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: 1024184
Sex: M
Age: 44
State: MO

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Person receiving vaccine is also a staff member. While here during a vaccination event 2/10/2021 he voiced concern that during his 2nd dose he felt the needle was withdrawn too soon which caused liquid/vaccine from the syringe to splash on him. He felt that it was a decent enough amount to have him believe that he didn't receive a full dose. We spoke with our Chief Medical Officer who recommended that he be vaccinated that same day (2/10/21).

Other Meds:

Current Illness:

ID: 1024185
Sex: F
Age: 74
State: CA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: Gluten, sodium pentathol

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever/flush, chills/pale, body aches, headache, sore arm day 1 3 large red bumps below injection site, pain from shoulder to wrist, swollen wrist (watch too tight), sore/swollen axillary glands & neck on injection beginning day 1 night (reported to Moderna phone line) worsening & spreading day 2 treated with ice at injection and bump sites, 500mg Tylenol about every 4 waking hours

Other Meds: Simvastatin 40mg, Hydrochlorothiazide 12.5mg, Lisinopril 5mg, 2 Metoprolol tartrate 25 mg; PRN Immodium, Allegra; Supplements Vitamin D 10,000IU, Vitamin C 282mg

Current Illness:

ID: 1024186
Sex: F
Age: 68
State: WI

Vax Date: 01/28/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: Lymph nodes in underarm of injected arm swelled up to the size of a lemon and became sore/tender

Other Meds: Atorvastatin 10mg tablets, Triamcinolone acetonide cream .1%

Current Illness: No

ID: 1024187
Sex: F
Age: 53
State: IA

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

Lab Data:

Allergies: Erythra-Derm, Steroids, Penicillin G, Prednisone, Sulfa Drugs

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: patient had nausea, headache, hot and itchy eyes and ears. Patient was given 25mg Benadryl and 4mg zofran

Other Meds: Benadryl 25mg

Current Illness: no

ID: 1024188
Sex: F
Age: 48
State: IN

Vax Date: 01/07/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Tetanus toxoid

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

Symptoms: Lacy vascular rash on both calves. Calf pain and cramping.

Other Meds: Chia Seeds, .05 Estradiol patch, Imitrex as needed.

Current Illness: None

ID: 1024189
Sex: F
Age: 38
State: KY

Vax Date: 01/04/2021
Onset Date: 01/05/2021
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: Latex

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

Symptoms: 1/4 vaccination 1/5 Severe HA; extreme couldn't hold head. 1/6 Elevated BP 160/100 stayed for about 1 week; put on BP meds. Fatigue, joint pain; extreme. Could not stay awake. Thursday I went to Dr. Administered BP meds. Following week; Dr. Tested all inflammatory markers; elevated. *waiting to have markers retested. **missed 3 weeks of work. ***still having joint pain. Hasn't resolved.

Other Meds: HCZT, omeprazole 40

Current Illness: n/a

ID: 1024190
Sex: F
Age: 65
State: CA

Vax Date: 02/04/2021
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: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Sore, Swollen lymph glands under right arm pit

Other Meds: Coqu 10, C, D, Preservavision, B12 Celexa, bupropion, metropol, isorbide repatha, child?s aspirin, rosuvastin, fenofibrate, zetia

Current Illness: None

ID: 1024191
Sex: F
Age: 17
State: WI

Vax Date: 02/02/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Hives and swelling. Still uncomfortable in feet and ankles. Fingers are still kind of tight. Patient noticed itching and swelling on fingers, hands, feet, toes, ankles, and knees on Sunday (2/7). Had hives, went to urgent care, thought it was allergic reaction to vaccines received. Received influenza, meningococcal, and HPV on 2/2. Given prednisone and famotidine at after hours clinic and have been taking since then, swelling has gone down, still has pain in joints. Also taking benadryl and claritin. Hives come back at night, when steroids wear off. No new foods recently, no new products, not going anywhere.

Other Meds:

Current Illness:

ID: 1024192
Sex: F
Age: 79
State: MS

Vax Date: 01/08/2021
Onset Date: 01/19/2021
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: NKA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient reports she experienced Bells Palsy after first dose of Moderna Vaccine.

Other Meds: Unknown

Current Illness: Unknown

ID: 1024193
Sex: M
Age: 89
State: MO

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Weakness/dizziness

Other Meds:

Current Illness:

ID: 1024194
Sex: F
Age: 76
State: MN

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: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa medications and general anesthesia

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

Symptoms: Diarrhea, headache, nausea, vomiting

Other Meds: Multi vitamin, fish oil, Tylenol

Current Illness: None

ID: 1024195
Sex: F
Age: 23
State: NC

Vax Date: 02/04/2021
Onset Date: 02/09/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: generalized rash, urticaria, hives, angioedema of lips, tongue

Other Meds: Celexa 20 mg

Current Illness: None known

ID: 1024196
Sex: U
Age: 23
State: CA

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

Lab Data:

Allergies: N/A

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

Symptoms: Extreme fatigue, and confusion, paired with a sinus pressure headache, and mild fever (100F)

Other Meds: Allegra-D (Daily Use to control allergies), MultiVitamin (Daily Use), Melatonin 10mg (Nightly Use).

Current Illness: N/A

ID: 1024197
Sex: F
Age: 42
State: AZ

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

Lab Data:

Allergies: chocolate, and prozac

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

Symptoms: I started to have rash on my right arm with pumps showing up and is very itchy, itchy and redness with bumps on the right side of my lower face.

Other Meds: Vitamin C 1000 mg was taken 2 hours after vaccine shot

Current Illness: None

ID: 1024198
Sex: F
Age: 42
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: 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: Immediate feeling of tahycardia, numbness in feet and feeling of passing out after injection. My immunologist believes that this was a cytokine storm reaction (non anyphylaxis). Store gave me water and cookie to help. Discomfort continued. Paramedics were on site and did work up on me and allowed me after 1 hour to go home where fever and chills continued for 2 hours. Immunologist would like to administer second dose in her office using desensitizing approach.

Other Meds: Cell Cept, synthroid, liothyronine, tumeric, colace, phentermine

Current Illness: none

ID: 1024199
Sex: F
Age: 28
State: CA

Vax Date: 12/30/2020
Onset Date: 01/02/2021
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: Unknown

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

Symptoms: COVID + post 1st vaccine dose

Other Meds: Unknown

Current Illness: Unknown

ID: 1024200
Sex: F
Age: 25
State: IL

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: NONE

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

Symptoms: RASHES AT INJECTION SITE

Other Meds: PLEQUERIL, IMURAN, METOPROLOL, NERPLONON

Current Illness: LUPUS

ID: 1024201
Sex: M
Age: 24
State: MD

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: lactose, weeds, pollen, cockroaches

Symptom List: Ear pain, Hypoaesthesia

Symptoms: HEADACHE, PAIN AT SITE OF INJECTION, CHILLS, FATIQUE, MUSCLE PAIN, FATIQUE, FEVER-99.3

Other Meds: LACTOSE ADVANTAGE for lactose intolerance

Current Illness:

ID: 1024202
Sex: F
Age: 65
State: TX

Vax Date: 02/09/2021
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: Sulfa, tetracycline, nickl

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Arm tender for two days, ran a fever, body aches and headache for 12 hours. Blood pressure went up to 187/101.

Other Meds: Ayn hyoid, losarten, cevemeline, fish oil, vitamin D, Protonix, singular, gabapentin,

Current Illness: Sjogrens

ID: 1024203
Sex: F
Age: 17
State: PR

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

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

Symptoms: There are no adverse reaction, the reason of this report is because the patient was under age(17 years) at the moment of the vaccination.

Other Meds:

Current Illness:

ID: 1024204
Sex: F
Age: 32
State: MN

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: 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: Patient stated that her adverse symptoms started 6 days after she got the first vaccine, on 29 January 2021. It began as swelling, and redness at the injection site. She stated she had hives that were itchy and raised on her left arm around the site, and on 30 January 2021 the hives spread down her arm. She also noted that the lymph node in her left axilla was swollen. On 6-7 Feb 2021 patient stated that the rash has mostly resolved, but that she started having neck pain, on the sides of her neck, near her collar bone. This pain leads to a headache, which she has been taking Ibuprofen for. The Ibuprofen only helps with the headache pain, not the neck muscle pain. She also stated that since the 6 and 7 of Feb in the evening her chest begins to feel "heavy, like something is sitting on it". Patient stated that she went to see her primary care provider at the end of January and was sent to an allergist, who did not believe it was an allergic reaction. She was not prescribed any medication.

Other Meds: None

Current Illness: None

ID: 1024205
Sex: F
Age: 26
State: OH

Vax Date: 01/11/2021
Onset Date: 01/12/2021
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: Chills that lasted 2 hours and fatigue that lasted 24 hours

Other Meds: Vitamin D3 1000 mcg daily, Allegra 180 mg daily

Current Illness: None

ID: 1024206
Sex: M
Age: 51
State:

Vax Date: 01/27/2021
Onset Date: 02/01/2021
Rec V Date: 02/11/2021
Hospital: Y

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: Nose bleed started on 2/1/21 that would not stop for 2 days. Labs checked - Platelets dropped from baseline of 210 to "4" - sent to hospital on 2/2/21, required ICU Admission with dx of unspecified ITP. There are no other changes of medications or regimen prior to incident. Hospital notes also suspect from COVID vaccine as otherwise unexplained. Has not fully recovered, still in ICU.

Other Meds:

Current Illness:

ID: 1024207
Sex: F
Age: 62
State: MI

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: IRON, IDODINE, CIPROFLOXACIN; CODEINE;HYDROCHLOROTHIAZID;FERROUS GLUCONATE; BEE/WASP/HORNET/ ADHESIVE TAPE

Symptom List: Injection site pain, Pain

Symptoms: MODERNA COVID-19 VACCINE EUA ; BODYBONE PAIN, FEVER, CHILLS, HEADACHE, VOMIT, TIRENESS, INJECTION SITEHARD/SWOLLEN/HOT, LETHARGIC FOR 14.5 HOURS (FELT LIKE I DID WHEN I HAD COVID19 IN OCTOBER); SYMPTOMS EASED UP AFTER 24 HOURS.. I AM CONCERNED ABOUT GETTING SECOND DOSE

Other Meds: POTASSIUM CIT 1080MG; PROOMEGA 2000-D FISH OIL; MAXI VISION EYE VITAMIN & MULTI SUPPLEMENT; D3 5000 IU VITAMIN; CALCIUM +D; MEGA 3 OPTIVE EYE DROPS; AMBEIN .05MG (NOTE I DID NOT TAKE AMBEIN ON 08/09 & 08/10)

Current Illness: POS TEST FOR COVID 19 ON OCTOBER 14, 2020

ID: 1024208
Sex: F
Age: 50
State:

Vax Date: 01/29/2021
Onset Date: 01/30/2021
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: Injection site pain, Menorrhagia

Symptoms: 2/11/2021 Per Healthcare worker. Day after pt received 1st Covid vaccine went to ER for hives on face and abd pain. Also reported HA and body aches. Discharged from ER with unspecified stomach pains. Pt is nonverbal. Information obtained from Healthcare worker. As of 2/22/2021 patient is doing fine and having no s/s. Asked Healthcare worker to provide a statement from physician or PCP as to whether pt should receive the second dose of the Covid vaccine. RN

Other Meds:

Current Illness:

ID: 1024209
Sex: F
Age: 29
State: OR

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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Fatigue, headache, injection site redness and swelling, malaise, muscle pain and injection site pain.

Other Meds:

Current Illness:

ID: 1024210
Sex: F
Age: 70
State: GA

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

Lab Data:

Allergies: Allergic to latex exam gloves.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: She woke me at about 4:15am and told me she was freezing, she was shivering in the bed even though she had a blanket on, so I went and got her another blanket and put some socks on her feet. She went back to sleep until about 6:30am when she woke up and said she felt like she was burning up, so I took 1 blanket and her socks off. I took her temperature at 6:45am and it was 100.2 degrees, so I went to the store to buy her some Tylenol. I gave a cracker and a Tylenol with a glass of water. She went back to sleep until 9:45am, when she woke back up and I took her temperature, it was at 99.7 degrees, she ate another cracker and drank some water and some Diet Coke. She went back to sleep and at 11:35 she woke up and told me she was hungry so I made her some chicken noodle soup and 1/2 of a hotdog. Her temperature at that time was 98.6 degrees. Basically she was in bed the whole day and couldn?t do any of the things that she normally would do. She feels some what better today, no fever, but still has body aches and pains. Her arm is still bothering her and she has a rash at the injection site.

Other Meds: Vitamin D-3 5000 in. 1 every 3 days.

Current Illness: She had a head cold and some chest congestion, but she did not have a fever, for 2 weeks prior to her COVID-19 vaccine.

ID: 1024211
Sex: F
Age: 84
State: MI

Vax Date: 01/28/2021
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: RA

Lab Data:

Allergies: Sulfa

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 8 days post vaccination pt developed redness, warmth, and itching around site of injection. Pt states no other issues distal to injection site. Pt states redness 5 days later is spreading and approximately 7" x 5" across. Pt identifies it like a "sunburn". Pt did seek care at PCP who treated her with doxycycline for cellulitis, however she stopped it after two doses once her husband had same reaction the following date.

Other Meds: Chewable Aspirin, Statin, Glaucoma meds

Current Illness: None

ID: 1024212
Sex: M
Age: 29
State: CA

Vax Date: 02/10/2021
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:
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: C/O heart racing, dizziness and swollen lymph nodes

Other Meds:

Current Illness:

ID: 1024214
Sex: F
Age: 46
State: WI

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: RA

Lab Data:

Allergies: receives allergy shots, stated she hadnt had a severe allergic reaction to anything in a long time and nothing to IV/vaccines but after reaction stated she did have hives after first COVID vaccination

Symptom List: Nausea

Symptoms: Per EMS report: ED was dispatched to the vaccination clinic at city hall for a female having an adverse reaction. When we arrived the patient was found sitting in an upright position on a chair; she was conscious and alert. We were informed by medical staff on scene(EMT) the patient had developed some redness on her chest and had been given 50 mg Benadryl prior to our arrival. Patient informed us she has a history of adverse reactions to vaccines so she was expecting something to happen. She said she had initially gotten a feeling of warm/flushing from her feet and up into her body and then developed the redness. She also said her tongue had been feeling numb but she denied any shortness of breath or chest palpitations associated with her symptoms. According to the patient and provider on scene the redness was improving after the Benadryl. Patient also said her tongue was feeling normal again. The patient did not want to be transported to the hospital as she said she was feeling better. Health department staff on scene was going to be sending Benadryl with the patient in case she needed more. Patient signed medical release and ED cleared.

Other Meds: unknown

Current Illness: unknown

ID: 1024216
Sex: F
Age: 69
State: CA

Vax Date: 02/01/2021
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: None

Symptom List: Injection site pain

Symptoms: Red rash on arm, raised small blister, black and blue, growing from small circle spreading a bit

Other Meds: Vitamin D3, C, Zinc, probiotics

Current Illness: None

ID: 1024217
Sex: F
Age: 63
State: NJ

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

Lab Data:

Allergies: Comtrex

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

Symptoms: Had an aura at about 7:30pm on 2/10/2021 about 27 hours after vaccination, lasted about an hour, no headache developed. Do have history of migraines when around puberty that usually began with an aura...have not have one in about 10 _+ years .No

Other Meds: Metoprolol

Current Illness: None

ID: 1024218
Sex: F
Age: 71
State: CA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: plavix, doxycycline, tetracycline, vibramycin, Codeine, Nsaids

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

Symptoms: I felt an itchy feeling and scratched it. When I looked at the sight (where I had the injection) there were small welts, approximately 6 or 7 taking up an oval about 1" x 2". I applied lotion to prevent further itching. In the morning, the welts were smaller and the patch is red and still itches. I am continuing to apply lotion.

Other Meds: lisinopril, atenolol, crestor,calcium, multi-vitamin, aspirin, pepcid

Current Illness: none

ID: 1024219
Sex: F
Age: 26
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Chills, arthralgia, headache, and fatigue that resolved after 12 hours

Other Meds: Vitamin D3 1000 mcg daily, Allegra 180 mg daily

Current Illness: None

ID: 1024220
Sex: F
Age: 76
State: CA

Vax Date: 02/02/2021
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: Codeine

Symptom List: Erythema, Pruritus

Symptoms: Soreness, redness and edema came on a week following the vaccination.

Other Meds: acyclovir (ZOVIRAX) 400 mg tablet Take 1 Tab by mouth 3 (three) times daily amLODIPine (NORVASC) 5 mg tablet Take 1 Tablet by mouth once daily losartan (COZAAR) 100 mg tablet TAKE ONE TABLET BY MOUTH ONE TIME DAILY

Current Illness:

ID: 1024221
Sex: F
Age: 38
State: NM

Vax Date: 02/05/2021
Onset Date: 02/10/2021
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: No known allergies

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

Symptoms: Arm became red, mildly edematous, warm to touch. Used steroid cream and improved. 24 hours later with red circle at site of injection. No pain. It continues to itch. No PO medications used.

Other Meds: NONE

Current Illness: None

ID: 1024222
Sex: M
Age: 65
State: CA

Vax Date: 12/16/2020
Onset Date: 12/27/2020
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: Lotensin; Amlodipine

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

Symptoms: Stabbing pain over the right first metatarsophalangeal joint. Intermittent. No relation to activity. Progressed to nightly burning over the area, waking me up from sleep or preventing me from falling asleep.

Other Meds: Losartan/HCTZ; Atenolol; Aspirin; Diclofenac gel; Metformin; Fluticasone; Atorvastatin; Omeprazole; Sertraline; Coenzyme Q-10; Turmeric; Acetaminophen

Current Illness: None

ID: 1024223
Sex: F
Age: 11
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Shellfish

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient started with a rash on both arms , face and neck. Her face was flushed. She felt lightheaded and her arms hurt. She also became anxious. Initial VS: pulse ox:97% on RA, pulse: 102, BP: 102/64; 5 minutes later: pulse ox:96% on RA, pulse: 106 5 minutes later: Zyrtec 10 mg po given; 5 minutes later: pulse ox:99% on RA, pulse: 68; 10 minutes later: pulse ox:98% on RA, pulse: 91, BP: 104/62: lungs were CTA the entire time; no tongue swelling. Water given, a lollipop and brownie given. After 30 minutes; rash almost completely gone and pulse ox:97% on RA, pulse: 87. Patient discharged home with Mom and walked out of the office.

Other Meds: MVI

Current Illness: none

ID: 1024224
Sex: F
Age: 22
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Received first dose of Moderna COVID-19 on January 20, 2021 at Hospital. Received #2 dose of Moderna 21 days after first. Received vaccination earlier than recommended timing.

Other Meds: Escitalopram 20 mg, Omeprazole 20 mg

Current Illness: None

ID: 1024225
Sex: F
Age: 65
State: NJ

Vax Date: 02/06/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: levaquin

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

Symptoms: Flu like symptoms began 12 hours or so after injection: headache, lethargy, naseau, felt "unwell". Symptoms continued for 3-4 days. Noted that I previously had COVID infection in April 2020 for which I was hospitalized for a week on oxygen.

Other Meds: procardia metopolorol tramadol aspirin (81 mg) ibrubophen

Current Illness: total hip replacement surgery approx 3 weeks prior to vaccination

Date Died: 01/14/2021

ID: 1024226
Sex: M
Age: 63
State: TX

Vax Date: 01/06/2021
Onset Date: 01/14/2021
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: New onset dizziness with hypotension, tachycardia, and vomiting blood. Sent to ER - told he went into cardiac arrest and died.

Other Meds:

Current Illness:

ID: 1024227
Sex: F
Age: 35
State: WI

Vax Date: 02/02/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: NKDA

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

Symptoms: Chills Achy Lack of energy Tired Nausea No treatment just rest

Other Meds: Prenatal vitamin Folic acid Omeprazole Progesterone

Current Illness: N/A

ID: 1024228
Sex: F
Age: 21
State: MI

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: None - although, she apparently had allergic reactions to vaccines in the past that had required her to take benadryl to alleviate her issues. She failed to notate that on her vaccine administration record.

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

Symptoms: About an hour after administration, she started feeling like she couldn't catch her breath. She also stated that it felt like her tongue was too big for her mouth. She also stated that it looked like there was a mosquito bite at the site of administration. She took a benadryl (unknown strength) about 1 hour after developing the breathing symptoms, and an hour later, she was starting to feel better. As of 24 hours after, the administration site reaction is not resolved.

Other Meds: unknown

Current Illness: none

ID: 1024229
Sex: F
Age: 30
State: NY

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: Latex and Penicillin

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

Symptoms: Pt first developed numbness and tingling of the lips which was followed by very slight upper lip swelling. This numbness and swelling improved without intervention but over the next 10 mins returned but this time with swelling of the lower lips. Pt has h/o atrial thrombus as well as reaction to epinephrine (drooling, tachycardia, unsteady gait). Benadryl 50 mg given in hopes that this will slow the reaction while patient was transported to the ER. While epinephrine was indeed warranted this was not provided given her comorbidities and prior reaction to epinephrine. Patient with stable vitals, no dyspnea. Ambulatedto the Ambulance without difficulty.

Other Meds: Letrozole, Perjeta, Xgeva, Zoladex

Current Illness: H/o Breat Cancer, Atrial thrombus, HTN

ID: 1024230
Sex: F
Age: 26
State: MA

Vax Date: 12/21/2020
Onset Date: 12/22/2020
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: N/A

Symptom List: Vomiting

Symptoms: Patient had long hauler symptoms after a previous presumed COVID-19 infection beginning March/April 2020. Symptoms of severe exertional tachycardia, fatigue, shortness of breath, dizziness, and brain fog had improved and the patient was back to full duty at work October-December 2020 with mild-moderate exertional tachycardia and shortness of breath remaining. After vaccine given on 12/21/2020 the patient the next day had sweating, fatigue, dizziness, tachycardia, and mild shortness of breath. Was seen by PCP and an allergist that recommended premedication with Xyzal prior to second vaccine which resulted with no worsening symptoms after second vaccine. Relapse-like symptoms remain into February but are improving.

Other Meds: Occasional vitamin D and C, not daily

Current Illness:

ID: 1024231
Sex: F
Age: 64
State: MD

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Chills, headache, fever - 100 degrees, body aches, sore arm 2/10 & 2/11 Tylenol eased the symptoms

Other Meds:

Current Illness:

ID: 1024232
Sex: M
Age: 74
State: CO

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

Lab Data:

Allergies: Codine

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

Symptoms: Nausea, shakes, light headedness.

Other Meds: Glipizide, vitamin c, multi vitamin,metoprolol, lisinopril, pioglitazone, aspirin I have an infusion of entyvio every 8 weeks. Next one is Feb 14

Current Illness: None

ID: 1024233
Sex: F
Age: 32
State: CA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: chills, fatigue, nausea, body ache, vomiting lasted 3 days. took Ibuprofen after 24 hours to help with symptoms.

Other Meds:

Current Illness:

ID: 1024234
Sex: F
Age: 68
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: No

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

Symptoms: 6 hours after 2nd shot ran 202 degree fever, had head ache, muscle aches, chills, sweats, and fatigue for well over 48 hours.

Other Meds: Trazadone, duloxitinre, hydroxyzine,.montelukast., medical marijuana.

Current Illness: Stomach virus in early January

ID: 1024235
Sex: M
Age: 41
State:

Vax Date: 12/18/2020
Onset Date: 01/02/2021
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: None

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

Symptoms: Complete numbness in head, left side of face, left side of neck, left shoulder, left arm, and left hand. Numbness has been consistently present for 6 weeks now in left side but is now including the right side (right shoulder, arm, and hand namely). Has subsided slightly. Pain in neck and shoulder has increased. If arms are bent, even for a very short time, both hands instantly fall asleep with tingling feeling. Significant muscle loss has occurred in the left arm (bicep and tricep) as well. Doctor has diagnosed me with Parsonage Turner Syndrome and Cubital Tunnel Syndrome - both due to the 4th anthrax vaccine I received eight weeks ago.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm