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: 1008433
Sex: F
Age: 36
State: TX

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Bump at injection site, itchy at injection site, raised rash at injection site, hot to touch at injection site - 8 days post injection

Other Meds: Allegra Flonase Zoloft Iron

Current Illness: None

ID: 1008434
Sex: F
Age: 73
State: ID

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/06/2021
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: heacache, muscle pain, joint pain, burning, swelling at injection site, fatigue, fever

Other Meds:

Current Illness: depression, high blood pressure treated with medication, hyperlipidemia controlled with medication, sleeping disorder, anxiety, mild COPD

ID: 1008435
Sex: M
Age: 74
State: NM

Vax Date: 09/15/2020
Onset Date: 09/16/2020
Rec V Date: 02/06/2021
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 known

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

Symptoms: Beginning the day following the injection, I started having significant bursitis-like shoulder pain. This has been relatively constant for the five months subsequent to the inoculation. The pain is significant but tolerable. I cannot raise that arm over my head. Also, direct pressure on the site where I presume the injection was made causes a slight dull ache.

Other Meds: Enalapril, Carvidolol, baby aspirin, multi-vit, Vit d

Current Illness: none

ID: 1008436
Sex: F
Age: 43
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Headache, fatigue, chills

Other Meds:

Current Illness:

ID: 1008437
Sex: F
Age: 44
State: TN

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

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

Lab Data:

Allergies: Chili powder, Chile peppers

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

Symptoms: Fever of 101.8 - 102.3, rigors, severe headache, severe diffuse joint pain. Unable to get out of bed. Unable to perform normal ADLs.

Other Meds: Allegra, celecoxib, atorvastatin, Align probiotic, Citracal, Centrum Women?s MVI

Current Illness: None

ID: 1008438
Sex: F
Age: 64
State: CT

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/06/2021
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: Codeine Morphine Environmental seasonal

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

Symptoms: Pain in L forehead and face, superficial. Started 2/2/2021, called MD 2/6/2021. MD diagnosed likely shingles reactivation (have had once before). Prescribed valcyclovir.

Other Meds: Clonazepam as needed Losartan 25 mg PO daily Rosuvastatin 20 mg daily Vitamin D3 Multivitamin Cod Liver Oil

Current Illness:

ID: 1008439
Sex: F
Age: 69
State: CA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/06/2021
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: Vancomycin, Penicillin, Prednisone, Bactrim

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I developed a large red inflammed area on left arm (location of vaccine shot given on 1/26/21). Monitored for 13 days and the inflammed area continued to grow larger. The area started out measuring 2" x 2" in diameter and grew by the 12th day to measure 4 1/2" x 4" in diameter. It continued to be red and had a dark area in the middle of the inflammed area. It has been warm to touch, swollen and itchy at times. Registered with V-Safe; phoned CDC on 2/4/21 and was advised to go to emergency room. On 2/4/21, I contacted my primary physician and visited Urgent Care. Doctor described it as an allergic reaction, left arm swelling, vaccine reaction and I was given Solu-Medrol Steroid shot in buttocks. On 2/5/21, the area continued to spread in size. I consulted with my primary physician and he was concerned and referred me to an Allergist who I have been unable to reach at this time. My primary physician thinks I definitely am having an allergic reaction to the Moderna Vaccine.

Other Meds: Atenolol 25 mg once a day; Colace 100 mg once a day; Pepcid 20 mg once a day

Current Illness:

ID: 1008440
Sex: F
Age: 55
State: WV

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/06/2021
Hospital:

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

Lab Data:

Allergies: shellfish, morphine

Symptom List: Pharyngeal swelling

Symptoms: After 30 minute observation period pt reported bad headache, foggy mind, numbness/tingling of the tongue. Pt experience dizziness upon standing and then starts to dry heave. The tingling of the tongue becomes worse at this point. Pt is then given 25mg of liquid bendryl. Pt denies EMS help. Pt stands and "zones out". Pt unable to respond to commands and is unaware of her name. Pt is seated and has unequal hand grips, left pupil larger than right, flaccid arms when raised. Pt then speaks clearly but not appropriate. Thought her grown adult kids were babies, couldn't tell their names or her sister's name. Pt's husband shows up and she recognizes him but doesn't know why he is there. Husband says she acts like this when she is anxious and he can take care of her. The nausea/dry heaving is a new symptom. Recommended to go to hospital but leaves with husband. Later spoke with patient and she seems better and has been taking Benadryl every 4 hours. She is still experiencing tongue numbness and is going to her PCP.

Other Meds: cetirizine, clonazepam, prednisone, omeprazole

Current Illness: unknown

ID: 1008441
Sex: F
Age: 69
State: AZ

Vax Date: 02/03/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Severe headache for 1/12 days. Started getting better second day Extreme nausea the second day Better the 3rd day

Other Meds: Vitamin D Atorvastain Advil

Current Illness: No

ID: 1008442
Sex: F
Age: 63
State: MN

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Sore left arm, which I expected. Fever of 100.2.

Other Meds: none

Current Illness: none

ID: 1008443
Sex: F
Age: 41
State: PA

Vax Date: 01/29/2021
Onset Date: 02/05/2021
Rec V Date: 02/06/2021
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: Warm raised itchy reaction noticed 1 week at injection site. From moderna covid 19 vaccine

Other Meds: Diovan/hctz Synthroid Atenolol Prevacid

Current Illness: None

ID: 1008445
Sex: F
Age: 24
State: WI

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 02/06/2021
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

Symptom List: Rash, Urticaria

Symptoms: Itching, redness, swelling and small rash on arm of injection one week following first injection

Other Meds: Birth control, women?s daily vitamin

Current Illness: None

ID: 1008447
Sex: F
Age: 43
State: CT

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 02/06/2021
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, Cipro

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

Symptoms: Woke in morning on 1/14/21 with burning/throbbing pain in right great toe. As the day went on, I felt like I had ice blocks on both feet although right more than left. As the days went on I started feeling loss of warm/hot sensation to both feet, tingling/burning and coldness sensation through both feet and halfway up calves. I could not get my feet or lower legs warm. Eventually I began feeling this same coldness and tingling sensation in both hands/forearms along with extreme coldness to both hands. As of today, I do have more sensation back to both feet although the right big toe still throbs at times. The tingling sensation is minimal in bilateral hands and wrists at this time.

Other Meds: Lexapro 20mg Vitamin b12

Current Illness:

ID: 1008448
Sex: F
Age: 35
State: IN

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/06/2021
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: Ambien

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

Symptoms: Body aches Hives on arms, chest, neck Chills Low grade fever Nausea

Other Meds: Carvedilol Lasix Hydralazine Coreg

Current Illness:

ID: 1008449
Sex: F
Age: 55
State: NY

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Headache, lightheaded, dizziness, bilat foot and arm numbness, chest pain, SOB

Other Meds:

Current Illness:

ID: 1008450
Sex: M
Age: 41
State: MO

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/06/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Developed DVT in left leg from groin to ankle. Diagnosed on 01/29/2021. Pain, swelling, and difficulty walking lead to emergency room visit, admission to hospital for 2 days.

Other Meds: None

Current Illness: None

ID: 1008451
Sex: M
Age: 61
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/06/2021
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:

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

Symptoms: injection site pain and tenderness. fatigue , headache, muscle pain , joint pain , chills, fast heartbeat.

Other Meds: Brilinta,Metoprolol, Atorvastin, Anagrelide, Hydroxyurea, Entresto mulivatimin , aspirin 81mg., Resveratrol, Turmeric Curcumin

Current Illness:

ID: 1008452
Sex: F
Age: 68
State: MD

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/06/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, vancomycin, sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: developed a rash on the lower part of the inner thighs within 24 hours after the injection. My internist saids that it looks like something call a viral exantham and is considered benign. It itches and burned for about a day and the rash is still present. So far it does not itch or hurt or has gotten significantly worse and I have no other symptoms. It looks like the kind of rash that I had as a teenager with MONO that was treated with penicillin or a measles rash.

Other Meds: Levothyroxine 112MCG, Losartan 25MG

Current Illness: NONE

ID: 1008453
Sex: F
Age: 77
State: FL

Vax Date: 01/25/2021
Onset Date: 02/01/2021
Rec V Date: 02/06/2021
Hospital:

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

Lab Data:

Allergies: Mango

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Developed tremors/shakes on Feb 1, 2021. Have had symptoms since. Trouble holding items.

Other Meds: Gabapetin 600mg tramadol 50mg duloxetine 30mg carvedilol 25mg todiramate 25mg simvastatin 10mg olmesartan 40mg lansoprazole 30mg fenofibric 135mg furosemide40mg

Current Illness: No known

ID: 1008454
Sex: M
Age: 86
State: TX

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/06/2021
Hospital:

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

Lab Data:

Allergies: NO KNOWN ALLERGIES

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

Symptoms: THE PATIENT CALLED AND SAID THAT HIS TREMORS HAVE WORSENED, SIGNIFICANTLY. HE STATES THAT HE USUALLY HAS TREMORS, BUT HE WAS BARELY ABLE TO FEED HIMSELF TODAY.

Other Meds: UNAWARE. HE DOES NOT FILL HIS MEDICATIONS WITH US AT OUR PHARMACY.

Current Illness:

ID: 1008455
Sex: F
Age: 49
State: CO

Vax Date: 12/17/2020
Onset Date: 12/21/2020
Rec V Date: 02/06/2021
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: none

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

Symptoms: Bilateral large (3cm) axillary LAD, persisting for > 6 weeks epitrochlear adenopathy L arm Intercostal adenopathy R chest

Other Meds: none

Current Illness: none

ID: 1008456
Sex: F
Age: 67
State: PA

Vax Date: 02/03/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: I received vaccine subcutaneous in left arm and below the deltoid muscle- rash five to six inches below injection site from gravity - wondering if vaccine will be effective- have pictures.

Other Meds: Metoprolol 25mg daily, hydochlothyazide 12mg daily

Current Illness: None

ID: 1008457
Sex: F
Age: 66
State: MI

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/06/2021
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 known

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

Symptoms: Swelling under both eyes - right more pronounced ~ where filler had been injected in October 2020

Other Meds: Hair, skin & nail gummies with biotin, CoQ 10, Centeum silver, calcium, magnesium, zinc , hyaluronic acid, vivid cal, estroven

Current Illness: none known

ID: 1008458
Sex: F
Age: 33
State: DE

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Cefdinir

Symptom List: Injection site pain, Pain

Symptoms: Patient presented to COVID-19 Vaccine clinic on 02/06/21. Patient reported the following allergies on immunization consent form: "cefdinir - anaphylactic". Patient took diphenhydramine (dose unknown) at ~4:00pm prior to appointment. Patient received 0.3mL Pfizer COVID-19 Vaccine at 4:17PM from pharmacist. Pt. noticed she was developing hives and itching. Nurse at vaccine clinic was monitoring and called EMS. At 4:47PM, patient reported difficulty swallowing and had facial hives. Epi-pen was administed by pharmacist - per Immunization Emergency Protocol. At 4:50pm, EMS arrived at clinic, and patient was taken via ambulance to emergency department for further treatment at 4:53pm. Current status unknown.

Other Meds: Unknown

Current Illness: Unknown

ID: 1008459
Sex: F
Age: 75
State:

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/06/2021
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: Injection site pain, Menorrhagia

Symptoms: Semi-severe flu symptoms appearing about three hours post-injection. Treated with Tylenol and rest/sleep. Lasted about 12 hours, gradually lessening.

Other Meds:

Current Illness:

ID: 1008460
Sex: F
Age: 51
State: PA

Vax Date: 01/20/2021
Onset Date: 01/31/2021
Rec V Date: 02/06/2021
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: Penicillin, cephalosporin, clindamycin, sulfa

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

Symptoms: "Covid arm" - red, itchy rash on upper left arm, tender muscles on upper left arm. Developed 11 days after injection. Tenderness different than initial sore arm from injection - more tender to touch, and not sore with movement/use. No treatment. 90% resolved 6 days after onset.

Other Meds: Allegra 180 mg qd, Omeprazole 20 mg qd

Current Illness: none

ID: 1008461
Sex: F
Age: 56
State: MS

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Red raised rash on arm near injection site. With 1st shot it didn?t show up for 10 days and lasted about 5 days. Received 2nd dose yesterday and it was on arm this morning. It?s warm to touch but does not itch. It?s about 3 ? across by 4 ? long.

Other Meds:

Current Illness:

ID: 1008462
Sex: F
Age: 49
State: AL

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: pt was vaccinated at work with her 2nd dose on 1/20/21 and began having symptoms on 1/22. pt presented to my office on 1/25/21 she had confusion, memory loss, labial bp, relative hypotension, bradycardia, severe fatigue, muscle pain and weakness, barely able to rise from a chair or walk, also reported HA, diarrhea, hiccups,decreased O2 sat to a low of 91%-her baseline is 98-100%, she developed a rash after her appointment with me.

Other Meds: fluoxetine, pantoprazole, metoprolol, emgality, lyrica, lasix, carafate, vitamin d, maxalt, butorphanol

Current Illness: none

ID: 1008463
Sex: M
Age: 74
State: FL

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/06/2021
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

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

Symptoms: Slight temperature (100.0), headache, sore arm

Other Meds: protonix, lisinopril, metropilol, sertraline, aspirin

Current Illness: no

ID: 1008464
Sex: F
Age: 50
State: AR

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Nausea

Symptoms: got vaccine on Friday 2/5/2021, symptoms started on 2/6/2021 with fever chills, aches, and headache

Other Meds:

Current Illness:

ID: 1008465
Sex: F
Age: 27
State: OR

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 02/06/2021
Hospital:

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

Lab Data:

Allergies: Codeine: Shellfish: hives

Symptom List: Injection site pain

Symptoms: Axillary and cervical lymphadenopathy, hives on neck

Other Meds: Isibloom OCP Proair albuterol inhaler citalopram 40mg daily

Current Illness: n/a

ID: 1008466
Sex: F
Age: 73
State: CA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/06/2021
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 drugs X-ray contrast dyes chocolate

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

Symptoms: About 20 minutes after receiving the shot, I started feeling uneasy. Realized that my fingers were getting tight with swelling. I could feet the sides of my chests getting tight - felt like pressures were building up with swelling. I did not have problems with breathing. About 10 minutes later I could feel my lips swelling, but stopped after about 10 minutes. In the evening, felt nausea. Did not feel well for two days. Got a little better on the third day but not completely well. Completely recovered on the fourth day. Should I get the second shot? I am afraid it might be worse on the second shot if what I was feeling were due to allergy.

Other Meds: Levothyroxine 100 mcg Losartan-hctz 50-12.5 mg D3 50 mcg

Current Illness:

ID: 1008467
Sex: F
Age: 42
State: NJ

Vax Date: 01/09/2021
Onset Date: 01/18/2021
Rec V Date: 02/06/2021
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: A big red lesion on vaccine site.

Other Meds: None

Current Illness:

ID: 1008468
Sex: F
Age: 85
State:

Vax Date: 01/29/2021
Onset Date: 02/05/2021
Rec V Date: 02/06/2021
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: Moderna COVID-19 Vaccine EUA. Red itchy rash at site of injection on right arm appeared seven days after injection. Prior to onset there were no other adverse reactions to the injection.

Other Meds: Vitamin D

Current Illness:

ID: 1008469
Sex: M
Age: 27
State: VA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: A lot of severe dizziness, chills, fatigue, headache, tingling, swelling in legs, and maybe a fever.

Other Meds: Abilify 30mg daily, lamictal 150mg daily, paxil 30mg daily. One-a-day multivitamin

Current Illness: None

ID: 1008470
Sex: F
Age: 60
State: PA

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: none

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

Symptoms: diffuse hives on anterior and posterior chest; now confluent. No wheezing or throat constriction.

Other Meds: none

Current Illness:

ID: 1008471
Sex: M
Age: 16
State: IL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/06/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: The patient was given a dose of Moderna covid 19 vaccine, but he is only 16 years old.

Other Meds:

Current Illness:

ID: 1008472
Sex: F
Age: 43
State: VA

Vax Date: 01/27/2021
Onset Date: 02/05/2021
Rec V Date: 02/06/2021
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: Oranges

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Experciened itchiness in evening on lower left arm, woke up next morning with itchy, swelling rash from wrist to lower arm.

Other Meds: Omeprazole, Levothroxine

Current Illness: None

ID: 1008473
Sex: M
Age: 37
State: TX

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

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: Tuesday afternoon began with a headache. Chills followed in the late evening. Body aches by Wednesday morning with continued headache. Neck stiffness and soreness began Thursday evening. Severe chest pains early Saturday morning (3am). Taken to urgent care - EKG showed irregularity and high level of troponin. Transported from there to the hospital. They did angiogram, and diagnosed me with pericarditis. The on call physician believes this was most likely caused by the second dose of the vaccine.

Other Meds: NONE

Current Illness: NONE

ID: 1008474
Sex: F
Age: 78
State:

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Sulfa, Cipro, Penicillin, Codeine

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

Symptoms: Patient complained of difficulty swallowing, tingling feeling in her tongue. She initatally took 50 mg of benedryl, and after 15 more minutes, she continued to have the same symptoms, and in addition was breathing more labored, was having a harder time swallowing, and complaining of feeling dizzy and a headache. She then received an Epi Pen, was placed on oxygen, used her Xopenex inhaler, and EMS was called. She was then transferred to the ED for continued monitoring.

Other Meds:

Current Illness:

ID: 1008475
Sex: F
Age: 23
State: KY

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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 fainted. Pharmacists, nurses and EMS responded. Took blood pressure, blood glucose and stabilized patient. She was transported by ambulance to local ER.

Other Meds:

Current Illness:

ID: 1008476
Sex: M
Age: 42
State: KY

Vax Date: 01/16/2021
Onset Date: 01/18/2021
Rec V Date: 02/06/2021
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: On January 18, two days after getting the first dose of the vaccine I woke up with a sense of fullness or pressure in my left ear, mild sinus congestion, and chills. The congestion and chills ended after one day, but the feeling of fullness in the ear has persisted to this day. Then, on January 29, I had a bout of positional vertigo and vomiting that lasted two to three hours. I also experienced ringing or roaring in my left ear. Ever since, I have a bout of vertigo approximately every 24 hours, and the ringing and sense of fullness in the ear ebb and flow on 24 hours cycles as well. This experience has been debilitating and affected my ability to work. My doctor has diagnosed Meniere's disease and says he has been seeing similar symptoms apparently linked to the COVID vaccines. I started taking prednisone on doctor's orders yesterday (February 5), which has stopped the vertigo. Ringing and occasional fullness in the ears persist.

Other Meds: None; I have a prescription for Albuterol for asthma, but I rarely take this medicine.

Current Illness: None

ID: 1008477
Sex: F
Age: 34
State:

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/06/2021
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: penicillin, tree nut, honey bee venom

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

Symptoms: Symptoms reported by patient as follows. About 30 to 45 minutes after I received my vaccine The right side of my face went numb, my tongue slightly swelled and felt like it was burning. I had pain in my right ear, and body aches. most of my effects were gone after 24 hours. I do still have pain in my right ear, and slight numbness in my face Patient called primary care provider and the below note was documented. Call from patient she received the COVID vaccination and her side of face feels numb and side of tongue and lips. Explained this could be a side effect of the vaccine and if she develops any shortness or trouble breathing she should go to the Emergency room. Patient also states she has been using her incentive spirometer not often but maybe once a day and she feels like her cough is getting deeper. She has had to use her inhalers but is not using them routinely. Patient instructed to use incentive spirometer more often and that this sound normal after surgery. Did offer her a repeat chest xray but patient wishes to hold off on that now. Instructed patient to call with any other concerns. Also if any SOB with vaccine to go to ER

Other Meds:

Current Illness:

ID: 1008478
Sex: F
Age: 79
State: ME

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Asa [Aspirin] Rash Not Specified 3/22/2006 Past Updates... Only with high doses Bacitracin Zinc + Neomycin Sulfate + Polymyxin B Sulfate

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

Symptoms: Pt began experiencing feeling "short of breath" pt is double masked. Pt removed mask and did a couple deep breaths and felt slight improvement but s/s returned. Offered and pt accepted cold water, alleviating feeling short of breath. 5 pm pt began feeling more short of breath and was breathless w/speech. Nurse alert called and PO benadryl 25 mg in 10 ml PO given lot c13e exp 3/21. Vitals taken 145/745 56 HR and 95 O2. Pt taken to advanced urgent care by staff via wheelchair 507 pm

Other Meds: NOT ASSESSED

Current Illness: NONE

ID: 1008479
Sex: F
Age: 69
State: NY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/06/2021
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: NKDA

Symptom List: Vomiting

Symptoms: The patient reports fever, chills, fatigue, shortness of breath, and body aches

Other Meds: N/A

Current Illness: N/A

ID: 1008480
Sex: F
Age: 66
State: MS

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/06/2021
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: Pain at injection site, six days later, now visible rash.

Other Meds: Metoprolol

Current Illness: None

ID: 1008481
Sex: F
Age: 71
State: CA

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 02/06/2021
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: Patient states that she started experiencing pain the day of injection, starting at the injection site on her left arm. First the pain radiated up to her shoulder and neck, and now it has moved down from her elbow down to wrist. She has not seen a doctor yet. She is still experiencing pain, and feels a burning sensation.

Other Meds:

Current Illness:

ID: 1008482
Sex: F
Age: 78
State:

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: 1040 The patient received the COVID vaccine. At 1055 the patient began to complain of a dry scratchy throat. Zyrtec 20 mg given per MD. Patient monitored for another 45 minutes. Patient reported feeling better. Symptoms resolved. Discharged home per MD

Other Meds:

Current Illness:

ID: 1008483
Sex: F
Age: 24
State: NY

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Patient arrived to observation area. After 15 minute observation, patient reports she was experiencing dizziness. Escorted to treatment area. 12:05pm BP 125/70 HR 54. She states she hasn't eaten anything today in anticipation of getting the vaccine. She also reports a 1 hour commute to vaccine site on 2 very heated buses. Patient given water and granola bar and seated near an open window to receive fresh air. Patient closely monitored and after some time reports she feels better. 2nd set of vitals: BP - 126/64/ HR - 61. Patient had desire to leave and have a full meal. Left observation area at 12:48pm. ambulated without difficulty.

Other Meds: Buspar

Current Illness: Denies

ID: 1008484
Sex: F
Age: 32
State: NY

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/06/2021
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: Sore arm after first vaccine for 1 day. Resolved. Sore arm after 2nd vaccine about 2 hours after. 21 hours after, chills, lathargic, slight headache. Not feeling feverish but had a fever of 101.2 Took tylenol, waiting to see if it resolves.

Other Meds: none

Current Illness: slight sore throat, viral. covid negative. went away after 1 day.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm