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: 1014697
Sex: F
Age: 52
State: FL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: Sulfur Medication

Symptom List: Dysphagia, Epiglottitis

Symptoms: This was my second dose. Fever as high as 103.4F. Fever lasted 24 hours above 100.0F Chills, Shaking for 4 hours from about 8/9 pm to 12/1am. Nausea, vomiting, bowel pain, inflamed rectum after bowel movement the next day, loss of hearing, dizziness, Trying to sleep and waking up gasping for air about 5 times though out the early morning. Sever Headache which lasted Two and a half days. About 2 pm on 2/5/21 I took some Emetrol for the Nausea, and Tylenol for headache and fever. I took Tylenol again the evening of 2/5/21. On 2/6/21 I Tylenol and then Ibuprofen then Excedrin. On 2/7/21 I took Excedrin once and my headache was finally gone.

Other Meds: clopidogrel 75mg

Current Illness: Seasonal allergies

ID: 1014698
Sex: F
Age: 45
State: VA

Vax Date: 02/04/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
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: COVID Arm - raised patch 3 inches in diameter

Other Meds: Rybelsus

Current Illness: None

ID: 1014699
Sex: F
Age: 25
State: PR

Vax Date: 02/05/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Fever, muscular pain, dizziness, headache, heaviness, changes in sense of smell.

Other Meds: Acetaminophen

Current Illness: No medical conditions

ID: 1014700
Sex: M
Age: 79
State:

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

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pt was in the covid clinic and after the shot started with tightness in the throat was given 50mg of po benadryl

Other Meds:

Current Illness:

ID: 1014701
Sex: M
Age: 32
State: MN

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: severe chills and shaking lasted about 4-5 hours; fever of 101-102 degrees; severe headache lasted about 8-10 hours; these symptoms started approximately 12 hours after vaccine received;

Other Meds: none

Current Illness: none

ID: 1014702
Sex: F
Age: 52
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/05/2021
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: PCN

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

Symptoms: 15 hours after injection: high fever (x24 hours); general muscle aches; red rash began and advanced thru next day to include outer surface of upper arm from armpit to elbow; rash accompanied with pain, swelling, cherry red shiny skin, and feeling as if a rubber band was around lower part of rash tightening t/o the day. PCP contacted at 7:40 due to concern of increasing pain and advancement of red swollen area. PCP recc ER. Er visit 2/6

Other Meds: Hydrochlorothiazide 25mg 1x a day

Current Illness: NONE

ID: 1014703
Sex: F
Age: 39
State: MD

Vax Date: 02/06/2021
Onset Date: 02/07/2021
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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Headache Fever Fatigue Weakness Chills Muscle aches

Other Meds:

Current Illness: None

ID: 1014704
Sex: F
Age: 89
State: FL

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: 89 y/o female complained of paresthesia in her arms and hands during her 15 min wait period after vaccination. Patient alert, oriented and vitals stable and WNL before being transported to ER via ambulance for monitoring.

Other Meds:

Current Illness:

ID: 1014705
Sex: F
Age: 76
State: IL

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: rash on chest, back at approximately 5:30 p.m.

Other Meds: OTC : small dose aspirin,multi vitamin, vitamin D, calcium, fish oil, Persxcription : Amlodipine

Current Illness: none

ID: 1014706
Sex: M
Age: 74
State: IN

Vax Date: 02/06/2021
Onset Date: 02/07/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fatigue in morning then flu like symptoms (chills more serious fatigue, )slept most of afternoon the ok

Other Meds: Zolpidem, vitamin d, fish oil

Current Illness: NoneNone

ID: 1014707
Sex: F
Age: 58
State: OR

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: MULTIPLE, CODEINE, KEFLEX

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

Symptoms: pt c/o subjective dizziness and HA 8/10. pt speech clear, MAE well, grips equal. pt denies sob/cp/itching/rash,. Pt tolerating po well. pt provided wet washcloth for forehead and juice and crackers. Lung sounds CTA. HRR, s1 and s2 crisp and regular. Initial BP 163/82, HR 105, oxygen sat 98%.Pt observed from 1447-1620. HA improved to 4-5/10 upon discharge. pt was alert and oriented, no cp, no sob, no n/v/d. pt wheeled to spouse's car by transportation.

Other Meds: UNKNOW

Current Illness:

ID: 1014708
Sex: F
Age: 35
State: AZ

Vax Date: 02/01/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: Sulfa drugs

Symptom List: Rash, Urticaria

Symptoms: Started feeling feverish, chills, nauseous 14 hours after 2nd dose. Extremely achy, mild fever for 20 hours total.

Other Meds: Birth control, Zoloft, claritin

Current Illness:

ID: 1014709
Sex: F
Age: 72
State: FL

Vax Date: 01/31/2021
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: Sulfa Pencillin

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

Symptoms: Itchy rash at the injection site.

Other Meds: Rosuvastatin 5mg tumeric Calcium D3 flaxseed oil melatonin biotin multivitamin

Current Illness: None

ID: 1014710
Sex: M
Age: 25
State: GA

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

Lab Data:

Allergies: n/a

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

Symptoms: A couple hours after the shot, I began to experience some local area soreness. After seven hours, I began experiencing body aches, and before I went to bed around 9PM I was experiencing chills. Throughout the night I had a fever. When I woke up at 9:30AM the next day, I had a headache and slight body aches. I took some Tylenol and felt better at about 12PM that same day.

Other Meds: n/a

Current Illness: n/a

ID: 1014711
Sex: F
Age: 40
State:

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: 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: tingly fingertips

Other Meds:

Current Illness:

ID: 1014712
Sex: F
Age: 69
State: WA

Vax Date: 01/30/2021
Onset Date: 02/07/2021
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: Left arm injection site swelling and erythema with superficial blisters onset 1 week after vaccine administration

Other Meds:

Current Illness:

ID: 1014713
Sex: F
Age: 56
State: CA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Sulfa antibiotic, Albuterol, Biaxin, Cephalexin, Doxycycline Hyclate, Erthromycin Base, Levaquin, Pneumovax, Refresh Contacts Drops

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

Symptoms: Patient messaged our Doctor's office regarding an allergic reaction. She stated her temperature was elevated, site if shot pain and heat and sore leg muscles, she also noticed itchiness under her arm of where shot was received. Patient went on to say by afternoon after vaccine rash like with small pumps were near the armpit.

Other Meds: Magnesium, Multivitamin, Zyrtec , Aspirin

Current Illness: Carcinoma in situ of cervix uteri Chicken pox CIN III (cervical intraepithelial neoplasia III) Depressive disorder, not elsewhere classified Diplopia GERD (gastroesophageal reflux disease) History of sexual abuse Hx of Clostridium difficile infection Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus Other and unspecified ovarian cyst Perianal abscess Ventricular septal defect

ID: 1014714
Sex: F
Age: 41
State: MD

Vax Date: 01/28/2021
Onset Date: 02/05/2021
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: 9 days after receiving the first dose of the Moderna COVID a vaccine, I developed a large red spot on my left arm around the injection. The spot has continued to be painful, red, swollen, warm to the touch, and stings for the last three days.

Other Meds: Fluoxetine, iron supplement, and trazodone

Current Illness: None

ID: 1014715
Sex: F
Age: 70
State: FL

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: no

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Rash in chest and back

Other Meds: Zocor, Nexium, Qudexy, VIT D,

Current Illness: no

ID: 1014716
Sex: M
Age: 53
State: FL

Vax Date: 02/05/2021
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: Arm and shoulder pain starting at 3 hours through 36 hours, body ache starting at 8 hours through 48 hours, intermittent headache starting at 8 hours through 72 hours with associated nausea, headache was intense enough to require acetaminophen on three occasions, chills starting at 15 hours that responded to acetaminophen, fatigue from 8 hours through 84 hours.

Other Meds:

Current Illness: none

ID: 1014717
Sex: F
Age: 61
State:

Vax Date: 01/28/2021
Onset Date: 02/03/2021
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: Itchy rash spot above and below injection site

Other Meds:

Current Illness:

ID: 1014718
Sex: F
Age:
State: CA

Vax Date: 02/07/2021
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: Unevaluable event

Symptoms: Swollen area under arm that recieved the vaccine. When arm is lifted the swelling "pops" out from the arm pit. Large width of the swelling almost like a half of an avocado. When arm goes down into resting position, it goes back up and is painful.

Other Meds: Vitamin C, Vitamin D, Iron

Current Illness: None

ID: 1014719
Sex: F
Age: 84
State: CA

Vax Date: 02/05/2021
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: denied

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

Symptoms: Onset of hives to right side of face 10 minutes post vaccination. Localized with no other symptoms.

Other Meds: unknown

Current Illness: none

ID: 1014720
Sex: F
Age: 49
State: AZ

Vax Date: 02/03/2021
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: NKDA

Symptom List: Injection site pain, Pain

Symptoms: Very heavy menstrual cycle. Numerous clots. Severe cramping. All unusual for me

Other Meds: Lisinopril 30 mg PO QD As a 81 mg po QD MVI

Current Illness: None

ID: 1014721
Sex: M
Age: 34
State: TX

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Vaccine was injected (1130) too far up into shoulder. Noticed difficulty and pain to move shoulder 2 hours later. About 1900, pain was intense and shot down from shoulder to the hand and inability to move shoulder. Went to ER at 2030 after calling nurse advice line and was directed to see doctor. Doctors at ER noticed vaccine was injected too far up into shoulder and offered sling and percocet to help with pain. Declined percocet as it makes me vomit. Took it once for removal of wisdom teeth. Immobilized arm and used hot and cold packs to help decrease inflammation. Have recovered half shoulder mobility and still pain in shoulder down into hand.

Other Meds: Remicade, Imuran

Current Illness: Crohn's

ID: 1014722
Sex: M
Age: 53
State: IN

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

Lab Data:

Allergies: NKDA

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

Symptoms: Sudden onset of dizziness, lightheaded ness, nausea, swollen glands at cervical region, fatigue, body aches; lasting 5 hours. Ongoing gland swelling with meals.

Other Meds: Lisinopril, amlodipine, triamterene

Current Illness: None

ID: 1014723
Sex: M
Age: 41
State: AL

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: Left arm numbness lateral side of arm down to the wrist. Left side of face numbness, down left side of neck extending to left temple. Also tingling in areas previously addressed.

Other Meds: multivitamin, B12, mesalamine DR 1.2 gram tablet 4 times daily

Current Illness: none

ID: 1014724
Sex: F
Age: 30
State: VA

Vax Date: 01/29/2021
Onset Date: 02/03/2021
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: Ibuprofen Naproxen sodium Shellfish

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Possible swollen lymph node on left side of neck (biopsy scheduled)

Other Meds: Vitamin d Multivitamin Allegra Singular Fish oil Sea moss

Current Illness: None

ID: 1014725
Sex: M
Age: 75
State: OH

Vax Date: 02/03/2021
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: No

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

Symptoms: 24 hours after developed elevated BP 130/90 and pulse 102. Resolved on it own after 8 hours.

Other Meds: Amlodipine, losartan, OTC antihistamine, 81mg aspirin, multi vitamin, folic acid, combigan, trusopt.

Current Illness: No

ID: 1014726
Sex: F
Age: 32
State: FL

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: PCN

Symptom List: Nausea

Symptoms: SEVERE PAIN IN LEFT ARM X 1 WEEK NOT RELIEVED BY OTC MEDICATIONS, UNABLE TO MOVE ARM X FIRST 2 DAYS,; MILD PAIN IN LEFT ARM ON THE 2ND WEEK FEVER OF 100.7 DEGREES F 15 HOURS AFTER VACCINATION. FEVER DURATION OF 12 HOURS AND WAS ACCOMPAINED BY FATIGUE AND MILD BODY ACHES.

Other Meds: LEXAPRO, ZYRTEC, VITAMIN D, ATORVASTATIN, BIRTH CONTROL

Current Illness: NONE

ID: 1014727
Sex: F
Age: 51
State: PA

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

Lab Data:

Allergies: Bee Venom Sulfa

Symptom List: Injection site pain

Symptoms: patient waited 30minutes post vaccination. Then left and came back approx. 10 minutes later, patient came back due to having right side of face, neck, and tongue numbness and tightness. No chest pain, No Shortness of breath. 1825 she did report to staff she had difficulty swallowing. Patient was given Benadryl at 1853, 1930, 2004. vitals were monitored during this time also.

Other Meds: Epi Pen PRN

Current Illness: None Known

ID: 1014728
Sex: F
Age: 52
State: NC

Vax Date: 01/31/2021
Onset Date: 02/07/2021
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: NKA

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

Symptoms: Itching, soreness, redness and warmth at injection site 7 days post injection. Constipation & exacerbation of arthritis.

Other Meds: Tylenol PM, turmeric, cinnamon, berberine, melatonin,

Current Illness: Insulin resistance, Rosai-Dorfman, arthritis

ID: 1014729
Sex: F
Age: 64
State: MA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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, Mango, Latex

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

Symptoms: Tongue became very dry, felt faint first few minutes, but thought i was nervous , left facility after waiting 20 minutes, At home after one hour lips began to swell , I then went back to Hospital was admitted to ER , 50 mg Benadryl administered and I was monitored for several hours until lips began to return to normal

Other Meds: Atorvastatin, Calcim 33 mg, Vit D3 1200 Mg

Current Illness:

ID: 1014730
Sex: F
Age: 61
State: IA

Vax Date: 01/29/2021
Onset Date: 02/05/2021
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: Tremor

Symptoms: large red patch 4in long 2 inches wide (approx.) somewhat itchy, hot to touch.

Other Meds: Clobetasol 0.05% topical

Current Illness: none

ID: 1014731
Sex: F
Age: 85
State: NC

Vax Date: 02/06/2021
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: I don't tolerate epinephrin - makes me scream uncontrollably

Symptom List: Erythema, Pruritus

Symptoms: I didn't sleep well night of Feb. 7, got up three times to pee. I got up finally Feb. 8 at 6:30 and tried to stand but was too dizzy. Finally I was able to get to the bathroom, where I had diarrhea. I managed to make and eat breakfast, but was on and off dizzy, one more diarrhea episode. Took my blood pressure around 10:45, not too high, but heart rate low: 45bpm. I was ready to drive to the woods and take a walk, no further problem.

Other Meds: amlod,ipine 7.5mg, eliquis 2.5mg x2, levothyroxine 100mcg, hctz 12.5mg, fish oil 1200mgx2, multivitamin, co Q-0, stool softener, vitamin D50mcg

Current Illness: none

ID: 1014732
Sex: F
Age: 33
State: NY

Vax Date: 02/07/2021
Onset Date: 02/07/2021
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: None.

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

Symptoms: After 2nd dose, I developed left arm soreness, headaches and lateral neck pains, and about after 10 hours developed chills, muscular aches, fatigue, and low grade fever, after 12 hours, had night sweats, then vomiting. Treated with acetaminophen 650 mg twice within 6 - 8 hours apart. Day 2 post 2nd dose still having left arm soreness, headaches, and mild muscle aches.

Other Meds: None.

Current Illness: None.

ID: 1014733
Sex: F
Age: 51
State: CA

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

Lab Data:

Allergies: NKDA

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

Symptoms: fever 100-102.8, body aches, headache, dizziness, and diarrhea. Symptoms for several days 5-6

Other Meds: Tylenol 500 mg Ibuprofen 600mg Meclizine 25 mg ESzopiclone 1 mg

Current Illness: none

ID: 1014734
Sex: F
Age: 66
State: PA

Vax Date: 01/29/2021
Onset Date: 02/06/2021
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: Sulfa drugs, codeine, melons.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Large red and warm rash at injection site., eight days later. A little itchy, too.

Other Meds: Paxil, Celexa, centrum silver for women 50+, medical marijuana, airborne.

Current Illness: None

ID: 1014735
Sex: F
Age: 67
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: 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: About 45 minutes after the injection, my face became red, flushed and warm. My lips, tongue and mouth began tingling. I felt a little strange bur no other side affects. I took a Benadryl and all symptoms were gone in about 15 minutes. Then I felt fine.

Other Meds: pantoprazole, vitamin D, calcium, multivitamin

Current Illness: none

ID: 1014736
Sex: F
Age: 34
State: OR

Vax Date: 02/05/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Surgical tape Cephalexin

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

Symptoms: Current pregnancy: no issues (currently week 19, EDD 7/2/21). Previous pregnancies: 1. ADE: fatigue X 48 hours, nausea X 24 hours, headache X 72 hours after immunization. Prevented normal function over the weekend. Headache was mild as of today (Monday). Symptoms generally treatable with moderate dose acetaminophen. Symptoms waning and are consistent with robust immune response to vaccine.

Other Meds: Prenatal vitamin

Current Illness: None

ID: 1014737
Sex: F
Age: 63
State: NV

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

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

Lab Data:

Allergies: codine macrobid

Symptom List: Pain in extremity

Symptoms: the day of the injection arm pain at injection site. Later at 1:00am I had body ache, muscle and joint pain and fatigue. On following day early in the evening I lost the ability total ability to speak. I had a severe stutter. I was rushed to the hospital via ambulance. I remained in the hospital and was released on Feb. 8

Other Meds: Rapatha, Esomeprazole, vit. c, vit e, vit b-12, co-q 10, zinc, magnessium, vit d, probiotics, calcium, glucosomine, tumeric, Lutein, fish oil,

Current Illness:

ID: 1014738
Sex: F
Age: 75
State: VA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: ASA, MSG, Yellow DYE in food

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

Symptoms: Rash with itching at wrists and upper chest - administered 50 mg Benadryl PO with rash fading/itching resolved within 30 minutes after Benadryl.

Other Meds: Unknown

Current Illness: Unknown

ID: 1014739
Sex: F
Age: 66
State: GA

Vax Date: 01/24/2012
Onset Date: 02/08/2021
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: Demerol

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

Symptoms: 16 days after vaccine I noticed some soreness at the site for the first time this morning. Later this evening the site is red and itching. I also noticed a sore lymph node on the left side of my neck. I have not had any treatment for this.

Other Meds: Pravastatin, Pepcid, Metformin, PreserVision AREDS2, B-12 1000mcg 3xweek, Vitamin D2 50,000IU 1xweek

Current Illness:

Date Died: 02/06/2021

ID: 1014740
Sex: F
Age: 83
State: CA

Vax Date: 02/04/2021
Onset Date: 02/06/2021
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: NKA

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

Symptoms: Patient found down at home with agonal respirations and per EMS asystole, received 2 rounds of epi at her house with return of spontaneous pulses, lost pulse again in route to ER and another round of epi was given, CPR in progress when arrived at hospital. Prior to this patient's husband states he heard her fall in the bathroom but did not immediately check on her as he states that this has happened before. He checked on her 10 min later and that's when he found her unconscious. Daughter called 911 and she began CPR. No previous complaints of headache, chest pain, back pain, fever or chills. Husband states patient was drinking that evening which is not unusual for her. Patient died at hospital.

Other Meds: Lisinopri, Sertraline, pravastatin, alendronate, Cetirizine, Vitamin D3,

Current Illness: no acute illnesses

ID: 1014741
Sex: F
Age: 82
State:

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

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: Pt admitted with ICH, likely secondary to increased ICP from nausea and vomiting after receiving her second pfizer covid vaccine.

Other Meds:

Current Illness:

ID: 1014742
Sex: F
Age: 34
State: PA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: patient felt like her throat was getting tight and was really nervous. vitals were obtained 141/87, pulse 112 resp 18 and oxygen 98% patient went to the bathroom, walked outside to get cool air on her face, and felt better after doing those things. patient felt very anxious and felt that this caused her sx's. patient was discharged home.

Other Meds:

Current Illness:

ID: 1014743
Sex: F
Age: 24
State: PA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: no known allergies reported

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

Symptoms: patient called complaining of sharp pain in back and shortness of breath approximately 6 hours after receiving the first dose of Moderna COVID vaccine

Other Meds:

Current Illness: none reported

ID: 1014744
Sex: F
Age: 85
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: Statins

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fever, aches, headache

Other Meds: High blood pressure medication Zetia Meloxicam Vitamin D Allegra

Current Illness: COVID on November 28,2020

ID: 1014745
Sex: M
Age: 66
State: ID

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Myalgias, arthralgias, headache, photophobia, sweats, chills lethargy all lasting twelve hours improved with ibuprofen

Other Meds: Irbesartan, hydrochlorothiazide, aspirin, magnesium oxide

Current Illness: none

ID: 1014746
Sex: F
Age: 63
State: CA

Vax Date: 01/09/2021
Onset Date: 01/14/2021
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: None

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

Symptoms: I am an RN. Got my first Covid vaccine on Jan 9th 2021. A week later my eyes burned and itched horribly. Also my scalp itched terribly. Never had this in my life. I used some eye drops and in a few days it went away. 28 days later, got my 2nd Covid vaccine. Again about 5 days later my eyes are burning and itching as well. I have never had allergies to anything. I am again putting eye drops in. Systane and Visine. I also have gotten a very tiny blister below my right eye. Very tiny..smaller than a pea. I don't see this side effect anywhere written. I am not allergic to dust or animal dander. I am 63 years old. Just wanted you to be aware, I believe this is caused by the vaccine.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm