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: 1007039
Sex: F
Age: 53
State: ME

Vax Date: 01/13/2021
Onset Date: 01/20/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: One week after receiving the vaccine I developed mild itching at my upper left arm. There was redness and warmth at that site, approx size of lime. The itching resolved quickly. I felt tired and the redness/warmth spread downward. It was checked and circled by a physician at an appointment for a different issue (knee)?plan to call if area of redness increases. It did, but I monitored and within 6 days it resolved.

Other Meds: Lexapro; estradiol patch; promethium, Vitamin D; Ashwaganda and maca supplements

Current Illness: None

ID: 1007040
Sex: F
Age: 86
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: HAD A SLIGHT FEVER OF 99.0 AND WAS RESOLVED ON THE SAME DAY

Other Meds:

Current Illness:

ID: 1007041
Sex: F
Age: 22
State: MN

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: became flushed, feverish, chills, body aches and headache shortly after arriving to work this AM

Other Meds:

Current Illness:

ID: 1007042
Sex: F
Age: 48
State: MD

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: Previous known reaction to Herceptin, also has allergy to vancomycin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Within 5 minutes of receiving COVID vaccine, she had SOB, throat tightness, coughing, itchiness. BP 182/91 HR106, RR 30. Lung were clear. Patient was given PO diphenhydramine 25 mg x1 with no change in symptoms. EMS on site evaluating symptoms. Repeat BP 142/100 HR 97, RR 22. Patient's symptoms continued to remain unchanged therefore EMS called for transport to local ED. One hour post initial event patient was being evaluated in ED with improvement of symptoms.

Other Meds:

Current Illness:

ID: 1007043
Sex: F
Age: 50
State: AL

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: LA

Lab Data:

Allergies: NKA

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

Symptoms: nodule development in axilla region, edema to posterior L arm, nausea, achy joints, chills, light headed, malaise

Other Meds: Amlodipine, HCTZ, Famotidine, Estrogen, Potassium, Turmeric, Biotin, Multi Vitamin, Fish Oil, Stool Softener, Tylenol Arthritis

Current Illness: None

ID: 1007044
Sex: F
Age:
State: VA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: None

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

Symptoms: Constant vomiting, diarrhea, horrible body aches, fever. Ended up going to the ER for dehydration and pain.

Other Meds: Fluoxetine Propranol

Current Illness: None

ID: 1007045
Sex: F
Age: 48
State: MO

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: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Started with headache, then body aches and upset stomach, abdominal cramping, and diarrhea. Started approximately 2 hours after injection lasting through current time (27 hours after injection)

Other Meds: Full aspirin daily, Bupropion daily, Escitalopram daily

Current Illness: None

ID: 1007046
Sex: F
Age: 39
State: DC

Vax Date: 01/22/2021
Onset Date: 01/23/2021
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: Severe dizziness and nausea that kept me in bed the entire day after the vaccine. Pain at injection site on arm.

Other Meds: None

Current Illness: None

ID: 1007047
Sex: F
Age: 36
State: IL

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: bee stings

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 6 minutes after receiving vaccine patient reported that her tongue was starting to swell and that her heart was racing. Staff called 911 immediately. Pulse was 166-169, BP 125/88, O2 sat 97%. No wheezing, and the patient was moving air and talking. I had an epi-pen on hand but waited since patient was moving air and had such a high HR. After a few minutes patient reported she felt better and that her tongue was still swollen but not any more so; HR 120s, O2 sat 97%. EMTs arrived 10:39 a.m., got the same VS, and they decided not to give epinephrine. Patient was initially reluctant to be transported by ambulance and intended to have sister drive her to ED. However she reported her tongue was overlapping her teeth all the way around, and was persuaded to go by ambulance. She walked out of public health clinic into ambulance. She was treated with IV Benadryl and steroids. The ED doctor diagnosed anaphylactic reaction but also did not give epinephrine due to tachycardia. She felt better, but 4 hours afterward she did have a rebound reaction and was treated with more Benadryl and again felt better. She was discharged from the ED with 2 epi-pens. She currently feels well. States that they are having her take PO Benadryl q 4 hours x 48 hours. She was treated in the emergency department.

Other Meds:

Current Illness:

ID: 1007048
Sex: M
Age: 77
State: AZ

Vax Date: 01/21/2021
Onset Date: 02/03/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: delayed reaction by 7 days. Rash over arms and in between fingers. applied cortisone cream 2% however still itchy. outcome promising not effecting airway of breathing in anyway. Advise can use Benadryl if needed. Advised may cause drowsiness.

Other Meds: lisinopril

Current Illness: None

ID: 1007049
Sex: M
Age: 87
State: AR

Vax Date: 01/06/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient was diagnosed with COVID-19 3 weeks 2 days after first dose (prior to second dose) of vaccine. He was hospitalized for 2 days secondary to mild hypoxia but has otherwise had mild course thus far.

Other Meds: acetaminophen, albuterol inhaled, Zyrtec, vitamin D, vitamin B12, Pepcid, Namenda, Ativan, oxycodone, Miralax, Effexor, Flomax, Senna

Current Illness: None known

ID: 1007050
Sex: F
Age: 46
State: IA

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: SYR
Vax Site: RA

Lab Data:

Allergies: n/a

Symptom List: Rash, Urticaria

Symptoms: During the 15 minute observation period, patient started to have shortness of breathe and became flush coloring

Other Meds: Epi Pen

Current Illness: bleeding disorder

ID: 1007051
Sex: M
Age: 34
State: CA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: None

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

Symptoms: Soreness in arm, progressed into aching more generally, chills, fatigue, headache. Symptoms felt like they started in the left arm and spread across the body over time. All symptoms nearly completely resolved by the next day.

Other Meds: None

Current Illness: None

ID: 1007052
Sex: F
Age: 49
State: CA

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

Lab Data:

Allergies:

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

Symptoms: high Fever vomiting headache chills

Other Meds:

Current Illness:

ID: 1007053
Sex: M
Age: 67
State: CA

Vax Date: 01/26/2021
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:

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

Symptoms: Moderna COVID-19 Vaccine EUA. Rash over chest, back, and neck. Took Benadryl 50 mg

Other Meds: Sertraline HCL 50 mg 1 tablet a day Centrum Silver Multivitamin 1 per day

Current Illness:

ID: 1007054
Sex: F
Age: 82
State: PA

Vax Date: 01/06/2021
Onset Date: 01/26/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Sudden pain started in the evening of January 26th from only the right shoulder to the elbow. It was so painful, she was crying. No pain from the vaccine when it was administered on January 6th or any other time. She believes it was from the shot, and not any thing else

Other Meds:

Current Illness:

ID: 1007055
Sex: M
Age: 78
State: IA

Vax Date: 01/30/2021
Onset Date: 02/02/2021
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: None

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

Symptoms: Patient had discoloration of skin/bruising at the injection site

Other Meds: None

Current Illness: Unknown

ID: 1007056
Sex: F
Age: 65
State: CA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
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: PCN, CIPRO, OCEPHIN, JACK FRIUT, HIBISCOUS, JUJUBEES, LATEX

Symptom List: Ear pain, Hypoaesthesia

Symptoms: RASH, REDNESS INNECK AREA, STARTED AT 7PM ON DATE OF VACCINE. C/O PAIN IN LEFT EAR, REDNESS THAT LASTED 5 DAYS, EAR PAIN LASTED 24 HOURS

Other Meds: OLAIR/ ING 150MG ., LISINOPRIL, CRESTOR, TIMOLOL, ALBUTEROL INHALER , CQ10, FISH OIL, CA , D3, MAGNESIUM

Current Illness: RECEIVED SOLUBMEDROL 150MG. INJECTABLE.

ID: 1007057
Sex: F
Age: 73
State: CA

Vax Date: 01/22/2021
Onset Date: 01/28/2021
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: Penicilin Amoxycilin probably all cillins Bactrim Antihistamines

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Itching at site of vaccine injection on my right arm 6 days after injection, I noticed a rash red and itching, then blotches combined into an "angry" red blotch that grew larger over the next 6 days, was sore, hot to the touch and itchy. Today, 2-5-21, the red blotch is faded but still visible. It no longer hurts, and itches intermittently and much less severely. Treatment: Tylenol mostly at night as pain disrupted sleep, ice on the red patch, and I took Benadryl. First time was helpful, stopped the itching and discomfort. Second time I had a reverse reaction and was jittery with more itching and discomfort. The outcome is that the redness has faded, no pain, not hot and itching is very low level. I expect this redness will disappear completely soon. My sister on east coast, had 1st Moderna shot 2 days before me and had the same experience, a little less severe.

Other Meds: Cytomel Avorstatin Evista Zetia Prilosec

Current Illness: none

ID: 1007058
Sex: F
Age: 43
State: MI

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: None

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

Symptoms: Sore right arm after injection. Jaw pain right side, unable to open mouth or eat for over 24 hours. Right arm 2 weeks later still has a red rash like area and warm to the touch and painful.

Other Meds:

Current Illness:

ID: 1007059
Sex: F
Age: 42
State: FL

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: CODEINE MORPHINE

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

Symptoms: PT COMPLAINED OF REDNESS AND ITCHING OF RIGHT UPPER ARM FOR 10 MINUTES. AFTER 10 MINUTES, THE RASH AND REDNESS BEGAN TO SPREAD DOWNWARD TOWARD ELBOW WITH INCREASED ITCHING THAT EXTENDED INTO THE AXILLA AREA. WAS TRANSPORTED TO URGENT CARE FOR FURTHER TREATMENT AND EVALUATION. URGENT CARE - 9:00 AM

Other Meds: albuterol sulfate 90 mcg/actuation INHALE TWO PUFFS BY MOUTH EVERY 4 HOURS AS NEEDED FOR SHORTNESS OF BREATH alprazolam 0.5 mg oral Every 8 hours PRN butalb/acetaminophen/caffeine 50-300-40 mg TAKE ONE TO TWO CAPSULES BY MOUTH AS NEEDED -

Current Illness: N/A

ID: 1007060
Sex: F
Age: 63
State: KY

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: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Had vaccine#2 at noon on the 4th. Woke up with 101 temp and body aches at 4:30 the next morning. Temp is down with tylonol but back, neck, eyes... Especially back are extremely sure and achy. Slept at day with no energy

Other Meds: Effexor, simvastatin,aspirin,klorcon,metformin hcl,pramipexole,gnc women's offer 50 vitamins

Current Illness: None

ID: 1007061
Sex: F
Age: 26
State:

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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: INH- dizziness, hypotension, nausea

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

Symptoms: Signs/Symptoms: fever 102.7, chills, headache, tiredness, restlessness, pain in arm, loss of appetite, malaise. Time: midnight 01/15- 12pm, administered theraflu relieved most symptoms and slept for 4 hours, headache, malaise, and fever 100.9 returned at 5pm, took another theraflu at 9pm. All symptoms resolved overnight.

Other Meds: Prenatal vitamins, nexplanon implant

Current Illness: None

ID: 1007062
Sex: F
Age: 57
State: AL

Vax Date: 01/29/2021
Onset Date: 02/05/2021
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: Sulfa drugs

Symptom List: Injection site pain, Pain

Symptoms: Rash, swelling, redness and pain upper right arm one week after injection

Other Meds: Metoprolol , lexapro, amlodipine

Current Illness: None

ID: 1007063
Sex: F
Age: 54
State: CA

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: Ace inhibitors Aspirin Latex

Symptom List: Injection site pain, Menorrhagia

Symptoms: I had a severe headache daily. I had fatigue and chills that eventually went away. On Jan 1st, the symptoms returned with a fever of 104, muscle aches and achy joints. Tylenol and Ibuprofen would only help it to go down to 101 or 102, but it would go back up. I went to urgent care around the 3rd, where they tested me for COVID but it was negative. I was still having symptoms days later, so I called my PCP. My doctor decided to do another COVID and a flu test, but both were negative. I gradually improved and then once I was fever free for 72 hours, I returned to work. I still had the headache, though. I am continuously completing my vsafe checks, but I was scared about getting the 2nd dose. I went ahead and got it. I had fever, chills, body aches and joint pains, but it only lasted two days.

Other Meds: Diabetes meds

Current Illness:

ID: 1007064
Sex: F
Age: 51
State: NM

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

Lab Data:

Allergies: Codeine and topamax

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

Symptoms: Patient recieved vaccine at 1312 and by 1315 patient started to complain of burning in the chest. Patient denied shortness of breathe at that time. vitals were taken and were within normal ranges. RN contacted provider and antacids were ordered for patient. Medication was administered by 1323 and patient verbalized relief at 1333. Patient was assessed for 15 minutes and was released to return home.

Other Meds: Loratadine, magnesium oxide, aloh/mgoh/simethicone, albuterol/ipratropium, metformin hcl, losartan, nystatin, carbamazepine, furosemide, gabapentin, calcium, ibuprofen, fluticasone/salmeterol, albuterol hfa, carvedilol, aspirin, spironolact

Current Illness: None reported

ID: 1007065
Sex: F
Age: 58
State: MN

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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: febrile, sore throat, body aches, leg cramps, chest pain (hurts to breathe)

Other Meds:

Current Illness:

ID: 1007066
Sex: F
Age: 52
State: OR

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: RA

Lab Data:

Allergies: Sulfa drugs Bee stings

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Malaise, fever, chills, body aches, bad headache, water diarrhea, sinus pressure, and weaknesa.

Other Meds: Morphine 15 mg ER and IR 1 each. Meloxicam Lisinipril Hydrochlorithyizide Aspirin 84 baby Phenetermine 30 mg Toprimate 25 mg Clonidine 10mg 2 times a day Methocarbomal 750 mg Atorvastatin 80 mg Duloxetine 90 mg Tylenol for fever and body

Current Illness: Healthy not ill or having any issues.

ID: 1007067
Sex: M
Age: 58
State: VA

Vax Date: 01/28/2021
Onset Date: 02/01/2021
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: none

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

Symptoms: Pain, Numbness and loss of feeling from right neck, right shoulder, arm elbow and index and middle fingers. Started 2/1/21 worsened until this report 2/5/2021. Seeing neurologist 2/6/2021. Treatment rest and inactivity. Unknown outcome at this time.

Other Meds: Glucovance 2.5/500 , 1 tab in AM, 3 tabs in PM Januvia 100mg 1 tab in AM Zinc 50 mg daily Magnesium 250 mg daily Vitamin D3 25mcg BID Vitamin C 500 mg daily

Current Illness: none

ID: 1007068
Sex: F
Age:
State: CO

Vax Date:
Onset Date:
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: None

Symptom List: Nausea

Symptoms: I did not feel particularly lightheaded or dizzy, but I passed out in my kitchen while preparing breakfast at approximately 7:30 AM on the morning following my vaccination

Other Meds: Propaphanone Lisinopril Tobias Estrace suppository Women?s flora probiotic Maganesium malate Ubiquinol B vitamin complex Vitamin C

Current Illness: None

ID: 1007069
Sex: F
Age: 84
State: IL

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

Lab Data:

Allergies: Dimetapp

Symptom List: Injection site pain

Symptoms: Cold and shivering, painful arm, tiredness, nauseated, sweating. The next day she felt better but had no appetite.

Other Meds: Tylenol Arthritis, stool softner, Losartan, Atorvastatin, Amlodipine, Omeprazole, One A Day, Calcium

Current Illness: no

ID: 1007070
Sex: F
Age: 22
State: MI

Vax Date: 01/18/2021
Onset Date: 01/19/2021
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: n/a

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

Symptoms: Since the day of the vaccine, I have had a change in taste. Whenever I eat meat or anything savory, it tastes like gasoline. Some other things taste funny too. It began with my toothpaste, so I just thought it was a bad tube. After buying a new brand of toothpaste, I discovered that it was my tastebuds that were off. Toothpaste and anything minty or savory I once loved eating now tastes like gasoline smells. Once loved smells from cooking food are also unbearable now. Most sweet foods still taste the same, though and are good.

Other Meds: omeprazole, 40 mg

Current Illness: n/a

ID: 1007071
Sex: F
Age: 23
State: NC

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: Pt was in observation after her COVID administration. She began to feel lightheaded, felt her heart was racing. She denied SOB, sensation of throat swelling, sense of impending doom. She reported she had not eaten for hours and felt "very hungry." She was offered juice but she states she does not drink juice. She was sipping water. She ate some crackers. Feet were elevated upon encountering pt. She was with her partner. Initial vitals: Pulse 58 O2 sat 100% BP 80/52 (pt reports her BP always "runs low") 5:35 pm vitals: Pulse 55 O2 sat 100% BP 96/70. Pt reports she is at baseline. Continued to report she felt she had worked herself up into an "anxiety attack." Pt left facility with her partner eager to "go eat." She had all contact information if she has any other sxs. Pt was in observation after her COVID administration. She began to feel lightheaded, felt her heart was racing. She denied SOB, sensation of throat swelling, sense of impending doom. She reported she had not eaten for hours and felt "very hungry." She was offered juice but she states she does not drink juice. She was sipping water. She ate some crackers. Feet were elevated upon encountering pt. She was with her partner. Initial vitals: Pulse 58 O2 sat 100% BP 80/52 (pt reports her BP always "runs low") 5:35 pm vitals: Pulse 55 O2 sat 100% BP 96/70. Pt reports she is at baseline. Continued to report she felt she had worked herself up into an "anxiety attack." Pt left facility with her partner eager to "go eat." She had all contact information if she has any other sxs.

Other Meds: none

Current Illness: none

ID: 1007072
Sex: M
Age: 32
State: AZ

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: Erthyromycin, Doxycycline

Symptom List: Tremor

Symptoms: Patient received his vaccine and was waiting in the post-vaccination waiting space. Within 5-10 minutes he slumped in his chair and became unresponsive. Became responsive to voice but was slurring his words. Patient was diaphoretic. HR in 90s, O2 98%. His eyes rolled back in his head suspecting vasovagal episode, we moved patient to the floor and raised his legs. He became more responsive. Was fully oriented although did not seem incredibly alert. Cycled multiple BPs with 100s-110s/60s-70s. HR 70s-80s supine, O2 sat 96-98%. EMS was called for transport to ED given patient's lack of prompt recovery. We attempted to sit patient up and he again became lightheaded and had to lie back down. While in supine position, remained with normal and stable VS. At no time did he manifest any rash, respiratory symptoms, throat or chest tightness, abdominal discomfort, or other overt signs of anaphylaxis. Patient was transported to the ED where ROS was reported as: - CONST: +fatigue, denies fevers or chills - EYES: Denies vision changes - ENT: Denies rhinorrhea, sore throat - CV: Denies new chest pain - RESP: Denies SOB or cough - GI: Denies abd pain, n/v, diarrhea - GU: Denies dysuria - MSK: Denies new joint swelling or pain - SKIN: Denies new lesions or rash - NEURO: Denies new HA, numbness, or weakness - PSYCH: Denies suicidal ideation Vitals: BP 116/67, O2 99% on RA, Temp: 97.7F, Pulse 79. ED provider felt this was most likely vasovagal episode given occurrence following vaccine administration and associated sxs. EKG without evidence of dysrrhythmia. No PE risk factors, SOB or CP. Pt with HA that was not thunderclap nor severe in nature and was consistent with prior migranes, thus do ot suspect SAH. No hx to suggest anemia and no anemia on blood work today. No report of seizure. Pt is alert without report of post-ictal period.

Other Meds: Prazosin, Triumeq, Cholecaliferol, Mirtazapine

Current Illness: None

ID: 1007073
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NK

Symptom List: Erythema, Pruritus

Symptoms: soreness in arm, headache

Other Meds: Simvastatin, Hydrochlorothiazide, Cozaar, ASA81, PepcidNKn

Current Illness:

ID: 1007074
Sex: F
Age: 61
State: MN

Vax Date: 02/04/2021
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:

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

Symptoms: woke up with sore arm and some nausea

Other Meds:

Current Illness:

ID: 1007076
Sex: F
Age: 61
State: MD

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Syncope and hypotension. No previous history of syncope. Syncopal episode 20 hours after injection . Other symptoms were chills, low grade fever, headache. No allergic rxn, no rash. Hypotension lasted for several hours.

Other Meds: Actonel one pill weekly

Current Illness: None

ID: 1007077
Sex: M
Age: 29
State: NJ

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: Na

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Chills , Fatigue , Severe Head Ache , Body Aches , congestion , fever

Other Meds: Na

Current Illness: Na

ID: 1007078
Sex: M
Age: 63
State: NJ

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Honeydew melon Mold Cats Grass

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

Symptoms: Trouble falling asleep night of vaccine, headache, nausea,,dizzy, off balance (slight).

Other Meds: Bystolic Zetia Livalo Finasteride Tamsulosin

Current Illness:

ID: 1007079
Sex: F
Age: 51
State: CA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: Penicillin

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

Symptoms: about 10 minutes after receiving vaccine i got swelling of the tongue, mouth and a little hard to swallow , constriction of throat. i was given an epi pen and taken to Emergency at Medical Center. I was released a couple hours later. I ended up going back to Emergency later on that evening but to Hospital. Tongue started to swell up again and was getting constriction of the throat and hard to swallow. Got released a couple hours later

Other Meds: Daily multi vitamin, Fish Oil,

Current Illness: N/A

ID: 1007080
Sex: F
Age: 68
State: CA

Vax Date: 01/26/2021
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:

Symptom List: Pain in extremity

Symptoms: Tenderness, swelling, itching, heat rash in irregular shape over area of vaccination started 2/4/21 at 6 PM, slightly improved on 2/5/21.

Other Meds:

Current Illness:

ID: 1007081
Sex: F
Age: 27
State: CA

Vax Date: 01/12/2021
Onset Date: 01/14/2021
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: N/A

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

Symptoms: 4 hours after the dose I became extremely sleepy and was unable to lift the arm I got the vaccination in. 2 days after the first dose I experienced very sharp stomach pains in my upper abdominal area (close to my solar plexus region). This lasted for approximately 2 days. No vomiting from it but I was nauseous.

Other Meds: Wellbutrin, Gabapentin, Adderall, Deplin

Current Illness: None

ID: 1007082
Sex: M
Age: 21
State: AZ

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: benadryl

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

Symptoms: Tingling sensation down right arm (arm of injection) into fingers. Had sensations of hitting funny bone in elbow. We gave apple juice. Started to feel light headed and escorted to emergency room.

Other Meds: no

Current Illness: none

ID: 1007083
Sex: F
Age: 59
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Severe body aches beginning the evening of 2/4

Other Meds:

Current Illness:

ID: 1007084
Sex: M
Age: 51
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Headache Body/joint ache Chills 101.5 F fever Above symptoms lasted about twelve hours. Symptoms abated after administering ibuprofen

Other Meds: None

Current Illness: None

ID: 1007085
Sex: F
Age: 43
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: In addition to severe pain in my left arm at and around the injection site, my left lower back - which had been being treated by a doctor for a couple of years and was not hurting anymore - is now ON FIRE! Like hot knives stabbing me constantly in the same spot that was initially problematic resulting in MRIs, physical therapy, and taking Meloxicam (which I had stopped taking). My arm and back have both gotten progressively worse throughout the day.

Other Meds: Levothyroxine Norethindrone Acetate and Ethinyl Estradiol Tablets

Current Illness: Tested positive for Covid 1/14/21. Tested negative for covid 1/22/21. Received a cortisone shot for a sore throat, severe cough, and loss of voice on 1/11/21.

ID: 1007086
Sex: F
Age: 46
State: FL

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: Sulfa drugs Shellfish Tree nuts - pecan, brazil, macadamia

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

Symptoms: Within a few minutes of vaccine, I got a severe piercing headache and nausea / vomiting which we attributed to nerves and I went to go home without reporting. During the drive the headache and nausea got worse and my extremities and face began to tingle. My chest felt tight. My body was shaking. My colleague noted weak pulses and pale complexion. I am a doctor and gave myself epinephrine 0.3 mg IM and within 60 to 90 seconds the symptoms improved dramatically. I had my husband pick me up at the office and went home. The headache and nausea worsened on the drive but then settled down significantly. I rested for a few hours, then took oral pred 20 mg at about 2:45. I noticed that my headache was back and very intense at about 3:15 pm. No nausea this time, but my left eye began itching and it was very tight / hard to breathe. My extremities began tingling and I had spasms / tremors of my muscles. I injected another 0.3 mg epi into my thigh and followed with dex sodium phosphate 4 mg IM. Symptoms resolved within about 2 to 3 minutes. I took 40mg more of oral pred. I also took 10 mg of pepcid PO. I am still feeling well now with no headaches or other symptoms at this writing (7:30 pm), but I have another doctor with me and we are 2 minutes from the ER if needed. I am marking unknown below since it has only been a few hours without symptoms.

Other Meds: Ondansetron 8 mg at 7:30 am Vit D, A, Zinc

Current Illness: None A little nauseous this am, not sure why, but no other GI signs and ate breakfast / drank tea

ID: 1007087
Sex: F
Age: 29
State:

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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: Fatigue started roughly 1-2 hours after vaccination and lasted 3 days. Left deltoid started feeling stiff at around 3 to 4 hours after injection. Injection site developed a small hard lump roughly the size of the quarter. Painful when arm is moved and warm to the touch, lasting two days.

Other Meds:

Current Illness:

ID: 1007088
Sex: F
Age: 36
State: TX

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: None

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

Symptoms: Headache started 2-3-2021 at 9pm. I am still having headaches today (over 48 hours after vaccine). I was not sure if I needed to report it after it stops. I have not seek treatment for this.

Other Meds: Lo loestrin fe Multi vitamin gummy Align

Current Illness: None

ID: 1007089
Sex: M
Age: 83
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Elevated temp 100.2

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm