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: 1023768
Sex: M
Age: 86
State: WA

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: donepezil (GI upset), antibiotic (PCN maybe, but Zithromax tolerated without issues).

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient awoke at 1:00 AM on 2/10/2021, five days after his Moderna COVID-19 booster, with chest pain radiating to the back and worse with deep inspiration. Patient arrived in our office on 2/10/2021 at 9:30 AM for an evaluation. Patient was noted to have new EKG changes with new concave-up ST elevation across the precordium. Bedside echocardiogram showed no pericardial effusion and no pericardial friction rub was appreciated. Due to ongoing chest pain, patient was transported to Emergency Department by medics for further workup and evaluation for possible pericarditis. Formal echocardiogram in ED was normal. Acute myocardial infarction ruled out. ST changes improved. Patient now being discharged in stable condition 2/11/2021.

Other Meds: omeprazole 20 mg delayed release, fluoxetine 20 mg capsules, aspirin 81 mg

Current Illness: None

ID: 1023769
Sex: F
Age: 47
State: NY

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None reported

Symptom List: Anxiety, Dyspnoea

Symptoms: Hands and toes were cold and achy from the knuckle to tips and chills. Patient took acetaminophen and diphenhydramine at night for relief. Resolved in 24 hours.

Other Meds: Unknown

Current Illness: Unknown

ID: 1023770
Sex: F
Age: 56
State: TN

Vax Date: 01/25/2021
Onset Date: 02/02/2021
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: Penicillins

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

Symptoms: Severe tonic/clonic seizure of approximately 60 second duration observed by nursing staff at home at approximately 6:30am on 2/2/21. Patient was awake and lying in bed. Patient has no previous history of seizures. The only treatment was continued observation, with no further seizures noticed to date. Patient is on hospice due to her diagnosis of dementia, and both Hospice and her PCP were notified. On 2/9/21, patient was diagnosed with a fractured hip, unknown if that occurred secondary to the seizure mentioned above.

Other Meds: Senna Plus, Levothyroxine, Sulfamethoxazole/Trimethoprim, Hydr

Current Illness: n/a

ID: 1023771
Sex: F
Age: 75
State: MO

Vax Date: 02/05/2021
Onset Date: 02/10/2021
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: Reclast, ace inhibitors, neptazane, Celebrex, Vicodin, Glimiperide

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: None major. Occasional itch shoulder Last night found bruise on left leg. This morning looked at injection site , found bruise.

Other Meds: Too many to list

Current Illness: Kidney failure, High blood pressure, diabetes, asthma, sleep apnea, gout,osteoporosis, arthritis.

ID: 1023772
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 01/27/2021
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: anaphylaxis to contrast

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

Symptoms: sore throat, headache, nasal congestion

Other Meds:

Current Illness:

ID: 1023773
Sex: F
Age: 72
State: AR

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: Penicillin, sulfa drugs

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

Symptoms: Woke up at 1:00 am with extremely rapid heart beat?130 bpm. It did not subside so I contacted the pharmacy who suggested I notify my doctor. I visited his office at 2:00 pm. He ran an EKG. It was normal so gave me a prescription for a beta blocker. After taking that, my heart rate returned to normal. I also had a slight fever, body aches & headache.

Other Meds: Lipitor, vitamin D & C, Zyrtec, Flonase

Current Illness: None

ID: 1023774
Sex: F
Age: 24
State:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Temp 102, chills LL NIGHT, BODY ACHES, Headache

Other Meds:

Current Illness:

ID: 1023775
Sex: M
Age: 33
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Pharyngeal swelling

Symptoms: Fever, Muscle Ache, Chills, Joint Pain

Other Meds: no

Current Illness: no

ID: 1023776
Sex: F
Age: 68
State: WI

Vax Date: 02/10/2021
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderna COVID-19 Vaccine EUA Short-lived nosebleed 24 hours after vaccination. Very unusual for patient. No ibuprofen, aspirin, etc. within 10 days prior

Other Meds: Fluoxetine 20 mg Simvastatin 20 mg Multivitamin Calcium supplement

Current Illness:

ID: 1023777
Sex: F
Age: 73
State: PA

Vax Date: 01/27/2021
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: Cipro/Flagyl

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Soreness in arm lasting about 4 or 5 days after injection. Also, slightly red and warm. On Feb.8, 2021 (12 days after injection) - redness and heat on large section of upper left arm. Lasted about 4 days. No treatment.

Other Meds: Rx - Zyrtec, Zocor, Lisinopril, Hydrochlorothyazide

Current Illness:

ID: 1023778
Sex: F
Age: 37
State: NC

Vax Date: 01/25/2021
Onset Date: 01/29/2021
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: strawberries

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

Symptoms: She notes arm soreness, mild malaise first 24-48hrs. After day 3, started to note L sided neck soreness which progressively increased in size. Remains tender and firm today

Other Meds: Lorazepam, magnesium, flonase nasal stray, sumatriptan

Current Illness:

ID: 1023779
Sex: F
Age: 47
State: CA

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: SYR
Vax Site: RA

Lab Data:

Allergies: METFORMIN, PLAQUENIL SULFATE, ADHESIVE TAPE, H/O BEE STING

Symptom List: Rash, Urticaria

Symptoms: Pt. at 10 minutes past vaccine began to itch ears. Redness to ears and neck noted. Pt given benadryl 50 mg. Pt then began to cough. Reported feeling tightness to chest. Epi administered. Pt sent to ER.

Other Meds: N/A

Current Illness: N/A

ID: 1023780
Sex: F
Age: 77
State: FL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Bactrim (hives); Cephalexin and Sulfamethoxazole (itchy); been venom (hives).

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

Symptoms: Tingling in the tip of my tongue as well as in all fingertips. Took two Benadryl within a half-hour of the injection. The tingling disappeared in the fingertips, but my tongue, although no longer tingling, still feels sore and irritated almost two weeks after the injection. As far as I can tell, no swelling involved. Also still experiencing tiredness.

Other Meds: Pantoprazole 40 mg, Ezetimibe 10 mg daily, rosuvastatin 3x's/week, Trazadone 25 mg as needed for sleep, baby aspirin, generic Claritan, Eye Tears, Fluticasone propionate 2 sprays each nostril/day, advanced eye drops twice a day .

Current Illness: None

ID: 1023781
Sex: F
Age: 42
State: ID

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

Lab Data:

Allergies: no allergies

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

Symptoms: PACs - pre-atrial contractions

Other Meds: multi-vitamin

Current Illness: none

ID: 1023782
Sex: F
Age: 66
State: IL

Vax Date: 01/02/2021
Onset Date: 01/04/2021
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: Naprosyn Ivory Soap

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

Symptoms: Nausea for three days and vomiting

Other Meds: Methotrexate Gabapentin Triamperene Lisinopril panto Folic Acid vitamin D3 Zinc Flax Seed Oil Calcium glucosamine

Current Illness: None

ID: 1023783
Sex: F
Age: 36
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa Cephalosporins Dapsone Augmentin Albuterol

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

Symptoms: Raised, warm,, hard, itchy, 3? reaction at vaccination site continuously since just after injection Moderna COVID?19 Vaccine EUA

Other Meds: Lexapro Buspar Nexium Dymista Loratadine Ativan

Current Illness: None

ID: 1023784
Sex: F
Age: 77
State: WI

Vax Date: 02/02/2021
Onset Date: 02/09/2021
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: siprol flaxin

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

Symptoms: Any problems until a week later i got arm got red and hot and now it has spread and gotten quite large.

Other Meds: Hydrochlorothiazide, benazepril, simvastatin, baby aspirin multivitamin, B12 Vitamin D, calcium, Niacin, and Vitamin E

Current Illness:

ID: 1023785
Sex: F
Age: 47
State:

Vax Date: 01/15/2021
Onset Date: 01/17/2021
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: Moderna injection given 01/15/2021 reaction began after 11 hours. Eye, face swelling. Went to see physician on 01/17/2021 was given steroid shot and placed on steroid pack. Swelling went down but redness and irritation continued on eyes and inside eyes. Swelling began 01/23 again returned to physician on 01/24/21 per physician cellulitis beginning on eyes. Started on antibiotics and eye drops. 01/25 eyes began to swell again.

Other Meds:

Current Illness:

ID: 1023786
Sex: F
Age: 35
State:

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: Temp, chills, right arm sore after vaccine, body aches, and head ache

Other Meds:

Current Illness:

ID: 1023787
Sex: F
Age: 86
State: FL

Vax Date: 01/26/2021
Onset Date: 02/09/2021
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: Penicillin

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

Symptoms: Red rash starting from injection site down to elbow

Other Meds: Lisinipril

Current Illness: Zero

ID: 1023788
Sex: M
Age: 69
State: TX

Vax Date: 02/04/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: Moderna COVID-19 Vaccine EUA

Other Meds: Vitamin C Zinc 50 mg Omeprazole Paroxetine Carvedilol Valsartan Metformin Pravastatin Fenofibrate 83 m baby asprin daily mens vitamin

Current Illness: none

ID: 1023789
Sex: F
Age: 21
State: CA

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Chest pain, Palpitations. BP 130/98 pulse 90 respirations 16- Placed on 2 liters of 02 and symptoms resolved after 10 minutes. Pulse went down to 82. Did complain of previous elevated heart rate day before.

Other Meds: None

Current Illness:

ID: 1023790
Sex: F
Age: 59
State: TX

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: No known allergies

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

Symptoms: Per patient had a seizure

Other Meds: aripiprazole Celecoxib

Current Illness: NA

Date Died: 02/01/2021

ID: 1023791
Sex: M
Age: 71
State: CA

Vax Date: 01/27/2021
Onset Date: 02/01/2021
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: methadone, morphine, nortriptyline

Symptom List: Injection site pain, Pain

Symptoms: DIED WITHIN 5 DAYS OF RECEIEVING THE 2ND DOSE, EXPERIENCED GENERALIZED WEAKNESS.

Other Meds: Escitalopram Oxalate,amlodipine,aspirin,cyanocobalamin,docusate sodium,ergocalciferol,evothyroxine,Melatin,multivitamin,pravastatin,loratadine,senna,Protonix,carvedilol,Lokelma,lidocaine adhesive patch,buprenorphine ,hydralazine,Miralax,hy

Current Illness: : G93.40 Encephalopathy, unspecified(Primary, Admission), R56.9 Unspecified convulsions, S06.5X9D Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, subsequent encounter, M62.81 Muscle weakness (generalized), R26.89 Other abnormalities of gait and mobility, Z48.811 Encounter for surgical aftercare following surgery on the nervous system, W19.XXXD Unspecified fall, subsequent encounter, R47.01 Aphasia, N17.9 Acute kidney failure, unspecified, N18.30 Chronic kidney disease, stage 3 unspecified, D64.9 Anemia, unspecified, N28.1 Cyst of kidney, acquired, E11.9 Type 2 diabetes mellitus without complications, E03.9 Hypothyroidism, unspecified, I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris, I50.22 Chronic systolic (congestive) heart failure, I21.4 Non-ST elevation (NSTEMI) myocardial infarction, N28.9 Disorder of kidney and ureter, unspecified, F33.9 Major depressive disorder,

ID: 1023792
Sex: F
Age: 41
State: WA

Vax Date: 02/08/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Left arm pain starting the day after receiving vaccine - worsening pain, with light touch, decreased function as I have had trouble lifting things with affected arm. Interrupts sleep when I accidently roll over on the the left arm. Woke up this morning with an area of redness, firmness, and warmth to left arm just below where injection was given. Deep pain now radiating in to my axilla. Increased pain with arm movement today. Treatment: I have been taking ibuprofen 800mg every 8 hours since Tuesday morning 2/9/21.

Other Meds: women's daily MVI

Current Illness: None

ID: 1023793
Sex: F
Age: 69
State: IN

Vax Date: 02/08/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: On Feb 10th, After dinner at about 7pm, , within about 15 min I started throwing up and also had diarrhea . My injection site became inflated to the size of a ping pong ball and VERY dark pink in color and extended out from the injection about 4 inches. I also had an enormously terrible headache and my sinuses were very sore and burning. Approximately about every 15-20 minutes I was throwing up again until about 4am. This throw up was not chunky with food but more flemm and jello like. Finally around 4am I was able to get to sleep in a recliner chair until about 7am. Currently it is 2:30pm on Feb 11th and my headache is just about gone, the soreness is gone from my body and I feel much better. My major question is , Should I take the 2nd vaccination and will I have the same reactions to it. What can I do to make myself feel better if I do get the 2nd shot. ?

Other Meds: Irbesartan , Rosuvastatin calcium, Clopidogrel, Metoprolol Tartrate, amLodipine Besylate, Pantoprazole, Ofev Glutathione, Vitamin D, Magnesium, Vitamin K2MK7, Fibermucil, Omega 3

Current Illness:

ID: 1023794
Sex: F
Age: 33
State: CA

Vax Date: 02/11/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient reported to recovery nurse burning in arm, warmness in BLE, and tightness in chest. VS WNL BP 120/70, HR-100, O2 - 98%, Resp. 18. Pt. Reports this is a chest pain she has experienced before, but never the ?warmness?. Writer offered to call EMS for further assessment/transportation, patient refused, patient states she will be able to transport herself to urgent care. VS obtained again prior to patient leaving, remain WNL BP 125/75, HR-95, O2-98%, Resp. 18.

Other Meds: Lamictal 200mg q HS

Current Illness: None

ID: 1023795
Sex: F
Age: 69
State: MD

Vax Date: 02/10/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Tylenol w codeine , milk products , dogs , mold

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Woke up at 3 am and could not rest on right arm too painful pain radiates and still does 12 hours later up and down entire right side arm neck to ear . Woke up again at 8! sneezing only right side sneezes lasted 3 hours sneezing constantly finally 2 pump in both nostril zicam nasal spray. But started back up nose dripping ... headache ... no fever ,

Other Meds: ArmpourThyroid, losartan, proleia, allergies shots

Current Illness:

ID: 1023796
Sex: F
Age: 36
State: WA

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:
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: Body Aches, Chills, Headaches, Fever (38.5)

Other Meds:

Current Illness:

ID: 1023797
Sex: F
Age: 31
State: CA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
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:

Symptom List: Nausea

Symptoms: 12/31 symptoms started: Chills,Fatigue,Fever,Muscle/Body Aches which lasted for 1 week. Took tylenol the first day which helped with the fever.

Other Meds:

Current Illness:

ID: 1023798
Sex: F
Age: 95
State: OH

Vax Date: 01/28/2021
Onset Date: 02/04/2021
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: None.

Symptom List: Injection site pain

Symptoms: The day of vaccine she had no problems. The following wee her arm was red, swollen and hot at the top. That reaction slowly went down and it's just above her elbow, she's 95 and it is kind of filled up with a hard mass in that area. Her arm looks like a sunburn with two different shades of skin, on the back side of her arm where it is red. She still has it on her arms today, 2/11/21. She has not taken anything for it or put anything on it. Her doctor told her to call us to see what we said she should do. There is no pain, but it just looks bad and she is concerned.

Other Meds: Lipitor, Allopurinol, Hydrochlorothiazide, centrum silver for women.

Current Illness: None.

ID: 1023799
Sex: F
Age: 24
State:

Vax Date: 02/03/2021
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:

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

Symptoms: Swelling and pain at injection site 7 days after initial vaccine.

Other Meds:

Current Illness:

ID: 1023800
Sex: F
Age: 76
State: SD

Vax Date: 02/10/2021
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: RA

Lab Data:

Allergies: codeine

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

Symptoms: Patient reported symptoms started on 2/11/21 with low grade fever, "fuzzy head", sore arm and body aches. Patient will take tylenol or ibuprofen as needed.

Other Meds: Paxil, Synthroid

Current Illness: none

ID: 1023801
Sex: F
Age: 70
State: PA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs

Symptom List: Tremor

Symptoms: Hives Claritin and topical anti-itch gel

Other Meds: Hydrochorothiazide, lisinopril, glucosamine chondroitin, multivitamin, Vitamin D, Claritin

Current Illness:

ID: 1023802
Sex: M
Age: 35
State: AL

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

Lab Data:

Allergies: None.

Symptom List: Erythema, Pruritus

Symptoms: Local: Mild redness and swelling at injection site 12 hours after injection along with moderate pain at site. Pain began to taper off 36 hours after injection but persists at mild level 69 hours after injection (current). Systemic: Mild chills, muscle, and joint aches 14 hours after injection. Mild fever, moderate chills, and moderate-severe muscle and joint aches 21 hours after injection. Moderate muscle and joint aches continued until 30 hours after injection reducing to occasional mild chills and aches 36 hours after injection persisting through 69 hours after injection (current). Slightly swollen and mildly, at times moderately, painful lymph nodes in neck and near armpit on injection side began 48 hours after injection persisting through 69 hours after injection. Treatment: occasional acetaminophen or ibuprofen (alternating) taken during onset of severe ache pain which reduced to moderate; four doses in total over the course of 24 hour period beginning 14 hours after injection. Mild, moderate, severe categories as described on CDC's reactogenicity page for the pfizer vaccine.

Other Meds: None.

Current Illness: None.

Date Died: 01/16/2021

ID: 1023803
Sex: F
Age: 92
State: IL

Vax Date: 01/04/2021
Onset Date: 01/06/2021
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:

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

Symptoms: Was contacted by the person's daughter on 2/5/21. Patient started vomiting 2 days after vaccination. She aspirated and passed away 1/16/21. Patient had history of stroke and swallowing problems.

Other Meds:

Current Illness:

ID: 1023804
Sex: F
Age: 66
State: IN

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

Lab Data:

Allergies: Cardizem, Lisinopril, Crestor, Ezetimibe cat dander, Dog dander, Grass pollen, Mold, Tree, shrub, and weed pollen

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

Symptoms: late after swelling and hot to touch, iced periodically, by evening did not want to move upper part of arm, husband called it a goose egg - it was round but close to size of chicken egg and very swollen -- could move arm and better by Saturday, it is Thursday now (over week later) and it is still hot to touch, red, and painful but I continue to use it and ice every now and then -- I haven't heard of anyone else last so long -- concerned that Im due for 2nd shot March 3!!!

Other Meds: Losartan, Osphena, Potassium chloride 10 mew capsule Calcium, vit D3, CoQ10, fish oil, flaxseed oil, B12, multivitamin, Allegra prn

Current Illness: none

ID: 1023805
Sex: F
Age: 49
State: RI

Vax Date: 01/25/2021
Onset Date: 02/05/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Facial and arm rash Friday 2/5 at 7:00 pm Facial and arm rash Saturday 2/6 @ 5:08 PM Benadryl taken / self medicated - rash went away

Other Meds: None

Current Illness: None

ID: 1023806
Sex: F
Age: 28
State: TX

Vax Date: 02/03/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Shellfish, phenergin

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

Symptoms: 8 days after injection itchy red, raised welt at injection site

Other Meds: Daily vitamin

Current Illness: None

ID: 1023807
Sex: F
Age: 65
State: FL

Vax Date: 01/23/2021
Onset Date: 01/24/2021
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: Allergic to Codeine GI vomting. , Pcn swelling of eyes. Pollen resp running nose

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

Symptoms: 1/24/21 sx Red & sore at site for 2-3 days. 1/28/21 sx worsen Palm size rash and edema, hot & itchy for 4-5 days and subsided. Asx now. apap PM at HS and cortisone cream used. Plan to follow-up with PCP and if risk > 2nd vaccine benefits.

Other Meds: atorvastatin maxide

Current Illness:

ID: 1023808
Sex: F
Age: 50
State: NY

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: I experienced a fever, chills, body aches. I do have a history of lupus and it felt like a had a lupus attack. I received treatment and blood work.

Other Meds: Prednisone 10mg, Coumadin 5mg, Topramax 400mg BID, Acedone 150mg at night

Current Illness: Lupus, systemic, anti phospholipid syndrome

ID: 1023809
Sex: F
Age: 63
State:

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

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

Symptoms: Patient called and stated she got the Moderna vaccine on Monday. She stated she has a hard knot and red raised circle about an inch wide at injection site. She stated it is sore to touch. RN stated to call her provider since it has been several days. She is not sure if the red circle started yesterday but it was there today. RN asked if she had any other side effects. She stated the same evening she got the shot she was feeling weak, and had a headache. She stated she took Tylenol, which she stated helped, but has a headache again today. RN stated to call doctor today so he may advise. RN stated will follow up with her tomorrow.

Other Meds:

Current Illness:

ID: 1023810
Sex: M
Age: 38
State: PA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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: CIPRO, KEFLEX, PCN, STATINS

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

Symptoms: FOLLOWING SECOND DOSE, RAPID ONSET OF SEVERE PAIN IN LEFT ARM AND SHOULDER, PAIN OF NECK, UPPER BACK, RIGHT SHOULDER. THE FOLLOWING DAY, 01/31, FEVER VARYING FROM 101 TO 105 FOR FOUR DAYS. ABDOMINAL AND CHEST PAIN, RUNNY NOSE, HEADACHE AND MIGRAINE SYMPTOMS. DIAHRREA, NAUSEA AND VOMITING. LOOSE STOOLS PERSISTED FOR ELEVEN DAYS FOLLOWING INJECTION OF SECOND DOSE OF THE MODERNA 030L2OA. AFTER EVERY MEAL, UNDIGESTED STOMACH CONTENTS PASSED VIA RECTUM, WITH WATERY MUCOUS. LOSS OF APPETITE, GENERAL MALAISE. ON DAY 3, NEAR SYNCOPE COUPLED WITH HYPOTENSION AND HYPOGLYCEMIA WITH DEHYDRATION. CONSUMED 1L OF PEDIALYTE/DAY, WITH 2L OF WATER/DAY. COVID-19 RAPID TEST WAS NEGATIVE.

Other Meds: METOPROLOL 25MG, SERTRALINE 50MG

Current Illness: NONE

ID: 1023811
Sex: M
Age: 84
State: IN

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

Lab Data:

Allergies: bee venom, cleocen

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

Symptoms: fever,joint pain, tired, restless headache / lasted 32 hours

Other Meds: metforman, simvastatan, lisiniprol, alipuronol

Current Illness: none

ID: 1023812
Sex: F
Age: 35
State:

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Unusual fatigue, Headache and feeling weak

Other Meds:

Current Illness:

ID: 1023813
Sex: M
Age: 85
State: OH

Vax Date: 01/22/2021
Onset Date: 01/26/2021
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: Adhesive bandages

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient states he was not able to get his sleeve up far enough but the person that gave the injection went ahead and gave the injection in the bottom part of his arm. The patient began having pain and burning in his arm and it went into his back and neck area. The pain and burning continued until the patient sought medical care at an ER and was referred to Neurology Clinic.

Other Meds: CLOPIDOGREL 75 MG ORAL TAB BACLOFEN 10 MG ORAL TAB METOPROLOL SUCC 25 MG ORAL TB24 HYDROCORTISONE--TOP 2.5% OINT ASPIRIN ENTERIC COATED--PO 81MG TBEC APIXABAN 5 MG ORAL TAB ESOMEPRAZOLE (NEXIUM)--PO 40MG CAP ATORVASTATIN 40 MG ORAL TAB FINA

Current Illness:

ID: 1023814
Sex: M
Age: 40
State: TN

Vax Date: 01/25/2021
Onset Date: 02/03/2021
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: Adverse drug reaction to Diazepam

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

Symptoms: Moderately severe tonic/clonic seizure of approximately 60 second duration observed by nursing staff at approximately 7:00am on 2/3/21. Patient was awake sitting at the dining table. Patient has no previous history of seizures. The only immediate treatment was continued observation, with no further seizures noticed to date. Patient visited his PCP later that day for follow-up, no treatment advised.

Other Meds: Montelukast, Loratadine, Levothyroxine, Docusate, Fluticasone,

Current Illness: n/a

ID: 1023815
Sex: F
Age: 69
State: FL

Vax Date: 02/02/2021
Onset Date: 02/05/2021
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: Pollen, Dust, Animal dander

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Persistent Cough

Other Meds: Celexa, Crestor, Norvasc, Pronethazine, Glyburide, Novolog flexpen, Synthroid, Basaglar

Current Illness: None

ID: 1023816
Sex: F
Age: 49
State: TX

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: asp caterpillars PCN Cpmpazine fentanyl

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

Symptoms: fever High heart rate difficulty breathing severe body aches Hot red arm for 3 days

Other Meds: Claritin D Singular

Current Illness: none

ID: 1023817
Sex: M
Age: 42
State: CA

Vax Date: 12/21/2020
Onset Date: 12/29/2020
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: Unknown

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

Symptoms: COVID + after 1st dose of vaccine.

Other Meds: Unknown

Current Illness: Unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm