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: 1030978
Sex: F
Age: 59
State: NY

Vax Date: 02/12/2021
Onset Date: 02/14/2021
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: neosporin , bacitracin

Symptom List: Dysphagia, Epiglottitis

Symptoms: a large red lesion near injection site that is swollen, red, and itchy. Read that this is called COVID arm and took an overthe counter antihistamine drug.

Other Meds: Biotin, Vitamin D, Hyaluronic acid

Current Illness: none

ID: 1030979
Sex: F
Age: 54
State: NY

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Mild allergy to melon Mild allergy to latex

Symptom List: Anxiety, Dyspnoea

Symptoms: flushing, racing heart and light headedness lasting about 2 minutes 25 minutes after the shot and again 2 hours later.

Other Meds: Xeljanz XR, Vitamin, D, Zinc, Magnesium, CoQ-10

Current Illness:

ID: 1030980
Sex: F
Age: 56
State: MN

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: Allergic to latex, pollen, dust mites, animal dander-dogs and cat, ragweed, grass allergies

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

Symptoms: 15 hours after receiving the vaccine I started having severe body aches all over and in my bones, moderate headache, fatigue, dizziness. Then 21 hours after receiving the vaccine I developed a temperature of 100.5. I treated the fever and pain with ibuprofen 600 mg orally every 6 hours. I was ill and not able to work or get out of bed for a total of 1 1/2 days.

Other Meds: Cymbalta30 mg daily , Topamax 50 mg daily , Wellbutrin 150 mg daily , vitamin D 2000 units daily, singular 10 mg daily,

Current Illness: None

ID: 1030981
Sex: F
Age: 20
State: FL

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

Lab Data:

Allergies: Coconut

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Painful Swollen lymph node on side of breast/under armpit on third day after receiving the vaccine.

Other Meds:

Current Illness:

ID: 1030982
Sex: F
Age: 74
State: CA

Vax Date: 02/08/2021
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:

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

Symptoms: 1 wk after shot arm itch and red at site and below several inches. Arm very warm. Other side arm pit area small lump.

Other Meds: tamoxifen, donnatal, amlodipine besylate

Current Illness:

ID: 1030983
Sex: F
Age: 68
State: ID

Vax Date: 02/15/2021
Onset Date: 02/10/2021
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: None

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

Symptoms: Swollen itchy injection site

Other Meds:

Current Illness:

ID: 1030984
Sex: F
Age: 80
State:

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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: fatigue, moderate site pain

Other Meds:

Current Illness:

ID: 1030985
Sex: F
Age: 41
State: CA

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

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Pt took 25mg benadryl prior to arrival. reports she always feels dizzy when she takes benadryl, but this is different. vital signs stable. bp 106/72 hr 66. 100% on room air. ambulated with a steady gait. accompanied by significant other. time course 39 minutes. no sob, tongue swelling, throat swelling, rash.

Other Meds: took benadryl over the counter 25mg prior to arrival

Current Illness: had similar symptoms with the first vaccine

ID: 1030986
Sex: F
Age: 59
State: IL

Vax Date: 01/28/2021
Onset Date: 02/08/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: swelling, burning, itching, redness, hot to the touch, change in skin texture - spreading up:down are from injection site for 10 days and not getting any better. COVID ARM

Other Meds: lisinopril butalbitol/codeine

Current Illness: seasonal allergies, sensitivity to light, renaud syndrome, controlled HBp, hyperparathyroidism

ID: 1030987
Sex: F
Age: 68
State: NJ

Vax Date: 02/09/2021
Onset Date: 02/12/2021
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: tetracycline (upset stomach), wasps

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Infection, inside lower eyelid, left eye. Treated with Ciprofloxacin 0.3% eye drops.

Other Meds: Dexilant, metformin, levothyroxine, rosuvastatin, vitamins B12, C, D3, biotin, calcium, glucosamine/chondroitin

Current Illness: N/A

ID: 1030988
Sex: F
Age: 39
State: MN

Vax Date: 02/06/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: 5 cm induration and 12 cm erythema at injection site

Other Meds: Levothyroxine, Vyvanse, lisinopril

Current Illness: Nasal/sinus congestion, dry cough

ID: 1030989
Sex: F
Age: 58
State: OH

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

Lab Data:

Allergies: Zetia, Zithromax, Doxycycline, Flagyl, Niacin, Morphine, Codeine, Demerol, Erythromycin, Fish Oil and tomatoes.

Symptom List: Rash, Urticaria

Symptoms: Extreme pain, redness, swelling of right arm and fingers not only at the injection site but entire arm. Headache like I have never experienced, sore muscles and joints, fever 101.9 for 24 hours, nausea, swelling of face and hands, rash on right ear external, extreme fatigue, chills, could not sleep due to pain in my right arm. Also, when given the injection, the LPN rubbed my arm very hard immediately following the injection. It was very painful!

Other Meds: Vitamin D3-1,000 1 x day Nasacort- 1 x day

Current Illness: none

ID: 1030990
Sex: F
Age: 40
State: WA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
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: Chills; fatigue; fever; headache; joint pain; muscle pain and pain at injection site.

Other Meds:

Current Illness:

ID: 1030991
Sex: F
Age: 97
State:

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: pain at site

Other Meds:

Current Illness:

ID: 1030992
Sex: F
Age: 70
State: AZ

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: First day severe pain under left shoulder, 2nd my whole body hurt with muscle pain could hardly move. 3rd day fine 4th day muscle pain through out my body. Could not move neck. Pain down my whole spine.

Other Meds:

Current Illness: None

ID: 1030993
Sex: M
Age: 77
State: MA

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: 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: Moderna COVID-19 Vaccine EUA Symptoms were fatigue and chills

Other Meds: All meds taken daily Allopurinol 300MG Lisinopril 40 MG Hydrochlorothiazide 25 MG Vitimin C Vitimin D Multivitamin Aspirin 81 MG

Current Illness: COVID-19 detected on January 6,2021

ID: 1030994
Sex: F
Age: 83
State: MA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: foods high in histimines;salicytates; nsaids; folmaldehyde; other chemicals; polyester

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

Symptoms: had waves of spasms that would start at my stomach and go up ward about every two to three minutes.. no dizziness, not nauseous stayed at valley medical for about two hours.. took two 25 mg of benadryl at two different intervals. as blood pressure and heat rate came down left. took 50mg for the rest of the day 1 ad day two every 4-6 hrs and dropped to 25mg for a day and a half. Have an appointment with allergist before the second vaccine.

Other Meds: cromolyn sodium; vitD; hydroxyzine; salt water nose drops

Current Illness: none

ID: 1030995
Sex: F
Age: 70
State: GA

Vax Date: 02/03/2021
Onset Date: 02/10/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 5 to 7 days after the vaccination the vaccination site became itchy and pink Circle. It would come and go but mostly staying. It is a little warm to the touch. No lump and doesn't hurt. Went to my primary care doctor this morning and she wants to see me again tomorrow and she is checking with the pharmacy about this and she asked that I report this to you.

Other Meds: None

Current Illness: None

ID: 1030996
Sex: F
Age: 35
State: CO

Vax Date: 01/30/2021
Onset Date: 02/09/2021
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: penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 10 days after immunization, redness and itching of arm in the area of the injection that lasted a week. Immediately after immunization, joint aches in the wrist and elbow of the immunization arm that lasted 2 days.

Other Meds:

Current Illness:

ID: 1030997
Sex: F
Age: 90
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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:

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

Symptoms: pain at site

Other Meds:

Current Illness:

ID: 1030998
Sex: F
Age: 59
State: WA

Vax Date: 02/12/2021
Onset Date: 02/14/2021
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:

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

Symptoms: This was second dose of Moderna vaccine. First dose was on 1/19/21 and second dose on 2/12/21. 02/12/21 - Slight sore arm throughout day. p.m. sore arm more intense in evening hours. No redness noticed in arm. 02/13/21 - Sore arm, headache, achy body muscles, chills throughout day and evening. No redness noticed in arm. 02/14/21 - Sore arm, and notice redness about 3 inches below injection site. The area of redness approx. 2" x 3" in a.m. Area is hot to the touch. By p.m. hours the area of redness has grown to approx. 3" x 4" and moving toward front of body and remains noticeably warmer than surrounding skin. No other symptoms. 02/15/21 - a.m. hours, at this reporting, area of redness on arm remains and is sensitive to touch. Remains hotter to touch than surrounding area.

Other Meds: Levothyroxin 112mcg taken at 5:00 a.m. day of shot. Take it every day. Ropinirole .25 mg - 2 pills taken night before shot. Take every night before bed.

Current Illness:

ID: 1030999
Sex: M
Age: 67
State: FL

Vax Date: 02/10/2021
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:

Symptom List: Unevaluable event

Symptoms: pt had no sx until this morning. Today pt woke up at 6am with tongue swollen and redness on one side of his tongue. no progression, no worsening, breathing ok and able to swallow. Unable to confirm this is related to the vaccine, but possible. Since no progression and red area is only on one side of the tongue, I mentioned to also consider the possibility of sxs being due to him accidentally biting his tongue while sleeping. May take a dose of Benadryl-if indeed this is an allergy reaction, monitor yourself at home, f/u with pcp. Call 911 if any difficulty swallowing and/or difficulty breathing. Call back if any q. Will f/u.

Other Meds:

Current Illness:

ID: 1031000
Sex: F
Age: 66
State: GA

Vax Date: 02/12/2021
Onset Date: 02/15/2021
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: Arm was extremely sore after the second vaccination I noticed that it was hot and red and on day four after the vaccination was given it started to itch I understand this is something called Covid arm I put Benadryl cream on it very disturbing

Other Meds: Vitiamns centrum Vit b Buspar 15 mg 2 times a day took Morin and Tylenol for fever from shot and body aches. Got Covid arm 4 days later arm had been painful from the vaccine but started itching on 4 th day put benedyrl on spot of injection

Current Illness: None

ID: 1031001
Sex: F
Age: 59
State: MI

Vax Date: 01/22/2021
Onset Date: 01/24/2021
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: allergy reaction to facemask being worn during pandemic, switched to hypollargenic facemask. Allergy to dustmites and mold, does not take medication for this

Symptom List: Injection site pain, Pain

Symptoms: Received 2nd Covid vaccine on 1-22-21. The next day had muscle aches, fatigue(1-23). On 1-24-21 woke up with 2 black eyes and a blood nose. This was about 8-8:30am. Blood nose lasted between one hour and one and a half hours. She packed her nose and by 10am it was not bleeding through and she left in place until 1pm. No more bleeding from nose after that time. All symptoms resolved by the end of the day 1-25-21. No more bleeding, denies bruising or any symptoms after that date.

Other Meds: Atorvastatin 20mg, which she did not take from date of incident until 2-11-21 as a precaution.

Current Illness: none

ID: 1031002
Sex: M
Age: 15
State: OR

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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: Unknown, do not have VAR in front of me

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient was vaccinated before the 18th birthday with Moderna vaccine, a medication administration error parent reported that child had a sore arm following vaccination, but no other adverse effects

Other Meds: Unknown

Current Illness: Unknown

ID: 1031003
Sex: F
Age: 90
State:

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

Lab Data:

Allergies:

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

Symptoms: site pain

Other Meds:

Current Illness:

ID: 1031004
Sex: F
Age: 71
State: WA

Vax Date: 02/06/2021
Onset Date: 02/14/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Eight days after receiving vaccination, I awoke with a baseball size rash oat the injection site. It was itchy, warm and a bit hard. Tolerable.

Other Meds: Valtrex, baby aspirin, vit.C, vit. D3

Current Illness: None

ID: 1031005
Sex: F
Age: 29
State: CA

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Clindamycin, Keflex, Latex, Peanuts,

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient began feeling nauseous at 11:15, mild emesis. BP 124/75, p-73, No complaint of chest pain or shortness of breath, no difficulty swallowing. Patient transferred to observation hub and Epinephrine 0.3 mg given by paramedics. Vital signs monitored by paramedics and after 30 minutes, patient released to home with caregiver

Other Meds: Plavix, Iron tabs, Anti-seizure medication

Current Illness:

ID: 1031006
Sex: M
Age: 75
State: TN

Vax Date: 01/24/2021
Onset Date: 01/11/2021
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: Bells Palsy 20 days after vaccination. Vacination left arm Bells Palsy Left side of face

Other Meds: Felodapine, Amilorid Spirilatain

Current Illness: Hypokalemia Hypertension

ID: 1031007
Sex: M
Age: 80
State: OH

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

Lab Data:

Allergies: Phenergan

Symptom List: Nausea

Symptoms: Rash on arms, legs and especially on ankle

Other Meds: Multaq, Lisinopril, Protonic, MOBIC, Eliquis, Vitamin B-12, Iron, Klor-Con, Multivitamin, Fish Oil, Curcumin, Vitamin D, Melatonin. Also last dose of a 10-day regimen of sulfa anti-biotic was completed on 14 Feb

Current Illness: Infection in Neck Cyst

ID: 1031008
Sex: F
Age: 66
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/13/2021
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: benzonatate, bupivacaine, contrast dye, amoxicillin, Cipro, Erythromycin, Latex, meloxicam, sulfa, Valtrex, Codeine, epinephrine, nitrofurantoin, nitrofurantoin microcrystalline, prednisone pack, PPD hair dye, Marcaine,

Symptom List: Injection site pain

Symptoms: pt states that she had a normal sore arm and fatigue after the injection but on 2/13/21 she noticed she had developed a 2x 2 1/2" itchy, raised, red area around the injection site. She said she self diagnosed it as covid arm. She took pictures of it and sent them to her PCP and also contacted her Asthma doctor. She was told to put ice pack on the infected area, take Benadryl and use cortisone cream. Pt states it is improving.

Other Meds: metoprolol tartrate , esterase, Mucinex 600 mg x 2, Clonazepam, Citrucel , children's Allegra,

Current Illness: no

ID: 1031009
Sex: F
Age: 76
State: CA

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

Lab Data:

Allergies: NKA

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

Symptoms: The vaccine was diluted with 0.8ml NS instead of the correct 1.8 ml NS. Phone call to patient within 24 hours after vaccine to inform of the error; arm was sore with movement, not swollen or warm to the touch, denied redness at site. Denied fever chills or malaise at 24 hours. Phone call to Pfizer, spoke with the call center concerning this incident, there were trials with a higher dose that did not cause harm to the patient. Pt reassured with this information

Other Meds: Multivitamin, Ferrous Sulfate, Tramadol, Amlodipine, Pantoprazole, Yuvafem, actaminophen

Current Illness:

ID: 1031010
Sex: F
Age: 31
State:

Vax Date: 02/01/2021
Onset Date: 02/02/2021
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: No known drug allergies

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

Symptoms: Information provided by patient. After second COVID vaccine dose on 2/1 at 10:20am, I woke up around 3am on 2/2 with chills and shaking. These chills alternated with sweats - waking up frequently either with chills or sweats. These symptoms ended around 1900 on 2/2. Also on 2/2, I began getting left flank pain. I thought this was muscular. Throughout 2/2 and 2/3, the flank pain became worse and worse and I realized it may be a kidney stone (I have had a kidney stone before). I left my work shift early on 2/3 to go to the ER at 2100. There, it was a little complicated because I am pregnant and could not receive a CT scan to check for stones. Based on the information gained from ultrasounds and the UA, they decided to treat for pyelonephritis. I left the ER around 0130 on 2/4 and picked up pain medications and 14 days of cefdinir. I do know this may not be related to the vaccine, but I think we need to report everything in case there are trends. ER Provider notes as follows: 31 y.o. female who arrived by Home presented to the emergency department for left flank pain that radiates to her left groin. The pain has been present since yesterday and it is sharp in nature. She took tylenol at 7pm this evening, but it did not help with the pain. She is also 12 weeks pregnant. Patient reports that she passed a kidney stone 3.5 years ago. At the time, she was told that she had an additional stone in the left kidney and has been following with urology. She also reports nausea that has improved with Zofran. Denies fever or chills, urinary urgency or frequency, or blood in her urine. Patient had an ultrasound at Hospital two or three weeks ago that showed a viable IUP. This is her third pregnancy. She denies complications with previous pregnancies and reports two prior cesarean sections. Patient is sitting up in bed, in no acute distress. Vital signs are normal. Patient presents for left flank pain for the past day that radiates into her groin with associated nausea, and she is 12 weeks pregnant. She has a history of a kidney stone three and a half years ago with an additional stone present in the left kidney at the time of diagnosis. Will obtain CBC, CMP, UA, urine culture, POC kidney ultrasound. Given 1L IV NS bolus, IV zofran and IV morphine. DDx: Nephrolithiasis versus UTI versus pyelonephritis versus ovarian cyst versus musculoskeletal etiology On reassessment, UA negative for nitrites and leukocyte esterase but positive for 50-250 bacteria perr hpf. POC kidney ultrasound negative for hydronephrosis and UA negative for blood. POC US showed IUP with FHR in 170s with good fetal movement. POC renal US repeated after 1L IVF without evidence of hydronephrosis. Will treat for asymptomatic bacteriuria in pregnancy with cefdenir for 14 days given concern for early pyelonephritis. Nephrolithiasis is still possible but unlikely cause of symptoms as there is no sign of obstructive uropathy on bedside US. Through shared decision making, will not undergo CT limited high for stone evaluation at this time given risk of radiation to fetus. Will discharge home with plan to follow-up with OB and PCP in 1-2 days - also provided Rx for roxicodone and miralax. Strict return precautions discussed. Patient voices understanding and agreement with plan. Denies further questions at this time.

Other Meds:

Current Illness:

ID: 1031011
Sex: F
Age: 39
State: IL

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Lymphadenopathy to Right axilla, fever, body aches, chills, injection site erythema/pain/swelling

Other Meds: None

Current Illness: None

ID: 1031012
Sex: F
Age: 89
State:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: pain at site

Other Meds:

Current Illness:

ID: 1031013
Sex: F
Age: 44
State: KY

Vax Date: 02/03/2021
Onset Date: 02/11/2021
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: Seasonal/outdoor

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

Symptoms: Large knot at injection site and a small rash on 2/11/2021. Today (2/15) the knot is almost gone. The rash has been off and on. Today the rash is bigger, slightly raised and itchy.

Other Meds: Zyrtec, Provide AC

Current Illness:

ID: 1031014
Sex: F
Age: 35
State: WA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
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: Had the following symptoms after being vaccinated: -chills -body aches/generalized -joint pain/generalized -fever -headache -fatigue -swelling/pain at site of vaccination/photos available

Other Meds:

Current Illness:

ID: 1031015
Sex: M
Age: 32
State: CA

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

Lab Data:

Allergies: None.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Flu-like symptoms approximately 8 hours after 2nd dose of Moderna vaccine. Fatigue, fever, heart palpitations, nausea, back pains, headache, pain in left arm. Symptoms cleared up 80% after 24 hours of symptoms, cleared up 100% after 48 hours.

Other Meds: Viviscal, minoxidil 5%

Current Illness: None.

ID: 1031016
Sex: F
Age: 73
State: AR

Vax Date: 01/26/2021
Onset Date: 02/05/2021
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: Latex Codeine Sulfa

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

Symptoms: (1)Red, itchy splotches on and around injection site-- took oral benadryl 4 nights till gone (2) Stopped up ears began same day as above symptoms with one round of 3 or 4 sneezes. Disappeared gradually by same day as above mentioned splotches.

Other Meds: Pantoprazole Cholestyramine Lantanoprost drops Metronidazole cream Vitamin D Viactive calcium chews Melatonin Prolia injections

Current Illness: None

ID: 1031017
Sex: F
Age: 69
State: MT

Vax Date: 02/11/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sulfa drugs

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

Symptoms: Slight fever, chills, headache, body ache, general weakness; no treatment needed; duration of symptoms was about 36 hours; I had covid19 about 100 days earlier than the date of the administration of this first covid vaccination

Other Meds: tamoxifen

Current Illness: none

ID: 1031018
Sex: F
Age: 74
State: NC

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:

Symptom List: Pain in extremity

Symptoms: 2/6 Awoke with arm muscles very sore & couldn't lift arm high. By Sum 2/7 was a little less sore. Didn't check injection site until Thurs 2/11 and large reddish/pink area around site & arm was sore to elbowl

Other Meds: Vitamin C, E, D, Folic Acid, Calcium with Magnesium & Zinc & Probiotic

Current Illness: No

ID: 1031019
Sex: F
Age: 74
State: NC

Vax Date: 02/13/2021
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: Sulfa

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

Symptoms: Itching and swollen size of softball. Applied ice pack and took Benadryl. Continued from onset to swell and itch. Someone mentioned that if you're allergic to metal that would happen and I am allergic to certain metals. Swelling in lymph nodes under arm.

Other Meds:

Current Illness: None

ID: 1031020
Sex: F
Age: 57
State: MI

Vax Date: 02/12/2021
Onset Date: 02/14/2021
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: Augmentin, Methylchloroisothiazolinone, Imidazolidinyl Urea

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

Symptoms: Noticed a rash on left arm about 3 inches lower than injection site 2 days after injection. Arm was very sore in that area. Woke up on 3rd day after injection and my arm was extremely sore and rash was much worse. Pain, redness, warm to touch.

Other Meds: Hydroclorothiazide, Oxybuytnin, Atorvastatin, Omeprazole

Current Illness: None

ID: 1031021
Sex: F
Age: 70
State: GA

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Explosive Diarrhea, & explosive vomiting lasting over 10 hours. Rapid heart rate which began prior to above diarrhea & vomiting. Muscle cramping & muscle twitching much like electrical shock especially in lower extremities along with severe headache. Low grade fever & mild chills. Extreme tiredness/low energy which still remains. There was also a degree of dizziness which remains as well.

Other Meds: Multi vitamin

Current Illness: None

ID: 1031022
Sex: F
Age: 51
State: FL

Vax Date: 01/08/2021
Onset Date: 01/21/2021
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: none

Symptom List: Vomiting

Symptoms: About two weeks after first moderna does I ended up having Shingles. A ton of pain and rash in the middle of my back down right shoulder and right arm. Was treated on 1/31 at urgent care with antiviral and gapapentin for pain. So far its been about 3 weeks..rash has scabbed still having some itching and pain.

Other Meds: lexapro 5mg progestrone 100 mg WP thyroid 65 mg half every other day Nurtec prn ativan prn melatonin 3mg prn

Current Illness: Head cold/sinus infection

ID: 1031023
Sex: M
Age: 60
State: CA

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

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Right upper arm became very swollen, hard, and painful to the point that I could not raise my arm or touch the spot. I also had a fever and headache.

Other Meds: Vitamin B-12, D, zinc, calcium

Current Illness: None

ID: 1031024
Sex: F
Age: 72
State: MN

Vax Date: 02/11/2021
Onset Date: 02/14/2021
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: Penicillin

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

Symptoms: I have welts that itch under my chin and on my left outer ear

Other Meds: Kirkland Mature Multi Vitamin 1000IU Vitamin D3 500 mg with D3 Kirkland Calcium Adult Gummies

Current Illness:

ID: 1031025
Sex: M
Age: 86
State: IN

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

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: unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient told doctor that his blood sugar went up (>400) after his first COVID-19 vaccine and he was hospitalized.

Other Meds: unknown

Current Illness: Unknown

ID: 1031459
Sex: F
Age:
State:

Vax Date: 12/30/2020
Onset Date: 12/30/2020
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: Vision not clear; Pounding of chest; throat felt contracted; A report was received from a healthcare professional concerning a female patient who was participating in the mRNA-1273 Emergency Use Program and experienced vision not clear, pounding of chest, and throat felt contracted. The patient's medical history, as provided by the reporter, included asthma and hypoglycemia. No relevant concomitant medications were reported. On 30 Dec 2020, approximately 15 minutes prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 30 Dec 2020, 15 minutes following vaccine administration, the subject's vision became unclear, and she described everything seeming hazy and smoky. Her throat then began to feet contracted and her chest was pounding. The patient was transported to the emergency room (ER) via an ambulance. Her electrocardiogram (EKG) result was normal, while blood pressure and blood sugar results were increased. She remained in the ER overnight but was not admitted. Her vision returned to normal 5 pm the same day. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The event, vision not clear, was considered resolved on 30 Dec 2020. The outcome of the events, pounding of chest, and throat felt contracted were unknown. The reporter did not provide an assessment for the events, vision not clear, pounding of chest, and throat felt contracted.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. The Patient's medical history of asthma and hypoglycemia remains as confounders.

Other Meds:

Current Illness: Asthma; Hypoglycemia

ID: 1031460
Sex: F
Age:
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Convulsing; Mild diarrhea; Fatigue; Mild bladder infection; Sweating; Pain; Fever; Nausea; Chills; A spontaneous report was received from a consumer concerning a 77-years-old, female patient who received Moderna's COVID-19 Vaccine, and who experienced pain, fever, nausea, chills, convulsing, uncontrollable body jerking, sweating, full body ache, fatigue, and mild diarrhea. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 15 Jan 2021, approximately the night of prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Lot number 011L20A) intramuscularly for prophylaxis of COVID-19 infection. On 15 Jan 2021, the patient developed pain, fever, nausea and chills. On 16 Jan 2021, the patient entire body started convulsing and sweating. She developed pain; entire body ached with uncontrollable body jerking. Patient was taken to the hospital, where she received intravenous fluid and paracetamol and was diagnosed with a very mild bladder infection. On an unknown date, the patient had mild diarrhea and fatigue. Action taken with mRNA-1273 in response to the events was unknown. The outcome of the events pain, fever, nausea, chills, convulsing, uncontrollable body jerking, sweating, full body ache, diarrhea, and fatigue was not reported.; Reporter's Comments: This case concerns a 77 year old, female patient, who experienced serious unexpected event of seizure, and non-serious unexpected event of hyperhidrosis and cystitis, and non-serious expected events of nausea, pyrexia, chills, diarrhea and fatigue. The event of pain, pyrexia, nausea, chills occurred 1 day (same day) date after mRNA-1273 (Lot# 011L20A), while the event of seizure, hyperhidrosis, and cystitis occurred 2 day (same day) date after mRNA-1273 (Lot# 011L20A). The event of diarrhea and fatigue occurred on an unspecified date after mRNA-1273 (Lot# 011L20A). Treatment included IV fluids and Tylenol. Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Additional information has been requested.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm