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: 1015260
Sex: F
Age: 67
State: TX

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: Aspirin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Just as the nurse started injecting the vaccine I felt a strong taste of metal in my mouth (similar to the times I have had CAT scans done). In a couple of minutes I felt very light headed. While scheduling my second dose, I started feeling strong pressure inside my head. I didn't not feel any pain, just a lot of pressure. When measuring my blood pressure (usually, in my case, it is 120 X 80) I was told my high number was at 178 x 80. After resting for some 20 minutes, I was fine again and drove home. I felt a bit strange for a couple of hours.

Other Meds: Prozac Ezetimibe 10 mg Hydrochorothiazide 25 mg

Current Illness:

ID: 1015264
Sex: F
Age: 42
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: rash with azithromycin

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient first had lip tingling 5 minutes after vaccination, but no changes in respiration. Patient began to develop hives 2 hours after vaccination. She came down to pharmacy. She was given 1ml of diphenhydramine 50mg/ml. Measurements of her blood pressure yielded very high readings. Called EMT due to high BP readings.

Other Meds:

Current Illness: lupus (no medication)

ID: 1015267
Sex: M
Age: 80
State: HI

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

Lab Data:

Allergies: NKA

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

Symptoms: Patient developed profound weakness in his legs and arms the following day. Had 2 mechanical falls which necessitated activation of EMS to get him off the ground.

Other Meds: Melatonin ASA 81 mg daily Lantus 48 units subQ daily Ramipril 10 mg daily Pioglitazone 30 mg daily Uloric 40 mg daily Pravastatin 80 mg daily Diltiazem RR 320 mg daily Januvia 50 mg daily Colchicine 0.6 mg daily Lyrica 50 mg tid

Current Illness: NONE

ID: 1015270
Sex: F
Age: 30
State: CA

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: possible not right dose. Patient in the list of vaccinator when it was brought to attention.

Other Meds: birth control, daily MVI, vitamin C

Current Illness: none

ID: 1015273
Sex: F
Age: 41
State: CO

Vax Date: 01/29/2021
Onset Date: 01/30/2021
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:

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

Symptoms: Fever, body aches, headache, nausea, sore injection site

Other Meds:

Current Illness:

ID: 1015276
Sex: F
Age: 68
State: WA

Vax Date: 01/23/2021
Onset Date: 01/30/2021
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: vicodin, hydrochlorothyiazide

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

Symptoms: Severe covid arm. Half of arm affected. Rash on neck, chest and itchy all over. Inflamed ear lobes.

Other Meds: amlodipine, losartan, levothyroxine, metoprolol, metformin, pravastatin, novolin, novolog

Current Illness: none

ID: 1015279
Sex: F
Age: 58
State: WA

Vax Date: 01/22/2021
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: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Urticaria on right arm adjacent to injection site.

Other Meds: none

Current Illness: none

ID: 1015282
Sex: M
Age: 54
State: OR

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

Lab Data:

Allergies: amoxicillin

Symptom List: Pharyngeal swelling

Symptoms: Mild rash at/near site of injection a week after injection. Seems to be getting better.

Other Meds: multi-vitamin, garlic supplement, turmeric

Current Illness: None

ID: 1015285
Sex: F
Age: 35
State: NV

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I did not have any adverse side effects with the first vaccine. The second vaccine was very different, which I know is common (nausea, fatigue, headache, fever, chills, body aches), but after 48 hours my arm became very red and swollen. The injection site is bruised and the redness and swelling is going down my arm from my shoulder to my bicep. I took Benadryl last night and will take Benadryl and Ibuprofen tonight and if the swelling gets worse a doctor will call me in a prescription for a steroid.

Other Meds: Prenatal vitamins, birth control pill, probiotics, ibuprofen

Current Illness: None

ID: 1015723
Sex: F
Age: 61
State: CA

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Large swelling entire upper arm, pain radiating to my Left side breast and Left upper back. Left upper arm hot to touch, fever 24 hrs.

Other Meds: Losartan .25 mg

Current Illness: none

ID: 1015724
Sex: F
Age: 70
State: OH

Vax Date: 02/02/2021
Onset Date:
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:

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

Symptoms: Pharmacy technician went to draw up vaccine and instead of using open diluted vial, she popped the top off the unopened vial, did not dilute, and administered to patient

Other Meds:

Current Illness: None

ID: 1015730
Sex: F
Age: 29
State: IL

Vax Date: 02/02/2021
Onset Date:
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:

Symptom List: Rash, Urticaria

Symptoms: Dizzy, hyperventilation

Other Meds: None

Current Illness: N/A

ID: 1015856
Sex: F
Age: 74
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: At 9:55 am, five minutes post vaccine, patient reports to observation nurse feeling dizzy, left sided neck pain, flush, and sudden left sided headache. Staff was notified EMS crew immediately. B/P 151/83, Also diapheretic. Patient reported not feeling well at all and would like to go to the hospital. Transported to local hospital. for evaluation

Other Meds:

Current Illness:

ID: 1015858
Sex: F
Age: 80
State: MI

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

Lab Data:

Allergies:

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

Symptoms: lethargic, malaise, complaining of a headache

Other Meds:

Current Illness:

ID: 1015860
Sex: F
Age: 57
State: KS

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

Lab Data:

Allergies: Sulfa, Tree nuts

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

Symptoms: Pt reports she received her 2nd dose of vaccine on Friday & that night she had chills. The morning of 2-6-2021 pt reports that she felt as though her heart was racing & chest throbbing. Pt was evaluated and treated in the emergency room.

Other Meds: multivitamin 1 PO Q Day, Omeprazole 20mg 1 PO QDay, citrucal 10 2 tabs PO Q Day, metoprolol 25 mg /2 tab Q Day

Current Illness: None

ID: 1016126
Sex: M
Age: 29
State: IL

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

Lab Data:

Allergies:

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

Symptoms: Patient fainted and fell to the floor. EMS administered first Aid and ref pt to hospital. Refused to be transported by Ambulance car. Brother tranport pt to Hosp.

Other Meds: N/A

Current Illness: N/A

ID: 1016284
Sex: F
Age: 74
State: NY

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: none known

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

Symptoms: C/O feeling Anxious and having a fast heart rate Vital signs were monitored and were WNL She wanted to return home, was seen by MD @ site and was sent home

Other Meds: none known

Current Illness: Hypertension

ID: 1016285
Sex: F
Age: 36
State: NY

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient received covid vaccine on 2/6/21 at 8:36am. She stated on 2/7/21 @ 5:30pm She felt pain on the same hand she received the vaccine and also stated the pain was localized and its radiating to other part of the shoulder patient took 2 tabs (650mg) of Tylenol PO

Other Meds: Ferrous Sulfate 1 tab daily Albuterol 2 puff q6h PRN

Current Illness: None

ID: 1016288
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
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: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Initially red arm w/mild swelling that resolved by Sat 1/30 Now with redness, warmth, swelling approx 2" x 3"

Other Meds: NONE

Current Illness: NONE

ID: 1016290
Sex: F
Age: 43
State: WV

Vax Date: 02/04/2021
Onset Date: 02/08/2021
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: The vaccine was given into the tricep accidentally instead of the deltoid region.

Other Meds:

Current Illness:

ID: 1016299
Sex: F
Age: 79
State: NJ

Vax Date: 01/23/2021
Onset Date: 01/31/2021
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: penicillin, MI/MCI (preservatives in soaps, shampoos etc)

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

Symptoms: After having NO reaction for 8 days, I experienced a slightly itchy rash at vaccination site. It lasted for about 2 days. It was slightly warmer than surrounding area. Comment: Not sure if vaccine was properly administered. It was almost half-way down to my elbow, possibly in the tricep area. I mentioned it to my nurse practitioner during a telemed visit which had been scheduled before my vaccination. When I showed her photo of my arm with the bandaid, she thought it might not have been placed high enough on the arm. Based on location, not sure if subcutaneous or intramuscular.

Other Meds: losartan, metroprolol, synthroid,amlodipine,atorvastatin

Current Illness:

ID: 1019969
Sex: F
Age: 48
State: NJ

Vax Date: 12/31/2020
Onset Date: 12/31/2020
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: No

Symptom List: Unevaluable event

Symptoms: Muscle pain

Other Meds: Amlodipine Benazepril 5/20mg

Current Illness: No

ID: 1020133
Sex: M
Age: 79
State: TN

Vax Date: 12/28/2020
Onset Date: 01/04/2021
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: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Pt reports that he had diarrhea that began 1 week after receiving first dose of Covid vaccine by Moderna. Pt received the second dose of Covid vaccine on 1/1/25/2021. Pt states that even after 2 weeks after receiving the second dose of Covid vaccine by Moderna the diarrhea has continued. Pt reports not issues with diarrhea prior to receiving the Covid vaccine by Moderna.

Other Meds: Betaxalol 2.5 mg PO daily. Cranberry pill. ASA 81 mg PO daily

Current Illness: None

ID: 1020138
Sex: M
Age: 42
State: WI

Vax Date: 04/17/2013
Onset Date: 04/18/2013
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:

Symptom List: Injection site pain, Pain

Symptoms: Anthrax-immunized area swollen, redness painful, itching, and unable to move arm

Other Meds:

Current Illness:

ID: 1020145
Sex: F
Age: 17
State: MA

Vax Date: 01/22/2021
Onset Date:
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:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Flu shot given too soon - 1 mo. after last one - did not need booster dose

Other Meds:

Current Illness:

ID: 1020146
Sex: F
Age: 55
State: KS

Vax Date: 01/28/2021
Onset Date: 02/01/2021
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: Patient received Moderna Vaccine at Hospital health vaccine clinic on 1/8/21. Patient was then signed up for pharmacy clinic to receive Pfizer vaccine on 1/28/21. No symptoms noted. Precautionary reporting.

Other Meds:

Current Illness: none

ID: 1022216
Sex: F
Age: 17
State: CO

Vax Date: 01/13/2021
Onset Date: 01/13/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Prolonged pain, swelling in muscle where injection given (7 days) affecting ability to move arm without pain

Other Meds: None

Current Illness: None

ID: 1022217
Sex: F
Age: 62
State: NY

Vax Date: 01/04/2021
Onset Date: 01/04/2021
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: RA

Lab Data:

Allergies: PCN, Sulfa drugs, Latex, ultram

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chills, headache, nausea, Joint Pain Red raised hot area at injection site- got better by Thursday - Symptoms returned including Rash arm on following Tuesday

Other Meds: dexilant, Calcium, multi vit

Current Illness: none

ID: 1022218
Sex: M
Age: 50
State: NJ

Vax Date: 01/12/2021
Onset Date: 01/13/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: SWELLING/TENDERNESS RIGHT SIDE OF CHEST NEAR ARMPIT

Other Meds: MULTI-VITS

Current Illness:

ID: 1022219
Sex: F
Age: 41
State: NJ

Vax Date: 01/30/2021
Onset Date: 01/31/2021
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: N/A

Symptom List: Nausea

Symptoms: Lymp nodes swollen in the neck area, underarm & clavicle area very tender & painful

Other Meds: Clarinex, Flonase, Yasmin, Vitamin D3 taken in the AM

Current Illness: None - COVID positive 01/04/2021

ID: 1022249
Sex: F
Age: 47
State: NY

Vax Date: 01/15/2021
Onset Date: 01/23/2021
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: Sulfa, Latex, Atrovent

Symptom List: Injection site pain

Symptoms: Rash At site of vaccination red, raised, tender & itchy

Other Meds: Synthroid, multivitamin

Current Illness: NA

ID: 1022275
Sex: F
Age: 61
State: NJ

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

Lab Data:

Allergies: ultram

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

Symptoms: Left arm administration site very swollen, sore, warm to touch

Other Meds: None

Current Illness:

ID: 1022288
Sex: F
Age: 32
State: HI

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: 0 NKA

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

Symptoms: almost immediately after receiving vax pt was very flushed, dizzy, slightly SOB (x1 min). Sat down. Pulse = 98, SpO2 98, ice pack to chest, MD examined, dizziness resolved after about 2 min SpO2 100% HR 70, no rash, alert, no Resp distress

Other Meds: BCP'S

Current Illness: 0

ID: 1022295
Sex: F
Age: 62
State: PA

Vax Date: 01/30/2021
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:

Symptom List: Tremor

Symptoms: Itching Red Lump at injection site - hard, warm to the touch.

Other Meds:

Current Illness:

ID: 1022296
Sex: F
Age: 1
State: CA

Vax Date: 01/26/2021
Onset Date:
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: Possible cereal & milk problem allergy

Symptom List: Erythema, Pruritus

Symptoms: Large local reaction and hives + vesicular euphoria & fatigue @ local site. Day 7+ largely 2/2 Varicella

Other Meds: unknown

Current Illness: n/a

ID: 1015288
Sex: F
Age: 39
State: OK

Vax Date: 01/26/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
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: Allergic to almonds

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

Symptoms: Light red/pink round rash on upper arm near injection site with darker red/pink edges. Slightly itchy

Other Meds: amlodipine 10mg Daily spironolactone 100mg 2x a day cryselle 300mcg daily fiber gummy 5grams fiber 2x a day

Current Illness:

ID: 1015292
Sex: F
Age: 36
State: CT

Vax Date: 01/13/2021
Onset Date: 01/21/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: A rash developed around the injection site about 8 days following injection. The area was also hot to the touch and itchy. Lasted about 5days. Applied some hydrocortisone cream after 4 days.

Other Meds:

Current Illness: None

ID: 1015295
Sex: F
Age: 44
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
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: Phenergan (rash at injection site) Trazadone (dizziness, syncope)

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Events lasting approximately 48 hours (onset 18 hours after vaccine): Allodynia (whole body) Muscle aches (whole body) Debilitating headache Pain and swelling at injection site (right arm) Painful joints *Safe dose range of OTC Tylenol ineffective Ongoing effects (onset approximately 24 hours after first vaccine): Painful lump right breast/armpit

Other Meds: Multivitamin with Iron Lexapro 20 mg every morning Prilosec 40 mg every morning

Current Illness:

ID: 1015298
Sex: F
Age: 74
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
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:

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

Symptoms: Dizzy, nauseous, pale, cold extremities, weak pulse. BP 90/44, HR - 44. O2 sat 96-99%. Blood sugar 127. Patient lay down, with feet elevated. Symptoms resolved.

Other Meds:

Current Illness:

ID: 1015301
Sex: F
Age: 51
State: WA

Vax Date: 01/31/2021
Onset Date: 02/08/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: itchy swollen injection site, put ice on

Other Meds:

Current Illness:

ID: 1015304
Sex: F
Age: 43
State: WA

Vax Date: 01/30/2021
Onset Date: 02/08/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Pain in extremity

Symptoms: Redness, warm to touch, sensitive to touch

Other Meds: 40 mg citalopram daily

Current Illness: No

ID: 1015310
Sex: M
Age: 57
State: NY

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/09/2021
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: Extreme soreness in upper left arm, painful to lift arm, approximately 10 hrs after I received the vaccine shot.

Other Meds: Amlodipine 5mg, Atorvastatin 80mg

Current Illness: None

ID: 1015313
Sex: F
Age: 37
State: IN

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/09/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Severe allergic reaction to IV contrast on 2/1, hydrocodone (SOB), Breo ( anaphylaxis), abilify (spontaneous lactation from breasts bilaterally during and for 4 weeks after stopping), lamicital ( auditory/visual hallucinations), prozac (suicidal ideation with inpatient psych admission), Effexor XR (severe mania/insomnia/racing thoughts x 11 days), lamb (abdominal cramping/diarrhea), aspartame (abdominal pain/diarrhea), silk tape/ clear medical tape (rash/welts), latex (rash)

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

Symptoms: I know this vaccine is inherently good for the population as a whole. I was recommended to receive this vaccine as a registered nurse because it had been over 3 months since I had Covid. However, I was a Covid long hauler with lingering symptoms until 12/23/20 that never really fully resolved completely. I believe I received the Moderna vaccine too soon after my long term symptoms mostly resolved and hence the immediate and severe reaction that my doctors and specialists are still trying to figure out and how to treat properly. There was a nurse that reported some similar symptoms to mine after receiving the Moderna vaccine and this was on national news. However, I am not sure she ever had Covid or the long term symptoms I had from the virus before getting the vaccine and that sets us apart. However, both I and this nurse were on depress medicine when receiving the vaccine and unsure if there is a possible correlation or interaction between the vaccine and depression meds.

Other Meds: Levothroxine, buspar, pristiq, Claritin, nexium, vitamin d3, vitamin b12, prednisone, topirimate, requip, trazadone, hydroxyzine prn for insomnia/anxiety, fiorcet every 4 hrs headaches

Current Illness: Lingering COVID long term effects including headaches, fatigue/lethargy, muscle weakness /pain, decreased activity tolerance, increased resting heart rate/blood pressure, increasing neuropathy symptoms since COViD onsetb5/13/20 and dizzy spells.

ID: 1015316
Sex: F
Age: 40
State: IN

Vax Date: 01/05/2021
Onset Date: 01/09/2021
Rec V Date: 02/09/2021
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: I still hv swollen painful node above my collarbone..just been taking tylenol..no much relieve

Other Meds: none

Current Illness: none

ID: 1015320
Sex: F
Age: 77
State: AK

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
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: Codeine

Symptom List: Vomiting

Symptoms: Severe all over muscle and joint ache, fatigue, dry cough, chills, dizziness and weakness. Began around 7 or 8 am February 5 and continued all day and evening. I slept most of the day. Around 11:30 that night I woke up feeling quite a bit better. I slept all night. The next morning, Saturday, the aches had gone away and I was alot better. The cough, however, continued. The cough continued through Sunday. Monday the cough happened only a few times and I felt energetic and completely back to normal.

Other Meds: Multi vitamin, omega 3, calcium, vitamin D, vitamin C, potassium, lutein, co enzymeQ10

Current Illness: None

ID: 1015324
Sex: F
Age: 62
State: NY

Vax Date: 01/30/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
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: Penicillin, aspirin and ibuprofen

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The day I received the shot, the site became red and warm to the touch and itchy with swelling. It calmed down in about 4 days. Then 7 days after the vaccine my injection site became very swollen, red, very hard in the injection area and itchy. I also felt slightly achy and had a headache for 3 days before that. Now 2 days later the reddened area is larger and circular like a target. Skin is warm to the touch and itchy. I?m no longer achy and no more headaches. The swelling in the left arm has decreased slightly but the redness is bigger.

Other Meds: Pepcid, omega 3, multiple vitamin, vitamin C, echinacea, glucosamine

Current Illness: None

ID: 1015327
Sex: F
Age: 66
State: NV

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/09/2021
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 reported itching and redness at vaccination site. Also reported a blister on the face and having a sore throat. pt stated this started shortly after the vaccine administration and noticed it a lot on Friday 2/5 when pt reported it. Pt was attempted to be reached on 2/8 for follow up but no response.

Other Meds:

Current Illness:

ID: 1015331
Sex: F
Age: 59
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: -On second day, began to develop low grade fever (up to 99.9), chills, and body aches. Tylenol helped somewhat. -On third day, became lethargic and extertional fatigue with shortness of breath symptomology and mild nausea; no fevers/chills on this day -On fourth day, mild diarrheal episodes (x 3, within 45 minutes), no abdominal pain/vomiting, but nausea persisted, in addition to worsening lethargy, and exertional fatigue with shortness of breath upon ambulation and climbing stairs - On fifth day, dry cough symptoms upon awakening for 1 hour, then continued lethargy and exertional fatigue with shortness of breath upon ambulation and climbing stairs, with somewhat improved nausea, oxygenation saturation 100%; by 9pm on fifth day, 30-40% improvement in symptoms

Other Meds: None

Current Illness: None

ID: 1015333
Sex: F
Age: 36
State: OR

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

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

Lab Data:

Allergies: Gluten (celiac)

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

Symptoms: Fatigue, malaise, headache 24-48hrs after receiving Rash 2 inches below injection site formed at 72hrs, skin red, tender and warm to touch, elevated. Approx 3x5 inches in size.

Other Meds: Probiotic, B6, vitamin d, magnesium, sodium naproxen, tyleonol

Current Illness: None

ID: 1015336
Sex: F
Age: 41
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/09/2021
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: Nka

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

Symptoms: Body aches, joint pains, fever, severe chills, muscle spasms, and fatigue began 12 hours post vaccination. Fever and chills lasted approximately 17 hours. Fatigue, body aches, joint pains last 4 days. Severe left TMJ pain began 31 hours post vaccination. Debilitating pain and muscle spasms continued. Chiropractor adjustment day 7. Family doctor consulted day 11 and started steroid and muscle relaxer. Dentist consulted day 14 and referred to physical therapist, recommended massage therapy and continued chiropractor care. Referral to oral surgeon if no improvement in 1 week.

Other Meds: Levothyroxine 25mcg daily Spironolactone 50mg twice daily

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm