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: 1022741
Sex: F
Age: 55
State: CA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
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: NONE

Symptom List: Dysphagia, Epiglottitis

Symptoms: ITCHING ON R ARM IN THE MIDDLE OF THE NIGHT. NOTICED RED RAISED BUMPS ON R ARM 4 DAYS LATER. THESE RED RAISED BUMPS TURNED INTO PUSTULES AND ARE ON BOTH ARMS AND A FEW ON MY BODY LEGS, TORSO. TODAY I PUT LOTION ON AND THEN THEY BECAME MUCH MORE NOTICABLE. THEY FEEL HEAVY AND COULD POSSIBLY BECOME ITCHY IF I STARTED TO ITCH.

Other Meds: NONE

Current Illness: NONE

ID: 1022742
Sex: F
Age: 77
State: MA

Vax Date: 01/24/2021
Onset Date: 01/25/2021
Rec V Date: 02/11/2021
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: Lisinopril

Symptom List: Anxiety, Dyspnoea

Symptoms: On 01-25-2021, I started to experience left arm soreness. I felt like my left arm was going to "drop-off" with extremely pain. I also had a high fever, was extreme cold, was disoriented, felt my brain foggy and these symptoms lasted up until 3AM. I also felt extremely fatigued. By Friday 01-29-2021, I was getting back to normal.

Other Meds: Extra strength Tylenol and Naproxen taken in the mornings and night because of oral surgery

Current Illness:

ID: 1022743
Sex: F
Age: 37
State: NE

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 02/11/2021
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: none

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

Symptoms: Received my vaccine on 12/23, woke up 12/24 and was really tired as morning went on I got really cold and could not get warm, throat started to hurt, body aches and had low grade temp of 100.5, 12/25 felt the same but throat was really sore, 12/26 tested positive for Covid, 12/27 lost sense of taste and smell, 12/28 had horrible shortness of breath and burned when I breathed. 12/29 and 12/30--was very tired, body aches and generally did not feel well. 1/1 woke up and felt well, 1/2 had shortness of breath with activity and not feeling well in general. 1/3 had severe shortness of breath and tachycardia at rest--had to report to ER. 1/4-still had shortness of breath and burning while breathing and then had nausea, vomiting and diarrhea throughout the night. 1/5 went to er because I was so nausea and could not keep anything down and was having heart racing and chest pain. received fluids in er and nausea medications. 1/6, 1/7, 1/8 and 1/9 was very weak and still did not feel well, short of breath. 1/10 woke up and had lung burning, chest pain , shortness of breath and heart racing--was seen in ER for chest pain. week of 1/10 was very tired and short of breath. finally returned to work 1/18---still am short of breath, heart races and tire easily

Other Meds: none

Current Illness: none

ID: 1022744
Sex: F
Age: 28
State:

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Diarrhea that persisted for 3 weeks and still continuing

Other Meds:

Current Illness:

ID: 1022745
Sex: F
Age: 73
State: FL

Vax Date: 02/01/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: red rash on my arm where the shot was given

Other Meds: levothroxine

Current Illness: none

ID: 1022747
Sex: F
Age: 65
State: IN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: NA

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

Symptoms: Red, inflamed rash on both arms and chest. I took Benadryl and applied anti-itch cream.

Other Meds: Atorvastatin Citalopramm topiramate Cyclibenzapr Clonazepam Bupropion Propanol

Current Illness: NO

ID: 1022748
Sex: F
Age: 60
State: FL

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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: Rash 36 hours after second dose of COVID. This also happened with dose #1, rash 48 hours after vaccine.

Other Meds: Sertraline Amlodipine Ibuprofen Vit D

Current Illness: None

ID: 1022749
Sex: F
Age: 59
State: FL

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Immediately after (10 minutes) injection, " felt funny" with her cheeks turning pink.

Other Meds:

Current Illness:

ID: 1022750
Sex: F
Age: 54
State: DE

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1022751
Sex: F
Age: 43
State: VA

Vax Date: 02/05/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
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: Nausea, extreme fatigue, migraine

Other Meds: Losartan hctz 50 Escitalopram 20 mg Norethindrone .36 mg

Current Illness: None high blood pressure

ID: 1022752
Sex: F
Age: 72
State: FL

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/11/2021
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: colds/flu/headache sxs started about Feb 5, 2021 called number listed and spoke to pt herself. pt states she had fever and chills this past saturday and sunday. pt was tested for covid monday and was just contacted she was covid positive (unsure test performed). pt today only has nasal congestion. she has not contacted pcp about her positivity. she inquiring about her son who has downs syndrome and has a heart condition. rec: contact pcp for further treatment and or therapies, quarantine herself, wear masks, wash hands, and have son stay with family and limit exposure to her. contact his md for possible vaccination.

Other Meds:

Current Illness:

ID: 1022753
Sex: F
Age: 59
State:

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/11/2021
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: pain at injection site, body aches, headache, fatigue, and mild chills for about 28 hours post vaccination. Treated with Tylenol and rest.

Other Meds:

Current Illness:

ID: 1022754
Sex: F
Age: 47
State: MO

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/11/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: After 10 min receiving the second dose I passed out during observation at the vaccination site, was rushed to the ER. They monitored me, gave me fluids and performed an EKG.

Other Meds: Trazadone, Lemictil, Busfar, Zoloft, Omeprazole, Afrin, had the last dose of Hydrocodone due to a surgery the day before.

Current Illness: COVID positive after first dose (12/23/2020)

ID: 1022755
Sex: F
Age: 55
State: LA

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 02/11/2021
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: penicillin and Demerol

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

Symptoms: after about an hr i started to get shortness of breath and heart tachycardia, i felt like i was running. it lasted about two hrs. heart rate stayed in the 90s and its usually in the 60s for about an hour

Other Meds:

Current Illness:

ID: 1022756
Sex: M
Age: 62
State:

Vax Date: 02/05/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital: Y

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

Symptoms: sustained Atrial Fibrilation (AFIB)

Other Meds:

Current Illness: None

ID: 1022757
Sex: F
Age: 67
State: CA

Vax Date: 02/01/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: Donnatal, Mobic, possibly penicillin

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

Symptoms: Red rash at injection site, first noticed 10 days after injection. No pain or itching. Sore at injection site for a few days after injection.

Other Meds: Ginger root, multi vitamin

Current Illness: None

ID: 1022758
Sex: F
Age: 44
State: TX

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/11/2021
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: Fever: 101.6*F, extreme flu like symptoms.

Other Meds:

Current Illness: Kidney stone, no fever.

ID: 1022759
Sex: M
Age: 70
State: FL

Vax Date: 02/06/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: BLEEDING IN MY RIGHT EYE

Other Meds: Acetaminophen, Aspirin 81mg

Current Illness: diabetic

ID: 1022760
Sex: F
Age: 82
State: CT

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1022761
Sex: F
Age: 40
State: IN

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Headache, fever, chills, aching, abdominal pain ; 24 hours after dose 1 1/12 and 24 hours after dose 2 on 2/9.

Other Meds: Multivitamin Zyrtec

Current Illness: None

ID: 1022762
Sex: F
Age: 42
State: AR

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Employee states she developed a migraine the evening after receiving her 2nd COVID vaccine. She took medication which help dull the headache. She woke up the morning of 2/11/21 with hives on her face. She states her face was red and her eyelids swollen. The left eye lid more than the right. Employee took benedryl which helped, but her left eyelid remains red and swollen. Advised employee to contact her PCP.

Other Meds:

Current Illness:

ID: 1022763
Sex: F
Age: 36
State: VA

Vax Date: 01/03/2021
Onset Date: 01/06/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to entire latex cross sensitive panel.

Symptom List: Unevaluable event

Symptoms: I developed a cough on 01/06/2021 that progressed on the 7th; 8th; 9th and the 10th was resolved.

Other Meds: I take zyrtec and singular.

Current Illness: No

ID: 1022764
Sex: F
Age: 76
State:

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
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: Approximately 9:00 PM, experienced severe chills, after having zero side effects all day. She went to bed, and could not get warm. She was unable to use body muscles, could not stand without help, and was conscious, but was unaware of her surroundings. She started regaining muscle control about 12:30 AM, but still no awareness of things around her. Next morning, she was fine, with no remaining side effects. It should be noted that she had a small glass of red wine about 30 minutes before experiencing chills.

Other Meds: Travatan Eye Drops Simbrinza Eye Drops Omeprazole 25 MG Once Per Day Yuvafem 10 MG Calcium 250 MG Vitamin C/D3 500 MG Vitamin D3 50 MCG Rivastigmine Transdermal 4.6 MG Melatonin 5 MG Aspirin 81 MG

Current Illness: Mild Dementia

ID: 1022765
Sex: F
Age: 51
State: PA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/11/2021
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: corn, soy, egg

Symptom List: Injection site pain, Pain

Symptoms: pt stated that after her vax that her left arm developed swelling, red rash, pain around the injection site extending from her shoulder to her elbow. Pt had a slight fever with chills and body aches which kept her in bed the entire day after the injection. Pt has contacted her PCP and waiting to hear back from them for medical advice since she states she still has pain, swelling, redness and can hardly move her left arm.

Other Meds: declined

Current Illness: no

ID: 1022766
Sex: M
Age: 71
State: FL

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient recieved second Moderna COVID vaccine on 02/06/2021 at 0940 at Hospital. Patient reported fever of 100.2 this morning 02/07/2021. patient did not take any medication for symptoms. patient denies any allergies. patient has hypertention. Patient reported he takes Olmesartan 20 mg. I instructed the patient to monitor his fever and to seek medical attention if fever persisted. I instructed the patient to take Tylenol if needed.

Other Meds: olmesartan 20 mg

Current Illness:

ID: 1022767
Sex: F
Age: 64
State: IN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/11/2021
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: None

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

Symptoms: Patient called on 2/11/2021 and stated that she had some redness and swelling at the injection site. Patient also stated she had a baseball sized knot on her arm at the injection site. Patient was seen at the Clinic on 2/11/2021 at 9:40 am. Patient was prescribed Benadryl and Prednisone.

Other Meds: unknown

Current Illness: Unknown

ID: 1022768
Sex: M
Age: 73
State: GA

Vax Date: 02/02/2021
Onset Date: 02/07/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had no issues with the first Moderna dose, but 5 days after the 2nd dose I experienced chills, dizziness and slight nausea when up and moving. This lasted 2 days and started going away on day 3, but the dizziness is still slightly present. Also, during this time I?ve continually monitored my BP and pulse. My BP has been elevated averaging around 165/95 (my normal is close to 145/85). Pulse has been steady averaging around 66-68 which is normal for me. Today, my BP is around 150/90 so it?s slowly getting back to normal on day 9 (post vaccine #2). Also, I had no other symptoms and my temperature was steady at 97 degrees since the vaccination. Thank you

Other Meds: Baby Aspirin (81mg) every other day and not the day of vaccination. Metoprolol 25mg Protonix 40mg

Current Illness: None

ID: 1022769
Sex: F
Age: 75
State: CA

Vax Date: 02/01/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Nine days later has her skin turned red 2 inches around. Warm to touch. Itches.

Other Meds:

Current Illness:

ID: 1022770
Sex: M
Age: 54
State: MI

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
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: lisinopril, provigil

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

Symptoms: Patient stating 2-4 hours after receiving vaccine, constant dizziness began. Was seen in office 3 days later, 2/8/21, at which time it continued. Has a headache as well, but a chronic problem for him, not new with dizziness. Had not been able to work and dizziness worsened as the day went on. No ear pain or hearing changes. Initially had ringing in ears, but that had resolved by time of visit. Positive dix hallpike as well at visit. Meclizine was prescribed. spoke with patient today, 2/11/21, and he states gradual improvement in vertigo.

Other Meds: Elavil, Vitamin C, Symbicort, Vitamin B12, flonase, multivitamin, Omega 3, omeprazole, sertraline, flomax, trazodone, albuterol, azelastine, cyclobenzaprine, fexofenadine-pseudoephedrine, tadalafil

Current Illness: none

ID: 1022771
Sex: F
Age: 42
State: MA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
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: Nausea

Symptoms: body aches in low back, legs around 12 hours post vaccine. followed by chills and fever between hours 15-20. diaphoresis , headache and aches continued for until following day around 11:00 am. Fever of 100 at 14:30 even 1 hour after 800 mg of ibuprofen. following date headache and brain fog continued along with fatigue.

Other Meds: none

Current Illness: none

ID: 1022772
Sex: F
Age: 68
State: WA

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Latex, Penicillin, Demerol

Symptom List: Injection site pain

Symptoms: Active HSV2 lesions in buttock area, before shot received. Now have painful, bleeding sores appearing in random areas over entire body (left calf, right wrist, over vaginal and caudal area, and ESPECIALLY inside both nostrils- mostly the left nostril (resolved, then immediately returned). Extreme fatigue, sweating, hot-flushes, but no elevated temp.

Other Meds: Duloxetine, Premarin, Fenofibrate, Telmisartan, Amlodipine, Melatonin, Tylenol

Current Illness: HSV2 sores (2) (amount of, increasing greatly since Moderna Covid19 shot)

ID: 1022773
Sex: F
Age: 51
State: CA

Vax Date: 01/30/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Sulpha Walnuts Irish Spring Soap Grass/trees/cats

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

Symptoms: Rash over whole body except face. Worse on back and itchy on back. Lasting over a week so far, but it is resolving significantly.

Other Meds: Omeprazole Singulair Vitamin D

Current Illness: None

ID: 1022774
Sex: F
Age: 79
State: NY

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
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: Actonel-nausea Amoxicillin -unsure of reaction Boniva- nausea Fosamax- nausea, GI upset Penicillins- unsure of reaction Prednisone - diarrhea, headache, vomiting, moderate to severe Risedronic acid- unknown

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

Symptoms: Patient reported she had second dose of COVID vaccine (moderna) on 2/8. She states later that evening developed severe headache, and vomiting- which lasted 36 hours. Nausea and slight chills during that time. Injection sight sore but no redness, swelling, rashes. Today patient has been able to eat and drink fine, and feels much better.

Other Meds: levothyroxine, rosuvastatin

Current Illness: n/a

ID: 1022775
Sex: M
Age: 52
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/11/2021
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: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1022776
Sex: M
Age: 50
State: PA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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: Fluphenazine

Symptom List: Erythema, Pruritus

Symptoms: Patient received a 3rd dose of Moderna Covid-19 mRNA vaccine. Admitted to our facility on 2/3/21. Received per IIS 1st dose on 1/5/21 and booster dose 2/3/21 prior to leaving previous inpatient placement. Patient administered 3rd dose on 2/11/21 as part of our second round of vaccinations for patients who refused or were admitted since beginning vaccination process in late December, early January.

Other Meds: n/a

Current Illness: none

ID: 1022777
Sex: F
Age: 69
State: MS

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/11/2021
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: Penicillin , Codeine

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

Symptoms: Nausea with Vomiting X 1 Left side of tongue swelled but not enough to affect breathing

Other Meds: Lisinopril HCTZ 10/12.5mg daily Crestor 5mg daily Fenofibrate 160 mg daily Metformin 1000 mg bid ASA 81 mg daily Prilosec 40mg daily Citracal Multi vitamin Glucosamine/Chondroitin Cranberry Benefits

Current Illness: none

ID: 1022778
Sex: F
Age: 32
State: IL

Vax Date: 02/03/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
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: Allergies to sulfa drugs (specifically Septra, and shellfish (epi-pen)

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

Symptoms: Sometime between 02/07/21 and 02/08/21 I noticed slight pain and swelling of lymph nodes in my left armpit region and the left side of my neck, close to the collarbone. I spoke to a medical professional and they informed me that there can be swelling of lymph nodes after the vaccine. Currently (02/11/21) I have no more pain, but the lymph nodes in my neck are still slightly swollen. I have no more pain in my armpit. This only occurred on my left side, which is where I received the vaccine. Additionally, sometime between 02/09/21 and 02/10/21 I started itching my left shoulder around the injection site. When I looked in the mirror there was a big (2-3inch) red circle around the injection. The edge of the circle was slightly puffy, and the whole thing is super itchy and stupid. No pain associated with it, just a lot of itching.

Other Meds: None

Current Illness: None

ID: 1022779
Sex: F
Age: 49
State: PA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/11/2021
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: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Started with brain fog, unable to focus, fatigue, chills and body aches. Continued to progress to temp 101.8, shaking chills, EXTREME arm pain, upper back pain, chest pain, wheezing, SEVERE headache, nausea, vomiting, diarrhea, EXTREMELY swollen axillary lymph nodes enlargement. Symptoms started approx 2 hours after injection and proceeded for 6 days then started to slowly improved then resolve.

Other Meds: Amitriptyline; Prevacid; Probiotic, immune, gut health (OTC) Supplement (OTC) Motrin prn

Current Illness: No acute illness.

ID: 1022780
Sex: M
Age: 73
State: GA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: 2/9/2021 2nd dose moderna vaccine received; 2/10/21 3 AM nose bleed; 2/11/21 3-5 AM nose bleed

Other Meds: Amlodipine, Metoprolol, Lisinopril, Vitamin B, Vitamin D, B-Complex Vitamin

Current Illness:

ID: 1022781
Sex: F
Age: 62
State: NJ

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: Penicillin Sulfa Aspirin Iodine Peanuts Hazelnuts Soft shell crab

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

Symptoms: Low grade fever (99.6 F) Chills Fatigue Myalgia Headache

Other Meds: Zetia 10 mg po qd Famotidine 20 mg po qd Culturelle Probiotic 1 tab po qd Fiberchoice 1 chewable tab qd Vitamin D 2000 u po qd Elderberry 300 mg po qd Zinc 2 mg po qd Vitamin C 100 mg po qd

Current Illness: N/A

ID: 1022782
Sex: F
Age: 76
State: AL

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Sulfur, Cefdinir 300mg, Levofloxacin, Crestor.

Symptom List: Pain in extremity

Symptoms: Severe pain with itching hives, that started ion back and spread with nausea.

Other Meds: Amlodipine-benapril 5-20mg, Centrum Vitamins, COq10 200mg, Vitamin D3 1000iu, Calcium 600mg, Thera tears, Probiotic, Simbrinza.

Current Illness: Sinus Infection

ID: 1022783
Sex: F
Age: 65
State: NH

Vax Date: 01/23/2021
Onset Date: 01/29/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline, sulfa

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

Symptoms: Large red rash at injection site that spread to size of orange. Itchy and hot to the touch.

Other Meds: Metformin, januvia, zarelto, levothyroxine, vitamin d3, biotin,

Current Illness: None

ID: 1022784
Sex: M
Age: 46
State: KS

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: No Known Allergies

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

Symptoms: I received my Moderna COVID-19 Vaccination at approximately 0800 am on February 10, 2021. At approximately 1800 hrs the same day, I experienced a sudden onset of muscle spasms to my lower back. I was at rest, sitting in a chair at the time of onset. The muscle spasm to my lower back was extremely intense and I had difficulty walking. This continued for about 1.5 hours. Also, during this time, I experienced cramping to the arches of both my feet. This was intermittent. I also had pain/soreness to my hips bilaterally. After approximately 1.5 hours the lower back spasms and cramping to my feet subsided. I do not have a history of lower back issues and this is my first experience of spasms of my lower back.

Other Meds: none

Current Illness: none

ID: 1022785
Sex: F
Age: 31
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/11/2021
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: About 2 hours after my first dose, I lost feeling in both my lower arms and hands. I was barely able to move my fingers or wrists. This lasted about 30 minutes. With my second dose, taken 2/1/2021, also the Pfizer vaccine, I was very ill in the middle night (vaccine taken at 11:15am). I had temperature of 102.5F, severe chills, trembling, and moving took too much effort. I was bedridden for about 8 hours. The symptoms improved quickly there after.

Other Meds: None, I did take lots of vitamins prior to the vaccination to have a strong immune system

Current Illness: None

ID: 1022786
Sex: F
Age: 67
State: IN

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
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: shellfish

Symptom List: Vomiting

Symptoms: Pfizer-BioNTech COVID-19 Vaccine On 2nd day 8 am was very very tired and took several naps. Lasted for about 8 hours. Took ibuprofen at 10 am.

Other Meds: Daily: Levothyroxine 112 mcg; Sertraline HCL 150 mg.; Atorvastatin 80 mg; Lisinopril 10 mg. ; Multivitamin; Aspirin 81 mg. weekly: Alendronate sodium 35 mg.

Current Illness: none

ID: 1022787
Sex: F
Age: 35
State:

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: TACHYCARDIA UPTO 130S ALMOST 24 HOURS AFTER 2ND DOSE OF VACCINE AND CONTINUED TACHCARDIA 100-110 WITH LIGHT ACTIVITY SUCH AS WALKING OR STANDING, CHILLS, BODYACHES, LOW GRADE FEVER. 13 WEEKS PREGNANT

Other Meds: PRENATAL VITAMIN

Current Illness: NONE

ID: 1022788
Sex: F
Age: 63
State: TX

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 02/11/2021
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: Dolatioid,Morphine sensitive, Lincocin, Azithromycin, Latex,Vichrotine, Scholapine patches?,Gluten food products

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

Symptoms: I exp 3 1/2 x 5 inch red rash around the injection site,muscle cramps and few joint pains. It was still present when I received my 2nd dose.The size of the rash around injection site is significant.

Other Meds: Synthroid, Vit supplements

Current Illness: No

ID: 1022789
Sex: F
Age: 42
State: AR

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 02/11/2021
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: Discomfort in the left fore arm that has lasted for 1 month. Increasing discomfort with use. Noticeable at rest.

Other Meds: None

Current Illness: None

ID: 1022790
Sex: F
Age: 67
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
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: Fever 101.4 , headache, redness and swelling at injection site

Other Meds: Metformin , lisinopril

Current Illness: Nonenone

ID: 1022791
Sex: M
Age: 46
State: AL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: cats

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

Symptoms: itching of throat and tongue and feeling hot. pt removed some of his clothes and was given water to drink and ice packs to cool him. Also felt some numbness of his tongue. no respiratory distress noted and no coughing noted. signs were normal. pt continued to be able to talk and was alert at all times.

Other Meds: none mentioned

Current Illness: diabetes

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm