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: 1013168
Sex: F
Age: 28
State: CA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
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: IV contrast; Kiwi, Sulfa drugs, Dogs and cats

Symptom List: Dysphagia, Epiglottitis

Symptoms: Started feeling extreme fatigue on 2/6 at 12:33pm, soreness at injection site; on 2/7 I was more fatigued, had body aches, mild fever, headache, nausea, loose stools, weakness, generally feeling unwell, feeling a "brain fog", some dizziness, and chills. Additionally, the arm was red and swollen at injection site. On 2/8, I have continued to feel fatigued, weak, with mild body aches, no fever or chills, but still feeling weak. As of 13:05 on 2/8, I am feeling better, but still not 100%. I had previously had all these symptoms with the first shot except the swelling and redness at the injection site, that was new. With the first dose, it took approximately 3-4 days for me to return to feeling normal.

Other Meds: Topamax 100mg PO QHS; Nexium 40mg PO BID; Mirena 5 year IUD

Current Illness: None

ID: 1013169
Sex: F
Age: 67
State: KS

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
Hospital: Y

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

Lab Data:

Allergies: cefoxitin, codeine, dilaudid, lortab, mefoxin, meperidine, morphine, penicillins, savella, sulfa drugs

Symptom List: Anxiety, Dyspnoea

Symptoms: Within 5 mins, pt notified staff she felt she was having a reaction. Pt c/o shortness of breath, chest pain, bilat leg numbness, no hives present, denied difficulty swallowing. Pt was brought to a room, placed on 02 10L by face mask. Initial BP 200/105 HR 116. Pt became non-verbal, PA-C dx'd stridor, epi 0.3mg was given deep IM to right thigh. Pt responded positively, within 2 mins, pt became alert and was able to respond to questions. EMS was contacted, arrived and took pt to hospital. She was unable to ambulate c/o of all over body numbness, racing HR. Pt was admitted for observation at Medical Center.

Other Meds: xanax 0.5mg TID prn, gabapentin 300mg BID, levothyroxine 25mcg daily, lexapro 10mg daily, tramadol 50mg q6 prn pain, trazodone 50mg HS

Current Illness: None noted

ID: 1013170
Sex: F
Age: 65
State: CA

Vax Date: 01/30/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
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: A week after the injection I had itchiness, swelling, redness and a firmness in the injection area. As of today I have not sought any treatment after reading about this side effect.

Other Meds: Valsartan HCTZ, Metoprolol, Flecainide, Vitamin D, Magnesium

Current Illness:

ID: 1013171
Sex: F
Age: 32
State: CO

Vax Date: 12/26/2020
Onset Date: 01/01/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to sulpha and penicillin.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 6 days after the vaccine, I had 4 days of nausea and vomitting.

Other Meds: N/A

Current Illness: No

ID: 1013172
Sex: F
Age: 67
State: CA

Vax Date: 01/31/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: 0

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

Symptoms: 6 days after the show on 2/6 I began to notice a soreness in my left armpit and assumed it may be a lymph node gland. The 7th day I took a jacuzzi that night and afterwards noticed my armpit more swollen and my left arm near injection site very warm and sore to the touch. After going to bed my whole left arm seemed to hurt more and into my back of neck and shoulders. Took a Tylenol PM. During the night I also felt pain in my left lower thigh but when I did finally get up everything felt better and no leg pain. However I noticed about a nickel size bruise around the injection site and about 2 inches lower a patch of red skin about 4 times that size. Non itchy. All 3 days I took temperature and blood pressure which seemed close to normal.

Other Meds: 25 MCG per day of Levothyroxine

Current Illness: 0

ID: 1013173
Sex: F
Age: 60
State: AZ

Vax Date: 01/02/2021
Onset Date: 01/13/2021
Rec V Date: 02/08/2021
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: Lisinopril, Zofran

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

Symptoms: Fever 102.4, feeling of nausea, vomiting, diarrhea, dizzy, joint pain in back mostly, syncope.

Other Meds: Losartan 50mg , hydrochlorothiazide 25mg, Tramadol 50mg BID, flexeril PRN

Current Illness: none

ID: 1013174
Sex: F
Age: 17
State: TX

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 02/08/2021
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 reported on consent.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Medication administration error: Adolescent was 17 yrs old at time of administration. No adverse events reported after vaccination.

Other Meds: Unknown

Current Illness: Unknown

ID: 1013175
Sex: F
Age: 52
State: OK

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: Cold Chills, Felt like I had a fever but no fever, joints ache, headache lasting one day

Other Meds: Lisinopril Omeprazole One A day Welbutrin Meloxicam lexipro Mucunex DM Hair and Nail

Current Illness:

ID: 1013176
Sex: M
Age: 78
State: TN

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient in for second COVID vaccination. 1st dose Pfizer given 1/2/2021. Was greater than 28 days. Information for Pfizer vaccine given and Lot number of Pfizer compared. Nurse inadvertently administered Moderna Vaccine that was also drawn up for vaccine POD. Patient had no complications from fist dose. Patient waited for 15 minutes after this administration without complications or adverse reactions

Other Meds:

Current Illness:

ID: 1013177
Sex: F
Age: 73
State: CA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
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: neosporin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt states they felt eyelids hot and felt a heachache. Pt stayed for additional monitoring. Pt denies any other c/o. Pt aloc x 4. Resp. unlabored and even. Pt later states her eyelids feel normal and headache went away. Pt d/c home.

Other Meds: bystolic, lyrica, atorvastatin, zoloft

Current Illness: none

ID: 1013178
Sex: F
Age: 71
State: WA

Vax Date: 01/26/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: "Covid Arm"--Approximate 5-inch by 3-inch rash on right upper arm over area of injection site. Red and hot to the touch.

Other Meds: Metoprolol, Ezetimibe, Atorvastatin, Vitamin C, Vitamin D3, Multivitamin, Viactiv Calcium Tablet

Current Illness: None

ID: 1013180
Sex: F
Age: 56
State: NC

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 02/08/2021
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: steroids

Symptom List: Rash, Urticaria

Symptoms: headace/pressure on right side of head/jaw bone; blister on upper lip; rash on left side forehead; chills; mouth tastes weird; achey.

Other Meds: advair diskus; one a day womens multivitamin

Current Illness: n/a

ID: 1013181
Sex: F
Age: 52
State: CA

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 02/08/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 7 days after my first vaccination, the vaccination site was hot, itchy, slightly painful, and had several raised red welts. I did not contact my doctor. I choose to take Benadryl that day and two days after. It took three full days for the symptoms to clear.

Other Meds: Claritin, Flonase, topical Retin-A, Cleocin-T, Soolantra, bupropion, doxycycline

Current Illness: None

ID: 1013182
Sex: F
Age: 64
State: OH

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 02/08/2021
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: NONE

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

Symptoms: ON 8TH DAY POST VACCINATION- WITH BANDAID STILL IN PLACE- INJECTION SITE BECAME REDDENED, AND FIRM TO TOUCH. 1/30 CLIENT WENT TO SEEK MEDICAL CARE AT A STAT CARE--- GIVEN DIAGNOSIS OF BEGINNING CELLULITIS, AND TREATED WITH KEFLEX 500MG TID

Other Meds: UNSURE OF NAME OF CHOLESTEROL MEDICATION- BELIEVES IT WAS PRAVACOL

Current Illness: NONE

ID: 1013183
Sex: F
Age: 20
State: TX

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
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: she waited 15 minutes then drove home. en route she experienced trouble breathing and dizziness. she pulled over and called the facitily. she was close to another fascility so I told her to call 911 and go to the facility to see about getting an epi pen. ems arrived and said she was dehydrated and had low blood sugar. they took her to the hospital

Other Meds:

Current Illness: ashtma

ID: 1013184
Sex: F
Age: 34
State: OH

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: no actual adverse events occurred at time of administration - patient received covid19 vaccine within 14 days of tdap vaccine

Other Meds:

Current Illness:

ID: 1013185
Sex: F
Age: 62
State: NC

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
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: Mercury, thimerosal, penicillin, adhesive/bandaids

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

Symptoms: I had difficulty forming thoughts and speaking in more than a few words at a time. I was aware I was trying to think or respond, but felt somehow blocked from access and ability to think and speak. This experience lasted for about 28 hours, and then my access to cognition returned. By the way, I am a doctoral level psychologist for whom these skills are typically easy.

Other Meds: Armour thyroid, Trulicity, Jardiance, Meloxicam, Propranolol

Current Illness: None

ID: 1013186
Sex: F
Age: 37
State: WA

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Immediately after, arm was sore for 2 days, 8 days later a rash appeared that was hard, warm and raised. It's 24 days after the shot and you can still see where the rash was. It is no longer hard, warm or raised but you can still see it.

Other Meds:

Current Illness: no

ID: 1013187
Sex: F
Age: 65
State: IL

Vax Date: 01/26/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
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: Itching, swelling, warm to touch, pink in color. On Feb 4, the size of mosquito bite. The next 24 hours which is day 11 it had a diameter of 4 inches.

Other Meds: Atenolol, fenofibrate, Centrum silver, krill oil 350mg, calcium with D3 and zinc, ,magnsium. Turmeric and curcumin

Current Illness: None

ID: 1013188
Sex: M
Age: 56
State: OK

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Cold chills, fever, cough, HA, and achy joints.

Other Meds:

Current Illness:

ID: 1013189
Sex: M
Age: 44
State: WA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
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:

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

Symptoms: Body aches that progressed to splitting headache, nausea, body pain, 100 degree fever, joint pains.

Other Meds:

Current Illness:

ID: 1013190
Sex: M
Age: 70
State: FL

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

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

Lab Data:

Allergies: Morphine

Symptom List: Unevaluable event

Symptoms: Heart racing, lightheaded and passed out causing a traffic accident on the way home. Just as quick as it came on it went. Under regular care for years with no problems that would of caused this. The only thing that was different on the day of the reaction was the 2nd Covid shot. No problems at all with the first one.

Other Meds: 81Mg Aspirin Levothyroxine Amlodipine Simvastatin Meloxicam Lisinopril Benzonatate Fish Oil Vitamin D Omeprazole Multi Vitamin

Current Illness: none

ID: 1013191
Sex: U
Age: 27
State: PA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient felt dizzy and fainted for 10 to 15 seconds. came to and was pale and felt nauseas

Other Meds:

Current Illness:

ID: 1013192
Sex: F
Age: 41
State: CT

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
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: Bactrim, clyndamyacin (spelling?), Sulfa based antibiotics

Symptom List: Injection site pain, Pain

Symptoms: Feverish, chills, severe fatigue and mild headache for several days. Then the night of 2/7/2021 I began to feel slightly less sore, but I was unable to fall asleep despite exhaustion, and was awake until after 9:00am the following day at which time I was able to sleep about 2 hours. Awoke with a terrible headache.

Other Meds: Methadone 90mg; seasonique (birth control); OTCs: melatonin 20mg; stool softener; xytal (allergy medicine); pre/probiotics; multivitamins; elderberry supplement; eleutherococcus senticosus supplement; marshmallow root (steeped twice daily)

Current Illness: Adverse reaction to first dose of vaccine; sinus infection

ID: 1013193
Sex: F
Age: 17
State: NM

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient was underage at time of vaccination, 17 not over 18.

Other Meds: none

Current Illness: unknown

ID: 1013194
Sex: F
Age: 73
State:

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 02/08/2021
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: Headache, muscle ache, joint ache, raised heart rate, difficulty breathing

Other Meds:

Current Illness:

ID: 1013195
Sex: F
Age: 68
State: CA

Vax Date: 01/27/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Erythema at the injection site for 3 days, beginning 10 days post vaccine. Brief erythema at other sites on limbs, not raised or itchy.

Other Meds: None

Current Illness: None

ID: 1013196
Sex: F
Age: 70
State: NH

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

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

Lab Data:

Allergies: Fosamax

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Palpitations with heart rate over 160- 1st episode on 2/5/21 within 5 minutes of receiving vaccine. Transferred to Urgent care for monitoring and EKG. EKG reported as normal. Reports she had a couple more heart racing episodes while sleeping overnight Friday 2/5 into Saturday morning; each episode lasted less than 2 minutes and not to the extent of episode on 2/5/21.

Other Meds:

Current Illness:

ID: 1013197
Sex: F
Age: 31
State: CO

Vax Date: 02/01/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
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: NKA

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

Symptoms: Pruritic, erythemic rash developed on left upper arm. Rash was approximately 10x12mm located over the bicep.

Other Meds: fluoxetine 60 mg daily yaz (ethinyl estradiol 0.02/ drospirenone 3mg) daily

Current Illness:

ID: 1013198
Sex: F
Age: 35
State: KY

Vax Date: 01/13/2021
Onset Date: 02/02/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Nausea

Symptoms: Chest pain and SOA for 2 weeks prior to 2/2/21. Went to ER on 2/2/21. Diagnosed with Chest pain, and Shortness of breath at rest.

Other Meds:

Current Illness:

ID: 1013199
Sex: F
Age: 80
State: NY

Vax Date: 01/26/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, sulta drugs , hornet stings

Symptom List: Injection site pain

Symptoms: Covid arm. Left arm hot sore and itchy, starting 8 days after vaccination.

Other Meds: Will supply

Current Illness: None

ID: 1013200
Sex: F
Age: 86
State: CA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: codeine, nitrofurantoin, sulfa

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

Symptoms: 30 minutes after vaccine administration, patient noted weakness in both legs and inability to walk. patient was examined, in no acute distress. vitals showed mild hypertension. exam showed mild right lower extremity weakness. The patient was sent to the ER for evaluation for stroke.

Other Meds: propranolol 10 mg bid, furosemide 20 mg daily, omeprazole 20 mg daily, atorvastatin 40 mg daily, Spiriva 2 INH daily, aspirin 81 mg daily

Current Illness: none

ID: 1013201
Sex: F
Age: 76
State: WI

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/08/2021
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: Penicillin - rash Percocet - brain fog

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

Symptoms: Moderna COVID-19 Vaccine EUA 3 am - Was awakened with severe headache, which passed after several minutes of being up out of bed. No medication required. For 2 days had tolerable discomfort in left upper arm, especially when raised arm outward and upward.

Other Meds: Hydrochlorothiazide 125 mcg 1 tab daily Metoprol Tartrate 25 mg 1 two times a day DHEA 5 mg tab 1 tab daily AREDS2 tab 1 gel tab twice daily Emergen-C 1000 mg 1 packet Aug thru May Vit. D3 10,000 IU in winter 2 gel tabs 5,000

Current Illness:

ID: 1013202
Sex: F
Age: 71
State: CO

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
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: NKDA

Symptom List: Tremor

Symptoms: Had COVID vaccine on Wed Feb 3, had seizure-like symptoms last night, her body mostly went stiff, happened at least 3 times during the night. Was very limp afterwards; has not had any issues since waking up this AM, has headache and body aches.

Other Meds: Unknown

Current Illness: None reported

ID: 1013203
Sex: F
Age: 71
State: TN

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
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: morphine

Symptom List: Erythema, Pruritus

Symptoms: APRN was notified of possible reaction to COVID-19 vaccine (lot # EN9581, exp. 5/31/21) at 2:18 pm. Patient initially complained of tongue pain and a headache; she then began to develop throat tightness and her voice began to change and she began to clear her throat and developed a "tingling" sensation. EMS was called at 2:25pm. First dose of epinephrine 0.5mg was administered IM right anterolateral thigh at 2:25pm, the sensation of her throat closing persisted at 2:30pm and another dose was administered of epinephrine 0.5mg was administered IM left anterolateral thigh at 2:30pm. EMS arrived and patient left in ambulance at 2:35pm. Vitals: 2:20 pm BP 110/64 HR 85 O2 sat 97% 2:25 pm BP 102/64 HR 93 O2 sat 95% 2:30 pm BP 112/60 HR 87 O2 sat 95% 2:32 pm BP 120/82 HR 90 O2 sat 98%

Other Meds: unknown

Current Illness: ALS

ID: 1013204
Sex: F
Age: 81
State: WA

Vax Date: 01/19/2021
Onset Date: 01/29/2021
Rec V Date: 02/08/2021
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: Sulfa Diaretics

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

Symptoms: Red swollen site 3 inches in diameter with a red ring around it and it itched.

Other Meds: Eloquis 5mg twice daily, Forteo 20mcg daily injected, Losartan 25mg once daily, Diltiazem 120mg daily, 400 mg magnesium citrate, 4,000 IU D3, Calc Citrate 630mg, Biotin 5,000mcg, Omega3 2,000, Citamin C 3,000 mg, Super b-complex 1 tablet, B

Current Illness: PMR GCA

ID: 1013205
Sex: F
Age: 47
State: MN

Vax Date: 01/26/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
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: I started to get a rash or hives about a week after the shot. It had a small area where it was itchy and raised. And has continued to be hot , itchy and hive like.

Other Meds:

Current Illness:

ID: 1013206
Sex: F
Age: 74
State: CO

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/08/2021
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: Perfume

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Feeling tired and weak Fever Redness where shot was given Headache Muscle pain No treatment Back to normal within 2 days except for redness (still pink 1 week later)

Other Meds: Losartan/hctz Atorvastatin Calcium citrate + D3 Zinc Vit C Airborne

Current Illness: None

ID: 1013207
Sex: F
Age: 68
State: IL

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Shellfish, iodine

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

Symptoms: Side effects profound fatigue, incessant chills, headache

Other Meds: Zyrtec

Current Illness: None

ID: 1013208
Sex: M
Age: 62
State: CT

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Shoulder pain - shortly following Fatigue, nausea and slight fever the next morning Lasted until sleep, woke next morning better with residual arm pain,

Other Meds: Carbadopa/ Lepidopa; lipitor, ramapril, sodium hydrothiazide

Current Illness: none

ID: 1013209
Sex: F
Age: 62
State: IN

Vax Date: 01/22/2021
Onset Date: 01/26/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: codeine

Symptom List: Pain in extremity

Symptoms: Arm swollen, red and itchy at injection site and remains slightly so through today 2/8/21.

Other Meds: Synthroid, Celexa, glucophage, farxiga, glipizide, actos, victoza, Advair, atorvastatin, losartan potassium, 80 mg aspirin, vitamins C & D, CoQ10, multivitamin, Fish oil

Current Illness: n/a

ID: 1013210
Sex: F
Age: 49
State: NC

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: temp increase of 3 degrees, chills and generalized body aches. Feels like shortened mild case of the flu

Other Meds: citalopram, wellbutrin

Current Illness: none

ID: 1013211
Sex: F
Age: 78
State: FL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/08/2021
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: None

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

Symptoms: I began feeling weak around 3:15 and was worse by 4 PM. Then I began having shivers but no temp. I felt weak and pulse raced as soon as I got up and walked around. Some aches and pains and malaise but I slept all night. Next day still felt poorly but no chills. Got a cold spell towards evening bu lasted about 1 hr. Some slight congestions that was relieved with a good cough maybe twice a day for another couple of days. That is all.

Other Meds: Night before Advil Gel Cap 200mg-

Current Illness: None

ID: 1013212
Sex: F
Age: 16
State: TX

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/08/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Shortness of breath, fatigue, tachycardia - persisting since vaccination

Other Meds: none reported day of vaccination

Current Illness: allergic rhinitis

ID: 1013213
Sex: F
Age: 37
State: WA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/08/2021
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:

Symptom List: Vomiting

Symptoms: 12 hours after injection: injection site swelling (all of shoulder). 48 hours after injection: intense/constant headache, general muscle aches, malaise, periodic chills, nausea.

Other Meds:

Current Illness:

ID: 1013214
Sex: M
Age: 34
State: NY

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
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: No Known Allergies

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received 1st dose of COVID19 Pfizer on 29Jan2021, Patient received the 2nd dose on 08FEB2021. Patient received vaccine on day 10day and not on day 21-42.

Other Meds: nicotine polacrilex, 4mg, gum; nicitine, 21mg/24hour, patch

Current Illness: NONE

ID: 1013215
Sex: F
Age: 76
State: NY

Vax Date: 01/12/2021
Onset Date: 01/21/2021
Rec V Date: 02/08/2021
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: Left arm, near injection site; swellings, itchy red rash; 7-9 days; benadryl

Other Meds: synthroid, 50 mg; multivitamin (ActivNutirents without iron, one); vitamin D, 2000 IU; Citracal, one, 200 mg; Osteoben, 2; OmegaGenics EPA-DHA 2400, 1/4 tsp; ProbioMax Daily DF, one every other day;

Current Illness:

ID: 1013216
Sex: M
Age: 30
State: IN

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
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: Allergic to Phenergan and any stomach related medications

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme Fatigue and light confusion for the rest of the day, and light fatigue the following day

Other Meds: Humalog, Omeprazole, Ritual Multivitamin

Current Illness: none

ID: 1013217
Sex: F
Age: 58
State: AL

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

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

Lab Data:

Allergies: Cold Weather

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

Symptoms: 10 second after the vaccine my are was tight and swollen. the third day after the vaccine I noticed that below the injection site I was bruised. I noticed discoloration (light blue , light back ) My arm cleared within 8 days I had a metal taste in my mouth I also had a headache

Other Meds: None

Current Illness: None

ID: 1013218
Sex: F
Age: 66
State: FL

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/08/2021
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: penicillin, sulfa, iodine

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

Symptoms: Initial swelling and redness. Next day redness and itching. Within a week, blistering, bright red, severe itching, site spread four inches wide and like an arm band around my arm.

Other Meds: atorvastatin, losartan, omeprazole,claritan, Flonase multi vitamins, vitamin c, calcium

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm