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: 1026347
Sex: F
Age: 24
State: MO

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Nauseous

Other Meds:

Current Illness:

ID: 1026348
Sex: M
Age: 61
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: little fever, cold, general weakness

Other Meds:

Current Illness:

ID: 1026349
Sex: M
Age: 44
State: MI

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: I had many of the usual side effects, including severe headache, body aches, chills, fever. I am reporting this only because my fever spiked all the way to 106.1, before receeding. This was the second dose of the moderna vaccine. The first shot I had no side effects at all, aside from a sore arm.

Other Meds: multivitamin

Current Illness: none

ID: 1026350
Sex: F
Age: 28
State: WA

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: "28 Y O female presents with rash to bilateral thigh. She received the pfizer covid vaccine in her left arm around 9am this morning and she developed rash to her face and thighs. Also reports mild neck stiffness. Left arm injection site is not swollen or red but hurts a little bit. Temp during call is 99.2."

Other Meds: None

Current Illness:

ID: 1026351
Sex: F
Age: 54
State: ID

Vax Date: 01/15/2021
Onset Date: 01/01/2021
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: Balsam of Peru

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

Symptoms: Patient reports large "crater" or "divot" in left deltoid after receiving Moderna first dose. "Crater / divot" was visualized in clinic and is substantial. Nickel sized divot noted upon visualization.

Other Meds: None known

Current Illness: None noted

ID: 1026352
Sex: F
Age: 54
State: TN

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

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

Symptoms: Heart palpitations on day 2 and 3 after shot day, so far.

Other Meds:

Current Illness:

ID: 1026353
Sex: F
Age: 43
State: CA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: No allergy to products, swelling from bee sting - one occurrence

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Within one minute of receiving the shot my throat felt like it was swelling and I had difficulty swallowing. Lasted about 30 minutes. Two days later my right leg felt dead and big, similar feeling to when I had a spinal for a cesarean section. The sensation was off and on for 2 days and then subsided.

Other Meds: Synthroid 50 mcg

Current Illness: No

ID: 1026354
Sex: F
Age: 76
State: VA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: Wheat

Symptom List: Pharyngeal swelling

Symptoms: I woke up with severe Number 10 pain in my right knee, front , back and side. It was red, tender and swollen. The pain moved down to my right ankle and foot with severe muscle spasms pulling my right foot inwards toward my left foot. I could not walk to bathroom without screeming. Then it moved to my right hip area with muscle spasms across my lower back. I am still experiencing pain and muscle spasms (not as severe) today at this writing. It seems to be attacking my body where I have old injuries.

Other Meds: Metoprolol , Vitamins b,c,d,k, April 81,Zinc,Magnisium, Miralax, Stool Softner

Current Illness: December 28, Covid positive, Autoimmume Disorder, Thyroid Disorder

ID: 1026355
Sex: F
Age: 74
State: MD

Vax Date: 02/03/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 3 inch diameter redness and warm to the touch. Also itchy and small lump in center

Other Meds: Hctz

Current Illness: None

ID: 1026356
Sex: F
Age: 32
State: CA

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: One hour after administration: Dizziness/vertigo. She sat down and became "shaky," developed into rigors. Some throat tightness. Treated with Benadryl 50mg and Tylenol (dose unknown) and O2 nonrebreather mask. Next day full body soreness, "bad headache." Evaluated by Doctor on site.

Other Meds: Progesterone birth control

Current Illness: None

ID: 1026357
Sex: F
Age: 65
State: NY

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

Lab Data:

Allergies: erythromycin, nsaids, penicillin-Nausea vomiting, diarrhea No allergic reactions Persantine IV solution-hives, rash Pilocarpine HCLtablets- nausea, vomiting Flue vaccine-Bells palsey

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

Symptoms: On 2/10/21 started with itching On 2/11/21 itching, burning sensation of skin on entire body Red pin start onpointtype rash on right and left buttocks, hips extending up to breasts rash flat not raised Called primary doctor To take Benadryl 25Mg three times a day until rash gone. On 2/12/21 rah turned into red raised rash to right and left hips groin abdomen breasts extending down legs and up to and around neck itching and burning sensation continues rash much worse No difficulty breathing Went to doctor Rash on back and arms looks like a sunburn to start Hydroxyzine three times a day

Other Meds: Amlodipine, Eliquis, Flecanide, Wellbutrin XL, Doxazosin Mesylate, Lovastatin, Metaprolol, Levothyroxin, Lansoprazole

Current Illness: None

ID: 1026358
Sex: F
Age: 34
State: CO

Vax Date: 12/30/2020
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: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: I started experiencing allergic reaction to all of my facial/body topical products on 2/3/21. I break out in hives/swelling/ redness/ itching at site and some times burning and swelling/hives around my eyes and throat. I have been just taking Benadryl, which does take away the symptoms within a couple hours.

Other Meds: None

Current Illness: None

ID: 1026359
Sex: M
Age: 50
State: NH

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

Lab Data:

Allergies:

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

Symptoms: Patient was supposed to get second dose of Pfizer but was accidentally given a Moderna dose. He did not develop any symptoms while on site and hasn't at time of this report.

Other Meds:

Current Illness:

ID: 1026360
Sex: F
Age: 58
State: NC

Vax Date: 02/04/2021
Onset Date: 02/05/2021
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: Amoxicillan

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

Symptoms: Red/Raised/Itching at injection sight starting the day after the injection for 3 days. Then went away like nothing happened. Red area the size of small egg. February 12 the red area is back same size, slighty raised.

Other Meds: Zoloft, Reuvastation, Motrin

Current Illness: N/A

ID: 1026361
Sex: M
Age: 74
State: GA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: Patient in clinic for second dose Pfizer Covid 19 vaccination. Patient received Moderna vaccination instead.

Other Meds:

Current Illness:

Date Died: 02/06/2021

ID: 1026362
Sex: M
Age: 32
State: PA

Vax Date: 01/01/2021
Onset Date: 02/04/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Patient stated he had a migraine after the vaccine. We were advised of a change in appetite on Thursday February 4th. Patient died on February 6th.

Other Meds:

Current Illness:

ID: 1026363
Sex: M
Age: 53
State: AZ

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: Sudden onset of severe tinnitus and some hearing loss.

Other Meds: Zyrtec

Current Illness: None

ID: 1026364
Sex: F
Age: 42
State: ME

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Multiple joint pain, light-headed and nausea

Other Meds:

Current Illness:

ID: 1026365
Sex: M
Age: 97
State: RI

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe left upper extremity edema and erythema (extended from the shoulder to arm and hand) with small bullae and weeping on forearm. Progressive acute onset over the course of a week. Started on oral clindamycin, however superimposed cellulitis was NOT suspected but oral antibiotics are low risk. Limited to left arm, showed no signs of systemic illness (afebrile). Had no signs of neurovascular compromise, was able to move hand, sensation intact and notable pulse.

Other Meds: Terazosin 2mg Prednisone (alternate 2.5mg and 5mg) Fosinopril 40mg

Current Illness: No known illnesses prior.

ID: 1026366
Sex: F
Age: 71
State: IN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Yes

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

Symptoms: Shortness of breath, headache, fatigue

Other Meds: Yes

Current Illness: Lupus

ID: 1026367
Sex: M
Age: 77
State: NC

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

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

Symptoms: MODERNA COVID-19 VACCINE EUA CHILLS, WEAKNESS, DIZZINESS, MUSCLE PAIN IN LOVER LEGS

Other Meds: MIDODRINE, TAMSULOSIN, ROSUVASTATIN

Current Illness:

ID: 1026368
Sex: F
Age: 38
State: OH

Vax Date: 01/29/2021
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: none known

Symptom List: Unevaluable event

Symptoms: I received the Moderna COVID 19 vaccine on January 29, 2021. On the night of February 7, 2021, I noticed a redness on the upper left arm, where I received the injection. At first, it extended 5 inches by 10 inches. As of today (February 12, 2021), it is about 6 inches by about 10 inches. Sometimes, it felt warm to the touch and itched a little. It seemed redder before I took my evening shower than at other times of day. It was never painful to the touch. I contacted my primary care physician, on Tuesday February 9 2021, and had a visual virtual examination. Dr. recommended that I apply an ice pack to the affected area 3 times a day for 5 minutes at t time and also that I take Tylenol 3 times a day. This morning (February 12, 2021), I went in to the doctor?s office for a follow-up, where the nurse prescribed IC Cephaleixin capsules (500 mg), to be taken 4 times a day. For now, we are continuing to monitor the condition of my arm.

Other Meds: levothyroxine losartan multivitamin tablet sprintec

Current Illness: none

ID: 1026369
Sex: F
Age: 58
State: AL

Vax Date: 02/10/2021
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: ?

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

Symptoms: PATIENT STATES SCRATCHY AND ITCHY THROAT BUT NO THROAT SWELLING OR TROUBLE BREATHING. PATIENT OBSERVED FOR 15 ADDITIONAL MIN. PATIENT STATES FEELS FINE AFTER DRINKING WATER AND WA INSTRUCTED TO FOLLOW-UP WITH DR OR EMERGENCY DEPARTMENT IF HAD ANY FURTHER NEEDS AFTER DEPARTURE FROM VACCINE CLINIC.

Other Meds: ?

Current Illness: ?

ID: 1026370
Sex: F
Age: 66
State: LA

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Rigors, fever, diarrhea, symptoms have not abated currently. Pt called to report symptoms but did not come in or go to outside facility

Other Meds:

Current Illness:

ID: 1026371
Sex: M
Age: 57
State: FL

Vax Date: 02/03/2021
Onset Date: 02/06/2021
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:

Symptom List: Injection site pain, Menorrhagia

Symptoms: itching and maculopapular rash on chest

Other Meds:

Current Illness:

ID: 1026372
Sex: F
Age: 65
State: IN

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

Lab Data:

Allergies: None

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

Symptoms: I developed 3 cold sores on my upper lip. I have had them before many years ago but thought this vaccine might have triggered something and you might want to be aware. Back when I first starting getting cold sores, I got very sick. The doctor at the time told me I had herpes simplex 1. It's not something I'm worried about. I'm treating it with abrevia and it is responding very well. No other ill affects were noted other than a sore arm.

Other Meds: Adderall, atorvastatin, calcium carbonate, cholestyramine, clonidine, levothyroxine, paxil.

Current Illness: None

ID: 1026373
Sex: F
Age: 32
State:

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Feeling faint, reported vasovagal

Other Meds:

Current Illness:

ID: 1026374
Sex: F
Age: 65
State: OH

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Syncopal episode, unresponsive. Able to arouse but slow, garbled speech. Transferred from chair to cot. BP 128/68, HR 95. Lethargic, oriented x3/3. Called EMS. Blood glucose 49, glucagon, juice and crackers given. Refused transfer to ED. Boxed lunch provided. Emergency contact called. Refused ride home. Observed for total of 1hr15minutes. Awake, A&O x3/3, steady gait when sent home.

Other Meds: Albuterol

Current Illness: COVID-19 one month prior

ID: 1026375
Sex: F
Age: 61
State: PA

Vax Date: 01/15/2021
Onset Date: 02/16/2021
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: Latex, and Compazine

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

Symptoms: Severely painful joints and muscles, mental fog, headache, nausea, chills, fatigue.

Other Meds: Metoprolol 50mg , qhs, Valsartan Hctz 160/12.5mg qd, Vit D 1000 mg qd, turmeric, Osteobiflex (MSM, Chondroitin sulfate)

Current Illness: none

ID: 1026376
Sex: F
Age: 75
State:

Vax Date: 02/02/2021
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:

Symptom List: Nausea

Symptoms: 6 Days after the vaccine she has a red spot about 2 inches in diameter and its hot and itchy.

Other Meds:

Current Illness:

ID: 1026377
Sex: F
Age: 69
State: PR

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: LA

Lab Data:

Allergies: unknown

Symptom List: Injection site pain

Symptoms: dizziness, cephalea, elevated blood pressure

Other Meds: unknown

Current Illness: unknown

ID: 1026378
Sex: F
Age: 24
State: NE

Vax Date: 02/03/2021
Onset Date: 02/06/2021
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: None

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

Symptoms: Moderna COVID-19 Vaccine Injection site has become an itchy, red rash that has spread in a weird pattern across my upper arm Lymph nodes in that same arm are in quite a bit of pain to the touch and during movement The most sensitive area to the touch is also the most red Joint pain (knees)

Other Meds: Aurovela Niacin

Current Illness: None

Date Died: 02/09/2021

ID: 1026379
Sex: M
Age: 58
State: OH

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

Lab Data:

Allergies:

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

Symptoms: patient 6 hours post vaccination

Other Meds: OXYMETAZOLINE HCL 0.05% NASAL SPRAY DISCONTINUED 30 02/09/2021 02/09/2021 02/09/2021 1 USE 1 SPRAY NASAL TWICE A DAY MAX OF 3 DAYS OF USE** DOCUSATE NA 50MG/SENNOSIDES 8.6MG TAB DISCONTINUED 60 02/09/2021 01/20/2021 01/21/2021

Current Illness: HTN-Iron def-h/o PE-chronic renal failure

ID: 1026381
Sex: M
Age: 69
State: NY

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

Lab Data:

Allergies: NKDA

Symptom List: Tremor

Symptoms: Pt became faint 10 minutes or so after dosing of cv19 vaccine. Per EMS pt passed out for about 1 minute. Pt came to stated he felt ok. Decreased blood pressure 80/40. pt states he had not eaten anything since 0700 blood sugar 125, pt loaded on to stretcher and transported via EMS to local hospital St. Lukes for fluids and monitoring.

Other Meds: Omeprazole Mag citrate Vit D 3 Preservision

Current Illness: Stage 0 leukemia diagnosed 1 year ago

ID: 1026382
Sex: F
Age: 26
State: CA

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

Lab Data:

Allergies: IBUPROFEN AND BENADRYL

Symptom List: Erythema, Pruritus

Symptoms: PATIENT COMPLAINED OF REDNESS AND SWELLING TO LEFT ARM THAT IS MOVING UP ARM TO SHOULDER, BROKE OUT IN RASH WITH SLIGHT SHORTNESS OF BREATH.

Other Meds: PATIENT TOOK NYQUIL

Current Illness: NONE

ID: 1026384
Sex: M
Age: 17
State: CA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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 came in at end of clinic hours. his appointment was for pfizer vaccine. decision was made to switch last few patients to moderna in order to not waste any doses. he ended up getting moderna though he is under 18 years old and not authorized for that age.

Other Meds:

Current Illness:

ID: 1026385
Sex: M
Age: 77
State: IN

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

Lab Data:

Allergies: NKA

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

Symptoms: At the time of injection, injection site immediately began to swell to approximately 2 cm diameter, No stridor, wheezing, or other sx. Blood Pressure 115/85, HR 60, SaO2 99%, Temp 97.7 F po. No progression of edema or any symptoms. Evalluated by rapid response team, patient opted to not go to the ER. Released after observation.

Other Meds: Eliquis

Current Illness: None

ID: 1026386
Sex: M
Age: 81
State: CA

Vax Date: 02/01/2021
Onset Date: 02/10/2021
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: Morphine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Moderna COVID-19Vaccine Injection site became hard, red, swollen and itchy 9 days after vaccination. Same symptoms, though milder, persisted through 2/11 i.e. 10 days after vaccination. I am completing this form on behalf of my husband, who has vision problems. We got our vaccination at the same time and place. I had exactly the same symptoms at the same time, i.e. 9 and 10 days after vaccination. (I don't plan to fill out a second report for myself - sorry!)

Other Meds: Metformin, Januvia, Leviteracetam, Famotidine, Lisinopril. Vitamin D, Glucosamine-Chondroitin, baby aspirin

Current Illness:

ID: 1026387
Sex: F
Age: 34
State: WA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
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: latex, gluten

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

Symptoms: 12/30 vaccination 12/31 felt incredibly run down, fatigue. I also had extreme SOB. I couldn't get enough air. Monday/Tuesday - clinic for SOB. Wheezing, crackling sound. Prescribed inhaler which administered ever 2 hours for 8 days. Prescribed Fluticasone propionate.

Other Meds: Thyroid meds, sertraline, prenatal

Current Illness: n/a

ID: 1026388
Sex: F
Age: 73
State: GA

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: PENICILLIN

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

Symptoms: MODERNA COVID-19 VACCINE EUA Patient received Covid-19 vaccine on 02/01/2021 and had soreness that afternoon and the next day, she applied cold compress to arm and soreness was relieved. Patient started having swelling in the arm and on 02/03 and is still swollen today 02/12. Swelling is about 3 inches vertically and 2 inches horizontally on left arm. It has a knot on palpation. Still has redness at injection site that is about 2 inches in diameter. Patient is not having any pain.

Other Meds: MULTIVITAMIN, ZINC, VIT D, VIT C, AMLODOPINE (AS NEEDED)

Current Illness:

ID: 1026389
Sex: F
Age: 38
State: WA

Vax Date: 02/02/2021
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: None

Symptom List: Pain in extremity

Symptoms: Itchy, burning, rash covering hands and feet. Swollen finger joints.

Other Meds: Adderall

Current Illness: None

ID: 1026390
Sex: F
Age: 77
State: NC

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

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

Symptoms: MODERNA COVID-19 VACCINE MUSCLE PAIN IN RIGHT LEG

Other Meds:

Current Illness:

ID: 1026391
Sex: F
Age: 81
State: MI

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

Lab Data:

Allergies: PENICILLIN

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

Symptoms: PATIENT CHOSE TO WAIT 30 MINUTES AFTER VACCINE FOR OBSERVATION. AT 25 MINUTES SHE BEGAN EXPERIENCE A HEADACHE. PATIENT STATES SHE NEVER GETS HEADACHE. SO THE EMS UNIT AT OUR LOCATION WAS REQUESTED. HEADACHE WAS RANKED A #2 FROM 1-10 PAIN SCALE. PATIENT STATED HER HEADACHE MAY HAVE BEEN AUSE BY THE FUMES FROM THE PROPANE HEATERS IN THE GARAGE, PATIENT RECOVERED AND WAS RELEASED

Other Meds: PREDNISONE, AMLODIPINE, ADEMPAS, METOPROLOL SUCC, LOSARTAN

Current Illness:

ID: 1026393
Sex: F
Age: 73
State: AZ

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

Lab Data:

Allergies: Doxycycline Hyclate to desert plants

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

Symptoms: Severe pain in the R arm vaccinated fainting almost 3 hours after receiving vaccine

Other Meds: calcium , magnezium, zink, d.3 multiple vitamin

Current Illness: L eye infection

ID: 1026395
Sex: F
Age: 65
State: FL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
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: None

Symptom List: Vomiting

Symptoms: Flu like side effects for 3 days, including fever. A week later, large, hot and itchy rash at injection site

Other Meds: Losartan, Metrpolol, Buspirone

Current Illness:

Date Died: 01/23/2021

ID: 1026396
Sex: F
Age: 90
State: MO

Vax Date: 01/14/2021
Onset Date: 01/15/2021
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: Unknown

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient experienced loss of taste and lack of appetite. Passed away on 1/23/21.

Other Meds: Unknown

Current Illness: Unknown

ID: 1026397
Sex: F
Age: 39
State: NY

Vax Date: 01/15/2021
Onset Date: 01/20/2021
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: NA

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

Symptoms: A red circular rash on and around the injection site and extreme itchiness at injection site. This started a few days after the vaccine was administered and lasted about 9-10 days.

Other Meds: Plaquenil, Vitamin D, Prenatal Vitamins, Collagen Supplements

Current Illness: NA

ID: 1026398
Sex: F
Age: 39
State: MI

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Chicken, turkey, barley, olives, coffee, cats, dogs, ragweed, Nubain

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Vaccine given at approximately 1300. At 1330 pt reported itchiness at injection site, 1335 itchy hair going down back, arm rash and chest tightness. 1338 Epi given in left thigh. 1345 Relief of chest tightness verbalized. O2 saturations: 95% and and pulse 85. Recommended pt. to go to ED via ambulance. Pt declined due to large copay for ambulance ride. RN, called report ED who later stated pt. arrived.

Other Meds: Zoloft, Zyrtec

Current Illness: None

ID: 1026399
Sex: F
Age: 27
State: IL

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

Lab Data:

Allergies: Penicillin, clindamycin, levoquin, amoxicillin

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

Symptoms: Second day having flu like symptoms. Body aches and pains. Sore at the injection site. Headache.

Other Meds: None

Current Illness: None

ID: 1026400
Sex: F
Age: 55
State: LA

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

Lab Data:

Allergies:

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

Symptoms: Approximatively 6-8 hours after receiving 2nd dose, patient began to experience low grade temp, general malaise, severe myalgia, and chills, and restlessness. This lasted over night. The next day patient returned to baseline.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm