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: 1021081
Sex: F
Age: 28
State: IL

Vax Date: 01/21/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
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: morphine, bee sting

Symptom List: Dysphagia, Epiglottitis

Symptoms: First day at first was just feeling fatigue and a sore arm for a day. 3 weeks after shot: feeling very tired, headache, body pain, numbing areas on body. Overall feeling sick.

Other Meds: Omeprazole

Current Illness: none

ID: 1021082
Sex: F
Age: 21
State: MN

Vax Date: 02/01/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
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: amoxicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: Red spot appeared on left arm in shot area two days after first dose of vaccine. The redness began to fade but has returned. With the recommendation of a nurse friend, I drew a line around the affected area and the redness has grown past the line. The size of the redness is about 3.5 inches wide and 1.5 inches tall. The area is also very itchy. It is concerning because the redness had almost dissipated and now has come back over a week after the first dose.

Other Meds: Birth Control

Current Illness:

ID: 1021083
Sex: F
Age: 51
State: FL

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Woke up next morning after injection and above my knee on top of thigh is numb. I have no feeling on top if my leg. Called my family practitioner to let her know. No action has been taken yet.

Other Meds: Duloxetine 60mg Ferrous Sulfate 325mg Promethazine 25mg as needed Baclofen 20mg Lisinopril 5mg Pantoprazole 40mg Valacyclovir 500mg Gabapentin 600mg Metoprolol 50mg Fluticasone nasal 50mcg Rizatriptan 10mg as needed Diclofenac Opical Gel as

Current Illness:

ID: 1021084
Sex: F
Age: 32
State: CO

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin, Lidocaine, Pumpkin, Dairy, Agave, Vicodin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Arm swelling and rash. Rash comes with hard swelling and itchiness. I initially experienced it the day after my injection for up to 4 days after, and the rash came back on day 7.

Other Meds: Lisinopril, Junel, Vitamin D

Current Illness: n/a

ID: 1021085
Sex: F
Age: 56
State: GA

Vax Date: 01/15/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: patient had a stroke the next day (after the clinic on 1/15/20)

Other Meds:

Current Illness:

ID: 1021086
Sex: F
Age: 80
State: CA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: N/A

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

Symptoms: 0934 am: per pt. daughter, pt reports SOB and dizziness. Pt. is slow to answer questions, EMT arrival 0939 am VS: BS 115, BP 154/73, REsp 19, HR 96, O2 98%. Rev BP: 124/73, HR 70, O2 95%

Other Meds: N/A

Current Illness: N/A

ID: 1021087
Sex: F
Age: 51
State: KY

Vax Date: 10/12/2020
Onset Date: 10/12/2020
Rec V Date: 02/10/2021
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: Patient stated felt pain with injection. Thought was just the needle so waited it out assuming normal injection site reaction. Contacted PCP after two weeks. PCP advised heat and Motrin trial for 2 weeks. No relief so seen by PCP for physical exam. PCP gave steroid and stretches. Steroid relieved pain shortly but pain resumed. PCP gave anti inflammatory to try for 2 months. Still pain so another appointment with PCP. PCP referred to orthopedic. Orthopedic ordered xrays and MRI. MRI showed visible damage in bursa.

Other Meds:

Current Illness:

ID: 1021088
Sex: F
Age: 48
State: WI

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
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 known

Symptom List: Pharyngeal swelling

Symptoms: Headache, body & muscle aches, chills, extreme fatigue, nausea (one day)- resolved with fluids & rest the next day Neck pain, neck stiffness (loss of ROM), posterior neck swelling (2 days)- went to urgent care, resolve after a few days of Tylenol & ibuprofen Total time of reaction: started the day after the vaccine, mostly resolved within 4 days.

Other Meds: Synthroid, Wellbutrin, Lamictal, Zoloft

Current Illness: None

ID: 1021089
Sex: F
Age: 36
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Ceclor allergy

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: After dose 1, I had pain at injection site and swelling and then a itchy and raised rash appeared a week after receiving the vaccine on my left arm. After dose 2, I started with fever of 102F, chills, nausea, achyness, headache, stomach cramping and vomiting one time. This all started approximately 12 hours after the vaccine.

Other Meds: Multivitamin Mesalamine suppository 1000 mg

Current Illness:

ID: 1021090
Sex: F
Age: 45
State:

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
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: Headache, systemic muscle tightness, full body pain, lymph node pain torso/neck/head (similar to insect stings). I am on my fifth day after vaccination and symptoms wax and wane throughout day.

Other Meds:

Current Illness:

ID: 1021091
Sex: F
Age: 26
State: CA

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Ulnar Nerve pain going down left arm to fingers aggravated with dorsiflexion of left wrist. Two erythematous circles one inch diameter four inches away from injection site.

Other Meds: None

Current Illness: None

ID: 1021092
Sex: F
Age: 28
State: CO

Vax Date: 12/23/2020
Onset Date: 12/31/2020
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and Amoxicillin- Hives, itching Sulfa drugs- rash

Symptom List: Rash, Urticaria

Symptoms: 8 days after first vaccination developed a red rash around the injection site and severely swollen lymph nodes in the right axillary area and collarbone area. Rash increased in size over 1-2 days and I experiences pain in the lymph nodes. Sought urgent care treatment on 1/1 (one day after rash appearing) and was told to monitor. Rash and swollen nodes persisted and I was seen again at urgent care on 1/4 and was started on antibiotics x7 days for possible infection.

Other Meds: Vitamin D supplement Prenatal Vitamin Fish Oil Supplement

Current Illness: N/A

ID: 1021093
Sex: F
Age: 30
State: CA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/10/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: An hour after vaccine was received I started to experience a pain on the left side of my neck like a strained muscle, it has been 2 weeks now and I am still experiencing this pain in my neck.

Other Meds: Birth control

Current Illness: common cold few weeks prior

ID: 1021094
Sex: F
Age: 48
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/10/2021
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: no

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

Symptoms: The injection day - about 8 pm, I noticed arm tenderness. About 3:00 am< I woke up with chills and couldn't warm up. I took my temp - had 100.2. At 5:30 am, my fever was 103. I took over the counter Tylenol. My arm was swollen, red, painful around the injection site of second dose vaccine and also at the original vaccine site. The fever broke (99) at 10 am. I didn't go to work. Hot and cold on and off. 03:00 pm, was fever at 101. I took Tylenol. At 6:30, I had 98.7 temperature. At 10:00 pm, I was back up to 101.3. I took over the counter Motrin. About 2 am, I woke and was sweaty. No chills, fever was gone. I went to work on Wednesday. I didn't have fever but the injection site was still swollen, fevered injection site. It was hard and raised. Was putting ice packs on at work to reduce swelling. Thursday, knot had gone down and I was just itching. I took the Hydroxocine (prescription for prior vaccine) for itching. Friday I was fine. If I push on it today it's a little tender - like a little bruise.

Other Meds: no

Current Illness: no

ID: 1021095
Sex: F
Age: 68
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: Erythromycin

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

Symptoms: Lightheaded BP: 113/49 ( Reports hx of hypotensive, states her BP is always low) HR: 71 Sp02: 96% No acute distress, Seen and cleared by EMS

Other Meds: Levothyroxine, atorvastatin

Current Illness:

ID: 1021096
Sex: F
Age: 55
State: LA

Vax Date: 02/01/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
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: Penicillin

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

Symptoms: At first was mild headache slight sore throat and fatigue. A day or 2 later same symptoms but added body aches all over after that add stomach aches with no diarrhea or vomiting. Still headache

Other Meds: Brilinta, aspirin, crestor, potassium cl, metoprolol, hydroxychloroquine and valacyclovir

Current Illness: Metastatic Lung cancer (no current treatment)

ID: 1021097
Sex: F
Age: 78
State: MT

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/10/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: Pt called to report raised, red, itchy skin at the injection site one week after COVID vaccination. She states it is the size of a silver dollar. Informed patient that this is know to occur. VAERS report completed as this is not listed on the usual side effects. Advised pt that it should resolve in 1-7 days and she should still receive the second COVID vaccine.

Other Meds:

Current Illness:

ID: 1021098
Sex: F
Age: 63
State: CA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/10/2021
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: elevated blood pressure 30 minutes after the vaccine, systolic reached 161. resolved after 30 more miutes

Other Meds: levothryoxine

Current Illness: mome

ID: 1021099
Sex: F
Age: 74
State: NM

Vax Date: 01/31/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: celiac disease

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 8 days after the shot, my arm swelled up, got really red and hot to touch

Other Meds: vitamins, colestrol, pyrolia shot

Current Illness: none

ID: 1021100
Sex: F
Age: 34
State: NV

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: metoclopramide

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

Symptoms: Patient reaction approximately 2 minutes after dose administered. Faintness, dizziness. We had her sit in a chair initially take her mask off. Drank some orange juice. She got worse over the following few minutes. Lost feeling, ability to move her hands/fingers. We had her lay flat on floor. She reported the loss of movement/feeling in her feet as well. After 5 minutes of laying on floor, she slowly got normal function back in her hands/feet. Was able to sit back up in chair after 10 minutes of laying on floor. Recovered progressively over the next 15 minutes. She contacted friend to pick her up instead of driving herself home after roughly 30 minutes.

Other Meds: unknown

Current Illness: none reported

ID: 1021101
Sex: F
Age: 26
State: NY

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
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: No

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

Symptoms: Fever (up to 100.5), chills, body aches, nausea for ~48 hours. Some fatigue persisting ~4 days. Arm pain and swelling for ~72 hours.

Other Meds: Birth Control

Current Illness: No

ID: 1021102
Sex: M
Age: 79
State: WA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Had prior severe reaction (Gillian-Barre episode which lasted several minutes of complete paralysis from the neck down) then took nearly 24 -48 hours to completely resolve.: this was after high dose flu vaccine in 2017 with pneumonia vaccination at the same time).

Symptom List: Unevaluable event

Symptoms: Five hours after no reaction to the vaccine chills commenced, nausea, vomiting, loss of appetite and severe muscle weakness; unable to ambulate even with walker; lost control of bowels and bladder functions; fatigue. Was bedridden for 36 hours . At about 28 hours upon recommendation from oncologist, took one Benadryl and within 2 hours started to improve. Took 1 Benadryl every six hours for next 48 hours and was feeling better except for residual whole body weakness. Would have been helpful to know about Benadryl before hand. Will take Benadryl 30 minutes prior to getting 2nd shot on March 5. Thanks. Hope this information is helpful to others.

Other Meds: Multi-vitamin, Calcium D3, Advil, low dose aspirin Prescribed medications: Zytiga daily; Prenisone 5mg bid Monthly injection of Firmagon to treat prostate cancer

Current Illness:

ID: 1021103
Sex: U
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 02/10/2021
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: None stated.

Other Meds: none

Current Illness: none

ID: 1021104
Sex: M
Age: 48
State: WA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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

Symptom List: Injection site pain, Pain

Symptoms: Body muscle aches, fever, chills, headache

Other Meds: Oemeprazole, Venlafaxine, multi vitamin, D3, magnesium citrate

Current Illness: None

ID: 1021105
Sex: F
Age: 59
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/10/2021
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: Patient felt tingling and numbness in both arms and head.

Other Meds:

Current Illness:

ID: 1021106
Sex: F
Age: 69
State: NJ

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Prior history of cervical surgery w/insertion of rods and screws (2019). Post surgery developed scapula dyskinesis on the left side. No current treatment for condition which has not been painful for the last two years. Also have had left shoulder issues separate from the cervical repairs which was last treated over a year ago with a cortisone injection. No problems following the first Moderna injection. However, about an hour after the second shot today I developed a sharp pain in the left scapula area and left shoulder that felt as if I had been stabbed. The pain resolved after sitting immobile on a recliner for about a half hour. It is now over six hours later and the pain seems to have resolved leaving me with just some discomfort in the area of the left scapula. I have remained sedentary for the rest of the day.

Other Meds: diclofenac sodium; diazepam; metoprolol; Fosamaz; pantoprazole; Vitamin D3; Co-Q10; magnesium; fish oil

Current Illness: None

ID: 1021107
Sex: F
Age: 59
State: NY

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
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: n/a

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 99 fever, hot flash, nauseated, dizzy, spinning, diarrhea, weak, fatigued, headache

Other Meds: lexipro 20mg, lotrel 5/20 , atorvastatin 40 mg, baby asprin, calcium 600mg

Current Illness: n/a

ID: 1021108
Sex: F
Age: 44
State: NY

Vax Date: 02/02/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Redness and swelling at injection site on day 8, with worsening spread of redness and induration on day 9

Other Meds: None

Current Illness: Mone

ID: 1021110
Sex: F
Age: 36
State: CA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/10/2021
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: s/p 2nd dose, complained of throat swelling. No signs of respiratory distress. No worsening sx.

Other Meds:

Current Illness:

ID: 1021111
Sex: F
Age: 34
State: IL

Vax Date: 02/02/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Nausea

Symptoms: Swollen, red and itchy in the injection spot.

Other Meds: No

Current Illness: No

ID: 1021112
Sex: M
Age: 54
State: PA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: Injection site pain

Symptoms: When I went to urinate, I noticed blood in my urine. Contacted the on-call nurse at the VA.

Other Meds: Alfuzosin

Current Illness:

ID: 1021113
Sex: M
Age: 57
State: FL

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever, Malaise

Other Meds: no

Current Illness: none

ID: 1021114
Sex: F
Age: 78
State: OR

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: Baclafin Hazelnuts

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

Symptoms: Aproximately 15 minutes after receiving the dose (and while being observed for 30 minutes for past allergic reaction history), the patient stated that her Parkinson's tremors had suddenly become more severe. Prior to the injection, she would have small tremors in hands and legs on occasion but not as severe as she was experiencing afterwards. Patient was examined and had normal vital signs, O2 saturations of 93% on room air (hx of Copd), and was negative for stroke evaluation. We placed her on her own 02 which she generally has on when short of breath, and ECG showed a sinus rhythm with a bundle branch block. We continued to monitor the patient which she stated her symptoms where "better" but continued to have sporadic Parkinson's like tremors which facility stated was more significant than normal. It was decided that the patient would be warrant an emergency room evaluation. The patient was transported to hospital.

Other Meds: unknown

Current Illness:

ID: 1021115
Sex: F
Age: 33
State: NY

Vax Date: 12/23/2020
Onset Date: 02/02/2021
Rec V Date: 02/10/2021
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: I found out I was pregnant between dose 1 and 2 of the vaccines. I received dose 1 on 12/23/21 and had a positive pregnancy test on 1/2/21. I had my 2nd dose on 1/13 at 5w6 days based on LMP. I had my first prenatal visit on 2/10/21 at which time US showed twin gestation but neither fetus had a heartbeat.

Other Meds: Prenatal vitamin

Current Illness: None

ID: 1021116
Sex: F
Age: 44
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: burning tongue and sharp pains neck above site injection

Other Meds:

Current Illness:

ID: 1021117
Sex: F
Age: 47
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: NA

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

Symptoms: Chills started by 2 pm on 2/9/21; extreme chills and shaking by 4 pm. Body aches , low fever, joint pain, and fatigue came after. By 7 pm, I had all of these symptoms, plus nausea and no taste. Today (2/10/21) by 4 pm, the chills and low grade fever were gone but still have body aches, joint pain, and fatigue.

Other Meds: NA

Current Illness: NA

ID: 1021118
Sex: F
Age: 55
State: MI

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
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: None stated.

Other Meds: none

Current Illness: none

ID: 1021119
Sex: F
Age: 39
State: NY

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: The symptoms started around 4:30pm on 2/10/21. I have a fever, chills, headache and muscle aches.

Other Meds: None

Current Illness: None

ID: 1021120
Sex: M
Age: 73
State: IL

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
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 known.

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

Symptoms: Severe muscle ache, including headache, severe fatigue, lack of appetite. Extreme fever, 104.8 at 10:30 pm.

Other Meds: Amlodipine Best late, Atorvastatin Calcium, D3 Levothyroxine Sodium, Pantiprazole Sodium, Tamsulosin HCL, Aspirin, Ocuvite 50+, Fish Flax & Borage Oil, Vitamin E, D3 Cholecalciferol, Noni Extract, Melatonin.

Current Illness: None known.

ID: 1021121
Sex: F
Age: 87
State: CA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
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: Codeine, ethacrynic acid, spironolactone, chlorhexidine gluconate, Dyazide, Lasix, trazodone.

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

Symptoms: shortness of breath and palpitations starting about 15 minutes after she got her Pfizer Covid vaccine 2/8/2021. She was able to make it home, had poor sleep because of palpitations although pulse rate when she took it was not all that fast. Breathlessness eventually subsided and palpitations subsided by the following morning. There was no coughing or wheezing.

Other Meds: Vitamin C, atenolol, bumetanide, calcium, vitamin D, Flonase, ipratropium nasal spray, lorazepam as needed, multivitamin, warfarin, zolpidem.

Current Illness: No acute or subacute illnesses.

ID: 1021122
Sex: F
Age: 67
State: NH

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 02/10/2021
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, simvastatin

Symptom List: Pain in extremity

Symptoms: Acute flare of uveitis R eye. Ocular pain, redness, photophobia

Other Meds: Plaquenil, prednisolone forte, adderall, Abilify, Pristiq, lipitor, amitriptyline, elmiron, Vit D, protonix, levothyroxine

Current Illness: None

ID: 1021123
Sex: F
Age: 47
State: NY

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Allergic to cephelosporins

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

Symptoms: The day after the 1st shot I developed terrible Migraine headaches that lasted 2 days. The afternoon of the 2nd shot I felt extremely dizzy. Friday night, I started to develop nausea, then I got diarrhea and drive heaving. Overnight I had severe pain in my legs, calves, back, hips. Advil did not help the pain. I was up all night with the pain. My joints felt like they were on fire and it hurt to walk, bend and even to lay down. I developed a 100.3 fever overnight that lasted throughout the day Saturday along with the body pain. I developed a migraine headache Saturday Night that lasted through Sunday. My fever broke Sunday afternoon.

Other Meds: Vyvanse, Wellbutrin, Zyrtec, Valcyclovir, Trintelax

Current Illness: Some nasal congestion

ID: 1021124
Sex: F
Age: 50
State: MN

Vax Date: 02/06/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: Amitriptyline Cefdinir Ceftriaxone Gatifloxin Gentamicin Levofloxacin Meperidine Morphine PCN SULFA Torodal Vancomycin

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

Symptoms: Swollen arm and swelling in armpit area size tennis ball. Tylenol. Day 3 and 4 post vaccine

Other Meds: None

Current Illness: None

ID: 1021125
Sex: F
Age: 65
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: chest tightness and cough, no wheeze

Other Meds:

Current Illness:

ID: 1021126
Sex: F
Age: 32
State: AZ

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Static/ringing in the ears 24/7. Have noticed it for two days now.

Other Meds:

Current Illness:

ID: 1021127
Sex: F
Age: 54
State: FL

Vax Date: 01/15/2021
Onset Date: 01/01/2021
Rec V Date: 02/10/2021
Hospital: Y

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: Severe thrombocytopenia (Platelets = 5) and diffuse petechial rash to trunk and extremities

Other Meds:

Current Illness:

ID: 1021128
Sex: F
Age: 44
State: FL

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Headache, Body Ache

Other Meds: no

Current Illness: no

ID: 1021129
Sex: F
Age: 47
State: AL

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: Nkda

Symptom List: Injection site swelling, Limb discomfort

Symptoms: MORNING AFTER 2ND DOSE AROUND 6AM WAS LITTLE WEAK AND SLUGHISH AND AS THE DAY PROGRESSED AROUNF 830 AM I WAS IN EXTREME PAIN IN MUSCLES AHES AND SHOOTING PAINS THROUGHOUT MY BODY AND FEELING VERY HEAVY TO THE POINT I COULD NO LONGER STAND UP. NO ENERGY AND SEVERE HEADACHE AND SORE ARM.

Other Meds: Ibuprofen, benadryl

Current Illness:

ID: 1021130
Sex: F
Age: 38
State: VA

Vax Date: 01/31/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Mild sensitivity to kiwi

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

Symptoms: Following the vaccination, the injection site felt a little hard to the touch, red (about 2? in diameter) and a little warm for a week. Then on day 8, the injection site felt extremely warm/hot to the touch, hard, red, and extremely itchy. The extreme itch seemed to last 6-12 hrs on day 8 post-vaccination.

Other Meds: OTC vitamins, Prozac, Phentermine, Wellbutrin, Synthroid

Current Illness: N/A

ID: 1021131
Sex: F
Age: 65
State: NY

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/10/2021
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: Sulfur, Iodine, Trimox, Macrodantin, Bactrin, Erythromycin, Cipro, Keflex

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

Symptoms: 8 days after receiving vaccine, a 2-3 inch red, itchy, hot rash appears around the injection site. There was swelling and pain at the injection site. 16 days after receiving vaccine, burning, itchy mouth. Tingling of lips when eating certain foods.

Other Meds: Levothyroxine, Low Dose Aspirin, Vitamin B12, Vitamin C, Vitamin D, Vitamin K27, Calcium, Magnesium, Zinc Carnosine, Immunotone, Tru Niagen, NAC, Lauricidin, Acidophilus, Ostinol, DMSA, Orthodigeszyme, Liposomal Gluthathione, Cholestyrami

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm