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: 1028580
Sex: F
Age: 73
State: CT

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

Lab Data:

Allergies: daypro and protonic

Symptom List: Dysphagia, Epiglottitis

Symptoms: Feb. 12 slight headache, temp 100, slight nausea Feb. 13 itchy rash around the neck and chest area

Other Meds: asprin(81mg), toprol(50mg), nexium, tamoxifen, calcium, D3, multivitamin, vitamin C, biotin, turmeric

Current Illness: none

ID: 1028581
Sex: F
Age: 65
State: WV

Vax Date: 01/23/2021
Onset Date: 02/01/2021
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: penicillin and amoxicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: had 2 Crohns attacks since Feb 1 2021 and Psoriatic Arthritis has flared up extremely in feet knees hands and hips

Other Meds: Ursodiol, Pantoprazole, Colestipol, Probiotic, Imodium, Iron , Hair Skin & nail Vitamin, Ambien & Celexa. Infusion of Remicade last dome on 12-23-2020

Current Illness:

ID: 1028582
Sex: F
Age: 47
State: WA

Vax Date: 01/15/2021
Onset Date: 01/29/2021
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: none

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

Symptoms: I have new onset painful, burning and itching toes after going for a 30 min walk. Small blisters on toes as well.

Other Meds: vitamin D zinc carnosine probiotic magnesium calcium

Current Illness: none

ID: 1028583
Sex: M
Age: 23
State: TX

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

Lab Data:

Allergies: Haloperidol, also called Haldol

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Nauseous /Lightheaded/Fatigue /Headache/Dizziness at 3:00PM CST - took Ibuprofen 600mg and Metoclopromide 10mg

Other Meds: Humalog (insulin), Metoclopromide, Ibuprofen 600mg

Current Illness:

ID: 1028584
Sex: F
Age: 35
State: NY

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

Lab Data:

Allergies: None

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

Symptoms: Covid arm. Hard, red swelling around injection site. Itchy.

Other Meds: None

Current Illness: None

ID: 1028585
Sex: F
Age: 57
State: AZ

Vax Date: 02/11/2021
Onset Date: 02/13/2021
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: Lysenoprol, Codien

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

Symptoms: Deep bone ache, muscles hurt, chills head congestion, hurts to move

Other Meds: Gabapentin, buphropion Losartan Metformin Hydrochloride, Pioglitazone, Docusate Sodium, 5mgs of oxycodones/325 Tylenol

Current Illness: None

ID: 1028586
Sex: F
Age: 24
State: VA

Vax Date: 02/11/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Linzess NSAIDs Diflucan Lamictal Laxatives

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Severe abdominal pain and diarrhea with nausea Redness and swelling (looks like a bee sting) at injection site with soreness in arm injected

Other Meds: Propranolol Depo Provera Dupixent

Current Illness: Stomach flu previous to vaccine

ID: 1028587
Sex: M
Age: 41
State: FL

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

Lab Data:

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: Fever, chills, headache, muscle ache, fatigue, dizziness

Other Meds: Eloquis 2.5 mg 2x per day

Current Illness: N/A

ID: 1028588
Sex: M
Age: 75
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pulse pounded hard and fast. BP up to 143. (Normal 115) No treatment 5 minutes after shot until about 7 hours later

Other Meds: Phenobarbital, lamictal, keppra, guafinosin, montelukast, aciphex , atorvastatin, Advair HFA inhaler

Current Illness: Seizure disorder, atherosclerosis, asthma, chronic sinusitis, Barrett?s esophagus.

ID: 1028589
Sex: F
Age: 38
State: PA

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Pennicilin azythramicin bees

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Sleep paralysis. Woke up unable to speak for a couple of minutes after taking a nap the day of my vaccination. The rest of my body was fine, my mouth and throat felt fine, just couldn't get my brain to make my voice speak. Googled it and seems to be similar to flu shot reaction so just wanted to let you know so other people won't be alarmed if it happens to them.

Other Meds: Vitamin d, c, b12

Current Illness:

ID: 1028590
Sex: F
Age: 78
State: MA

Vax Date: 02/05/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Bug bites carry an Epi pen

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

Symptoms: Diarrhea for 3+ days

Other Meds: Atorvastatin 20 mg Baclofen 20 mg Duloxetine 20 mg Hydrochloride Thiazide 25 mg Metoprolol 25 mg Warfarin 2.5 mg Vitamin D eye health

Current Illness: None

ID: 1028591
Sex: M
Age: 33
State: WA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Dye used in MRI and CT scans and Shellfish

Symptom List: Rash, Urticaria

Symptoms: Headache, Nausea, sore throat and cotton mouth within 5 mins of injection. EMT watch patient for half hour to make sure no major allergic reaction happens. Health Practioner and EMT suggested Benadryl and Tylenol and plenty of rest. If symptoms got worse to go into ER. Symptoms subsided after 5 hours.

Other Meds: Creatine

Current Illness: N/A

ID: 1028592
Sex: F
Age: 69
State: GA

Vax Date: 02/08/2021
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: sulfa meds, percocet, codeine

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

Symptoms: On 2/13/2021 around 2000, (name) requested care for rash/blisters that developed on right foot (top and bottom) and back present x 3 days after receiving the Pfizer COVID first dose on 2/8/2021. Patient complained the blisters were tender, burning and itchy. Patient was seen at the Emergency Dept on 2/12/2021 and advised she had a fungus and was given Rx steroid cream, which she states was not helpful. Patient called Dispatch Health to assess her symptoms; Provider diagnosed patient with exanthum related to herpes zoster (shingles) and Rx antiviral (oral) was provided on 2/13/2021.

Other Meds: ProAir, atorvastatin, Advair, folic acid, gabapentin, metformin, metoprolol, montelukast, nifedipine, olmesartan/HCTZ, omega 3s, omeprazole, zolpidem

Current Illness: no acute illnesses

ID: 1028593
Sex: F
Age: 22
State: OH

Vax Date: 12/23/2020
Onset Date: 12/30/2020
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: Penicillin

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

Symptoms: I had a menstrual flow on 12/30/2020 and 12/31/2020 that was heavier than I?ve ever experienced. This was particularly abnormal because I had already had my period from 12/08/2020 through 12/18/2020. The length of which isn?t abnormal because they are usually long but light, due to utilizing my birth control to have only a single period every three months. Then, it seemingly disappeared until 01/06/2021 and 01/07/2021 when I experienced some spotting, but then on 01/08/2021 I had a normal amount of flow for a regular period that appeared to stop before I woke up on 01/10/2021. As of today 02/13/2021 I have yet to experience more bleeding.

Other Meds: Vybriid, Bupropion, Apri, and flintstones complete chewables

Current Illness: HPV. I was diagnosed in January and have had it for an undeterminable amount of time, but I had no new partners in the past year so it?s certain I had it at the time of vaccination

ID: 1028594
Sex: F
Age: 41
State: NC

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: None known

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

Symptoms: Bruising, swelling, pain and red rash at injection site. Pain and swelling make it difficult to lift left arm overhead

Other Meds: Cyclafem birth control, multivitamins, calcium, ibuprofen

Current Illness: None

ID: 1028595
Sex: M
Age: 79
State: FL

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

Lab Data:

Allergies: Nuts, chocolate

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

Symptoms: Intense itching of hands and randomly on other parts of body. Red rashes. Occurred only at night and disappeared in the morning.

Other Meds: Metformin, Zetia, Synthroid, Rovastatin

Current Illness: None

Date Died: 02/13/2021

ID: 1028596
Sex: F
Age: 94
State: NC

Vax Date: 02/10/2021
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:

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

Symptoms: *extreme* fatigue. could not awaken for more than few seconds. When briefly awake she was coherent and not confused. slept deeply from 4pm and could not wake to eat or drink. No fever, bp normal, blood oxygen ok. Blood sugar at 11pm was 230. Gave her 15u lantus at 11pm (normally 25u). Was sleeping at 2:30am but had died at next check at 3:30am.

Other Meds: insulin, cardizem, aggrenox, potassium, aspirin 81mg, zofran 4mg, trimethoprim, gabapentin, colon health, AREDS, biotin, gas-x, tylenol, vitamin D3

Current Illness:

ID: 1028597
Sex: M
Age: 57
State: NY

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

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: R thalamic stroke 2 days after 2nd dose of Moderna vaccine with L sided numbness acute in onset

Other Meds: ALLOPURINOL 300 MG OR TABS Aspirin 81 MG Tab BD PEN NEEDLE NANO U/F 32G X 4 MM Miscellaneous citalopram 20 MG Tablet clopidogrel 75 MG Tablet Fenofibrate 120 MG Tablet HUMALOG KWIKPEN 100 UNIT/ML Solution Pen-injector Insulin

Current Illness: none

ID: 1028598
Sex: F
Age: 49
State: MN

Vax Date: 02/05/2021
Onset Date: 02/08/2021
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: Penicillin Sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Moderna COVID-19 Vaccine EUA Itching along with red area about 2 inches in diameter in middle of upper arm near injection site started on 2/8/2021, subsides for a few days, started itching again on 2/12/2021 and continues with a larger red area about 3 inches in diameter that is warm to the touch.

Other Meds: Slow release iron 45mg Junel 1.5/30 Multivitamin

Current Illness:

ID: 1028599
Sex: F
Age: 36
State: MO

Vax Date: 02/05/2021
Onset Date: 02/10/2021
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: On 2/10/21 I had pain and mild itching at the injection site. 2/11 I noticed red raised pinpoint lesions with itching and burning at the injection site. By that evening it turned into more diffuse erythema and pinpoint lesions that looked like hived, again itchy. The next morning 2/12 the rash was worse with multiple pin point lesions, red erythematous patches, with itching and burning to the injection as well as involving my right hand, forearms, and feet. By the time I saw the MD it was involving my chest.. I was seen by a MD 2/12/21 and dx with folliculits. Up to this point I was using hydrocortisone cream to soothe the itching and ice packs. Since seeing the MD on 2/12 I started cetrizine,predinsone and Kenalog cream.

Other Meds: None

Current Illness: None

ID: 1028600
Sex: F
Age: 61
State: CA

Vax Date: 02/02/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Light flu like symptions on day 4. Cold sores on day 6. Never had cold sores before.

Other Meds: Magnesium, Chaste Tree Berry, CoQnol,

Current Illness: none

ID: 1028601
Sex: F
Age: 68
State: FL

Vax Date: 02/03/2021
Onset Date: 03/11/2021
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: NKA

Symptom List: Unevaluable event

Symptoms: Arm started itching, large round area around injection site, swollen , area involved covered with little bumps/ rash

Other Meds: Nicatinimide, Vit D, Fish Oil, Air Shield dietary supplement

Current Illness: Low WBC

ID: 1028602
Sex: F
Age: 24
State: IL

Vax Date: 02/11/2021
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: LA

Lab Data:

Allergies: None

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

Symptoms: Around 5 pm on 2/11 (day of vaccination) I began to notice a very sore arm and dry mouth/dehydration. Drank water and continued as normal. Around 2 am of 2/12 I woke up with chills and had been sleeping very restlessly. I had body aches in my arm, legs and back. Around 3am my temperature was 100.2. I also felt very faint when standing and thought I may pass out. 3 times when standing, I had to quickly sit down to avoid it. I do suffer from vasovagal syncope so this may be unrelated to vaccination. I took Tylenol and drank more water. Temp rose to about 100.6 before beginning to drop at around 4 am. I continued to take Tylenol every 4 hours and it helped keep temp below 100 but towards the end of the 4 hours, it would start to rise again. I ate normally and drank extra water due to feeling dehydrated still. Around 1 PM 2/12 I started to feel nauseous and had an upset stomach. I was still have a general body aches and elevated temperature around 99.5. My normal temp is usually about 98.0. Nausea led to diarrhea 1 time. Symptoms continued until approximately 8 pm when very quickly the body aches, nausea, fever and soreness in injection arm all went away. None of these symptoms have returned and it is now 2/13 at 8 pm. I did test positive for Covid-19 on December 28, 2020 but have been fully recovered with no symptoms since 1/8/2021.

Other Meds: Propranolol, birth control - nortrel, Zyrtec, magnesium, biotin

Current Illness: None

ID: 1028603
Sex: M
Age: 26
State: OH

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

Lab Data:

Allergies: Allergic to Penicillin

Symptom List: Injection site pain, Pain

Symptoms: After receiving my first shot of the Moderna COVID-19 vaccine on 11 Feb 2021, the site of the shot turned red and swelled about 24 hours after receiving the vaccine on 12 Feb 2021. With the swelling and redness, it felt painful to the touch. Additionally, it felt sore overall. The swelling did not spread to any other part of my arm or body. It stayed in the area that I received the shot. On 13 Feb 2021, the swelling and pain were virtually gone.

Other Meds: lisinopril and amlodipine

Current Illness:

ID: 1028604
Sex: F
Age: 63
State: KY

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Tingling to the tongue, started 10 min after injection. Pt was given 10 ml of Bendryl after 30 min of additional observation pt felt better and was able to leave the site.

Other Meds:

Current Illness:

ID: 1028605
Sex: F
Age: 74
State: FL

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

Lab Data:

Allergies: morphine, penicillin, tetanus

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

Symptoms: Extreme nausea, very high fever, dizziness, arm pain

Other Meds: levothyroxine, amlodipine, estradiol, norvasc, diuretic, estradiol, pantoprazole

Current Illness: none

ID: 1028606
Sex: F
Age: 7
State: NY

Vax Date: 02/12/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Large red circular local reaction at injection site. Started day after IM injection. No pain, no fevers. Of note, pediatrician (for unknown reason) administered TWO flu vaccines this season. Last one was 9/2020.

Other Meds: none

Current Illness: none

ID: 1028607
Sex: M
Age: 23
State:

Vax Date: 02/05/2021
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: NKDA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever 24 hours, then recurred approximately 5 days later., prompted ED eval, then two days later prompted IM admission with hepatitis, fever, leukopenia.

Other Meds: NA

Current Illness: chronic tonsillitis

ID: 1028608
Sex: F
Age: 74
State: IL

Vax Date: 02/04/2021
Onset Date: 02/12/2021
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: Penicillin, sulfa (Sulfonamide Antibiotics).

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

Symptoms: I got my first Covid vaccine dose on Feb 4, 2021. 8 days later, a red welt appeared at the point of injection. My upper arm was hot, itched and had a "ring" with a rash that was inside the "ring", above and below the "ring". The reaction lasted a little over 24 hours. My husband a physician called it a "delayed cutaneous hypersensitivity." I am due for the second dose on March 4, 2021. There was no treatment involved.

Other Meds: see below:

Current Illness:

ID: 1028609
Sex: M
Age: 79
State: CO

Vax Date: 02/04/2021
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: RA

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: 2 days after vaccine - left sided weakness in arm and leg, speech/swallowing impairment. ER then 3 days in hospital- home with walker, assistance and home health.

Other Meds: Losartin, pravastatin, oxybutinin, finistrade, tamsulosin, gabapentin, 162 gr aspirin, multiple vitamin, Dupixent, Tylenol PM

Current Illness: None

ID: 1028610
Sex: F
Age: 70
State: AZ

Vax Date: 01/11/2021
Onset Date: 01/19/2021
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: Avalox Macrobid Red Yeast Rice Dairy Sensitivity

Symptom List: Injection site pain

Symptoms: Vaccine #1: Eight days after receiving had a delayed reaction involving very intense swelling and itching of Rt. arm injection site. There was a hot red rash and swelling with a large ridge surrounding it around the entire right deltoid and slightly down the right arm. It persisted for 3 days and gradually subsided. Benedryl was taken on the first day for the itching. Vaccine #2: A less intense but very similar reaction occurred on the third day after injection on the Lft. arm injection site. It subsided after 2 days.

Other Meds: Lipitor 10 mg., Levothyroxine 75 mcg.

Current Illness: None

ID: 1028611
Sex: M
Age: 24
State: NC

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:
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: Headache Muscle Ache Fever chills slight nausea

Other Meds: Pre workout

Current Illness: Non

ID: 1028612
Sex: F
Age: 67
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: Ketamine, MSG, latex tape

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

Symptoms: Vertigo when I awoke on 2.12.21. The smell of roasting chicken prompted GI symptoms like food poisoning: intense gastrointestinal cramps, soft stools, then vomiting. I slept for many hours, ate a little so I could take my antibiotic, slept, ate and took my second antibiotic, slept, awoke at 1 am with an intense headache, so ate 1/2 banana, took 2 Advil, then slept for 8 hours. I awoke feeling spent, but healthy again! Still experiencing vertigo from time to time.

Other Meds: Started a 10-day course of Doxycycline Hyclate 100 mg 2x/day on 2.10.21. Yes to supplements, but the list is long! On advice from my acupuncturist, I started taking 5 Gan Mao Ling tabs specifically to minimize vaccine after-effects 30 mins

Current Illness: None

ID: 1028613
Sex: F
Age: 48
State: MA

Vax Date: 02/05/2021
Onset Date: 02/10/2021
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: N/A

Symptom List: Tremor

Symptoms: 5x6 inches in diameter, flesh is hard, red, shoulder and arm very inflamed, itchy, tissue is hot to the touch.

Other Meds: Prozac, ampheta/dextro, clonazepam

Current Illness: None

ID: 1028614
Sex: F
Age: 60
State: AZ

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

Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: last night at work i experienced extreme sleepiness, but thought it was just lack of sleep after shot before returning to work as i only got four hours of sleep yesterday, also was cold, but thought that was just because of the weather. slept all day today, but when woke up this evening to prepare for work, experienced chills when i got out of bed, then in the bathroom, i experienced dizziness and weakness, and moderately loose stool. sat on the floor for a little while, while regaining my composure, then went back to the bedroom and called in to work that i would not be coming in. have been experiencing chilling. weakness went away, chilling lasted longer. was told that some other people called in today due to symptoms from same shot

Other Meds: vitamins, vit c 1000mg, probiotics, calcium

Current Illness: none

ID: 1028615
Sex: F
Age: 39
State: NY

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: Severe muscle aches and joint pain. Fever of 101-101.7 (with tylenol). Sever symptoms lasted about 32 hours and prevented normal daily functioning and activities.

Other Meds:

Current Illness:

ID: 1028616
Sex: F
Age: 35
State: TX

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

Lab Data:

Allergies: Levaquin, ampicillin, ativan, prednisone, methergine, fir trees, eggplant

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

Symptoms: a few minutes after recieving the vaccine i got dizzy, cold sweats, tingly feeling all over body, and broke out in a red slightly itchy rash.

Other Meds: lexapro, multi vitamin, tumeric, vitamin c, zinc, omega 3,6,9, b vitamins, k2/d3

Current Illness: none

ID: 1028617
Sex: F
Age: 66
State: IN

Vax Date: 02/05/2021
Onset Date: 02/13/2021
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: Sulfa

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Rash, itchiness, firm@ injection site

Other Meds: Vit.D Zinc probiotic

Current Illness: None

ID: 1028618
Sex: F
Age: 51
State: IN

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: SYR
Vax Site: LA

Lab Data:

Allergies: sulfa, amoxicillin

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

Symptoms: 11 hours after injection redness and swelling to injection site. 24 hours after injection, redness and swelling doubled in size. Took Motrin, Tylenol and Benadryl 1st day. Day 2 - took the same. Will continue to monitor myself.

Other Meds: enalapril, potassium, hydrochlorothiazide. alprazolam, Motrin

Current Illness:

ID: 1028619
Sex: F
Age: 39
State: NY

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: sulfites, penicillin, nsaids, gluten

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

Symptoms: headache- 38 hrs after vaccine

Other Meds: xarelto, levothyroxyzine, vitamin d, folic acid, claritin

Current Illness: bronchitis

ID: 1028620
Sex: F
Age: 28
State: IL

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: 48 hours of day/time of vaccine, I started experiencing chest tightness and pain around my sternum area (approx 11 am). Unsure what this foreign sensation and pain was, I tried to rule out GERD by taking omeprazole and tums with no relief. Throughout the day I started experiencing dizzy spells and a dry cough. I went to an urgent care and they ruled out pneumonia and other cardiac abnormalities. Chest X-ray was positive for bronchitis.

Other Meds: Ibuprofen 200mg

Current Illness: None

ID: 1028621
Sex: F
Age: 41
State: VA

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: Penicillin Tetracycline Ceftin

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

Symptoms: 8 days post shot patient experienced multiple episodes of vertigo and has a golf ball size lymphnode in armpit region of shot arm.

Other Meds: Claritin Viatamin D Zumamidine Multivitamin B12 Turmeric COQ10

Current Illness:

ID: 1028622
Sex: F
Age: 79
State: AL

Vax Date: 02/08/2021
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: None

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

Symptoms: Shaking chills and then fever to 100.7 3.5 days after administration.

Other Meds: Crestor Nexium Synthroid Ambien Tums Lumigan Amiodarone Claritin Probiotic

Current Illness: Hypothyroidism Hyperlipidemia GERD ESRD on hemodialysis SVT Glaucoma Seasonal allergies

ID: 1028623
Sex: F
Age: 29
State: OH

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

Lab Data:

Allergies: None

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

Symptoms: Fever, body aches, fatigue, pain in left armpit

Other Meds: None

Current Illness: None

ID: 1028624
Sex: F
Age: 30
State: AK

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Ambien, Triptan family (imatrex), Vicodin, Percocet, Augmenten, Penicillin, Dialoted

Symptom List: Vomiting

Symptoms: With in two minutes of injection I started having very rapid heart beat and heaviness in my chest. By four minutes I had throat swelling and pressure and slight difficulty breathing. I did not seek medical attention while at the clinic. Once home I took two Benadryl and contacted my primary provider for advice. She advised that because of my history of anaphylactic reactions to medications and the throat swelling I experienced to not receive the second shot. She suggested I take Benadryl and seek emergent medical attention if my symptoms worsened. Symptoms continued for several hours. I administered two more pills of Benadryl following the package instructions. The symptoms tapered over time. For days I was wheezy and my asthma was not controlled. I also had small runny nose and flared up my vocal cord dysfunction and asthma symptoms. With in a week and a half I was able to run again with out experiencing breathing difficulty that is abnormal. My breathing is still not 100% but I can not confirm that it is a result of the shot or my asthma not being completely stable.

Other Meds: Flonase, Zyrtec, Albuterol as needed, Symbacort daily

Current Illness: None

ID: 1028625
Sex: F
Age: 88
State: FL

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: aspirin upsets stomach

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The day after receiving the Covid vaccine, I began having shortness of breath. I had no fever. my blood pressure stayed normal, however, my pulse was elevated and my heartbeat accelerated whenever I exerted myself. This continued from Wednesday to Saturday when I began to feel somewhat better.

Other Meds: 5MG enalapril, 2.5 MG Amlodipine, Glucosamine Chondroitin with MSM

Current Illness: no other illness

ID: 1028626
Sex: F
Age: 52
State: MI

Vax Date: 02/10/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin, Avalox, Bees

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

Symptoms: Hives all over body

Other Meds:

Current Illness: None

ID: 1028627
Sex: F
Age: 45
State: OR

Vax Date: 02/01/2021
Onset Date: 02/10/2021
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: Keflex,bananas

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Low blood pressure 2 days ago 96/54. Very light headed. Also I have a lump on my right arm 3? hurts, red and itches.. in width and hot to touch. It has been present for 5 days

Other Meds: Eliquis, lisinopril, Prilosec, Claritin, morphine,sulfasalizine

Current Illness: Blood clotting disorder,arthritis , high blood pressure, past pulmonary embolism x 2 dv2 x 2 ischemic colitis past

ID: 1028628
Sex: M
Age: 53
State: NM

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

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

Symptoms: Large red inflammation at injection site. Still there 8 days later

Other Meds: Oxycodone, Lisinopril, simvastatin, metoprolol

Current Illness:

ID: 1028629
Sex: F
Age: 69
State: SC

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

Lab Data:

Allergies: none

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

Symptoms: Headache, muscle pain, joint pain, chills, fatigue

Other Meds: Ezetimibe, Janumet, Losartan, Cetirizine, Potassium Chloride, Atorvastatin, Synthroid, Nebivolol, Empagliflozin, Asprin, Omeprazole

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm