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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1028426
Sex: F
Age: 65
State: MO

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chest tightness, hot & cold, fast pulse, itchy red rash on both arms Benadryl 2 capsnone

Other Meds: Fetzema, Cymbalta, MVI

Current Illness: None

ID: 1028427
Sex: M
Age: 43
State: WA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Anxiety, Dyspnoea

Symptoms: fatigue (24 hours) muscle weakness (1 day) headache intermittent (2 days) sore arm (3 days) muscle aches - lower back right scapula

Other Meds: none

Current Illness: none

ID: 1028428
Sex: F
Age: 50
State: AK

Vax Date: 02/05/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
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: azithromycin, dogs, cats, feathers, dust

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

Symptoms: At Day 8, the injection site suddenly developed an itchy bump 1/2 inch across and a rash surrounding the bump 3 inches across. It is quite itchy. It was a sudden onset on Day 8, without any precursor except a slight itchiness on Day 2 that resolved by Day 3.

Other Meds: none

Current Illness: none

ID: 1028429
Sex: F
Age: 49
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies/hay fever

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Head to toe tingling, lightheaded, chest tightening, throat constriction, flush.

Other Meds: daily multivitamin, daily D3 vitamin, daily bee pollen (1/2t)

Current Illness: eczema located on neck, art

ID: 1028430
Sex: F
Age: 36
State: NY

Vax Date: 02/02/2021
Onset Date: 02/06/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: cephalosporins, sulfas, iodine, shellfish

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

Symptoms: left side facial numbness/pressure from temple/along cheekbone/ down side of face and jaw to neck, pain in the ear, swelling of lymph node, pain/burning sensation in the neck/shoulder, flushing and warmth to left side of face. all symptoms localized to the same side of injection. All symptoms developed a few days after the second dose and have remained steadily for one week unchanged

Other Meds: none

Current Illness: none

ID: 1028431
Sex: F
Age: 43
State: WI

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/13/2021
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: I have extreme diarrhea and vomiting. I had episodes in the double digits and the diarrhea persisted for 24 hours. I was not able to think clearly or function normally until 5 days after the shot

Other Meds: Daily vitamin, melatonin, calcium supplements

Current Illness: None

ID: 1028432
Sex: F
Age: 61
State: CA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: Pineapple

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After 15min wait patient had glassy eyes and shaky left hand ,increased heart rate ND low glucose. After being observed 30 min more patient was alright to drive. A follow up phone call was made patient was doing fine some pain at injection site.

Other Meds: Clonazepam

Current Illness:

ID: 1028433
Sex: F
Age: 54
State: CA

Vax Date: 01/25/2021
Onset Date: 01/30/2021
Rec V Date: 02/13/2021
Hospital: Y

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: Cellulitic Sweet's syndrome of lower extremity. Significant LLE erythema and pain out of proportion to exam that has continued to progress despite broad-spectrum antibiotics, now s/p OR cut down x3 with no e/o necrotizing fasciitis. Initially most c/f infection/cellulitis, however in discussion with ID, rheum, and derm and given progression of rash in s/o broad spectrum Abx and negative tissue cultures, now most suspicious for cellulitic variant of Sweet's syndrome (SS). Pathology report w/neutrohpliic inflammation w/evidence of ischemia, w/o evidence of infection, c/w Sweets Syndrome. While this is a rare disorder, it primarily occurs in the setting of recent infection or malignancy. Currently working up potentially triggers. Infectious work up thus far negative. Hematologic malignancy most often linked with SS, given new and worsening pancytopenia, will consult heme for recommendations for additional work up. Other potential triggers include vaccinations (question about COVID vaccine recently) and often idiopathic. Maintain of treatment for SS is steroids, dermatology currently managing dosing.

Other Meds: acamprosate, albuterol, buspar, combivent, descovy, duelra, iron, lasix, gabapentin, ibuprofen, levalbuterol, lithium, ativan, provera, methadone, mirtazapine, protonix, seroquel, senna, thiamine, dolutegravir, lactulose

Current Illness: unknown

ID: 1028434
Sex: F
Age: 66
State: IL

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Lactose Intolerant; Amoxicillin; Sulfa; Tobramyacin eye drops;

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: soreness at site; chills; fever; tiredness; headache; diarrhea; loss of appetite

Other Meds: Pantoprazole-40MG; Calcium 600mcg Plus Vitamin D3 20 mcg; Multivitamin Adults 50+;Ceylon Cinnamon 1,200 mg; Iron 65 mg; Aspirin 81 mg; Metoprolol Tartrate Tab 25 Mg; Oxybutynin Cl Er Tab 10Mg; Lactase Enzyme/Dietary Supplement 1 chewable ta

Current Illness: N/A

ID: 1028435
Sex: F
Age: 35
State: WA

Vax Date: 02/01/2021
Onset Date: 02/08/2021
Rec V Date: 02/13/2021
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: Zithromax Garlic Red-40 Lavender Clams (sensitivity) Gluten (sensitivity) Sodium (sensitivity)

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Covid arm - itchy red rash developed on day 8 following vaccination. Swollen around the injection site. Still slightly itchy and red 5 days after showing up.

Other Meds: None

Current Illness: Migraines

ID: 1028436
Sex: F
Age: 72
State: CA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: None stated.

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

Symptoms: Complaint of itching at injection site.

Other Meds: Plaquenil, Temazepam, Venaflexa, Losartan, Lorazepam

Current Illness: None stated.

ID: 1028437
Sex: F
Age: 73
State: CA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/13/2021
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 next morning I woke up with severe dizziness and nausea.

Other Meds: None

Current Illness: Neck injury with headache and slight dizziness

ID: 1028438
Sex: F
Age: 67
State: IN

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: mercury

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

Symptoms: fever, Chills, muscle aches, sick at my stomach, could not eat for 2 days, headaches, runny stools all of these have lasted 3 days

Other Meds: citalopram and pantoprazole

Current Illness: none

ID: 1028439
Sex: F
Age: 82
State:

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
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: sulfur cyclosporine

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

Symptoms: Extremely painful sore throat. Gargled with peroxide and water. Slowly getting better today 2-13. Fatigue

Other Meds: Acyclovir Methenamine Hipp Metoporol hydrochlorothiazide aspirin align biotin d3 c1000 zinc 10

Current Illness: high blood pressure iron deficiency anemia

ID: 1028440
Sex: M
Age: 82
State: IN

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: General nausea, tiredness, discomfort

Other Meds: atorvastatin, ramipril, latanoprost, fish oil, multi-vitamins

Current Illness: None

ID: 1028441
Sex: M
Age: 82
State: ME

Vax Date: 02/02/2021
Onset Date: 02/09/2021
Rec V Date: 02/13/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Vaccinated on Feb 2, slight pain in the side of injection for two days, Then on Feb 9 (5 days after injection) strong gradually increasing pain in R leg at hip and knee (medial side) - these parts were painful previously but not as strong pain as it is now. Using ibuprofen 200mg two tablets (400mg) twice a day with 80 % relief, strong pain during walk, but still worse during the night - difficult to find right position to reduce pain.

Other Meds: metoprolol tar (Milan Co) beta blocker 25 mg twice a day

Current Illness: hypertension

ID: 1028442
Sex: F
Age: 24
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: Bees.

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

Symptoms: Fatigue for about 6 hours.

Other Meds: None.

Current Illness: None.

ID: 1028443
Sex: M
Age: 26
State: CA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Received the first dose 12:30pm Thursday(2/11). Around 6pm that same night I notice the first symptom. I had a super strong headache that lasted the next 24 hours or so. Still lingering now but not as bad. Around 3am Friday (2/12) I woke up with chills and the inject spot was extremely tender. All day Friday I had signs of a fever. Chills and felt cold but body was hot to the touch. This lasted all day and it kept Me in bed the whole day. Around 6pm Friday night, my injection spot was extremely sore , and there was a red circle, about the size of a gold ball around the spot. That?s also when I noticed I had shortness of breath and was having a little difficulty breathing. Around 8pm I noticed I had really high anxiety that was abnormal. It went away in about 30 mins or so. I thought it was strange as I normally don?t have anxiety that bad. I went to sleep around 10pm and woke up at 5am itchy with a red rash/hives on the upper half of my body, mostly the neck and chest area. Also the red circle around the injection site grew to the size of a baseball. The headache is still there but not as bad . Maybe 2/10 Severeness. I feel better in terms of the fever and breathing today (2/13). However the rash/hives has gotten worse and seems to be spreading slowly. I plan on taking Benadryl when I grab it from the store in 30 mins or so

Other Meds: None

Current Illness: None

ID: 1028444
Sex: F
Age: 76
State: CA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/13/2021
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: Slight headache began about 6 hrs after shot. Extreme tiredness and light headedness hit the morning of the next day. Complete loss of energy...and I am a VERY energetic person. Tiredness and light headedness has continued from 2/4 thru 2/13 with no let up. 11 hrs of sleeping at night after being on couch all day. NO loss of appetite, taste, smell, fever, or aches. Headache lasted only a few days.

Other Meds: L-thyroxine, LosartanPotassium, Sertraline HCL, Triamterene-HCTZ, Vit D3, Probiotic 10

Current Illness: none

ID: 1028445
Sex: F
Age: 60
State: FL

Vax Date: 02/05/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: 3" round itchy rash on arm injected 8 days after receiving vaccine. Pain in arm at site of injection. Lasted 2 days.

Other Meds: Multi vitamin, D3, Propranolol 10mg

Current Illness: none

ID: 1028446
Sex: F
Age: 63
State: PA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: IVP dye, Tamiflu, Celebrex

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

Symptoms: Fever up to 100.8, for 24 hrs, 99.2-5 for 24 hrs, headache, body aches, fatigue, minimal arm soreness, rosacea like spots on right arm

Other Meds: Vitamin D, Vitamin B12, preservision, estrogen

Current Illness: None

ID: 1028447
Sex: F
Age: 68
State: IN

Vax Date: 02/05/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: Swelling and redness at injection site, beginning one week after injection and lasting for several days. Still ongoing

Other Meds: Prilosec and Lexapro

Current Illness:

ID: 1028448
Sex: F
Age: 80
State:

Vax Date: 02/01/2021
Onset Date: 02/08/2021
Rec V Date: 02/13/2021
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: Penecillan, comcastdye

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

Symptoms: shooting pain's in back at waist like someone is putting knife in back. Was sore in back next 2 days. Not sure how long it lasted was there for over 45 min.

Other Meds: Xarelton 20mg, Furasemide 25mg, Spironalactone 25mg, Diltiazem 40mg, Xopenex 2 puffs per exercise, Xopanex 20mg 1day, astapro 20 mg 2 day, nasanex 50 mg, symbicort 160mg cetrum silver , vir c,

Current Illness: none

ID: 1028449
Sex: F
Age: 67
State: CO

Vax Date: 02/06/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: some sulfa based antibiotics photo dermatitis Allergies to tree pollen, wild grass pollen on seasonal basis Some shellfish sensitivity which varies and has not been severe some vinegar reaction occasional alcohol flushing as reaction to certain Beer or other beverages

Symptom List: Injection site pain, Pain

Symptoms: Moderna Arm: classic symptoms as documented online.

Other Meds: 0 Prescriptions Multivitamins Vitamin D supplement Turmeric supplement-occasionally

Current Illness: none

ID: 1028451
Sex: F
Age: 47
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: Chills, fever over 100, body aches, fatigue

Other Meds: Armour Thyroid, adderall

Current Illness: None

ID: 1028452
Sex: F
Age: 88
State: IA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/13/2021
Hospital: Y

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

Lab Data:

Allergies: Quinidine

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

Symptoms: The patient suffered embolic strokes and was admitted to the hospital the day after she received her first COVID-19 vaccination. She has a history of strokes, with atrial fibrillation, but was faithfully taking her Eliquis at the time she suffered these recurrent strokes.

Other Meds: amiodarone (PACERONE) 200 MG tablet Take 0.5 tablets by mouth daily. apixaban (ELIQUIS) 2.5 MG TABS tablet Take 1 tablet by mouth 2 (two) times daily. atorvastatin (LIPITOR) 40 MG tablet TAKE 1 TABLET BY MOUTH AT BEDTIME lisinopril (PRINI

Current Illness: none

ID: 1028453
Sex: M
Age: 95
State: CA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/13/2021
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: Patient was first given the first dose of Pfizer at the Hospital. He was told to go to Hospital on Feb 3, 2021 for the second dose. He told them he needed the same medicine for the second dose. He was told it didn't matter. They gave him the maderna vaccine. We called Hospital, and they didn't say much. This is written by his daughter . I was not with my dad, dont know lot number, etc.

Other Meds:

Current Illness:

ID: 1028454
Sex: F
Age: 45
State: OH

Vax Date: 01/25/2021
Onset Date: 02/06/2021
Rec V Date: 02/13/2021
Hospital: Y

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: 10 days after second dose awoke at 11:30 at night with nausea then after a few minutes began to itch and break out into hives then proceeded to get chest pressure and unable to breath until I passed out. Husband able to revive me 3 times until 911 came then went to urgent care Nausea with vomiting and chest pain, back pain, heart burn, and urinal incontinence. Sent to MC for NSTEMI work up of echo and cardiac stress test. Cardiologist said NSTEMI from low oxygen and hypotension.

Other Meds: Phentermine 37.5 mg take 1/2 pill daily

Current Illness: None

ID: 1028455
Sex: F
Age: 78
State: CA

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 02/13/2021
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 known

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

Symptoms: ~1 wk after injection big red itchy rash appear on injection arm below injection site. Thought maybe a bite UNTIL a same thing happened to a friend. Physician friend asked if I used anything like Miralax. I do. POSSIBLY MORE IMPORTANT, however, is that I had a colonoscopy 2 days before injection with Miralax prep - 14 doses in a 12 hourr period.

Other Meds: yes

Current Illness: none

ID: 1028456
Sex: F
Age: 24
State: NY

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
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, cats, grass

Symptom List: Nausea

Symptoms: Sore throat, 2pm Fatigue, 6pm

Other Meds: Levothyroxine 75mg, Methylphenidate 18mg, Claritin-D

Current Illness:

ID: 1028457
Sex: F
Age: 17
State: WA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
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: Injection site pain

Symptoms: Patient received 2nd Moderna (Covid-19) dose under the age of 18. No adverse reactions/allergies were reported from the first dose.

Other Meds:

Current Illness:

ID: 1028458
Sex: F
Age: 56
State: AK

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Morphine Birch related raw fruits and vegetables, most all pitted fruits, raw carrots, celery Sulfa Percocet Codeine Vicodin

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

Symptoms: In less than a minute - the time it took me to got sit across the room (15sec?) I felt a funny "knot" in my stomach. Then I felt warm and then I felt palpitations. I have an Apple Watch so I quickly got my pulse/heart rhythm. My heart rate is usually in the upper 60's. While feeling palpitations my heart rate went up to upper 80's. It subsided within a minute. I did not have a reaction to the first dose of Moderna Vaccine. I took 20mg of Ceterizine prior mo my 1st dose because I was afraid of a reaction in a grocery store!

Other Meds: None this time. I took 20mg Zyrtec for the first vaccine on Jan 3rd

Current Illness: History of migraines

ID: 1028459
Sex: F
Age: 65
State: CA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: Statins, Lobster, some wines, tramadol

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

Symptoms: Muscle aches, prickly lower lip and tongue, swollen and small amount of blistering to the lower lip, redness and slight swelling to the tip of my tongue. Took Tylenol 1000 mg, Liquid Benadryl 50mg. Improved symptoms and was able to sleep but currently the prickly sensation to lips and tongue are returning. Therefore, I took another does of Tylenol 1000 mgs and Liquid Benadryl 50mgs by mouth.

Other Meds: Losartan, Amlodipine, Pepcid, aspirin 81, Turmeric, MVI, vitamin C, zinc

Current Illness: Presumptive COVID-19 positive in December 2020

ID: 1028460
Sex: F
Age: 78
State: FL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/13/2021
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: Flatly, Prozac, Levofloxacin, Asmonex inhaler powder, Amlodipine5 mg. Mfg Lupin

Symptom List: Tremor

Symptoms: Hour after vaccine shot started with Slightly swollen lips & numbness in the lips red color of cheeks. . Took Benadryl and 16 ounces of water around 1hour 15 minutes after shot Two hours after shot experience slight sore throat lightheadedness head cold symptoms Symptoms lasted another six hours took a second then a drill. Rank another three bottles of water Symptoms became lighter with a little bit of a headache After 20 hours everything went away except tiredness and light headaches

Other Meds: Symbicort 80/4.5. 2 buffs in am

Current Illness: Rheumatoid arthritis , knee osteoarthritis, Epstein, Hashimotos+AT 6 thyroid

ID: 1028461
Sex: M
Age: 66
State: IN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/13/2021
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: Bad headache, sore arm, and woke up in a sweat after going to bed.

Other Meds: Atorvastatin, Bayer Aspirin 81mg, Vitamin E, Vitamin D, Vitamin B12, Magnesium, Centrum Silver.

Current Illness: Dizziness, poor balance

ID: 1028462
Sex: M
Age: 75
State: IN

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: Began evening of 02/11/2021 with injection site soreness, severe body ache, headache, severe body chills, slight fever and night sweats. Finally subsided by evening of 02/13/2021.

Other Meds:

Current Illness:

ID: 1028463
Sex: F
Age: 36
State: OK

Vax Date: 01/23/2021
Onset Date: 01/26/2021
Rec V Date: 02/13/2021
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: N/A

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

Symptoms: My face slowly started to swell and then on Tuesday afternoon it was extreme and very uncomfortable and scary because the sides of my face and Tongue was very swollen. Which made me panic and made it worse. I have the feeling in my cheeks like you were about to eat a lemon or lime were thinking about eating it the little tingling feeling but it was that times like 10. Went to the ER in And they gave me antibiotics and told me to eat a bunch of lemons or lemon drops and drink water. At first I didn?t even think it would be a reaction because it was three days later but the emergency doctor believes it was from the shot.

Other Meds: Lemons, lemon drops and antibiotics

Current Illness: N/A

ID: 1028464
Sex: F
Age: 68
State: SC

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/13/2021
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: PCN

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Most of the vaccine ran down my arm. My are felt the cold liquid before the needle was anywhere close to being injected. The administrator wasn't sure if it was a faulty syringe or his error, but acknowledged that my shirt sleeve was very wet. He had no idea how much vaccine actually was administed but stated he could not attempt a second injection.. I contacted my physician, SCDHEC, the CDC and was sent in circles. Noone knew how to handle this error. I travel internationally and am VERY concerned that I do NOT have adequete protection without this second dose and have requested that someone address this; but no one has and all claim that they have no guideance in this particular situation.

Other Meds: None

Current Illness: None

ID: 1028465
Sex: F
Age: 77
State: TX

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: c/o dizziness Patient disoriented to name and year for about 3min when medical and EMS arrived. Mental status back to normal after 3min. Reports anxiety, denies chest pain, SOB, palpitation, dizziness, headache. BP: 117/65 ( sitting), 147/71 ( standing) HR: 94 Sp02: 98% No acute distress, seen and cleared by EMS

Other Meds: lisinopril, hctz, prednisone, methotrexate, folic acid

Current Illness:

ID: 1028466
Sex: F
Age: 59
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/13/2021
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: None

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

Symptoms: Lower abdominal (pelvis/bladder area) intense pain. This pain prevented me from walking upright. Had to hold an to countertops and walls and crotch down in order to move from one place to another, Could not bear weight on feet. Also intense muscle pain in legs (thighs) from knees up to lower abdomen. This started approximately 6 hours after injection. I thought I had a very bad either UTI or bladder infection. Went to Hospital Emergency Room and CTScan as well as bloodwork results showed no infection, no kidney stones and bloodwork came back ok. I had tested positive for Covid on January 15 then tested negative Feb 2

Other Meds: None

Current Illness: None

ID: 1028467
Sex: F
Age: 38
State:

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: One week after receiving the vaccine, my left arm pit was sore. I also noticed that the left side of my neck was a bit sore and I had an earache on my left side.

Other Meds: Daily multivitamin and Fyavolv

Current Illness: None

ID: 1028468
Sex: F
Age: 44
State: NY

Vax Date: 02/05/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Prednisone

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

Symptoms: One week after the first shot a Red, hard, very itchy circle developed at injection site.

Other Meds:

Current Illness:

ID: 1028469
Sex: F
Age: 73
State: CO

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: penicillan, lactose, Iodine, doxycyline

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

Symptoms: slight fever headache pain in arm by 4 am Feb 13, 2021: increased headache, aches and pains everywhere, swollen face and joints

Other Meds: Rasagiline, Rytary, Furosemide calcium, vitamin D, B12, folate, magnesium,lutein &Zeaxanthin,

Current Illness: none

ID: 1028471
Sex: F
Age: 82
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: muscle soreness, mild headache, no appetite, slept more than 18 hours during the next 24 hours. All symptoms gone by ten AM 2,13/21.

Other Meds: centrum/women 50 +, fish oil

Current Illness: osteoarthritis

ID: 1028472
Sex: F
Age: 51
State: IN

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/13/2021
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 known

Symptom List: Vomiting

Symptoms: Felt like throat swelled but not to dangerous level- lasted a couple of hours then throughly was itchy

Other Meds: Metformin bupropion losart an htz

Current Illness: None

ID: 1028473
Sex: M
Age: 83
State: CA

Vax Date: 01/25/2021
Onset Date: 02/04/2021
Rec V Date: 02/13/2021
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: Sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 2 inch diameter redness of the skin at the injection site, mild blistering. itching for next 10 days

Other Meds: Levothyroxine 125 MCG Lisinopril 10 MG Latanoprost 0.005% Acyclovir 400 MG

Current Illness: None

ID: 1028474
Sex: F
Age: 46
State:

Vax Date: 02/06/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: Round, red mark at injection site appearing about a week after vaccination. Slightly itchy and tender to push on.

Other Meds:

Current Illness:

ID: 1028475
Sex: F
Age: 70
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/13/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 2/9 - Extremely sore arm at injection site. Awoke with vertigo and dizziness which seemed to subside somewhat as day progressed. Also had low temp 99.1 on/off throughout day and sluggishness. 2/10 - Arm still sore. However awoke again with vertigo and dizziness along with very stiff neck and neck pain that got progressively worse as day progressed. Called my family doctor late morning to report and get direction on what OTC meds I could take. Doctor returned my call after hours and recommended I go to ER to get checked and rule out meningitis since that can sometimes be side effect of vaccines with similar symptoms. ER doctor said he thought since I had Covid back in March and April of 2020, I probably still had antibodies and my immune system was fighting off the vaccine, resulting in the viral symptoms I was having. He told me I could return to taking Mobic and Tylenol (that I had been taking up to 3 days prior to vaccine) and also gave me a RX for Meclizine for vertigo.

Other Meds: * Metoprolol Succ (Toprol) Er 1/2 of Tab 25 mg - 1/day * Rosuvastatin (Crestor) 40mg - 1/day * Flonase 50 mcg - 1-2 sprays/day as needed * Rogaine w/2 or 5% Minoxidil - 1-2 ml/day * Melatonin 10 mg at bedtime as needed * Biotin 10,000 mcg

Current Illness: None

Date Died: 01/28/2021

ID: 1028476
Sex: F
Age: 79
State: AR

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/13/2021
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:

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

Symptoms: She started having breathing problems/heart attack appearance. on 1/22/21 and went to the ER. Upon admittance was told it was an anaphylactic shock from the Covid shot. They kept her in ICU and released her 1/23/21. At 12:45 am on 1/24/21 she passed out and we called the ambulance. Hospital admitted her and worked through multiple organ failure issues and thought her numbers were under control. She was released on 1/27/21 and was driving on 1/28/21 around 4:15 pm and appears to have had heart failure and had a wreck. She passed away that day.

Other Meds: Don't have a list

Current Illness:

ID: 1028477
Sex: F
Age: 79
State: PA

Vax Date: 01/22/2021
Onset Date: 01/31/2021
Rec V Date: 02/13/2021
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: IVP dye, Pcn, Torodol,

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

Symptoms: Maculopapular rash, itching, tender on hands and fingers swollen, scattered rash on arms, legs, knees,top and bottom of feet. Injection site large (2 1/2 x 5 in) red swollen. Skin started peeling 2/12/21. Zyrtec 10 mg twice a day, Clobatesol cream.

Other Meds: Fkecainide, Atenolol, Eliquis, Creon, Losartan, Amlodipine, Maralax, Calcium citrate, Dexalant, Zileuton.

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm