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: 1029032
Sex: F
Age: 66
State: MN

Vax Date: 01/28/2021
Onset Date: 02/01/2021
Rec V Date: 02/14/2021
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: Sore throat - first symptom 2/1 11pm Fever to 103 - early morning 2/3 shaking chills nausea muscle aches lymphadenopathy

Other Meds: Diltiazem Lipitor Magnesium Vit. D Biotin ASA low dose LaTisse Rogaine 5% for women

Current Illness: None

ID: 1029033
Sex: F
Age: 73
State: MO

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital: Y

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

Lab Data:

Allergies: Erythromycillin Levaquin

Symptom List: Anxiety, Dyspnoea

Symptoms: Day of vaccine headache, fatigue, soreness 2nd day 2/13/21 Had issues sleeping and felt uncomfortable. In early a.m. hours, felt dizzy, feeling of sick stomach, and fainted in the bathroom. Paramedics were called by my spouse and they worked with me, then was transported by Ambulance to emergency room where they ran tests and released me the same day. I was told by the doctor that apparently my blood pressure decreased too fast causing me to faint.

Other Meds: AmODIPine Besylate 5 mg tab. for Blood Pressure One per day (took one at 6:30 am day of vaccination) Omerprazole 20 mg. 2 per day (took one at 6:30 a,.m. day of vaccination)

Current Illness: None

ID: 1029034
Sex: M
Age: 62
State: WA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Bee sting

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

Symptoms: a 62 y/o M who presents with concerns for an allergic reaction to the second dose of the Covid vaccine. According to him he got the vaccine around 8:45 AM. He has a history of anaphylactic type reactions with a swelling and urticaria in the past but has not had any symptoms in the last 5 years. He felt sudden onset pit in his stomach, tingling and warm sensations over his face and some chest tightness. He denies all the symptoms currently. He did get medications prior to arrival but states his symptoms were already getting better before he been given anything. He was given epinephrine as well as Benadryl beforehand. He denies any symptoms currently. Denies headache, change in vision, difficulty swallowing, lightheadedness or vertigo, chest pain, sore throat, wheezing, cough, nausea or vomiting, rash, falls or injuries. Denies any recent foreign travel or sick contacts. He did work a full shift yesterday and was coming off a 24-hour shift prior to getting his vaccination. He denies any significant reactions to the first vaccine. Medical Decision Making On initial presentation is an overall well-appearing 62-year-old male who has normal vital signs without fever or tachycardia. He is presenting with concern for allergic reaction of the field to a recent vaccination. The vaccine was given roughly 1 hour prior to arrival. He was given epinephrine intramuscularly as well as IV Benadryl. He states he is currently feeling mildly tired from the Benadryl. He denies any other recurrent symptomatology and feels better. Examination is not concerning for anaphylaxis at this time, no evidence of airway involvement or multisystem involvement. No evidence of local allergic reaction. Low clinical concern for occult infection, metabolic abnormality, ACS or arrhythmia for a cause of his symptoms. He is overall very well-appearing. Labs have been obtained as part of screening for reactions to the vaccination per CDC recommendations including a tryptase and C4 complement. They were drawn over an hour after the vaccine was administered. ECG was within normal limits. After observation patient remained asymptomatic. Did offer steroids, however he wanted to hold off on them as he just got his vaccination which seems appropriate at this time. He was sent home with a new EpiPen. We also gave him follow-up in the allergy clinic. He has any worsening symptoms we do recommend he use the EpiPen as well as call 911. He is understanding. At this point he stable for outpatient management. I did tell him he should expect to feel aches and potentially have inflammatory response to the vaccine, he is understanding of this. Pt was discharged home/self-care. Pt provided strict return precautions, including but not limited to, any worsening symptoms or any new concerning symptoms. Otherwise, Pt instructed to see PCP on an as needed basis.

Other Meds: Fexofenadine Zolpidem

Current Illness: None

ID: 1029035
Sex: F
Age: 36
State: WA

Vax Date: 02/08/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pain and swelling in left arm pit. Pain is 2-3, swelling is mild.

Other Meds: Clomid, fish oil, vitamin D3, iron, prenatal vitamin, chaste tree berry, rhodiola, folic acid, vitamin C

Current Illness: None

ID: 1029036
Sex: F
Age: 50
State: IL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Injection site stiffness, pain. This also occurred after first shot. New symptoms for this shot? headache, nausea, body aches, tired, fever. These symptoms started about 14-16 hours after shot. Rest. Fluids. Ibuprofen? symptoms gone 36 hours after shot.

Other Meds: Vitamin d Allegra Estroven

Current Illness: None

ID: 1029037
Sex: M
Age: 63
State: TX

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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 known

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

Symptoms: Fever 100.1. Nausea. Joint pain. Fatigue. Chills. Pain redness rash swelling at injection site. Rash still on 2/14/2021.

Other Meds: Metoprolol . Vitamin d. Zinc. Melatonin. Aspirin. Probiotics. Eye vitamins

Current Illness: Diagnosed with covid on Jan 2. Quarantined till Jan 14. First symptoms Dec 20.

ID: 1029038
Sex: F
Age: 37
State: MD

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Vaccine on Friday afternoon, spiked 104 fever by Saturday night. Body aches and swelling at the injection site.,

Other Meds: Zyprexa, Lithium, Lamictal, Trileptal, Levothyroxine

Current Illness: None

ID: 1029039
Sex: F
Age: 41
State: NC

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: GLUTEN, MSG, RED DYE, LACTOSE INTOLERANT

Symptom List: Pharyngeal swelling

Symptoms: WHILE PATIENT WAS WAITING IN STORE AFTER RECEIVING VACCINATION ON 2-13-21 WITHIN MINUTES SHE BEGAN TURNING RED IN FACE AND NECK. FLUSHING OCCURED ALL OVER FACE/NECK AND DOWN ARMS. HER NOSE STARTED RUNNING AND SHE BEGAN TO PRODUCE PHELGM - WHICH WOULD GET STUCK IN HER THROAT. SHE DID NOT HAVE ANY SWELLING IN TONGUE, LIPS OR THROAT. AROUND 6PM SHE NOTIFIED THE PHARMACIST ON DUTY. SHE STATED TO ME THIS TYPE OF REACTION OCCURS WHEN SHE EATS GLUTEN OR MSG. WE CHECKED THE VACCINE INGREDIENTS AND DIDN'T FIND SUCH IN MODERNA. SHE WAS THEN GIVEN A 50MG BENADRYL BY THE PHARMACIST. AFTER 10 MINUTES SHE SAID SHE STARTED TO FEEL BETTER. ALL OF A SUDDEN HER CHEST STARTED TO FEEL HEAVY WHICH SHE WAS BELIEVED TO BE FROM ALL THE EXTRA PHELGM PRODUCTION. WE CONTINUED TO WATCH AND WAIT. AROUND 6:30PM SHE AGAIN SAID SHE FELT WELL ENOUGH TO GO HOME. I OFFERED HER AN EPI PEN. SHE DELCLINED. SHE WAS GIVEN 50MG BENDARYL TO TAKE HOME JUST IN CASE. STATED SHE WAS OK TO GO HOME AND DIDN'T NEEDED ANY FURTHER ASSISTANCE FROM ME OR 911. I CALLED THIS AM 2-14-21 TO CHECK IN ON HER. SHE STATED THE RASH/FLUSHING RESOLVED LAST NIGHT AND SHE WAS MUCH BETTER TODAY. THE ONLY SYMPTOM SHE HAD TODAY WAS A SORE ARM.

Other Meds: EMGALITY, NURTEC AS NEEDED , TRAMADOL AS NEEDED PROMETHAZINE AS NEEDED, MULTIVITMAIN, THYROID COMPLEX OTC

Current Illness: NO

ID: 1029040
Sex: F
Age: 39
State: NH

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/14/2021
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: Severe hives, facial puffiness, itchy throat, body aches x?s 3 days.

Other Meds:

Current Illness: None

ID: 1029042
Sex: M
Age: 68
State:

Vax Date: 02/01/2021
Onset Date: 02/07/2021
Rec V Date: 02/14/2021
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: Sore throat (5 days +)

Other Meds: Baby aspirin Multivitamin

Current Illness:

ID: 1029043
Sex: M
Age: 67
State: OK

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Beginning at 1:00am February 13, 2021 I begin to feel feverish with a temperature of 99.4. I took the maximum dose of 3000 mg acetaminophen every four hours with the last dose at 2:00pm. My fever ranged from 99.4 to 100.8 during this period. After the acetaminophen wore off in the afternoon, my temperature went to 102.8. I took one dose 600mg of ibuprofen at 5:00pm and began to feel better throughout the evening and night. Today I am very weak but recovering.

Other Meds: Alfuzosin 10mg, salmon oil 1000 mg, multi-vitamine, lutein 20mg, vitamin C 1000mg, NMN 500mg, olive oil 100mg, magnesium glycinate 400mg, Resveratrol 500mg, L-glutamine 1000mg, D3 + K2 5000iu.

Current Illness: None

ID: 1029044
Sex: F
Age: 70
State: FL

Vax Date: 02/02/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Fever, extreme chills, ending in sweating. Better next day.

Other Meds: Prednisone

Current Illness: None

ID: 1029046
Sex: F
Age: 59
State: WI

Vax Date: 01/19/2021
Onset Date: 01/30/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Silicone

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

Symptoms: On day 11 after my Moderna COVID-19 Vaccine EUA I noticed a red blotchness running down my arm approximately 5.5 inches from injection site to elbow. No itchiness, swelling, or hardness, just mild achiness. By day 12 the blotchiness was fading and by day 13 no real evidence seen. I took no specific modes of treatment. Just alerted by doctor and followed it's progression.

Other Meds: Gabapentin 300mg Calcium 600mg with Vitamin D3 Hair, Skin, and Nails Gummies Lactaid Metamucil

Current Illness: None

ID: 1029047
Sex: F
Age: 58
State: MN

Vax Date: 01/30/2021
Onset Date: 02/10/2021
Rec V Date: 02/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: I started developing pain around the vaccination site on February 10th. ( 11 days after vaccination). The pain moved up into my left shoulder with shooting pains generally in the arm and shoulder up to the base of the skull). On Saturday, Feb 13 a rash appeared. On February 14th I was diagnosed at clinic with shingles.

Other Meds: calcium and vitaminD

Current Illness: none

ID: 1029048
Sex: F
Age: 49
State: CA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Joint pain for several hours about 7 hours after shot

Other Meds: Multi-vitamin, vitamin D, magnesium, biotin, peptoid proteins

Current Illness: None

ID: 1029049
Sex: F
Age: 44
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: COVID tongue. Patchy red and raised off white/beige tongue with scrapeable off white thick substance. Inflamed papillae along the tongue edge where it meets the teeth on the front 1/3. Sparse inflamed papillae along the top of the tongue over the front 1/3. Feels coated and bad breath. No matter how much I brush, floss and scrape I feel like I'm tasting garlic. Also very sore injection site. I know this is common.

Other Meds: Iron (Thone Ferrasorb), Vitamin D3 2000 ( ProCabs Labs), Active B-Complex (Integrative Therapeutics), D-Amphetamine Salt Combo (Approx 7 1/2 mg)

Current Illness: none

ID: 1029050
Sex: F
Age: 36
State: NY

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: clindamycin, sulfas

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

Symptoms: I got vaccinated at 11:30am. Approximately 9 hours after vaccination (~8:30pm), I started to feel lethargic. 9.5 hours post-vaccination (9pm) my face started feeling warm; my temperature was around 99 and I developed a mild headache. At 10 hours post (9:30pm) I had chills and my temperature continued to climb (~101F). At 12 hours post-vaccination my temperature was 102.2, which is the highest it was that I know of. This was during the night and I woke up several times due to my fever and chills; my headache worsened and was very severe. I was extremely lethargic and had trouble getting out of bed. I did not take any over the counter medications. The following morning my temperature started coming down and my chills resolved. My headache has improved but is still present (mild). At around 19 hours post vaccination (~6am) my temperature was 101. And 24 hours post-vaccination it was 100.5.

Other Meds: none

Current Illness: none

ID: 1029051
Sex: F
Age: 68
State: MD

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/14/2021
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: I had extreme vaginal itching. I used anti-itch cream, coconut milk soap to the area, and also took baking soda baths.

Other Meds: None

Current Illness: None

ID: 1029052
Sex: F
Age: 54
State: NY

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/14/2021
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: I got the second does of the Pfizer. I had a massive headache and chills overnight. I had a fever of 100.1 at 7.10am the next morning. I was leaving my ground floor bathroom and I woke up on my basement floor. I fainted and fell down a flight of stairs. I passed out again, when I tried to get back up the stairs. I crawled back up the stairs and phoned my husband to come home, He did and helped me into the bathroom to wash my teeth. I fainted again and he caught me and carried me back into the sofa. I spent the rest of the day in bed. I am bruised and scraped all over. I am sore all over. I went to Urgent Care on 2/13/21 and got x-rays done. I have a fracture in my right thumb and may have a dislocated left shoulder. I have to see more doctors tomorrow. I sill don't fell well and I have no appetite. I fell really weak. I have dizziness when lying down, that may be related to the fall.

Other Meds: Remicade, Imuran, Levothyroxine, Prempro. Vitamin B and D, L-Glutathione & Theanine.

Current Illness: None

ID: 1029053
Sex: F
Age: 32
State: NM

Vax Date: 01/23/2021
Onset Date: 01/31/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Rash at injection site and swelling of lymph nodes in left armpit. Rash appeared 8 days post injection. Lymph node swelling occurred 4 days post injection and was most severe by day 8. Performed superficial massage to both areas as well as application of cold pack. Neither really helped. Symptoms resolved by day 12 post injection.

Other Meds: Lisinopril for high blood pressure, daily probiotics, and daily magnesium supplement

Current Illness: N/A

ID: 1029054
Sex: F
Age: 23
State: MO

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: hives, itching

Other Meds: None

Current Illness: No

ID: 1029055
Sex: F
Age: 60
State: PA

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: IV Flurosine, adhesive

Symptom List: Unevaluable event

Symptoms: Small red itchy circle approximate size of a quarter appeared on February 11th. By the next day there was a second circle about an inch away from the first circle. Today, February 14th the circles have spread and are now one large oval approximately 3 inches long and an inch wide. It is midly itchy.

Other Meds: Multi Vitamins, 81 mg asa, escitalopram 10 mg, doxycycline 50 mg

Current Illness: None

ID: 1029056
Sex: F
Age: 75
State: NY

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: extremely sore arm, fever, chills, joint pain, fatigue

Other Meds: sucralfate (1 gm), propranolol (10gm), ashwagandha root (600 gm), calcium +D (1500 gm), multivitamin

Current Illness: none

ID: 1029057
Sex: F
Age: 43
State: WI

Vax Date: 12/09/2020
Onset Date: 12/23/2020
Rec V Date: 02/14/2021
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: Shellfish, tegaderm

Symptom List: Injection site pain, Pain

Symptoms: Full body rash that occurred 10 to 14 days after injection. Nothing had changed with soap, detergent, diet, or medicines. Took Benadryl to manage rash symptoms. Rash lasted approximately 10 days.

Other Meds: Lexapro, multivitamin

Current Illness: None

ID: 1029058
Sex: M
Age: 32
State: WA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/14/2021
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: Patient was given vaccine on day 22, outside of grace period

Other Meds:

Current Illness:

ID: 1029059
Sex: F
Age: 38
State: FL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: NA

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

Symptoms: Day after vaccine, severe headache reported along with large amounts of blood in urine. Urgent care visit on 3rd day, 2/14/21, confirmed gross hematuria in urinalysis with referral to Urologist.

Other Meds: Adderall

Current Illness: NA

ID: 1029060
Sex: M
Age: 78
State: MD

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/14/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: We feel as if the vaccine completely counteracted with his Parkinson's medication. Patient was hallucinating for 2 days, completely unaware of surroundings, making non sensical words, mumbling, showing Parkinson side affects such as hand wringing, not able to balance, walk, completely different than his normal self. Side affects wore off in about 36 hours.

Other Meds: Metoprolol 100mg once a day Nuedexta 20-10 mg one capsule twice daily Rytary 61.25mg / 245mg once a day

Current Illness: None

ID: 1029061
Sex: F
Age: 77
State: FL

Vax Date: 02/03/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: penicillin codeine/morphene sulpha drugs vancomycin hibiscus tea

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: after a week site turned red and big and itchy

Other Meds: Eliquis 5mg

Current Illness: none

ID: 1029062
Sex: M
Age: 69
State: GA

Vax Date: 01/30/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
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: Pollen, latex

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

Symptoms: "Covid arm" - Large pink rash on left biceps where vaccine was administered. Rash includes injection site, but is asymmetric in shape. Injection site is not at the center of the rash. Rash is itchy and after 3 days it has grown a bit in size and the biceps has become sore, but still itchy. Rash did not response to 1% steroid cream administration.

Other Meds: AREDS 2 Ophthalmic supplement

Current Illness: None

ID: 1029063
Sex: F
Age: 67
State: CA

Vax Date: 02/01/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
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, amoxycillin, vancomycin, mild shellfish, juniper,

Symptom List: Nausea

Symptoms: severe site pain middle of night; continued site pain and hives in armpit beneath it 48 hours later

Other Meds: sertraline 100 mg, bupropion 100 mg, turmeric and ginger, elderberry, calcium and D3, salmon oil

Current Illness:

ID: 1029064
Sex: M
Age: 74
State: GA

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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: Redness on left bicep and redness on left forearm. Noticed next day about 10 am. No pain.

Other Meds: Lisinopril, carvedilol, rosuvastatin

Current Illness: None

ID: 1029065
Sex: F
Age: 45
State: FL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Prednisone

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

Symptoms: Rash at injection site that is endurated, erythemic, and warm to touch.

Other Meds: Metoprolol, lisinopril, buspirone, metformin

Current Illness: None

ID: 1029066
Sex: F
Age: 70
State: FL

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
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: Opioids, ceflaxen

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

Symptoms: Debilitating nausea, massive migraine, extreme fatigue

Other Meds: Allertec, Citracal,Travatan eye drops, Fosamax, Biotin, Preservision

Current Illness: None

ID: 1029067
Sex: F
Age: 70
State: CA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Cat dander Pine pollen

Symptom List: Tremor

Symptoms: 12 hours after shot - extreme migraine with nausea, sensitivity to all light, noise and movement along with chills, fever, muscle and joint pain - most symptoms gradually decreased over following 24 to 72 hours with acetaminophen (2-500 mg) taken every six hours over 72 hour period. Chills and headache lasting entire 72 hour period

Other Meds: Multi vitamin Calcium Vitamin D Iron Strontium Krill oil CoQ10 Milk thistle Evening primrose oil Valacyclovir

Current Illness: None

Date Died: 02/09/2021

ID: 1029068
Sex: M
Age: 79
State: WI

Vax Date: 02/07/2021
Onset Date: 02/08/2021
Rec V Date: 02/14/2021
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: No known

Symptom List: Erythema, Pruritus

Symptoms: Patient was given vaccine the following day he died ,

Other Meds: N/A

Current Illness: Mental health, dementia

ID: 1029069
Sex: F
Age: 86
State: FL

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
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: Soreness to injection site including redness and minor swelling and feeling of malaise which did not start until more than a week after the injection.

Other Meds: metropolol 50mg2/da spironolactone 25 mg 1/2 tab tamoxifen 20mg losartin 100 mg simvastatin 40 mg centrum silver calcium plus d

Current Illness: none

ID: 1029070
Sex: F
Age: 66
State: CA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Compazine

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

Symptoms: Muscle aches, chills, dizziness, sneezing, runny nose, elevated heart rate of 107, crazy thoughts, very intense and painful.

Other Meds: liothyronine 25mcg Famotadine 40 mg Calcium, magnesium, vit D, multiple vitamin

Current Illness: Chronic Fatigue Syndrome, Fibromyalgia, central sensitization pain syndrome, GERD

ID: 1029072
Sex: F
Age: 51
State: MD

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
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: unknown

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: broke out in hive, fatigue, shortness of breathe, throwing up

Other Meds: Metformin, Glipizide, Jardiance, Losartan, Atorvastatin, Loratadine, Advair

Current Illness: None

ID: 1029073
Sex: F
Age: 74
State: MI

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/14/2021
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: penicillin, keflex, sulfa, pineapple, garlic, chocolate, aspirin, Morphine, tetnus, codeine, demerol, bees, atropine

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

Symptoms: tingling of mouth and tongue with feeling of some tongue swelling, but no wheezing or shortness of breath. slight itching in general. lasted til next day without need of epi pen

Other Meds: synthroid, theodur, vit c

Current Illness: none

ID: 1029074
Sex: F
Age: 77
State: IL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Headache. Treated with ibuprofen . Nausea. Limited food.

Other Meds: Vitamin D 1/4 aspirin

Current Illness: None

ID: 1029075
Sex: M
Age: 66
State: IL

Vax Date: 01/15/2021
Onset Date: 01/20/2021
Rec V Date: 02/14/2021
Hospital: Y

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: see prior comments. Sudden pro-longed loss of strength

Other Meds: Levothyroxine 75mcg M-F; 112mcg-Sat;/150mcg- Sun Sertraline (Zoloft) 150 mg, daily Metoprolol Succinate 50mg- AM +25mg- PM; daily Buspirone 5 mg, twice daily Magnesium Lactate 84mg, twice daily Mexiletine 150 mg, three times daily Aspirin 8

Current Illness: My husband received an LVAD on July 25, 2020, was discharged from inpatient rehab on 10/14/20, and did 8 weeks of in-home PT, OT & ST, then started outpatient rehab on Jan 7, 2021. When he entered rehab on Jan 7 he was able to toddle (with supervision) without the use of his walker. He did very well as outpatient for two weeks, but then started "de-abiltizing" (therapists' language). It coincides with having received COVID vaccine #1 (which I mentioned to his doctors). He's became so weak he can no longer support his own weight (or break his magnesium pills in half) and he began using a wheelchair in the house- which he never relied on -since discharge on 10/14. There's no medical reason for his loss of strength. He is doing very well with the heart pump, though he's had a couple of tachycardia episodes in the past 2 months (Dec 10, 2020 & Jan 9, 2021) He is entering in patient rehab.

ID: 1029076
Sex: F
Age: 51
State: VA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: Patient reported itching, local rash, and tachycardia several minutes after vaccination of second dose Moderna vaccine. Patient reported no SOB or no throat closing. EMS was called, already onsite, to respond to reaction. No Epi was administered. Patient self-reported previous allergic reactions to antibiotics. Due to panic attack, EMC gave 2 L NC oxygen and observed patient for 30 minutes. Pulse was initially at 150, then decreased to 90. Patient called a friend and took back to home.

Other Meds: Unknown

Current Illness: Unknown

ID: 1029077
Sex: M
Age: 90
State: SC

Vax Date: 01/17/2021
Onset Date: 01/24/2021
Rec V Date: 02/14/2021
Hospital: Y

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

Symptoms: Patients wife came in today to get her second Moderna Covid shot. She said that he was in the hospital with COVID and needed to reschedule.

Other Meds:

Current Illness:

ID: 1029078
Sex: M
Age: 44
State: IL

Vax Date: 02/01/2021
Onset Date: 02/10/2021
Rec V Date: 02/14/2021
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: Delayed reaction to the shot 8 days after. Soreness in arm hot, itchy , swollen and painful. 3 days later pain had stopped but right arm out swollen.

Other Meds: None

Current Illness: None

ID: 1029079
Sex: F
Age: 67
State: PA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/14/2021
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: tingling, pins and needles sensation in left thumb/hand area approx 10 mins. after vaccine administered as well as elevated BP. I was observed for 30 mins and BP taken 2 more times. 1 hour or so later at home began feeling jittery sensation throughout body. 2 days later emailed Dr. about ongoing mild jitters. Dr. out of office but person responding told me to try Benedryl and if it got worse, go to emergency room. Suncay 2/14, still experiencing this feeling along with slight headache and earlier today a racing heart beat. Now scheduled Dr. appt for tomorrow AM.

Other Meds: lisinopril 5mg/day, omeprazole 20mg/day, rosuvastatin calcium 2.5mg/day, Centrum silver women's every other day

Current Illness: none

ID: 1029080
Sex: F
Age: 70
State: FL

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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, Demerol, penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 3 hours after shot: headache, dizziness, nausea, fatigue. Next morning: soreness at site of shot, headache, slight light-headedness, fatigue.

Other Meds: Singular, albuterol sulfate, calcium, magnesium, vitamins C and B, fish oil, CoQ10

Current Illness:

ID: 1029081
Sex: F
Age: 56
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Fever and muscle aches lasting approximately 24 hours

Other Meds:

Current Illness:

ID: 1029082
Sex: F
Age: 82
State: AZ

Vax Date: 01/21/2021
Onset Date: 02/01/2021
Rec V Date: 02/14/2021
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: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: None at first. February 1-15. Developed very slight swelling at site of injection that encompassed most of upper left arm above elbow, with slight pain, rash, and increased warmth in area. This gradually receded and last 4-5 days of reaction the area was itchy.

Other Meds: Furosemide 40 mg. Losartan Potassium 100 mg. AmLodipine 2.5 mg. Omeprazole DR 20 mg

Current Illness: High blood pressure irritable bowel syndrome with diarrhea

ID: 1029083
Sex: F
Age: 55
State: IL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Diflucan

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

Symptoms: Woke with a headache, dizzy and very foggy. Continued with a fever all that day of up to 101.5 Periodic nausea. Took Tylenol every 4 hours and went to bed that night at the 29th hour with 100 degree temp. At 36 hours still had 100 temp and nauseaus and tired . Lasted until about hour 50 and then was able to eat a small meal. Third day still have 99.5 temp but feel fine today and mostly back to normal

Other Meds: Vitamin D, Baby Aspirin, Cymbalta 30mg SID

Current Illness: none

ID: 1029084
Sex: M
Age: 72
State: IL

Vax Date: 02/03/2021
Onset Date: 02/06/2021
Rec V Date: 02/14/2021
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 contrast dye

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

Symptoms: Moderna Covid-19 Vaccine EUA Shingles outbreak on right torso,extreme fatigue,body aches and dizziness

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm