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: 1017412
Sex: F
Age: 54
State: OH

Vax Date: 01/06/2021
Onset Date: 01/22/2021
Rec V Date: 02/09/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: amoxicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient is a 55 y.o. female presenting from home with complaint of shortness of breath. Patient tested positive for COVID-19 infection in January 15. Last 2 days started to get sob with mild cough, no phlegm production Denies chest pain Initially had fever, but no fever last 3 days In ED, dropped sat to 89% momentarily, but was found to be tachycardic 130 range sinus CT PE was negative for PE, showed Mild infiltrative changes of the left lower lobe and lingula. Likely related to patient's known atypical infectious process. No superimposed dense airspace consolidation Pt has been treated with Remdesivir, Decadron and supportive care. Pt has been stable in room air. Pt wants to go home today. She will receive the fourth dose of Remdesivir. Then she is OK to be discharged home. She will follow up with primary care physician Pt reported dysuria. Her UA showed positive nitrite. One dose of Cipro 500 mg given (pt is allergy to Amoxicillin). She will continue take Cipro 500 mg twice a day for 7 days for UTI.

Other Meds: topiramate, tizanidine, naproxen, magnesium oxide, Vitamin D3, eletriptan prn

Current Illness: none

ID: 1017413
Sex: F
Age: 75
State: MN

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
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: cephalexin

Symptom List: Anxiety, Dyspnoea

Symptoms: erythematous area starting at the deltoid now spread to bicep. Area is warm to the touch. No other symptoms. patient was ancouraged to use cold compresses, Tylenol, and he was given an antibiotic

Other Meds: lorazepam, vitamin D, pantoprazole

Current Illness: none

ID: 1017414
Sex: M
Age: 66
State: NV

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
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: iodine, latex, valium

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

Symptoms: Caused my breathing to be erratic, heart rate increased about 15% and Glucometer readings increased 50-70 points each reading. Breathing/heartrate has gotten better and sugars are almost back to my normal readings.

Other Meds: Glimepiride, Piolitazone, Pantoprazole Sod Dr, Low Dose Aspirin, Centrum Silver, Tumeric, Potassium, Liver Balance(Nature Sunshine), Magnesium/Zinc/Vit D3 combo, Naproxen, Rosuvastatin, Fenofibric Acid Dr, Methocarbamol, Oxycodone HCL

Current Illness: none

ID: 1017415
Sex: F
Age: 58
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
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: Symptoms: 101.5 Fever, Nausea, Chills, Body Aches, Neck ache, mild headache, exhaustion Treatment: tylenol and rest.

Other Meds: None.

Current Illness: None.

ID: 1017416
Sex: F
Age: 64
State: NJ

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: sulfa

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

Symptoms: pt stated that on the same day she started having stomach cramping and diarrhea. Next day pt woke up with head congestion and coughing with major drip of mucus going down her throat. She is also weak and dizzy. Three days later pt had tingling in upper lip and gum. Fourth day pt still had congestion and still had the tingling in lips and gums. Pt spoke w/ PCP on call and was told to rest. Fifth day pt still had all of the same symptoms and then she had developed a light vibrating sensation on her right side on the inside area around the breast. Pt had this symptom for the next 2 days. She went to her Pulmonologist which did not find anything wrong w/ her lungs and thought she may have hurt her back. Pt started feeling better but is still very weak. Pt stated about a week later she developed a headache that she could not get rid of. On 2/8/2021 pt still has headache. On 2/9/2021 she woke up weak and dizzy and just dont feel well. Pt is concerned about taking her 2nd vaccine.

Other Meds: none

Current Illness: no

ID: 1017417
Sex: F
Age: 65
State: FL

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 02/09/2021
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: Penicillin Procaine

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

Symptoms: I Developed a hive raised area about size of 3 quarters with rash area extending around the raised area. Itchy Date of rash was 8 days after the 1st dose of vaccine Vaccine date 01/14/2021 Rash appeared on 01/22/2021 around 12:00 pm

Other Meds: Xanax 0.5 mg at hs Vitamin D 1000 mg Advil as needed Benadryl with the reaction

Current Illness:

ID: 1017418
Sex: F
Age: 73
State: CA

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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Large itchy red rash at injection site. Some swelling and tenderness

Other Meds:

Current Illness:

ID: 1017420
Sex: M
Age: 63
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
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: Chills with shaking, nausea, fever (101.5?), body aches

Other Meds: Metformin, Losartin, Jardiance, Amlodipine, Aspirin, Nexium

Current Illness: None

ID: 1017421
Sex: F
Age: 31
State: CT

Vax Date: 02/05/2021
Onset Date: 02/09/2021
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: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I received the vaccine on 2/5/2021 at 0840. I woke up this morning at 2/9/2021 at 0800 and brushed my teeth. My tongue has all these white dots on it.

Other Meds: Lexapro, adderall, woman's multivitamin, NAC, Vitamin B12, B complex

Current Illness: I developed white bumps all over my tongue 4 days after the vaccine. I am unsure if this is an anaphylactic reaction or an "immune response"

ID: 1017422
Sex: F
Age: 15
State: IA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/09/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: No A/E reported, patient is under the 16 year old age limit.

Other Meds:

Current Illness:

ID: 1017423
Sex: F
Age: 84
State: NY

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/09/2021
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: "Started to have a rash on rt side of her face, along with dizziness, weakness and tingling in her rt arm. Rapid response team called and came, RRT took her to ED"

Other Meds:

Current Illness:

ID: 1017424
Sex: F
Age: 53
State: MA

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 02/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Not aware of

Symptom List: Rash, Urticaria

Symptoms: Full blown case of facial Shingles, involving right eye, right ear, and scalp can send pictures if you wish

Other Meds: Pepcid. Daily vitamin

Current Illness: None

ID: 1017425
Sex: F
Age: 37
State: TX

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

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

Symptoms: Patient reports that 20 minutes after receiving vaccination that she developed throat tightness and swelling and associated trouble swallowing and shortness of breath. She was treated with IM Epinephrine and IV Benadryl on site and EMS transported to Emergency Department. EMS reported symptoms returned en route and 2nd dose of IM epinephrine given. In the ED, pt received a 3rd dose IM epinephrine when her symptoms worsened again, and was admitted to the hospital for monitoring overnight. She was discharged home today.

Other Meds:

Current Illness:

ID: 1017426
Sex: F
Age: 40
State:

Vax Date: 01/22/2021
Onset Date: 01/25/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: latex (rash); clindamycin (urticaria)

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

Symptoms: 2 days after shot developed painful rash to chest which resolved with topical steroids. 4 days - 2 weeks after developed itchy raised plaques approx 1 cm diameter scattered on the neck.

Other Meds: topiramate; sumatriptan; refresh drops; vitamin D2

Current Illness: none

ID: 1017427
Sex: F
Age: 52
State: OK

Vax Date: 12/30/2020
Onset Date: 01/05/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: Antibiotics, Chocolate

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

Symptoms: A few days after the vaccination on 1/5 I starting having chills, severe body aches which eventually a fever arose and I developed a cough. I felt a little foggy in the head so I asked my facility to perform a COVID test on me on 1/5 and on 1/7 was diagnosed with COVID .

Other Meds: Vit D, C and A, Zinc

Current Illness: no

ID: 1017428
Sex: M
Age: 76
State: AK

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: NKA

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

Symptoms: Joint pain

Other Meds: Albuterol Atorvastatin lisinopril Singular ASA Spiriva

Current Illness:

ID: 1017429
Sex: F
Age: 71
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
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: 0

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

Symptoms: Within 3 hours Sore arm, Within 24 hours chills, fever, nausea, body aches, extreme fatigue Ongoing

Other Meds: Amitrypteline, , levothyroxin, celexa, hydrochlorithiazide, pravastatin, met form in, fish oil, chroiniditin, glucosamine, vitamin D

Current Illness: 0

ID: 1017430
Sex: F
Age: 63
State: MA

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

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

Lab Data:

Allergies: no

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Systemic: Anaphylaxis- Medium

Other Meds:

Current Illness:

ID: 1017431
Sex: F
Age: 29
State: CA

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

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

Lab Data:

Allergies: seafood

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: One hour 10 minutes after dose employee was at work station, stood up, felt faint and fell to the ground. Regained consciousness in less than 30 seconds and asked for help from nearby co worker. She was taken by ambulance to Hospital due to recent hip injury and fall to insure no further injury occurred. Pt has previously passed out while receiving flu vaccine. Pt is currently using a knee scooter to assist with mobility.

Other Meds: doxepin

Current Illness: hip injury awaiting further diagnosis

ID: 1017432
Sex: F
Age: 55
State: CA

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

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

Lab Data:

Allergies: PENICILLIN

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

Symptoms: PATIENT STATES HER EYES STARTED WATERING AND GETTING CRUSTY AT NIGHT. SHE WOKE UP NEXT DAY WITH SWOLLEN EYELIDS

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1017433
Sex: M
Age: 65
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/09/2021
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: Pennecillin

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

Symptoms: With 06:10 pm injection on 02/02/2021 symptoms started the next day (02/03/2021) at 2:00 pm when I became slightly dizzy with a fever of 100 degrees (my normal is 97.2 degrees). Fever, dizziness, tiredness continued 12 hours with fever decreasing to 97.4 degrees at 04:00 am (02/04/2021) and dizziness/tiredness ended aprox 02:00 pm that afternoon.

Other Meds: Levothyroxine; Desvenlafaxine ER; Simvastatin; Famotidine

Current Illness: None

ID: 1017434
Sex: U
Age:
State: NH

Vax Date:
Onset Date:
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:

Symptom List: Unevaluable event

Symptoms: When I awoke on 02/07/2021 I had a severe headache, fever, sore throat and fatigue to the point of not being able to move. I lost all appetite and did not take in anything PO for >24 hours. My stomach cramped up as well and my joints were so inflamed the pain was almost unbearable. Anytime I crossed my legs or put any pressure anywhere that limb fell asleep immediately (which is a phenomenon I've never had happen before). Carrying my small purse on my shoulder for example made my arm fall asleep. I was able to go into work on 02/08/2021 but unable to complete my shift due to the pain and lethargy.

Other Meds:

Current Illness:

ID: 1017435
Sex: M
Age: 64
State: CT

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: LA

Lab Data:

Allergies: none

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

Symptoms: Mild swelling on left side of face, neck and back of tongue. Began to fade after appx. 1 hour.

Other Meds: multivitamin, fish oil, vit. D3, zinc, low dose aspirin

Current Illness: none

ID: 1017436
Sex: F
Age: 45
State: PA

Vax Date: 02/07/2021
Onset Date: 02/08/2021
Rec V Date: 02/09/2021
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: Penicillin clindimyacin

Symptom List: Injection site pain, Pain

Symptoms: Chills , headache, fatigue Sore, swollen arm with red Mark that is huge

Other Meds:

Current Illness:

ID: 1017438
Sex: M
Age: 29
State: VA

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Menorrhagia

Symptoms: On 1/22/21 ,(7 days after receiving #1 COVID 19 vaccine) developed burning, tingling of upper inner aspect of left arm and later that same day developed faint, pink rash over the painful area. Over the next 24 hrs rash became more distinct; pink papules on an erythematous base in region of T1 and C5 dermatones, no vesicles.

Other Meds: Humalog U-100 insulin - pump, Vitamin D

Current Illness:

ID: 1017439
Sex: F
Age: 55
State: WI

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

Lab Data:

Allergies:

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

Symptoms: started with chills ,fever, than excessive fatigue, headache, muscle pain, and nausea

Other Meds: centrum multi vitamin, glucosamine chondroitin

Current Illness: none

ID: 1017440
Sex: F
Age: 39
State: WV

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Immediately after her second Covid vaccine injection, she began to have a cluster headache and felt flushed. O2 was administered for 15 minutes to treat headache. All vitals were normal Cardiopulmonary assessment was normal. All abnormal feelings resolved prior to her leaving the vaccine clinic approximately 45 minutes after injection. Later that day, she started to have "lockjaw" symptoms and went to her PCP. She received an IM injection of dexamethasone and has been fine since.

Other Meds:

Current Illness:

ID: 1017441
Sex: F
Age: 89
State: VA

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

Lab Data:

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1017442
Sex: F
Age: 57
State: OR

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: minocycline, doxycycline

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

Symptoms: general malaise at 12 hours later, got into bed and immediately developed body aches 6/10 and chills 5/10; did not fall asleep until 3:30 am

Other Meds: estradiol patch .0375, progesterone 100mg,fish oil, Vit B complex, calcium with zinc, mag, and Vit D, niacinamide

Current Illness: none

ID: 1017443
Sex: F
Age: 55
State: IL

Vax Date: 01/20/2021
Onset Date: 01/20/2021
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: Augmentin, Neomycin

Symptom List: Nausea

Symptoms: Dizziness, Sick at stomach for 9 days, diarrhea

Other Meds: Vitamins

Current Illness:

ID: 1017444
Sex: F
Age: 32
State: NY

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

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

Lab Data:

Allergies: n/a

Symptom List: Injection site pain

Symptoms: eye pain, discharge with eyes

Other Meds: n/a

Current Illness: n/a

ID: 1017445
Sex: F
Age: 89
State: IL

Vax Date: 01/29/2021
Onset Date: 02/03/2021
Rec V Date: 02/09/2021
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: nka

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

Symptoms: Patient is a 89 y.o. female with a history of a TAVR that presented to the emergency room few hours after having a 40 min episode of chest pain. The patient states she was just eating and suddenly started having sharp pain on the left side of her chest. There was a little bit of associated shortness of breath, but not much. She states it was sharp in nature and seem to stay about the same for about 40 min. She states that she does seem to get chest pain sometimes when she vacuums, but usually if she sits down it immediately goes away. She reports that she saw PAC about a week ago and was thought to be a little bit fluid overloaded. She was started on a little bit of oral Lasix and was supposed to come see provider later in the week. She states she has diuresed very aggressively the last few days and is feeling quite a bit less short of breath. In the ER, her EKG did not show anything acute. Troponin was normal. BNP was mildly elevated, but her imaging did not show any signs of acute congestive heart failure. Her D-dimer was elevated. However, she was not having any pain while she was in the emergency room. Her pulse was normal and her oxygen saturations were in the high 90s.

Other Meds: amlodipine aspirin chlorthalidone nitroglycerin potassium chloride

Current Illness:

ID: 1017446
Sex: F
Age: 51
State: NJ

Vax Date: 02/06/2021
Onset Date: 02/08/2021
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: RA

Lab Data:

Allergies: penicillin

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

Symptoms: I received my 2nd Moderna vaccine on 2/6/2021. My arm hurt from the injection, but nothing unusual. On 2/8/2021, around 9:00 pm, I noticed that my arm was more sore and there was an area of redness the size of my hand on my upper arm. Site is warm to the touch and firm when compared to the rest of my arm.

Other Meds: losartan

Current Illness:

ID: 1017447
Sex: F
Age:
State: AL

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

Symptom List: Tremor

Symptoms: Within 24 hours after the Pfizer vaccine pt experienced low grade fever of about 100 degrees. This was accompanied by mental status changes . She was taken to hospital and admitted overnight to rule out stroke . All symptoms resolved within 24 hours . She is now fine

Other Meds:

Current Illness:

ID: 1017449
Sex: F
Age: 72
State: CA

Vax Date: 01/30/2021
Onset Date: 02/07/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: 10 cm by 5cm rash surrounding injection site.

Other Meds:

Current Illness:

ID: 1017450
Sex: F
Age: 90
State: NC

Vax Date: 02/05/2021
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: n/a

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1017451
Sex: F
Age: 49
State: IL

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: aminophylline, doxycycline, duoneb, lamictal, sulfa drugs, theophylline, azithromycin

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

Symptoms: Approx 15 minutes after vaccination patient complained of a sensation that her throat is closing and difficulty breathing. She was given benadryl and utilized her home albuterol inhaler. She asked to be taken to the ED. In the ED patient received albuterol nebulizer (@1327), epinephrine 0.3 mg (@1345), famotidine 20 mg (@1327) and methylprednisolone 125 mg (@1327). She was discharged with a prednisone prescription. Symptoms seemed to improve with albuterol and steroids. Epinephrine did not seem to improve symptoms. Patient was discharged with a diagnosis of asthma exacerbation. Patient reported to ED again on 2/9 with feelings of lightheadedness and palpitations. All diagnostic evaluations were negative. Increased heart rate contributed to prednisone use for previous mentioned asthma exacerbation.

Other Meds: zolpidem, albuterol, diclofenac, mirtazapine, alprazolam, chlorpromazine, latuda, duloxetine, propranolol

Current Illness: n/a

ID: 1017452
Sex: M
Age: 79
State: WA

Vax Date: 02/06/2021
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: lysenpril

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Exactly 12 hours after getting the shot he woke up with chills, fairly severe headache and bodyaches. He took two extra strength tylenol. The chills only lasted for about 20 minutes, but he was cold. All of that next day he was in a reclining chair, taking two extra strength tylenol every four hours for headaches and body aches. Yesterday he stopped the tylenol because the head ache was resolving.

Other Meds: lovestatin 40 mg daily losartin 50 mg daily famotidine 150 mg daily hydrolorthizide 25 mg daily flomax .4 mg aspirin 81 mg multivitamin preservision areds 2

Current Illness: None

ID: 1017453
Sex: F
Age: 77
State: MS

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: codiene morphine

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

Symptoms: chills, fever, body ache, headache, weakness redness and swelling of right arm

Other Meds: lisinopril, calcium with magnesium & zinc, preservision eye vitamin, sr multivit

Current Illness: none

ID: 1017454
Sex: F
Age: 73
State: VA

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 02/09/2021
Hospital: Y

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: Two days after receiving the vaccine, on Jan 28th, I noticed pain in my right lower back area. It went away so I didn?t pay much attention to it. On Jan 29th, I woke up to stabbing pains in my right chest which continued to night of Jan 30th. Morning of Jan 31st, I was very short of breath and could hardly get around. I went to the ER in evening of Jan 31st. I was admitted due to two pulmonary embolisms in my lungs. Doctors were convinced I had Covid 19. However, three tests came up negative. I was put on a Heparin drip and then eventually on Eliquis. I have always been healthy up to this point and never had any clotting issues. I now am on Eliquis for at least six months (have to have a follow-on echocardiogram due to issues on right side of my heart.). I am convinced the vaccine triggered the clots.

Other Meds: Esomeprazole Singulair Vitamin D Zinc Vitamin B12

Current Illness:

ID: 1017455
Sex: F
Age: 18
State: VA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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:

Symptom List: Pain in extremity

Symptoms: Hard of breathing, heavy chest (8 hours)

Other Meds: Levothyroxine, Blisovi

Current Illness:

ID: 1017456
Sex: F
Age: 49
State: TN

Vax Date: 02/03/2021
Onset Date: 02/03/2021
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:

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

Symptoms: received the second covid injection 2/3/2021 at about 1pm. The typical symptoms began with soreness at injection site. Then random joint pain, muscle aches and stiffness. During the night muscle ache turned to pain radiating around upper abdomen up into right shoulder as did the injection site with nausea, stomach upset and gas. 2/4/2021 around 9am the chills started and fatigue, increased muscle aches and chills with difficulty controlling my bladder, in addition my urine turned dark. 2/5/2021 all the same symptoms with increased discomfort around upper abdomen circling to my back and new muscle twitching at the injection site. All continued through 2/7/2021 and began lessening. Starting 2/8/2021 mild aches and random chills with upper abdominal pain continuing. At night for some reason it all starts again, I wake up wet from perspiration every night and I switch from painful chills with aches and pain to being hot.

Other Meds: atorvastatin Norvasc lexapro

Current Illness: 2 weeks after the first covid injection I felt achy and chills but tested negative for covid and symptoms went away in a couple of days

ID: 1017457
Sex: F
Age: 45
State: AL

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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:

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

Symptoms: Patient experienced a vagal response approximately 5 minutes after receiving the vaccine. Patient transported to ED via EMS - seen and discharged.

Other Meds:

Current Illness:

ID: 1017458
Sex: F
Age: 66
State: FL

Vax Date: 01/22/2021
Onset Date: 01/25/2021
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: NKA

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

Symptoms: Flu-like symptoms, light-headedness, nauseous, exhausted. No outcome to date - symptoms continue.

Other Meds: ezetimibe 10 mg.; amlodipine 5 mg.; losartan 100 mg.; montelukast 50 mg.; Cymbalta 60 mg.

Current Illness: none

ID: 1017459
Sex: F
Age: 33
State: TX

Vax Date: 01/29/2021
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, sulfa, trimethoprim, vancomycin

Symptom List: Vomiting

Symptoms: reported to PCP office 2/5/2021 c/o bodyaches, cough, fever, congestion, flu test negative, COVID IgG positive 2-5-2021, pt recieved Bamlanivimab 700mg IV infusion on 2-5-2021 at the Hospital for symptom control. has home oxygen 4lpm nc but admits to not wearing it as she should, sob on exertion on presentation to MH

Other Meds: ranitidine 300mg po qhs, beamethasone valerate 0.1% topical cream BID, ketoconazole 2% topical cream bid prn, buspirone 10mg po bid, tylenol codeine #3 300mg-30mg 1 po qid prn, loratadine 10mg po qd prn, albuterol sulfate hfa 90mcg/actuatio

Current Illness:

ID: 1017460
Sex: F
Age: 69
State: CA

Vax Date: 01/25/2021
Onset Date: 02/02/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: GANGLIOS LINFATICOS INFLAMADOS DOLOR EN EL LUGAR DE LA INYECCION COVID ARM

Other Meds: Omeprazole Levothyroxine Ibuprofen Vitamin C Triple Flex Biotin

Current Illness:

ID: 1017461
Sex: F
Age: 67
State: CA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: Amoxicillin, Vicodin, pravastatin

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

Symptoms: 20 min after inj-itching, hives, lip and eyelid swelling, chest pain, neck pain, pain radiating down spine and to the legs, nausea, no vomiting, headache, treated Epinephrine, solumedrol, Benadryl, ambulance was called, but pt felt better and refused and stayed in clinic for observation, then d/c home

Other Meds: ? metFORMIN (GLUCOPHAGE). ? Lisinopril (PRINIVIL/ZESTRIL) ? Rosuvastatin (CRESTOR) 5 mg Oral Tab . ? Ketotifen (ALAWAY) 0.025 % (0.035 %) Opht Drop ? ? Gabapentin (NEURONTIN) 300 mg Oral Cap ? Hydrocortisone 2.5 % Top Crea ? SUDOGEST PE 1

Current Illness: none

ID: 1017462
Sex: M
Age: 45
State: MD

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: Patient presented in normal healthy condition. After describing side effects and precautions, patient was administered vaccine through intermuscular route. Patient appeared to have a normal response to the administration and showed no reaction. The patients wife was the administered the vaccine within 2-3 minutes in the same treatment room. After her administration, the patient was noted with his head positioned forward, pale skin color and no response to questioning. At that point an emergency response was called. The patient remained unresponsive. At the time he was seated. Within about 2 minutes, the patient was laid on the floor and quickly returned to normal consciousness. The emergency squad was called and responded in about 10 minutes. By the time the emergency arrived the patient was fully recovered; he did not require further medical intervention.

Other Meds: none

Current Illness: None known

ID: 1017463
Sex: M
Age: 45
State: WV

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

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

Symptoms: Let me start by my wife also works at Tech and got the shot right before me. So, I was comparing my symptoms to hers. We both complained about pain and swelling at the injection shot but my swelling was much worse than hers. You could tell that my shoulder was swollen just by looking at my arm with my shirt on. So, I knew from talking to everyone that took it that my injection shit should hurt for a couple days so I thought that everything was normal. Then after about a week it had not gone away and even started to hurt worse. I have gotten to the point that when I have any type of physical activity my shoulder starts killing me. It's real sharp pains that cause me to stop what I'm doing and sit down and hold still until the pain fades. So after about 11 days from the day of the vaccine my wife walked into the kitchen where I was trying to make dinner and had stopped and closed my eyes standing there in pain. She said, if it hurts that bad you need to see a doctor. So the next day I visited my doctor and he didn't really know what was causing it . It had been 12 days since the injection and you can still slightly feel the place in my arm. He gave me a medium dose of steroids and a antibiotic to see if something like that will help. Early on I was putting ice packs on it and taking hot showers with the hot water stream directly on my shoulder. One strange thing about it is it only hurts after/during activity and the pain is at other locations like running up my neck and around the back of my shoulder. I feel like it's something with the joint or nerves because of that. The only thing that seems to help is my not moving it.

Other Meds: Omega-3 1000MG , One A Day Men's multi vitamin, Aspirin EC 81 MG Lisinopril 40MG Ibuprofen 800MG Atorvastatin Calcium Tablets 40MG Metoprolol Succ ER 25 MG

Current Illness: None

ID: 1017464
Sex: M
Age: 53
State: OR

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: low grade temp for a couple hours Fatigue for two days Mild to severe headache for two and a half days

Other Meds: Amlodpine 10mg Atrovastine 40mg Asprin 81 mg

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm