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: 1026659
Sex: F
Age: 56
State: MN

Vax Date: 01/06/2021
Onset Date: 01/07/2021
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: sulfates, sulfites, nitrates, acetaminophen sulfa antibiotic, ibuprofen, Benadryl, Azithromycin, lavender, no artificial sweetener

Symptom List: Dysphagia, Epiglottitis

Symptoms: pt states that she started having pain in left back shoulder area and right upper thigh also left thumb was achy. She also had a 98.8 fever that went up 99.0. 36 hours after vax pt had brain fog and she did not know where she was. Pt has not contacted her PCP w/ her symptoms at this time.

Other Meds: no

Current Illness: no

ID: 1026660
Sex: U
Age: 75
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: 11:30 am vaccinated. Symptoms started 1152am ; SHE EXPERIENCED TINGLING IN HER LIPS AS SHE WAS DRIVING OUT OF THE GARAGE AFTER HER 15 MINUTE OBSERVATION WHEN SYMPTOM AROSE. OUR ONSITE EMS TEAM WAS REQUESTED. PHYSICIAN ON SITE EVALUATED PATIENT. NO SWELLING OF LIPS OR TONGUE, NO DIZZINESS REPORTED. SYMPTOMS RESOVED. PATIENT WAS RELEASED TO HOME.

Other Meds: ANASTRAZOLEM HYDRALAZINE

Current Illness:

ID: 1026661
Sex: F
Age: 72
State: IN

Vax Date: 02/09/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin, sulpha

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

Symptoms: Fever, body aches, headache, weakness and fatigue, nausea

Other Meds: None

Current Illness: mild migraine

ID: 1026662
Sex: F
Age: 23
State: MI

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received her first dose of Moderna Covid-19 vaccine in left deltoid. Approximately 5 minutes later the patient began feeling extremely dizzy, hot, and started to have severe nausea. Her blood pressure was elevated (153/110) initially and continue to remain elevated. She decided to have us call EMS to be transported to the hospital.

Other Meds:

Current Illness:

ID: 1026663
Sex: F
Age: 29
State: RI

Vax Date: 02/01/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: pt with redness to chest

Other Meds:

Current Illness:

ID: 1026664
Sex: F
Age: 34
State: MD

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: none

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

Symptoms: Patient complained of starting to feel shaky in her hands and lips. Denies any other symptoms. Benadryl 25mg given. Patient reported feeling better after 30 minutes. Mother came to pick up the patient. Advised to follow up with PCP or go to the ER if continued to have any problems. Vitals remained stable

Other Meds: albuterol inhaler prn

Current Illness: none

ID: 1026665
Sex: F
Age: 71
State: SC

Vax Date: 01/15/2021
Onset Date: 01/20/2021
Rec V Date: 02/12/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient tested positive for COVID six days after receiving her first COVID-19 vaccination. Her symptoms began one day earlier on 1/20/21. She went to the hospital on 1/23/21 but was sent home. She was later taken back to the hospital and admitted to ICU on 1/25/21.

Other Meds:

Current Illness:

ID: 1026666
Sex: F
Age: 37
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no known allergies

Symptom List: Pharyngeal swelling

Symptoms: I became light headed, then passed out, then woke up and started vomiting, vomited/dry heaved about a dozen times, then had severe chills and could not feel my feet and hands for about 2 hours. I have had vasovagal events in the past and this was exactly like them, only normally they are triggered by an event, and there was no event so I assume it was the vaccine. After sleeping it off under multiple blankets for a couple hours I seem to be recovered and just have a headache.

Other Meds: citalopram

Current Illness:

ID: 1026668
Sex: F
Age: 46
State: NY

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever, chills, headache, sweating, lower back pain, fatigue

Other Meds: Dupixent

Current Illness: None

ID: 1026669
Sex: F
Age: 83
State: NY

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: pt developed a rash at the injection site about 20 minutes after injection. The rash spread to her back, neckline, and chest. The rash subsided after 24-36 hours. She is fine after 4 days.

Other Meds:

Current Illness:

ID: 1026670
Sex: F
Age: 34
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: No allergies

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

Symptoms: I developed severe body aches, chills, fevers, right arm pain approximately 8 hours after my vaccination. This was my first dose so I did not expect such severe symptoms. I was completely unable to function the day after my vaccination. I was severely weak, dizzy, fever was 100.7, severe chills and shaking. I had COVID 10/13/21 with some cardiac complications at the time which resolved entirely in November. I was hesitant to boost my immune system after having this, but decided to get it fearing some long-covid syndrome should I get infected again. I want to document what I have also seen in the news as of this week stating I had covid and was vaccinated and had a very strong immune reaction to the 1st dose. It would help people to be more prepared for this as I was sick in bed all day and had to cancel and have other people cover my responsibilities. My arm continues to be sore, but the rest mostly resolved by Sunday evening.

Other Meds: Multivitamin, vitamin D3 4000 IU

Current Illness: None

Date Died: 01/08/2021

ID: 1026671
Sex: F
Age: 95
State: TN

Vax Date: 01/06/2021
Onset Date: 01/07/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: The vaccine was administered at the patient's residence in an assisted living facility. The morning following the vaccination staff report that she was very agitated and stated she did not feel well. They called an ambulance and she was transported to a local ER, staff report that it was not at the hospital that the patient is usually seen by when when she has issues and they were concerned that the facility did not have her medical history to treat her properly. The patient's grandson reported back to the assisted living director that the patient was diagnosed with asymptomatic pneumonia, was transferred to the ICU and passed away in the night.

Other Meds: unknown

Current Illness: none reported

ID: 1026672
Sex: F
Age: 36
State: OH

Vax Date: 02/05/2021
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: None

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

Symptoms: 7 days ago I received the Covid vaccine, no symptoms. Today, my injection site began to hurt. It is swollen about the size of a baseball. It is red, hot, and itches. Our school nurse (I am a teacher)sent us a link about Covid arm. The link suggested reporting the issue for data collection purposes.

Other Meds: None

Current Illness: None

ID: 1026673
Sex: F
Age: 76
State: OR

Vax Date: 01/26/2021
Onset Date: 02/02/2021
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: Sulfa medications and rabbits

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

Symptoms: Beginning 7 days post-injection there was itching, a hard bump and redness in a circle form, measuring approximately 3", gradually lessening until gone 10 days after noticing this.

Other Meds: Metformin,1000mg daily; Lisinopril, 10mg daily; Chlorthalidone, 12.5 mg daily; Pravastatin, 40 mg daily; Fish Oil, 500mg daily

Current Illness: None

ID: 1026674
Sex: F
Age: 54
State: NY

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: LA

Lab Data:

Allergies: Unknown

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

Symptoms: BP 206/116 S/p Vaccine. Employee taken to the ER for evaluation and treatment of hypertension

Other Meds: Unknown

Current Illness: Unknown

ID: 1026675
Sex: M
Age: 69
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: 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 RECIEVED 1ML DOSE INSTEAD OF 0.5ML DOSE

Other Meds:

Current Illness:

ID: 1026676
Sex: M
Age: 1
State: NY

Vax Date: 05/12/1998
Onset Date: 05/01/1998
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: Environmental

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

Symptoms: Patient was born healthy, but within days of being vaccinated he ran around screaming like he was in pain, banging his head and smashing things. Over the next 3 months, he became speech delayed, getting stuck on three words: mama, dada, and hi. These problems persisted and at age 5 Patient was diagnosed with Asperger's Syndrome, an autism spectrum disorder. Patient also developed gastrointestinal problems including constipation and multiple food intolerances. He is socially awkward and struggled through school, unable to get a high school diploma. He is 24 now and still has this diagnosis. We believe the MMR vaccine was the cause of this.

Other Meds:

Current Illness:

ID: 1026677
Sex: M
Age: 58
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: Vaccine administration error. The vaccine leaked out of the arm with blood after the needle was removed from the vaccination site. I need clinical guidance as to what to do next. This was my second shot. Please contact me with information ASAP.

Other Meds:

Current Illness:

ID: 1026678
Sex: F
Age: 61
State: NV

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: for 7 days had intense headaches, muscle aches, chills, nauseous, lightheaded, fevers (ranging from 100 - 104 for 5 days - 3 of those days fever was 102-104)

Other Meds:

Current Illness: no

ID: 1026679
Sex: F
Age: 51
State: OR

Vax Date: 02/07/2021
Onset Date: 02/09/2021
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:

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

Symptoms: Local arm pain close to injection site, dizziness, back pain close to elbow to the head, dirrhea, vomiting, headache, burping, bitter taste in mouth, body aches, weakness, farting, tiredness. Still experiencing adverse effects.

Other Meds: levothyroxine 88 mcg, losartan 100 mg, gestodene 0.75mg + ethinylestradiol 0.2mg

Current Illness:

ID: 1026681
Sex: F
Age: 32
State: IA

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: 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: 9 minutes after receiving 1st dose of vaccine, client states "I feel different than I did before the shot". When asked to explain, client reports headache, dizziness, chilled and face and neck were visibly flushed and warm. VS were taken. Client was 98-99% on RA with no respiratory distress. HR was elevated at 110. Denied chest pain. Blood pressure was initially 130's/80's. Client was assisted to clot to lie down and reports less dizziness at that point. HR did return to 70-80's and blood pressure to 120's/70's. Client continued to denies issues with breathing or chest pain. Due to continued weakness, headache and dizziness, client was taken to ER at Hospital for evaluation

Other Meds:

Current Illness:

ID: 1026682
Sex: M
Age: 23
State: PA

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: Unevaluable event

Symptoms: 2/10/21 at 9:30 pm, the night after I received the vaccine, I noticed a red rash on my chest/stomach. The next day I noticed that it had spread a bit to my back. As of right now, 2/12/21, it has lightened to a more pink color. It doesn't hurt, at most it itches but otherwise I don't really notice it.

Other Meds:

Current Illness:

ID: 1026683
Sex: M
Age: 48
State: TN

Vax Date: 01/30/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sudafed, various other can be obtained from my doctor

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

Symptoms: Slight cramping in left leg, followed by slight cramping in right leg,cramping got worse until both legs and shoulders were involved. Unable to get comfortable for more the a few hours at a time. Sleep became erratic. Most of the time only two to three hrs of sleep. Per night. It is ongoing still

Other Meds: Insulin, Lithium,trazadone,

Current Illness: Type 1 diabetes, bipolar

ID: 1026684
Sex: F
Age: 27
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: 101.8 fever, body aches, cold sweats, chills, pain at injection site, sore arm (arm where injection was), fatigue, headaches, joint pain, whole body in pain to the touch, starting around 9pm day of shot 2/11/2021. Continuing until today 2/12/2021 fever still at 101 unable to go to work

Other Meds: Omeprazole, adderall, digestive advantage

Current Illness: N/A

ID: 1026685
Sex: F
Age: 39
State: OR

Vax Date: 12/29/2020
Onset Date: 01/04/2021
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: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Arm pain and fatigue right away; January 4th I noticed I was bleeding - I had a miscarriage. Went to doctor the next day and they did lab tests and confirmed I had a miscarriage. Pregnancy - 3rd pregnancy; and it was my second miscarriage. I was about seven weeks pregnant.

Other Meds: Prenatal vitamins; vit d

Current Illness: no

ID: 1026686
Sex: M
Age: 71
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: My husband has been experiencing flu like symptoms since the day after his vaccine. These include body aches, chills, no taste or smell, low grade fever up until 48 hrs. ago and extreme fatigue and tiredness.

Other Meds: Amlodipine, atorvastatin, low dose aspirin, vitamin d3 2000 units

Current Illness: None

ID: 1026687
Sex: M
Age: 44
State: IA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
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: NA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fatigue set in, after 6 hours, chronic pain in the right arm/shot location that drastically affected sleeping ability, At 18 hours or so, achy, pains, headache, fatigue, loss of appetite - very flu-like symptoms, until about 3pm (24 hours after) At 32 hours or so, extreme fatigue set in Right arm pain (though less) still evident, some 48 hours after

Other Meds: Glucosomine Men's Daily Vitamin

Current Illness: NA

ID: 1026688
Sex: F
Age: 65
State: TX

Vax Date: 01/29/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I got a rash on my left arm below shot area Feb 12

Other Meds:

Current Illness:

ID: 1026689
Sex: F
Age: 31
State: CA

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: RA

Lab Data:

Allergies: None

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

Symptoms: Abdominal pain/queasiness Treated with Benadryl 50mg x 1 and Maalox observed for 30 mins Symptoms resolved, Vitals stable

Other Meds: Benadryl 50mg orally x 1 dose Maalox

Current Illness: No

ID: 1026690
Sex: M
Age: 74
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: PATIENT WAS GIVEN 1ML DOSE INSTEAD OF 0.5ML DOSE

Other Meds:

Current Illness:

ID: 1026691
Sex: F
Age: 65
State: MS

Vax Date: 02/09/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Started having diarrhea about 4:00 am on Friday, Feb 12-lasted about 4 hours. Headache,chills, nausea started about 8:00 am. Still having headache and chills. Have not gone to doctor

Other Meds: Two alleve. Took Lisinopril 20 mg that evening

Current Illness: None

ID: 1026692
Sex: F
Age: 69
State: MA

Vax Date: 02/06/2021
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: sulfa "sensitivity"

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

Symptoms: The patient developed a rash on her L lower arm 1 day following her second dose of the Pfizer covid-19 vaccine. Supportive treatment was provided. The rash was improving on 2/10/2021 when we spoke. We are following her closely. Her symptom is not yet resolved.

Other Meds: Amlodipine 5 mg QD Allegra 180 QD (start) Flexeril 10 HS, 10 PRN during the day Tramadol 50 mg 1/2-1 tab up to TID PRN MVI with D3 600 Ca 600 with D 400 Mg 300 BID glucosamine/chondroitin Probiotic C 1000 QD Echinacea Curcumin Psyllium CBD

Current Illness: Pt had a homeopathic injection on her L arm and neck on 2/5/2021

ID: 1026693
Sex: M
Age: 77
State: CO

Vax Date: 01/28/2021
Onset Date: 02/03/2021
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: 1. Sulfa based drugs; 2. Sulfites food additives

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

Symptoms: Event: "Delayed Cutaneous Hypersensitivity" or Lay Term "COVID arm". Symptoms at Injection Site: Itching, 3-inch high by 2-inch wide rash, slightly elevated surface temperature. Elevated Surface Temperature: Determined by Exergen temporal thermometer on 2/5/2021 with surface temperature readings of 99? on temple, 97.9? on upper right arm and 99.2? on upper left arm injection site. Treatment: No treatment of symptoms undertaken. Outcome: Symptoms subsided without treatment. Start of Symptoms: 2/3/2021 or 6-days after Dose 1 injection. End of Symptoms: Itching subsided on 2/6/2021 or 3-days after Start; Rash had (see Continuation Page...)Additional information for Item 18: 99% subsided on 2/12/2021 or 9-days after Start.

Other Meds: Six different items for this question on Continuation Page...Additional information for Item 9: 1. Omega 3 Fatty Acids 2,000 MG (1) capsule per day; 2. Ascorbic Acid 500 MG (1) tablet per day; 3. Multivitamin-Minerals (1) tablet per day; 4.

Current Illness: None

ID: 1026694
Sex: F
Age: 59
State: MD

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

Lab Data:

Allergies: Sulfa

Symptom List: Tremor

Symptoms: About 30 minutes after shot, I got a warm sensation. I started to break out is cold sweats, I felt extremely nauseous. Had slight tunnel vision. Lasted about 30 minutes then I was fine. Just felt very cold the rest of the evening.

Other Meds: Vitamin D Multi vitamin Vitamin B

Current Illness: None known

ID: 1026696
Sex: F
Age: 77
State: CO

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Severe chills, fever, body aches, fatigue, diarrhea

Other Meds: Amlopidine

Current Illness: None

ID: 1026697
Sex: F
Age: 50
State: SC

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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: None

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

Symptoms: New eruptions of my lupus facial rash appeared over the course of the first seven days after the injection along with 2 weeks of multiple areas of joint pain and extreme fatigue.

Other Meds: Levothyroxine Chlorthalidone

Current Illness: None

ID: 1026698
Sex: M
Age: 29
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: HE WAS COMPLAINING OF NOT FEELING WELL AND FEAR OF NEEDLES. ONSITE EMS WAS REQUESTED. HE RECOVERED AND RELEASE TO GO HOME

Other Meds:

Current Illness:

Date Died: 01/30/2021

ID: 1026699
Sex: M
Age: 95
State: OH

Vax Date: 01/20/2021
Onset Date: 01/23/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Had a stroke 3 days after round one of Covid vaccine and subsequently died the next week due to complications of stroke. Upon admission to hospital, was in afib.

Other Meds:

Current Illness:

ID: 1026700
Sex: F
Age: 37
State: GA

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient was on observation area after receiving vaccine. Patient fainted falling face first onto the floor from seated position. Patient denied history of anaphylactic reaction to any inject-able medication. EMS was called and patient left with EMS.

Other Meds:

Current Illness:

ID: 1026701
Sex: F
Age: 52
State: CA

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

Lab Data:

Allergies: Tegretol

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

Symptoms: I had the vaccine on 2/2/21 the next day a little soar around the area of the injection and by Friday 2/5/21 my left arm was still soar and redness around the injection area. A week later 2/9/21, itching, redness, swallowing and soar.

Other Meds: Emergency

Current Illness: N/A

ID: 1026702
Sex: F
Age: 38
State: CA

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: Pain in extremity

Symptoms: At around 1030 hours the patient felt: dizzy, lightheaded, nauseous, had blurry vision, tightness in her throat, and was hypotensive with a BP of 62/27 and HR of 45. At around 1035 hours the patient was given 0.3 mg of epinephrine and her BP was then 81/37 and a HR of 55. Medics arrived at 1040 hours and the patient was sent to a hospital.

Other Meds:

Current Illness:

ID: 1026703
Sex: F
Age: 41
State: MN

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: body aches, fatigue, sore throat, headache

Other Meds:

Current Illness:

ID: 1026704
Sex: M
Age: 76
State: OH

Vax Date: 01/29/2021
Onset Date: 02/09/2021
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: simvastatin, gabapentin

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

Symptoms: Pain the underneath part of left arm, pain in tendon of left ankle and rash on left side around to the middle of back which itches severely and is very tired

Other Meds: pravastatin, magesium,pioglitazone,.finasteride, lisinopril, pantoprazole, glimepiride, tamsulosin,vitamin D-3,ginko biloba, mega men, aspirin, ozempic

Current Illness: none

ID: 1026705
Sex: F
Age: 37
State: MN

Vax Date: 12/31/2020
Onset Date: 01/08/2021
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: Amoxicillin

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

Symptoms: Developed a cellulitis in left upper arm one week following the injection. Treated with oral Keflex QID X 7 days. Cellulitis resolved with some ongoing skin discoloration noted still at this time.

Other Meds: Effexor; Birth Control; Vitamin D; Multivitamin

Current Illness: None

ID: 1026706
Sex: F
Age: 42
State: IL

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Fever, chills, fatigue, nausea, diarrhea, bad pain in arm-throbbing and burning, headache

Other Meds: Women?s Vitamin Eye Promise Fish Oil

Current Illness: None

ID: 1026707
Sex: F
Age: 80
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: PATIENT GIVEN 1ML DOSE INSTEAD OF 0.5ML DOSE

Other Meds:

Current Illness:

ID: 1026708
Sex: F
Age: 39
State: WI

Vax Date: 02/03/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: BODY ACHES FATIGUE

Other Meds:

Current Illness:

ID: 1026709
Sex: F
Age: 56
State: MN

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

Lab Data:

Allergies: sulfates, sulfites, nitrates, acetaminophen sulfa antibiotic, ibuprofen, Benadryl, Azithromycin, lavender, no artificial sweetener

Symptom List: Injection site swelling, Limb discomfort

Symptoms: pt noticed after rcvg 2nd dose she had pain in her gluteus maximus and had pain in her upper left arm. These symptoms lasted 22 hours. Pt stated feeling feverish. Fever was 99.1 that rose to 99.7 by night time. On 2/5/2021 pt had trouble focusing and couldn't read like she had the flu. Pt had went to a appt to establish care w/ her new PCP and let them know she had been vaccinated but did not give her any medical advice. Pt states she is still having pain in her left thumb which started hurting after 1st covid vax.

Other Meds: no

Current Illness: no

ID: 1026710
Sex: F
Age: 25
State: MA

Vax Date: 02/05/2021
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: sulfur and amoxycillin

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

Symptoms: Redness, swelling and itching appeared at injection site on left arm a full week after initial shot

Other Meds: sprintec birth control, d-mannose, biotin, and vitamin D

Current Illness:

ID: 1026711
Sex: F
Age: 51
State: PA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
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: -Very sore arm resolved in 3 days. -Ongoing brain fog that is not improving (irritability, fatigue, depressive symptoms, difficulty concentrating/thinking, lack of energy, diffiuclty with vision). Symptoms began within 24 hours and remain over 3 weeks later with no improvement and some days are becoming worse. -Nausea and poor digestion (loose stool), lack of appetite that began within 24 hours and have not improved.

Other Meds: vitamin C, vitamin D

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm