amitriptyline, Restasis, Vit. D3, Lutein

Current Illness: None

ID: 1007026
Sex: F
Age: 59
State: ND

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: woke up with chills and feeling feverish

Other Meds:

Current Illness:

ID: 1007027
Sex: M
Age: 72
State: TX

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/05/2021
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: Extreme fatigue , aches, headache and nausea. Right arm very sore for about three days. No respiratory problems. Food doesn't taste normal. Felt just as bad as when I had Covid 19. Very little strength to get out of bed and slept all day into the night. Took shot on Monday, then sick all day the following Tuesday. On Wednesday I was better , but was still very fatigued and had mild headaches . By Thursday was back to normal.

Other Meds: None

Current Illness: Covid 19 last week of Oct. 2020 to first week of Nov. 2020

ID: 1007028
Sex: F
Age: 85
State: IN

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Elevated temp 100.6

Other Meds:

Current Illness:

ID: 1007029
Sex: F
Age: 37
State: VA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: Latex, avocado, adhesive tape, strawberries, sulfa, ultram, augmentin

Symptom List: Pain in extremity

Symptoms: Left arm sore at day 10, arm itching, large red hive, itching down arm.

Other Meds: Nucynta, Gabapentin

Current Illness: n/a

ID: 1007030
Sex: M
Age: 34
State: CA

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 02/05/2021
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: Soreness in injection site arm, unable to raise arm over head level, and swollen lymph nodes in left side of neck and shoulder.

Other Meds: None

Current Illness: None

ID: 1007031
Sex: F
Age: 62
State: TN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Simponi Aria infusion

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

Symptoms: soreness in arm, bad headache, nausea, itching on head, face and upper body.

Other Meds: calcium, folic acid, vitamin D, vitamin C, Methotrexate injection, Celebrex, Sulfasalazine

Current Illness:

ID: 1007032
Sex: F
Age: 85
State: WA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: HAD A FEVER AT 100.7 AND WAS RESOLVED ON THE SAME DAY

Other Meds:

Current Illness:

Date Died: 02/04/2021

ID: 1007033
Sex: M
Age: 76
State: CA

Vax Date: 01/22/2021
Onset Date: 02/01/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Patient presented to emergency room on 2/1/2021 with a chief complaint of having a chronic headache and fatigue following receipt of the Moderna vaccine 10 days prior. Following examination by the physician, the patient was diagnosed with an acute subdural hematoma. The patient subsequently underwent decompressive surgery, however demonstrated worsening neurologic status over the next several days and ultimately expired on 2/4/2021.

Other Meds: ? acetaminophen (TYLENOL) 500 mg tablet, Take 500 mg by mouth once daily as needed for mild pain (level 1-3)., Disp: , Rfl: ? amLODIPine (NORVASC) 10 mg tablet, Take 10 mg by mouth every evening. , Disp: , Rfl: ? ascorbic acid (VITAMI

Current Illness: History of headaches

ID: 1007034
Sex: M
Age: 62
State: MD

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Muscle cramps in lower back area. Feels like Kidney area Cramps started on 1/31/2021. I called out of work on 2/1/2021 Went to urgent care on 2/5/2021. I had blood work done

Other Meds: Rosuvastatin- 20 MG a day Gabapentin- 300 MG a day Lisinopril- 20 MG a day Aspirin- 325 MG a day

Current Illness: None

ID: 1007035
Sex: F
Age: 69
State: IN

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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:

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

Symptoms: Elevated temp 101.2

Other Meds:

Current Illness:

ID: 1007036
Sex: M
Age: 30
State: WA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Approximately 2 1/2 hours after the vaccine administered, he felt lightheaded and nauseated. Began sweating, and shaking for about 5 minutes. Continued to have episodic dizziness over the next 4 hours.

Other Meds:

Current Illness:

ID: 1007037
Sex: F
Age: 57
State: CA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: chills sore arm fever headache

Other Meds:

Current Illness:

ID: 1007038
Sex: F
Age: 62
State: NE

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
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: Cephalosporin. Penicillin.

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

Symptoms: 2/3- aching. Fever 100.2. Nausea. Headache. Excerdrine taken 4 x that day and relieved the symptoms. 2/5- red hard itchy bumpy raised rash below injection site. Size is 9.2cm x10.6cm. Swollen lymph node.

Other Meds: Omeprazole

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm