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

Date Died: 02/12/2021

ID: 1026141
Sex: M
Age: 82
State:

Vax Date: 01/16/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: death 2/12/21

Other Meds:

Current Illness:

ID: 1026142
Sex: F
Age: 24
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: Dilaudid

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever headache chills

Other Meds: Birth control

Current Illness:

ID: 1026143
Sex: F
Age: 62
State: WI

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: This was my second dose of the COVID vaccine. I had no reactions to the first dose. After the second dose on 2/12/21, I had the standard body aches and slight fever. As I got ready for bed, I took 2 of the chewable Allergy tablets before bed as I had done about 5 other times over the course of 6 months to relieve ear stuffiness that accentuates my tinnitus and impacts my sleep. I never experienced any reaction after taking it those days in previous months. I took the tablets at 8:45 p.m. on 2/11/21. At 2:00 a.m. on 2/12/21, I woke up from feeling very dizzy and nauseous. I was drenched in sweat and shaking. I opened my eyes and the room was spinning wildly. This went on for 45 minutes. I eventually started throwing up. I began feeling better after the vomiting stopped.

Other Meds: Genexa Allergy-D - Non-drowsy organic allergy and decongestant

Current Illness: None

ID: 1026145
Sex: F
Age: 45
State:

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: Red, Swollen Arm. Muscle aches, flu like symptoms, joint pain. Has a scar on her arm that is typically flat, but is raised as a result of inflammation

Other Meds:

Current Illness:

ID: 1026146
Sex: F
Age: 26
State: FL

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

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

Lab Data:

Allergies: Sulfa, augmentin, possible mango allergy

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

Symptoms: Hives on lips - tiny red bumps on outer edge of top and bottom lips, swollen lips - both top and bottom, both lips bright red

Other Meds: Adderall, birth control

Current Illness:

ID: 1026147
Sex: F
Age: 71
State: OH

Vax Date: 02/02/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
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

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

Symptoms: After vaccination, the next day sore arm, by Friday I didn?t fee good and on Saturday I was hurting down my arm into my joints from top of neck all the way down arm. I had breast surgery 1 ? ago and don?t know if its significant. I was diagnosed with Shingles by my physician.

Other Meds: No

Current Illness: no

ID: 1026148
Sex: F
Age: 66
State: GA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/12/2021
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: Penicillin-skin rash

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient reported flushed feeling, bad taste in mouth and tingling on the outside of right cheek. Administered Benadryl 25mg 0.5cc IM RD muscle at 2:46pm. Patient did not have a rash, redness, nor swelling. Patient was not in any distress. Patient left facility alert, awake at 3:20pm. Symptoms had subsided and patient had no further complaints.

Other Meds: unknown

Current Illness: unknown

ID: 1026149
Sex: F
Age: 41
State: WI

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Chills, fever, tired.

Other Meds: Tylenol prior vaccine

Current Illness: None

ID: 1026150
Sex: F
Age: 30
State: NH

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: L arm Pain, Temperature 100.

Other Meds:

Current Illness:

ID: 1026151
Sex: F
Age: 52
State: NY

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/12/2021
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: Fluroquinolone antibiotics (tendinitis).

Symptom List: Diarrhoea, Nasal congestion

Symptoms: The night of my second dose I developed, what felt like, heartburn. Neither Tums nor food relieved the pain. Pain lasted about 5 days. On the fifth day, heartburn-like pain subsided and a moderate headache developed. Eyes also felt very hot and continue to to this day.

Other Meds: Zoloft, Relizen, Glucosamine/Chondroitin/Turmeric, Excedrin Mi

Current Illness: Covid-19 virus: 1/16-18/2021

ID: 1026152
Sex: F
Age: 65
State: NM

Vax Date: 12/24/2020
Onset Date: 12/25/2020
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: NO

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

Symptoms: flu like symptoms, including fever and dizziness

Other Meds: No

Current Illness: MS diagnosis

ID: 1026153
Sex: F
Age: 50
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/12/2021
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: no

Symptom List: Rash, Urticaria

Symptoms: arm swollen, black and red and itchy

Other Meds: no

Current Illness: no

ID: 1026154
Sex: F
Age: 63
State: AZ

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Tingling sensation - full body; duration 5 minutes; no treatment; resolved Heart palpitations - significant - started ~2 hours post injection; duration 1.5 hours (worse when resting); considered going to ER; no treatment; resolved.

Other Meds: Multivitamin daily

Current Illness: Elevated TSH

ID: 1026155
Sex: F
Age: 53
State: IL

Vax Date: 02/10/2020
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: None

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

Symptoms: Muscle cramps neck,calves back head; Tired; Arm sore

Other Meds: Vitamins ppi

Current Illness: Vitiligo Gerd hiatal hernia

ID: 1026156
Sex: F
Age: 44
State:

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Fever, muscle cramping, headaches

Other Meds:

Current Illness:

ID: 1026157
Sex: F
Age: 44
State: MD

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: nil

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

Symptoms: Headache, feeling spaced out.

Other Meds: nil

Current Illness: nil

ID: 1026158
Sex: F
Age: 34
State: IN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: Woke up in the middle of the night 2/10 around 1:00 a.m. with headache, nausea, body aches, and chills. Went to work that morning 2/10 late & ended up leaving early because of the body aches, dizziness, and nausea. The day after vaccine 2/10 when I was feeling poorly I took tylenol, excedrin, and ibuprofen.

Other Meds: OTC multivitamin, OTC probiotic, generic seasonique birth control

Current Illness: none

ID: 1026159
Sex: F
Age: 55
State: IL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, Azithromycin, Levothyroixine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Within 8 minutes of receiving the Moderna Covid-19 vaccination, patient was dizzy, sweaty, and hypotensive Blood pressure was 66/43, and 8 days after vaccine had injection site reaction of erythema, increased warmth, and induration

Other Meds: Armour thyroid and vitamin D

Current Illness:

ID: 1026160
Sex: F
Age: 38
State: MD

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: rashes and redness on arm

Other Meds: none

Current Illness: none

ID: 1026161
Sex: F
Age: 55
State: WI

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

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

Lab Data:

Allergies: Cephalexin, cephalosporins, Mastisol adhesive, Morphine, PCN, Pseudophedrine HCL, Tegaderm, seasonal allergies

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

Symptoms: patient had a Moderna shot 2/1/2021, Day of injection developed dime sized blister. Following day developed redness, warmth and swelling approx 4"x4" . Today 2/12/2021 area is still somewhat erythematous, warm and red. Shot was given fairly low in the arm.

Other Meds: Adderall XR, Bupropion SR, Ergocalciferol, Fluticasone, Lorazepam, Meloxicam, Nicotine patch, pro air inhaler.

Current Illness: None

ID: 1026162
Sex: F
Age: 44
State: MA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/12/2021
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: NKA

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

Symptoms: Bilateral ringing in ears. Started 8 hours after 2nd dose of Covid Vaccine. Lasted 12 hours. No history of same. Reported as peer had similar side effects. No dizziness

Other Meds: Ibuprofen, Melatonin

Current Illness: None

ID: 1026163
Sex: F
Age: 84
State: AZ

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/12/2021
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 meds

Symptom List: Unevaluable event

Symptoms: Received vaccine 7:30 PM Monday, began feeling tinging in lower lip Tuesday, did not notice any symptoms Wednesday, Thursday 11:00 AM noticed drooping left side of face, couldn't smile on left side, eye drooping, difficult to close left eye. Transported to ER by ambulance at 11:30 AM. Diagnosed with Bell's Palsy. Released from ER to home.

Other Meds: Xarelto, Digoxin, Donepezil, Vitamin D3,Carvedilol, Synthroid,

Current Illness: none

ID: 1026164
Sex: F
Age: 55
State: OR

Vax Date: 02/02/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: sulfa drug, aspirin, ibuprofen, bee stings, Augmentin

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

Symptoms: red splotchy raised spot set in 8 days after injection. Slightly itchy, tender.

Other Meds: Flonase, triamcinolone, multi-vitamins

Current Illness: none

ID: 1026165
Sex: M
Age: 20
State: TX

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/12/2021
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: Minocycline

Symptom List: Injection site pain, Pain

Symptoms: Patient became extremely diaphoretic with a syncopal episode. Patient was lethargic and unable to answer questions approximately 5 after occurrence of episode.

Other Meds: None

Current Illness: Seizure, family history of seizure, hypoglycemia, contact dermatitis of hands.

ID: 1026166
Sex: F
Age: 74
State:

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Timolol; Cymbalta; Gabapentin; Lisinopril; Pregabalin; Tramadol

Symptom List: Injection site pain, Menorrhagia

Symptoms: Cold sweat, says tongue felt thick; Patient was given Benadryl 50 mg and monitored; Patient was observed for over an hour and was allowed to leave, feeling fine

Other Meds: Albuterol, amlodipine, budesonide, cyclobenzaprine, diclofenac, ergocalciferol, esomeprazole, fluticasone, ginger, kava, lactobacillus, levothyroxine, lidocaine, losartan, lopressor, percocet, hypromellose, pantoprazole, spiriva handihaler

Current Illness:

ID: 1026167
Sex: F
Age: 43
State: ME

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: CT CONTRAST PINEAPPLE

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

Symptoms: After the second dose I wasn?t feeling great, I slept an entire day and woke up Thursday feeling great, Thursday evening I developed burning and itchy hives all over my neck chest and face, my face appeared swollen, I also had a smaller outbreak on my legs I took benedryl which seemed to calm the reaction some when I woke up the following morning, and another dose seemed to calm it some more

Other Meds: Citoprolam

Current Illness: none

ID: 1026168
Sex: F
Age: 36
State:

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Severe HSV2 outbreak 24-48 hours after injection. Gave acyclovir, calmed symptoms down. Stopped and 2 days later returned with rectal HSV, started 5 days acyclovir again, stopped and 2 days later had eye pain. Switched to valcyclovir for 30 days.

Other Meds:

Current Illness:

ID: 1026169
Sex: F
Age: 66
State: IN

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

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

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever over 100 degrees, severe chills, muscle aches, joint pain, headache

Other Meds: Venlafaxine

Current Illness:

ID: 1026170
Sex: M
Age: 71
State: OH

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/12/2021
Hospital: Y

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: multiple statins

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

Symptoms: Shortly after first Moderna injection, while driving home, developed shortness of breath and chest pain, was diagnosed with an MI per the hospital, abnormal EKG and enzymes, currently on ventilator and awaiting surgery for coronary bypass surgery. Hospitalized at the point of this input.

Other Meds: Allopurinol, ezetimibe, finasteride, gabapentin, glipizide, liraglutide, losartan, metformin, metoprolol, oxybutynin, tamsulosin

Current Illness:

ID: 1026171
Sex: M
Age: 82
State:

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

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: WOKE UP THIS MORNING NOT FEELING WELL, MANAGED TO SLOWLY WALK INTO KITCHEN, FELT PROFOUNDLY WEAK, BECAME DIAPHORETIC, UNABLE TO SPEAK, SYMPTOMS LASTED FOR 10-15 MINUTES AND GRADUALLY RESOLVED OVER COURSE OF 1 HOUR.

Other Meds: XARELTO, LISINOPRIL/HCTZ , SIMVASTATIN, OMPERAZOLE

Current Illness: NO OTHER CURRENT IN PAST MONTH

ID: 1026172
Sex: F
Age: 34
State: MN

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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, carbomer.

Symptom List: Injection site pain

Symptoms: Sore, puffy red rash about 2 inches in diameter around the injection site.

Other Meds: zolpidem 10mg QHS, IUD, multi-vitamin QAM, pantoprazole 40mg BID.

Current Illness: None

ID: 1026173
Sex: F
Age: 42
State: CO

Vax Date: 02/03/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Melon, gluten

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

Symptoms: Approximately one week after the shot, I noticed some mild itching at the injection site. On 2/11/21, I noticed a large, red rash around the injection site, 2-3 inches in diameter. The rash was itchy and hot. Consulted with primary care doctor who advised Benadryl, which was taken. On 2/12, the rash has faded a bit but is still itchy and warm.

Other Meds: Priobiotics, Vitamin B, Vitamin C, Zinc, Calcium, Turmeric, Ashwagandha

Current Illness: None

ID: 1026174
Sex: F
Age: 20
State: WI

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: Unknown.

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

Symptoms: Received the shot at 2:10. 2:15, she was feeling light headed and tingly sensation in her extremities. She didn't let anyone know at this time. The person observing her noticed she seemed zoned out and asked how she was doing at about 2:17 and learned that her tingliness was turning into numbness of extremities focused on her upper body. She started displaying other symptoms of a minor panic attack. We monitored her for the full 30 minutes, had her walk around, drink water, etc. She claimed that while her numbness wasn't getting better, it also wasn't getting worse. It was starting to itch though, so she was given some benedryl. She then went home for the evening where her roommate could monitor her. Next day, she called in to confirm that her numbness/itchiness had turned into a rash on her chest which has disappeared. But now is experiencing diarrhea, headache, weakness and dizziness. She was informed that these symptoms were within the normal range of immune responses, but that if she was too miserable, she could go in to urgent care for medical assistance. She declined to do so at that time (approximately 11:45 am).

Other Meds: Unknown.

Current Illness: None.

ID: 1026175
Sex: M
Age: 45
State: IL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/12/2021
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: Injection site reaction: erythema, increased warmth, and induration, began the same day as vaccine but continue to worsen for 9 days post vaccination

Other Meds: none

Current Illness: morbid obesity

ID: 1026176
Sex: F
Age: 31
State: NE

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Menstrual irregularities. Patient is on OCPs and her period came early after both vaccinations- within 12-24 hours on both occasions.

Other Meds:

Current Illness:

ID: 1026177
Sex: M
Age: 61
State: MS

Vax Date: 02/01/2021
Onset Date: 02/04/2021
Rec V Date: 02/12/2021
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: Patient developed a rash on all 4 extremities and trunk

Other Meds:

Current Illness:

ID: 1026178
Sex: F
Age: 41
State: OH

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: Allergic to lemons

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

Symptoms: Fever, chills, headache, body aches, runny nose, sore throat

Other Meds: Ocella

Current Illness: None

ID: 1026179
Sex: M
Age: 66
State: TX

Vax Date: 01/31/2021
Onset Date: 02/08/2021
Rec V Date: 02/12/2021
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: ibprophen

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore left arm and felt bad a couple of days, then early this week my blood pressure spiked to 145/100 and has stayed in that range. It is accompanied by chest pain when I have any physical movement. If I walk across the room I have chest pain and caused the blood pressure to go up.

Other Meds: Prasagrel, linsinopril, amlodapine, metopolol, asprin, atorvastatin, protonix, hydrocodone, vit D, Zinc, C, Biotin, multivitamin,

Current Illness:

ID: 1026180
Sex: F
Age: 24
State: KS

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: Strawberries and Imuran

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

Symptoms: nausea, light headed, headache, sore arm, body aches, chills, fever

Other Meds: Q8 week Entyvio IV Infusions

Current Illness:

ID: 1026181
Sex: F
Age: 69
State: NC

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/12/2021
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: NKA

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

Symptoms: Tachycardia & irregular heart beats

Other Meds: Metformin, HCTZ, Losartan, Spironolactone, Potassium

Current Illness: None

ID: 1026182
Sex: F
Age: 49
State: OK

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 02/12/2021
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: Pain in extremity

Symptoms: I received my first COVID vaccination on 12/23/2020. Within 24 hours I had a very painful arm at the injection site & flu like s/s such as HA & myalgias. This continued & on 12/29/2020 I began to have an irritated bronchial & even stayed home from work this day. Each day the s/s progressed & by Monday 1/4/2021 I was beginning to have wheezing and chest congestion, productive cough, & SOB, diarrhea, & abdominal pain. The last symptom I have had was the horrible mouth lesions. I worked on Monday 1/4/2021 sick but then was off on 1/5, 1/6, 1/7, 1/8, & Monday 1/11/2019. Throughout my time of not feeling well I never ran a fever. On Friday 1/8/2021 I had a negative COVID test through the respiratory clinic. I did a round of antibiotics & even a round of steroids. I was last seen on Monday 1/11/2021 by the AMG PCP & was given the magic mouthwash. The mouth lesions have since gone away but I continue to have intermittent SOB, wheezing, and a productive cough. At this time I will wait until I am completely better to take the second vaccine. I just want to remind you that I did register through the CDC VSAFE program & continue to answer their questions through text & made them aware of the problems I have had since taking the vaccine. As discussed please file this documentation in my employee health file. My office coordinators have been very helpful & understanding throughout this time. appreciate all you do. Thank you.

Other Meds: Singulair, multivitamin, iron supplement, calcium plus D, Claritin, lexapro

Current Illness:

ID: 1026183
Sex: F
Age: 36
State: MI

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Bactrim and Vicodin

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

Symptoms: Patient reported feeling nausea and dizziness post vaccination. She began vomiting. Offered oral hydration but patient unable to tolerate. BP 95/57, HR 52, and O2 99% on room air. Patient reported severe dizziness with standing. Transported to ED for further evaluation.

Other Meds: Wellbutrin, Oneprazole, Ativan

Current Illness:

ID: 1026184
Sex: F
Age: 45
State: NY

Vax Date: 02/08/2021
Onset Date: 02/01/2021
Rec V Date: 02/12/2021
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: wellbutrin

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

Symptoms: rash over entire body except face. fever, loose stools, headache and chills. fatigue.

Other Meds: xanax, asthma meds,

Current Illness: none

ID: 1026185
Sex: F
Age: 34
State: MO

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/12/2021
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: Fever-102.7, nausea, diarrhea, fatigued, headache, loss of appetite, chills, dizziness, sore sight of injection, heart palpitations

Other Meds: Sertarline 100mg

Current Illness: None

ID: 1026186
Sex: F
Age: 49
State: TX

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: At 1100 Nausea, stomach pain, sore arm, and chills. Reported taking Zofran 4mg and Tylenol 800mg for pain.

Other Meds:

Current Illness:

ID: 1026187
Sex: F
Age: 43
State: WA

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 02/12/2021
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: I felt very dizzy in the afternoon of the vaccine - it went away an hour later. Day 3, itchy rash on my neck and chest and a sandy, itchy feeling in my throat. I took a Claritin and it went away after I woke up. Day 5 - felt very dizzy and had chills and rash came again - all over my chest. It was a burning sensation. Called Dr about 10 PM in evening and she told Claritin and Benadryl for a week. I had lymph node enlarged above my left clavicle on Day 5, as well. Really bad fatigue started occurring - really bad fatigue; headache. Felt horrible. Eventually I started feeling better. Rash went away but I fatigue was still lingering. Lymph node became slowly less enlarged but got the second dose of the vaccine and it enlarged larger than the first time. (Second dose of COVID Vaccine was date was January 27, 2021 about 3:00 PM.)

Other Meds: Prenatal vitamins plus low iron; Vit CQ10; Vit D oil

Current Illness: no

ID: 1026188
Sex: F
Age: 68
State: GA

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: None

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

Symptoms: Convulsions/Mini Seizure

Other Meds: Exelon patch 9.5 mg/24 hr Quetiapine Fumarate 25mg tablet Namenda 10mg Vampiric Acid 250/5ml Centrum Multi Vitamin for Women Cranberry Soft Chews 500 mg Melatonin 5mg

Current Illness: None

ID: 1026189
Sex: F
Age: 24
State: NV

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: PT PRESENTS IN OFFICE FOR SKIN REACTION DUE TO COVID VACCINE. RASH IS ON LEFT ARM, AND IS WARM TO THE TOUCH. SHE HAS C/O HEADACHE, AND HAS TRIED TYLENOL OTC. WE ADMINISTERED DIPHENHYDRAMINE 50MG. PER PROVIDER PT SHOULD TAKE BENADRYL EVERY 6 HOURS AS NEEDED AND USE ICE ON AND OFF. PT SHOULD STAY HOME AND MONITOR SKIN REACTION AND ANY SYMPTOMS. IF SYMPTOMS GET WORSE OR SHE EXPERIENCES SOB, CHEST PAIN, FEVER, ARM NUMBNESS SHE IS TO GO TO THE ER IMMEDIATELY.

Other Meds: Advair Diskus 250 mcg-50 mcg, Cetirizine 10 mg tab, Daysee .15 mg-30 mcg, doxycycline hyclate 100 mg, famotidine 20 mg, Mirena 20 mcg, Prednisone 20 mg

Current Illness: None reported

ID: 1026190
Sex: M
Age: 70
State: LA

Vax Date: 02/05/2021
Onset Date: 02/08/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Non-specific food allergies

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

Symptoms: Mild facial swelling - Resolved without treatment.

Other Meds: Atorvastatin Levothyroxine Tamsulosin Dutasteride Lisinopril Triamterene-HCTZ Vitamin C

Current Illness:

ID: 1026191
Sex: M
Age: 82
State: FL

Vax Date: 02/06/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: NAUSEA VOMITTING DIARRHEA CHILLS MUSCLE JOINT PAIN GENERAL MALAISE LIKE HAVING A HEAVY FLU NO FEVER SLEEPY STAYED IN BED UNTIL 02/12/2021 SLOWLY RECOVERING

Other Meds: PROGRAFF CELLCEPT ATENOLOL FINASTERIDE PRAVASTATIN

Current Illness: NONE

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm