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: 1030547
Sex: F
Age: 40
State: NY

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
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: Shellfish allergy - has improved over time, Patient eats shellfish now without complications.

Symptom List: Dysphagia, Epiglottitis

Symptoms: R sided facial flushing/fullness sensation x 22 hours after injection. 10mg PO decadron provided and 50mg benadryl PO.

Other Meds:

Current Illness:

ID: 1030548
Sex: F
Age: 53
State: PA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Chills and hardness at injection site occuring several hours after injection. Patient developed redness surrounding injection site last night measuring approximately 3 inches.

Other Meds:

Current Illness:

ID: 1030549
Sex: F
Age: 72
State: FL

Vax Date: 02/05/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
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: On February 10th, fever, chills body ache. Subsequently, right arm swelling, redness and tenderness.

Other Meds: Metoprolol Tartrate 100mg twice daily Eliquis 5mg tablets twice daily Lisinopril 40mg tablets twice daily Venlafaxine ER 75mg capsules once daily Dorzolamide HCI/Timolol eyedrops twice daily

Current Illness: none

ID: 1030550
Sex: F
Age: 61
State: FL

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/15/2021
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: Went to bed at 8:30 pm the night I received the second dose as I was extremely tired (02/25/21). Woke up at 2:00 am and was a little achy, took 2 Motrin and went back to bed. Woke up at normal time to go to work and had a little bit of a fever that lasted about two hours. Very tired the rest of the day (02/26/21). Symptoms were gone on 02/27/21.

Other Meds: None

Current Illness: None

ID: 1030551
Sex: M
Age: 85
State: AL

Vax Date: 01/25/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
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: None

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

Symptoms: No adverse effects for the first two weeks. The morning of 2/7/21 he claimed he was not able to sleep the night before. He was cold, but only wanted something cold to drink. He was not able to get through his normal morning routine. By 8 am we was beginning to get confused and weaker. By 9 am he vomited and was not able to stand up or walk. The confusion was increasing. We called 911. When they arrived he had chills and was agitated. He did not have a fever at that time. He was transported to the emergency room. We were not able to accompany him there, but were told he was confused, agitated and combatant. His fever was up to 101 degrees. The started him on antibiotics and began tests. He tested negative for COVID and the flu. By that evening they diagnosed him with viral meningitis and admitted him to the hospital. The next day we were told that they had ruled out viral meningitis as well as other infections. The infectious disease doctor said that all tests had come back negative, but they were continuing to give him antibiotics. A neurologist and cardiologist were called in and they were not able to find anything either. He did complain of chest pains, but it was determined that it might be heart burn. They did see a sign of Afib, but test were not conclusive. On Friday, Feb. 12th he was sent home with antibiotics and heart medicines. The confusion has improved, but he is very weak and not mobile without assistance.

Other Meds: Vitamin D3

Current Illness: None

ID: 1030552
Sex: F
Age: 61
State: IN

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

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium

Other Meds:

Current Illness:

ID: 1030553
Sex: F
Age: 68
State: NY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: I had ammonia smell or a strong smell through my noise and was just sitting in my living room. Later that night about 12:00 pm I had itching all over my legs and upper torso along with the chills very bad. I took a Zartac for the itching. In the morning if felt washed out and aches and pains. I took 2 tylennol. This seemed to help. By 12:00pm that day I was feeling better.

Other Meds: aspirin 91mg, Losartan 50mg.

Current Illness: none

ID: 1030554
Sex: M
Age: 86
State: PA

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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: Sulfa and Penicillin

Symptom List: Pharyngeal swelling

Symptoms: ON 2/10/2021- Resident with wife and he felt like he was going to pass out, became silent and arms began to shake and then his dead went back and he began snoring. He was unresponsive for two minutes. While nurse was there to follow up he felt like he was going to pass out. He became silent again, but nurse kept talking to him. His legs began shaking uncontrollably. He remained alert with this episode.

Other Meds: Aspirin 81mg daily / Lisinopril 10mg daily / Donepezil 10mg daily / Vitamin D 1000iu daily / docusate sodium 100mg daily / Omega-3 100mg daily / mealtonin 5mg Ohs / lantanoprost drops daily

Current Illness: None known

ID: 1030555
Sex: F
Age: 78
State: CT

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

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

Lab Data:

Allergies: milk, strawberries, trees, mold, mildew, dust Valium, latex, pennicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Severe exacerbation of fibromyalgia for 3 days and itching at the injection site

Other Meds: Xanax, Qvar inhaler, nasacort (nasal spray), Allegra,

Current Illness: Fibromyallgia. asthma

ID: 1030556
Sex: F
Age: 61
State:

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 02/15/2021
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: Began to have identical symptoms as pericarditis (tachycardia, constant heart pain) 3 days after vaccine. Lasted 3 weeks with around the clock prescription strength ibuprofen. History of viral pericarditis with pericardial effusion which took 1 1/2 years to resolve with cardiologist management. Will not be taking second dose of vaccine.

Other Meds:

Current Illness:

Date Died:

ID: 1030557
Sex: F
Age: 69
State: PA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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

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

Symptoms: According to her husband, approximately 3 hours after vaccine, patients clasped and was instantly unconscious. She was pronounced dead upon arrival to hospital and physician told husband that she had suffered a burst abdominal aneurysm and passed immediately. Nothing was out of ordinary during vaccination and during 15 minute wait time after.

Other Meds: Losartan/HCTZ 100/25mg Alendronate Sodium 70mg

Current Illness: none

ID: 1030558
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
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:

Symptom List: Rash, Urticaria

Symptoms: "Covid Arm". Large bright red rash, severe itching, swelling, pain at site. Started 2nd day after injection; lasted several days; 6 inches at longest point, and 3 inches at widest point; doctor gave me antibiotic for 3 days; seemed to clear up the problem significantly; somewhat healed from reaction, but not completely. Light rash remains today (2/15/2021)

Other Meds:

Current Illness:

ID: 1030559
Sex: F
Age:
State: FL

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: second shot given 2/5/21 at 0700 first vaccine given 1/15/21 lingering sx is no taste started on 1/14/21 had chills and aches on 2/6/21... fatigue and body aches is improved

Other Meds:

Current Illness:

ID: 1030560
Sex: F
Age: 43
State: WI

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: NKDA; food allergies to basil, fenugreek

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

Symptoms: Fever, malaise - onset at 16h, relieved at 48h post-vaccine Left axillary lymph node swelling and discomfort - onset at 24h post-vaccine, has not subsided

Other Meds: Lamotrigine 400mg qhs, Quetiapine 200mg qhs, Pravastatin 80mg qhs, Cetirizine 10mg qhs, Melatonin 20mg qhs, Guaifenisin 40mg qhs, Acetaminophen 500mg prn, Ibuprofen 400mg prn, Mirena IUD.

Current Illness: 1st dose covid-19 vaccine (Pfizer) 01/20/2021

ID: 1030561
Sex: U
Age: 69
State: MI

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

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

Lab Data:

Allergies:

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

Symptoms: Patient reported respiratory distress, onsite EMS responded. BP 180/90 HR 60 O2 99% on room air. Refused care released against medical advice.

Other Meds:

Current Illness:

ID: 1030562
Sex: F
Age: 58
State: RI

Vax Date: 02/03/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: Allergic to penicillin and aspartame.

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

Symptoms: Beginning nine days after vaccination, developed large circular red, swollen, and itchy area at injection site. Called my primary care physician and sent her pictures. She told me it is called "Covid Arm." She told me to report it to you, and informed me that it is still safe for me to get the second injection.

Other Meds: Calcium 600 mg. & Vitamin D 800mg - daily

Current Illness: No illnesses.

ID: 1030563
Sex: F
Age: 86
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: unknown

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

Symptoms: 24 hours after inoculation the inoculation site became reddened and warm to the touch. Patient took oral allegra.

Other Meds: Allegra, Atenalol, ELiquis, Lovastatin, Synthroid, Anastrozole, vitamins

Current Illness: Atrial Fibrillation, Seasonal allergies

ID: 1030565
Sex: F
Age: 65
State: NE

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies: Morphine, Percoset, Bee stings, Bananas

Symptom List: Ear pain, Hypoaesthesia

Symptoms: At injection site a hard, red with white swollen area appeared 7 days later. It is now day 11 and still throbbing. It is feverish, local only. When I apply a cold pack the red swelling goes away, but comes back when ice removed. I have pictures I could send via text if helpful. Wanting to know if I should seek help or will it go away on own. Also, concerned for 2nd dosage because reported side effects are worse. How should I proceed?

Other Meds: Dupixent injection, Letropolze, Synthroid, Pantropazole, Venaflaxine, Lunesta Multivitamin

Current Illness: Breast cancer, Melanoma, Thyroid Cancer, Rheumatoid Arthritis, Puriago Nodularis (skin disorder) wit scarring close to site of injection

ID: 1030566
Sex: M
Age: 50
State: NY

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: seafood

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: body aches/chills/headache/lymphadenopathy L sided (side of injection) - all resolved except of significant Left axillary lymphadenopathy - swelling was the size of small melon, non-tender, rather uncomfortable. Next day, it got a bit smaller - about size of large fist, but still present, day 4. Post auricular and posterior cervical Left lymph nodes were also enlarged and tender, but not to the same extend.

Other Meds: none

Current Illness: covid-like symptoms, however PCR was negative twice

ID: 1030567
Sex: F
Age: 60
State: MD

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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: About 12:30 AM on 2/14/21, I woke with extreme chills, muscle weakness, possible fever and sweats, joint pains. About 2:30 AM, I took two 325 MG aspirin. About 9:30 AM, I woke again with the same extreme symptoms listed above. I took an additional two 325 MG aspirin. About 4 PM, my symptoms were not as severe, but I was still unable to engage in daily activities, and I took an additional two 325 MG aspirin. Symptoms continued, but lessened, and about 9 PM, I told an additional two 325 MG aspirin and a zolpedim CR to help me sleep throughout the night. I woke about 6:45 AM on 2/15/21, with mild muscle weakness, joint pain, and feeling slow and tired. As of this report at 11:15 AM on 2/15/21, I am functioning at about 80% capacity, some chills and muscle/joint pain.

Other Meds: tramadol

Current Illness: liver disease, hemochromatosis, arthritis

ID: 1030568
Sex: M
Age: 48
State: IN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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: Low grade fever, muscle soreness throughout body, fatigue.

Other Meds: Daily OTC allergy medicine.

Current Illness: None.

ID: 1030569
Sex: M
Age: 65
State: TX

Vax Date: 02/05/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
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: Unevaluable event

Symptoms: Woke up 6 days later with sever double vision. Eyes seems to work independently ok but close to mid-range sight is double. It's been going on now entering the 5th day.

Other Meds: None

Current Illness: None

ID: 1030570
Sex: F
Age: 81
State: NY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: My blood/glucose level was abnormally high for two days following the vaccine My diabetes symptoms were more prevalent( thirst, frequent urination, dry mouth, diarrhea)

Other Meds: Vitamin D-3 Repaglinide 2 mg. before meals Telemisarten 80 mg 1x daily

Current Illness: High Blood Pressure Diabetes 2

ID: 1030572
Sex: F
Age: 60
State: NY

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
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: NSAIDS / LEVOQUIN/ PRENISELONE/PENICILLINE/ ACE INHIBATORS/

Symptom List: Injection site pain, Pain

Symptoms: 2MIN AFTER DOSE DIZZY, VERY CONFUSED, SLIGHT CHEST PRESSURE, 30 MIN LATER SLIGHT SWELLING OVER EYELIDS, 1 HR LATER STILL VERY CONFUSED IN A FOG. VERY CONGESTED , SNEEZING, ITCHY EYES, STUFFY EARS, VERY CONFUSED. STRANGE FEELING INSIDE MY BODY - TINGLING . FEELING OUT OF BODY .... NOT MY SELF ...ITCHING. VERY CONFUESED AND VERY DIZZY FOR ABOUT 4 HR... SEVERED HEADACHES. NAUSAUES. 6 HRS LATER SWOLLEN FACE RIGFHT SIDE.

Other Meds: losartan 100/25 hct -- amplodipine 10 mg multivitamin

Current Illness: HIGH BLD PRESSURE / DIABETIC/

ID: 1030574
Sex: F
Age: 51
State: FL

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

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

Lab Data:

Allergies: Patient reports regularly using Benadryl for allergic reactions, hasn't needed to use Epi-Pen for a long time, has stated she's gotten reactions to vaccines in the past but is fine if takes Benadryl.

Symptom List: Injection site pain, Menorrhagia

Symptoms: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Other- Anxiety/Panic-Medium

Other Meds:

Current Illness:

ID: 1030575
Sex: M
Age: 65
State: AL

Vax Date: 02/04/2021
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
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: NKDA

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

Symptoms: 2-day history reported of headache and myalgias primarily leg pain bilateral with office visit on 2/11/2021; subsequent rash 2/12 compatible with shingles right T10 dermatome

Other Meds: Amlodipine 10/valsartan 320, aspirin 81, atorvastatin 10, chlorthalidone 25, escitalopram 10, Metformin 500, terazosin 2 mg.

Current Illness: None

ID: 1030576
Sex: F
Age: 76
State: PA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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: penicillin, peaches

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: back of neck swollen and inside of throat

Other Meds: none

Current Illness: had recent6 months hip and 9 months spine surgery

ID: 1030577
Sex: M
Age: 80
State: NY

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I awoke with a slight headache and a stuffed nose. When I blew my nose and cleared my throat there was a dark brown, grainy substance in the nasal and throat mucus. this persisted for about 20 minutes and then cleared. I've not had any repetition of this since.

Other Meds: Metoprolol Succ ER 50mg., HCTZ 25mg., Simvastaten 10mg. Preservision areds CoQ10, Tamsulosin HCL 0.4mg, Xarelto 15mg., Glucosamine, D3 5000iu, Melatonin 5mg.

Current Illness: none

ID: 1030578
Sex: F
Age: 30
State:

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Woke up at 5 am on 2/12/2021 with a 102.8 degree fever, nausea and chills. Got up to get Tylenol and experienced a vasovagal syncope episode with Loss of consciousness lasting 5+ seconds resulting in a closed head injury requring and emergent visit for approximated head wound, needing 4 staples.

Other Meds:

Current Illness:

ID: 1030579
Sex: F
Age: 57
State: IN

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)

Other Meds:

Current Illness:

ID: 1030580
Sex: F
Age: 82
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies: atenolol penicillin

Symptom List: Injection site pain

Symptoms: pressure points and hot spots and burning sensation that lasted 2 days... and still experiencing those hot spots.

Other Meds: levothyroxine chlorthalidone amlodipine besylate multi vit

Current Illness: no

ID: 1030581
Sex: F
Age: 61
State:

Vax Date: 02/12/2021
Onset Date: 02/17/2021
Rec V Date: 02/15/2021
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: Feeling painful numbness of finger tips of left hand which is migrating different fingers.

Other Meds: Multi Vitamin

Current Illness: None

ID: 1030582
Sex: F
Age: 53
State: TX

Vax Date: 02/02/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: Sulfa drugs, penicillin

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

Symptoms: Red, swollen and itchy arm at vaccination site. It started as pale pink and has gotten darker and bigger. The site is now about ten inches long and four inches wide at its widest point.

Other Meds: Zyrtec

Current Illness: N/A

ID: 1030583
Sex: F
Age: 79
State:

Vax Date: 01/29/2021
Onset Date: 02/02/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, macrodantin, sulfa, caffeine.

Symptom List: Tremor

Symptoms: At 1:30 a.m. on Tuesday, February 2, 2021 (88 hours after my vaccination) I I was awaken with horrific itching on both hands and wrists, I was scratching so hard I thought I would tear my skin. At times it went up my arms and there were red blotches on my wrists and arms. After a shower at 3:00 a.m. I went on the couch until 8:00 when I awoke in a complete fog with itching that was subsiding and gone by noon. I was just 'slow' the rest of the afternoon.

Other Meds: Prempro (0.625-2.5 mg m one half tablet); daily senior vitamin; low dose aspirin; probiotic.

Current Illness: None

ID: 1030584
Sex: F
Age: 81
State: WY

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Systemic: Allergic: Rash Generalized-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Other- exasperation of post-viral rash-Mild

Other Meds:

Current Illness:

ID: 1030585
Sex: F
Age: 84
State: NY

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: Lisinopril, Keflex, crab meat, Codeine, very allergic to barbituates

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

Symptoms: On Saturday mid morning she noticed a red, can see at the bottom of it where the swelling ends on the injection site near the shoulder, underneath that and one little area that seems to have gone down towards the armpit. It stung from the beginning. It resembles COVID arm that she has seen. It goes down towards the middle of her arm. Today, 2/15/21 it is the same, is pinkish/red, itchy, feels like she wants to scratch it. She did take Tylenol before she went to bed last night. She thinks it is less sore as a whole today as it was.

Other Meds: Xanax, Enablex, aspirin 81 mg, Lexapro, Clarinex, Lasix, Norvasc, Spironolactone, Prevacid, Synthroid, Toprol, Jantovin, Adderal, stool softener, senna tea, vitamin C.

Current Illness: None.

Date Died: 02/14/2021

ID: 1030586
Sex: M
Age: 65
State: PA

Vax Date: 02/11/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: This individual's employer informed our facility that he passed away at his home on 2/14/2021. Since he was not brought into our hospital, we do not have information regarding other health conditions or active medications. Since this individual received his second covid vaccine three days prior, this was reported to Moderna in addition to this VAERS report being completed. The coroner for County can be contacted.

Other Meds:

Current Illness:

ID: 1030587
Sex: M
Age: 37
State: OR

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, doxycycline

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever of 104F, pain in major joints, knees, hips. Teeth hurt, headache, even my finger nails hurt. Symptoms ceased after 18hrs

Other Meds: None

Current Illness: None

ID: 1030588
Sex: M
Age: 65
State: MN

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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: No

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

Symptoms: Minutes after shot felt woozy and light headed. As my fifteens was up , I started getting severe heightened sense of smell and could smell body odors from people all around me. Threw up before exiting building in rest room.Needed to get out of building ASAP fast for fresh air . Breathing-20 degree fresh air maskless helped but still felt weak so wife and medical aids brought me inside to isolated area on a cot to rest and take vitals . When I was sick with COVID-19 in September 2020 I had same issues with heightened smell and taste before I lost them for three months.

Other Meds: Simivastatin 20mg Levothyroxine 125 mcg Tamsulosin .4mg Hydrochlorothiazide 25mg Citalopram 20mg Multivitamin supplement

Current Illness: No

ID: 1030589
Sex: F
Age: 35
State: CT

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: Fever 100.7 degrees F x1 day, chills, headache, stomachache, diarrhea, fatigue, body aches

Other Meds: Lexapro 20 mg, vitamin d 2000 iu, vitamin b12

Current Illness: None

ID: 1030590
Sex: M
Age: 53
State: MA

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

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

Lab Data:

Allergies: I am allergic to an anti-inflammatory dark green capsule but do not know the name.

Symptom List: Pain in extremity

Symptoms: 30 minutes after vaccination mild headache in temple area. 5.5 hours after vaccination sneezing and runny nose and a feeling of dehydration. Following day minor stomach nausea upon waking up but dissipated after an hour. minor pain in right neck muscle.

Other Meds: none

Current Illness: I have narcolepsy

ID: 1030591
Sex: M
Age: 65
State: FL

Vax Date: 02/03/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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 (when I was 9)

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

Symptoms: Began to experience UTI type symptoms, with uncharacteristically frequent urination, and some burning. Began to have a fever which over the 24 hour period went from my normal of 97.6 to 101.2 at 10:30pm the second night. Throughout the period I had a mild headache and significant fatigue. I woke up this morning at 12:30am with the sheets, pillow and pajamas very wet (from sweat). I checked my temperature and for the first time in 24 hours, it had dropped (to 99.2). When I got up at 6 this morning, my temperature was 98.6 (still a little elevated for me). My wife experienced practically the same thing 4 days earlier without the urinary symptoms and temp not quite a elevated. We had the vaccine at the same time(s). I'm still fairly fatigued at this time (and my wife a little).

Other Meds: alfuzosin, finasteride, baby aspirin, dorzolamide eye drop, timlol eye drop, rosuvastatin

Current Illness:

ID: 1030592
Sex: M
Age: 88
State: IN

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 02/13/2021-pt could not stand/walk or support body weight, balance off, weak, brain fog

Other Meds: Aspirin 81 mg once daily, Carbidopa 25-Levodopa 100 mg three times daily three tablets each, Citalopram Hydrobromide 40 mg-20 mg (half) once daily, Cyanocobalamin 100 mcg once daily, Ipratropium BR .03 % nasal spray twice a day one puff eac

Current Illness:

ID: 1030593
Sex: F
Age: 67
State: NJ

Vax Date: 02/02/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: Itching under arm after about a week followed by slight redness near injection site over the next 4-5 days. I it has been 13 days and today the rash has gotten much bigger.

Other Meds: Ativan half dose of 0.5 mg

Current Illness: None other than occasional reflux

ID: 1030594
Sex: F
Age: 64
State: RI

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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: seasonal alllergies

Symptom List: Vomiting

Symptoms: headache, low grade fever, weakness, chills, dry mouth, stuffy nose, sore arm. crummy feeling. tired.

Other Meds: Prolia, Hydroxychlorequine, Losartan, Calcitriol, Metoprolol, Hydrochlorethiazide, Loratedine. Calcium supplements. low dose aspirin

Current Illness: CKD, Systemic Lupus.

ID: 1030596
Sex: F
Age: 67
State: PA

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
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: Scallops, opioids, penicillin,tape, benedryl, atarax,

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Left arm at injection site became red and hard and appeared to have a rash. My throat on the left side was also swollen.

Other Meds: Advair, Crestor, water pill, multi vitamins, calcium, d3, b3, coq10, turmeric, probiotic,

Current Illness: None

ID: 1030597
Sex: M
Age: 71
State: FL

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
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: 1st 1/9/21 1320 2nd 2/6/21 1320 ringing ears , cant sleep tinnitius has lessened but isn't completely gone. took a Acetaminophen PM to help go to bed and meditate.

Other Meds: tamsulosin

Current Illness:

ID: 1030598
Sex: F
Age: 32
State: VA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Some vaccine came out of the injection site post removal of the vanishing point needle which failed to retract. Patient did not appear to have any adverse outcome related to this.

Other Meds:

Current Illness:

Date Died:

ID: 1030599
Sex: M
Age: 84
State: WY

Vax Date: 01/18/2021
Onset Date: 01/22/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Flushed / Sweating-Mild, Systemic: Other- Death-Severe

Other Meds:

Current Illness:

ID: 1030600
Sex: M
Age: 44
State: TX

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/15/2021
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: Na

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

Symptoms: Swelling, dollar size lump and itchy

Other Meds: Lisinophril, multivitamins

Current Illness: Na

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm