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

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1031783
Sex: F
Age: 28
State: CA

Vax Date: 02/04/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
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Lot:
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Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Initial side effects were minimal/expected. After about 48 hours I started experiencing jaw pain in the left mandible extending up to the left temporomandibular joint. I have a relatively high pain tolerance so I wouldn't say the pain was severe or life-altering, but since the frameworks reported occurrences of reactogenicity at 3 or greater and I am taking OTC pain medication to manage my jaw pain, I figured it was a data point worth reporting. The pain is certainly tolerable, but makes opening my jaw fully or chewing on the left side unpleasant enough to make it worth taking painkillers.

Other Meds: Duloxetine HCL, 90 mg daily Vyvanse, 50mg daily Hydroxyzine, 10mg as needed

Current Illness: None

ID: 1031784
Sex: F
Age: 70
State: CA

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

Vax Type:
Manufacturer:
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Vax Site:

Lab Data:

Allergies: Prednisone

Symptom List:

Symptoms: I have never had this before, but since getting the vaccine, I have had horrible nightmares every night since getting the Pfizer vaccine. My husband has to wake me every night, and this has not let up. Also, I have had a Fibromyalgia flare-up since getting the vaccine.

Other Meds: Effexor, Vivelle Patch, Multi-vitamin, Calcium, Vitamin D

Current Illness: Fibromyalgia

ID: 1031785
Sex: F
Age: 39
State: NV

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Ginger, Singulair, MSG

Symptom List:

Symptoms: Rash, itching and rash is growing

Other Meds: Tylenol

Current Illness: None

ID: 1031786
Sex: M
Age: 88
State: MN

Vax Date: 01/29/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Darvocet, Demerol, adhesive, dasatinib

Symptom List:

Symptoms: presented to ED with stroke like symptoms, slurred speech, weakness, hypotension and tachycardia. Stroke team activated and no hemorrhage noted on CT. Treated with alteplase after consult with neurology and then transferred to hospital for further evaluation and treatment.

Other Meds: allopurinol, aspirin, celery seed extract, centrum, colchicine, crestor, furosemide, glucosamine, Indocin, lisinopril, potassium

Current Illness: none

ID: 1031787
Sex: F
Age: 55
State: CA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: NA

Symptom List:

Symptoms: patient may have received different dose. Patient in the list of vaccinator when brought to attention

Other Meds: NA

Current Illness: NA

ID: 1031788
Sex: F
Age: 88
State: WI

Vax Date: 01/27/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Patients arm became red and raised. Upper arm surrounding vaccine site was affected. No warmth.

Other Meds:

Current Illness:

ID: 1031789
Sex: F
Age: 92
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Joint Pain and weakness. Losing ability to stand and walk

Other Meds: Amlodipine

Current Illness: back pain

ID: 1031790
Sex: F
Age: 94
State: WI

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: Tramadol

Symptom List:

Symptoms: Received influenza vaccine 1/29 at PCP clinic. Received Moderna vaccine on 2/6 by pharmacist at her place of residence. She was taken to the ER on 2/9, unresponsive. Staff reported she wasn't acting normally since 2/7. During her hospital course (2/9-2/13) she was only able to open her eyes. Unable to follow any commands. MRI showed large right MCA stroke. She was discharged from the hospital on hospice.

Other Meds: Docusate Vitamin D

Current Illness: None

ID: 1031791
Sex: F
Age: 52
State: VA

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

Vax Type:
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Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: starting around 8 pm 2/12, patient experienced sharp pain around the liver and gallbladder. by the time she went to bed, she was experiencing extreme bloating and gas, and developed diarrhea soon after. on saturday 2/13, the patient's arm began to swell and a rash developed on several parts of the body (trunk, arms, legs). swelling and hives went away after patient took benadryl, diarhhea and bloating have lessened, by are still present as of monday 2/15

Other Meds: armour thyroid 30 mg

Current Illness: unknown

ID: 1031792
Sex: F
Age: 68
State: TX

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

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Lab Data:

Allergies: RX = Penicillin, Amoxicillin, Celebrex, Biaxin, Sulfa drugs, Ceclor, Levaquin, Neomycin, Bacitracin Foods = wheat, soy, sesame, mustard, lactose intolerant Other = latex, pollens, environmental chemicals, perfumes, cleaners

Symptom List:

Symptoms: Immediately following the injection and till the next morning, my arm was tender at the injection site. The following morning my arm was more painful at injection site. Around noon the day after the 2nd shot, I began to feel achy all over and couldn?t get warm. By 2:00 a headache began. At 3:01 I had a fever of 101.7*, at 4:02 it was 102.*, at 6:23pm it was up to 103.1*. The body aches and headache worsened. At 9pm I called a nurse advocate who said all symptoms were normal and to take 2 ibropfen for the fever. I slept most of the afternoon and evening. By 10:30, I woke up all sweaty and the fever had broken. On Feb. 11th, my arm was only slightly painful, I had no fever or aches, just felt tired. On the 12th, I was fine.

Other Meds: Nasacort, Allegra 180, vitamins A, B, C, D, fish oil, probiotic, digestive enzyme

Current Illness: None

ID: 1031793
Sex: M
Age: 80
State: IN

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

Vax Type:
Manufacturer:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Swelling in shot area. Turned pink under Band-Aid, Hurt to the touch. Swelling continued for 5 days and now is fine. Area of show still a light pink. I did not need any help. Took no meds.

Other Meds: Allopurinol 300mg; Valsartan-HCTZ 80-12.5 mg; Multivitamin Men's 50+; D3 50 mcg X 2 = 4,000 IU

Current Illness: None

ID: 1031794
Sex: M
Age: 71
State: WI

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

Vax Type:
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Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies: No Known

Symptom List:

Symptoms: No adverse event reported. It was determined that only air was administered at time of vaccination.

Other Meds: No known

Current Illness: No Known

ID: 1031795
Sex: M
Age: 66
State: CA

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

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Immediately after pt received vaccine he told his wife (driver) that he was feeling dizzy. Wife then stopped vehicle in Lane #6 halfway down to observation and called for help from observation staff. Upon arrival of observation staff pt was found to be unresponsive but still had a pulse and was breathing on his own. Pt was in the passenger set. Observation staff alerted onsite medical professionals and MD and the crash cart was brought to the car. Vitals were taken. Within a minute pt became responsive and opened his eyes and began to communicate with healthcare staff. O2 sat was noted to be low so O2 was applied at 6L/min via facemask. Onsite Batallion Chief stated he had already called EMS and they were en route. MD remained at the vehicle with pt and continued to monitor until EMS arrived and assumed care. EMS did an EKG and pt found to have sinus brady, with a pulse in the 50's. EMS decided to transport pt to hospital for further evaluation. Pt transported to ambulance via stretcher in stable condition, alert.

Other Meds: None

Current Illness: None

ID: 1031796
Sex: F
Age: 51
State: IL

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

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Lab Data:

Allergies: none

Symptom List:

Symptoms: I received 2nd series of covid vaccine on Feb 11 @ 1:15 PM feeling fine until around 09:00 PM feeling fatigue. Woke up in the 4:00 A.M. due to body chills, headache, fever, shortness of breath and feeling sick. Around 8:30 a.m. I was feeling very sick shortness breath becomes work I felt chest tightness and pressure in my chest. I am also feeling dizzy so my son took me to urgent care after evaluation from the urgent care I was referred to go to the emergency room for further evaluation

Other Meds: none

Current Illness: none

ID: 1031797
Sex: F
Age: 70
State: NY

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

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Joint & muscle pain, fatigue, weakness, headache, nausea 1 full day Fatigue, loss of appetite 1 full day

Other Meds: Duloxetine, Wellbutrin, vitamin D, calcium

Current Illness:

ID: 1031798
Sex: M
Age: 71
State: WA

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: gentamicin, amoxicillin, Prevnar-13

Symptom List:

Symptoms: Mild muscle and injection site pain on the 1st day. 2nd day, injection site and muscle pain in left upper arm. 3rd day fever to 99.8, fatigue, general malaise, widespread muscle pain and soreness. Development of a new rash involving upper left arm slightly below the injection site. 4th day, again a temperature to 99.0F, achy, general malaise and fatigue. Increased rash on upper left arm 8 inches in length by 4 inches in width, painful and hot to touch and swelling. Treated with Benadryl and local steroids. 5day rash slowly resolving, no significant residual pain. Fever resolved, fatigue much improved.

Other Meds:

Current Illness:

ID: 1031799
Sex: F
Age: 72
State: IL

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

Vax Type:
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Lab Data:

Allergies: Lipitor, tetracyclines

Symptom List:

Symptoms: 20 minutes after administration, left bottom lip started to tingle and then tip of tongue began to tingle. Also feeling of "unwellness". These symptoms resolved in 3 1/2 hours. The next morning, felt as though I was coming down with illness. this resolved by afternoon.

Other Meds: enalipril, Zegerid, flonase, stool softener, vitamin D, magnesium, fiber, NADH

Current Illness: formerly breast cancer, IBS, high blood pressure, high cholesterol, macular degeneration

ID: 1031800
Sex: F
Age: 62
State: TX

Vax Date: 12/26/2020
Onset Date: 01/02/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: iodine - topical

Symptom List:

Symptoms: When I got the injection, it started to get red and hot and swollen/tender - for about three days. The injection site swelled back up and turned red after I got symptoms for COVID (like the fever). On Jan 2, 2021 started having fever, cough, congestion, body aches, fatigue. I called on the third for a COVID test. I still had a really productive cough on the 12th so I went back on the 14th. I had fever about three days - 4, 5th and 6th. Had a doctor visit - on January 6th or 7th. Dr gave me Z-pack and since I have other problems with antibiotics she gave me medicine to keep me from getting yeast infection: Diflucan. Ivermectin was prescribed as well. She prescribed a steriod but then she remembered I had just had the vaccine and so she told me not to take it. I still have headaches; and of an intermittant cough.

Other Meds: Vitamin C; vitamin D3; melatonin; zinc; Tylenol

Current Illness: no

ID: 1031801
Sex: F
Age: 47
State: IN

Vax Date: 01/09/2021
Onset Date: 01/12/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: lymph node swelling/pain beginning in my neck with neck pain. Progressively spreading until 2/14, large lump in breast, red streaks. Pain in groin and shoulder, all on left side.

Other Meds: synthroid, cymbalta, welbutrin, multivitamin

Current Illness: none

ID: 1031802
Sex: F
Age: 44
State: IL

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Latex, gluten/wheat

Symptom List:

Symptoms: Moderna COVID-19 Vaccine EUA: Major redness, irritated skin, warm to the touch on skin at injection site on shoulder. Swollen and painful lymph nodes in underarm on same side lasting for a week.

Other Meds: Daily multi-vitamin, fish oil capsule, Vitamin D

Current Illness: Upset stomach

ID: 1031803
Sex: F
Age: 39
State: CA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: COVID arm since 2/15/21 am. Warmth, localized redness around injection site, swelling and tenderness.

Other Meds:

Current Illness:

ID: 1031804
Sex: F
Age: 26
State: WA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Ran low grade fever on 2/6 at 100.8. Headache for most of 2/6. Swollen lymph node in armpit on same side as injection.

Other Meds:

Current Illness:

ID: 1031805
Sex: F
Age: 64
State: IN

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient given the vaccine subcutaneous instead of intramuscular and had reaction of heat and pain.

Other Meds:

Current Illness:

ID: 1031806
Sex: F
Age: 69
State: CA

Vax Date: 02/03/2021
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Polymixin, Verapamil

Symptom List:

Symptoms: itchy red rash, spreading , began at injection site

Other Meds: Elavil, Zoloft

Current Illness: none

ID: 1031807
Sex: F
Age: 68
State: NC

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

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies: Sulfa Shrimp

Symptom List:

Symptoms: Sudden fatigue, chills, headache, painful arm from injection site to fingers, tingling in left hand and fingers

Other Meds: Pantropozole Levothyroxine Desvenlafaxin L-Methylfolate Bupropion Meloxicam Calcium

Current Illness: None

ID: 1031808
Sex: F
Age: 72
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: patient vaccinated on 2/12, woke up dizzy on 2/13, taken by ambulance to hospital and remained overnight. treated with IV fluids, meclizine and Ativan. patient was on day 10 of antibiotics for ear infection

Other Meds:

Current Illness:

ID: 1031809
Sex: F
Age: 66
State: OH

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: None known

Symptom List:

Symptoms: I was fine all day working from home and it was the end of the day at 5:12 PM and was walking to the bathroom in my home and all of a certain I started shivering and was extremely cold. I could barely use the bathroom, but did and felt bad so I hurried and put on my pajamas and went to the family room and sat down my whole body shaking /shivering and I was freezing. I covered up with a blanket and shook profusely for about 25 minutes. I checked my temperature and it was 97.5 and then a few minutes later it was 97.7. The severe shivering and cold ceased and was kind of intermittent but not too bad. I was very tired and slept in my chair on and off until about 10:00 PM and then I went to bed and I had a headache. I also was a little warm after the shivering stopped. My temperature before bed was 98.2. The next morning had a mild headache most of the day, I took a Tylenol and didn't feel real good until about 3:00 PM, but I was fully functioning .

Other Meds: Triamterene/HCTZ, Rosuvastatin, Glimepiride, Metformin, potassium chloride, Valsartan, Brimonidine (eye drops), calcium, low dose aspirin, Lutein

Current Illness: None

ID: 1031810
Sex: F
Age: 74
State: KS

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

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Subjective Patient is a 74 y.o. female who was seen at Vaccine Clinic today for her first dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the left deltoid muscle. During her 15 minute waiting period after the injection, the patient began to experience throat tightness. She denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, hoarseness, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to abdominal pain, blood pressure abnormality , chest pain, collapse, drooling, hypotension, increased swelling, rapid progression of symptoms, respiratory distress, skin changes, tongue swelling and vomiting. Pt with hx of htn/a-fib, allergies and asthma. She has taken her allergy medications today along with her htn med. She reports she usually checks her home bp and runs around 140s systolic. She states her bp is up today as she is anxious. ALLERGY REVIEW OF SYSTEMS: Patient denies chills, fever, malaise/fatigue, facial swelling, sore throat, frequent throat clearing, cough, chest tightness, shortness of breath, wheezing, rash, hives, itching of skin, dizziness and headaches Negative for drooling: No vision changes: Previous Reactions: denies prior reactions. Objective Vitals Vitals: 02/09/21 1153 02/09/21 1156 02/09/21 1159 02/09/21 1200 BP: (!) 154/138 (!) 219/73 (!) 203/71 BP Location: Right arm Left arm Pulse: 74 73 72 70 SpO2: 100% 99% 98% 98% Physical Exam Vitals signs and nursing note reviewed. Constitutional: General: She is not in acute distress. Appearance: Normal appearance. HENT: Mouth/Throat: Mouth: Mucous membranes are moist. Pharynx: Oropharynx is clear. Eyes: Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulses: Normal pulses. Heart sounds: Normal heart sounds. No murmur. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing or rales. Chest: Chest wall: No tenderness. Musculoskeletal: Right lower leg: No edema. Left lower leg: No edema. Skin: General: Skin is warm. Coloration: Skin is not pale. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Gait: Gait normal. Psychiatric: Mood and Affect: Mood normal. Thought Content: Thought content normal. Judgment: Judgment normal. Assessment/Plan Treatment included: antihistamines Follow up response to treatment: fair. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health) and Red flag symptoms (CP, SOB, NVD, Visual/Neuro concerns) HTN: pt reports she will monitor at home. She states that she gets like this prior to doctor appointments or visits. She feels well and wishes to go home. Discussed reasons to follow up with pcp, monitor bp at home. Follow up in ED if throat symptoms worsens or do not improve. Pt offered wc out to front door. Pt with husband.

Other Meds:

Current Illness:

ID: 1031811
Sex: F
Age: 40
State: AZ

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

Vax Type:
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Lab Data:

Allergies: Demerol and codeineNorethisterone

Symptom List:

Symptoms: Severe myalgia in lower back and legs

Other Meds: Norethindrone

Current Illness: N/A

ID: 1031812
Sex: F
Age: 66
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Ko

Symptom List:

Symptoms: Very sore arm later the day of shot and worse the next day Sudden onset of horrible headache and chills 2/14/2021, 6 AM Still experiencing headache and some chills 2/15/2021

Other Meds: Excedrin extra strength Tylenol

Current Illness: None

ID: 1031813
Sex: M
Age: 65
State: WI

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: No Known

Symptom List:

Symptoms: No adverse event reported. It was determined that only air was administered at time of vaccination.

Other Meds: No Known

Current Illness: No Known

ID: 1031814
Sex: F
Age: 70
State: MA

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

Allergies: amoxicillin penicillin bioaxin doxycycline euriothmycine sulfa-drugs reglan IVP dye

Symptom List:

Symptoms: I had a bad headache on the first day getting the shot and had a mild headache for the few days. on Feb. 14th I had stomach ache and diarrhea and vomiting, and then I felt dizzy and fainted.

Other Meds: vitamin d multivitamin calcium claritin

Current Illness: None

ID: 1031815
Sex: F
Age: 23
State: OK

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

Symptom List:

Symptoms: About 1.5-2 hours post immunization the patient returned having developed a headache and a quarter sized welt that was lightly red, swollen and very tender to touch, just below her left collar bone about 4 inches from the injection site. The welt was outlined and observed and the patient was given 25mg of Benadryl. After about 20 minutes the swelling and tenderness had spread to an area approximately the diameter of a tennis ball. At this point she was refered to see a doctor at the Health Center. The nurse called to follow-up once the patient arrived as she had not seen this type of reaction after the vaccine. After discussion the physician was going to look at her. Reportedly the swelling had begun to retract and the patient apparently returned to work later that day, talking about her plans to receive the second dose.

Other Meds: no known

Current Illness:

ID: 1031816
Sex: F
Age: 70
State: TN

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

Allergies: Patient states penicillin reaction and drug sensitivities.

Symptom List:

Symptoms: Patient has a history of drug sensitivity to oral penicillin with a rash that developed greater than 4 hours after ingestion. The patient was administered Moderna vaccine Lot 016M20A at 1025 to the right deltoid muscle. At 10:49 the patient complained of facial itching, also stating a headache within minutes of injection. Patient was assessed, BP was 186/92 and HR 72. the patient was alert and oriented without signs of immediate distress. Just prior to administration of epi the patient complained of chest tightness. Patient BP was noted to be 182/94 at 5 minutes post epi. Ambulance arrived 11:05am and the patient was released to the care of EMS.

Other Meds: Medication list not available

Current Illness: None noted

ID: 1031817
Sex: F
Age: 42
State: MA

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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Lab Data:

Allergies: augmntin, rash after- new this year

Symptom List:

Symptoms: Body aches, redness, swelling, hot arm with muscle pain, exhaustion

Other Meds: Seratine, alerted, multivitamin, magnesium, apple cider vinegar gummy supplement, ibuprofen, Tylenol- BCP

Current Illness:

ID: 1031818
Sex: M
Age: 42
State: CA

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

Allergies: omeprazole, atenolol, aspirin, lisinopril

Symptom List:

Symptoms: patient may have received different dose. Patient on the list of vaccinator when brought to attention

Other Meds:

Current Illness:

ID: 1031819
Sex: M
Age: 75
State: VA

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
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Symptom List:

Symptoms: hives beginning on Feb 15

Other Meds:

Current Illness:

ID: 1031820
Sex: F
Age: 66
State: OH

Vax Date: 01/27/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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Allergies: None

Symptom List:

Symptoms: Caller states both her and her mother got their first dose of the Moderna COVID-19 vaccine on 1/27 around 14:50. Since then they have both had a Shingles flare up. Caller wanted to report this effect if necessary. They have both had telehealth care that prescribed antivirals. Caller is unsure of exact medication as she is about to pick hers up from pharmacy. No hospitalizations for this ADR. Refused Info for her mother. Daughter did not want to provide any info on her mother's behalf for privacy reasons. She provided more info for herself . She would not like anyone to contact her mother as she is frail.

Other Meds: None

Current Illness:

ID: 1031821
Sex: M
Age: 81
State: MN

Vax Date: 01/28/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
Hospital: Y

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Lab Data:

Allergies: lisinopril

Symptom List:

Symptoms: Presented to ED with altered mental status. He became fatigued and lethargic with a brief period of unresponsiveness. Could not speak and had a gaze to his left. Could not carry on conversation or answer questions appropriately. Stroke team activated and CT completed. CT negative for bleed. Neurology ordered Alteplase to be administered. Patient then transferred for further evaluation and treatment. Patient had left MCA occlusion with TICI IIb achieved. Admitted to neurology stroke service in ICU following procedure. Started on aspirin with plavix. Rehab referral.

Other Meds: amlodipine, aspirin, calcium, coreg, losartan, Lupron, multivitamin, omeprazole, pravastatin, prolia

Current Illness: unknown

ID: 1031822
Sex: F
Age: 29
State: NE

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

Allergies: Reported anaphylaxis to shellfish containing products

Symptom List:

Symptoms: Patient almost immediately stated she felt "tingly" on her toung along with the feeling of her throat swelling shut. Patient stated it felt much like it does when she has an allergic reaction to shellfish. 1 adult epinephrine pen was administered to patient intramuscular in thigh and patient was taken to hospital emergency department for workup and observation. In ED, symptoms had subsided, and patient reported feeling better. Patient was given IV diphenhydramine x one 25 mg dose (1751) and IV methylprednisolone x one 125 mg dose (1751). No additional doses of epinephrine were required.

Other Meds: Multivitamin once daily, ibuprofen as needd

Current Illness: None

ID: 1031823
Sex: F
Age: 34
State: TN

Vax Date: 02/06/2021
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
Hospital: Y

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Allergies: No

Symptom List:

Symptoms: The patient, who is my wife, went into preterm labor and delivered at 30 weeks and 3 days. Date of delivery was 2/9/21. EDD was 4/17/21. My wife is a G3P2. She had a very early miscarriage in 2016. She delivered a healthy child at 37 weeks and 3 days in 2018. During this current pregnancy, all prenatal visits, tests, and scans were unremarkable. Based on a gross examination of the placenta and a review of all clinical data by the patient's OBGYN, there was no obvious stimulus for the preterm labor. Fortunately, the baby is doing ok in the NICU at hospital.

Other Meds: Prenatal vitamin, omega 3 supplement, Zyrtec

Current Illness: Mild viral URI symptoms several weeks prior. Multiple people in family tested negative for COVID at that time.

ID: 1031824
Sex: F
Age: 35
State: CA

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

Symptom List:

Symptoms: 15 hrs after injection Nerve pain (burning) throughout the body, 9/10 pain, lasting for 12 hrs. 24hrs after injection, joint pain in shoulders and hips, lasting 8hrs. 72 hrs after injection, red/hard/painful/itchy rash at injection site still occurring as on 2/15/21.

Other Meds: Zoloft, multi vitamin

Current Illness: None

ID: 1031825
Sex: F
Age: 83
State: TX

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 02/15/2021
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Symptoms: COVID like symptoms-chills, body aches, weakness,

Other Meds: Lyrica, Hydrocodone, Omeprazole, Pravastatin, Duloxetine, Levothyroxine, Amlodipine, Oxybutynin, Vitamin D 50,000 units, Injection-Vitamin B -12, Calcium +D, Antihistamine, Zinc, Baby Aspirin, Acyclovir

Current Illness:

ID: 1031826
Sex: F
Age: 59
State: CA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/15/2021
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Allergies: Codine, Vicodin, Morphine, Iodine, Darvocet

Symptom List:

Symptoms: Swelling in upper breathing throat area between nose and mouth

Other Meds: St. John's Wort, Lovastatin, Oxybutyin, Omeprazole, Nortryptaline

Current Illness: ear ache, nausea

ID: 1031827
Sex: F
Age: 25
State: CT

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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Lab Data:

Allergies: Penicillin, dairy

Symptom List:

Symptoms: After 3-4 hours, patient experienced pain in left arm at injection site that increased throughout the day and into the evening. The arm became swollen in the evening hours. The patient experienced fatigue during evening hours. The next morning, 24 hours after receiving vaccine, patient experienced fatigue, pain and swelling in arm at injection site and patient ran a low grade fever that lasted until 4 pm that day.

Other Meds: Virorelle birth control, centrum multivitamin

Current Illness:

ID: 1031828
Sex: F
Age: 93
State: CA

Vax Date: 01/31/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital: Y

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Allergies: Codiene

Symptom List:

Symptoms: Severe, acute onset of vertigo and bradycardia

Other Meds: Metroprolol, Lasic, Eliquis, K-Tab. Vit C, Vit D, CoQ10, Magnesium, Calcium, Melatonin

Current Illness: None

ID: 1031829
Sex: F
Age: 46
State: NY

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

Allergies: No known allergies

Symptom List:

Symptoms: Patient flushed, tachycardia, elevated BP, headache, nausea, vomiting, chest pain

Other Meds:

Current Illness:

ID: 1031830
Sex: F
Age: 68
State: WA

Vax Date: 01/27/2021
Onset Date: 02/04/2021
Rec V Date: 02/15/2021
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Allergies: penicillin

Symptom List:

Symptoms: About a week after the moderna vaccine, I took my humira injection (which I administer in my stomach). Later that day, my left arm started hurting. It swelled up and developed a large red circle. At times it itched a little. Other times it felt like a bruise. It went away after a week. I was afraid that the humira medication was interacting adversely with the covid vaccine. I saw on line that this was called "co-vid arm" and that other people have developed it.

Other Meds: Humira injection, armour thyroid, low dose aspirin

Current Illness: None

ID: 1031831
Sex: F
Age: 32
State: PA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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Allergies: None known

Symptom List:

Symptoms: 102 degree Fever for two days Aches -2 days Chills- 2 days Nausea/vomiting - 1 day Arm soreness at injection site- 3 days

Other Meds: Prenatal vitamin (for breastfeeding)

Current Illness: None

ID: 1031832
Sex: F
Age: 52
State: CA

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

Symptom List:

Symptoms: 0900: Patient was administered Moderna in right deltoid, patient was moved over to observation seat in vaccination room for close monitoring. 0901: Patient reported feeling flushed, redness to face and cheeks, and reporting lower back pain. RN assessed onsite, patient remains alert, oriented. Patient vitals taken : 114/ HR 66, RR 18, 99% on RA, 98.4. Nursing staff elevated legs and provided Benadryl orally for possible allergic reaction to medications and provided ice pack. . 0906: Pt reported that symptoms were resolving, no longer feeling flushed, skin color and touch back to baseline. Patient remained with staff for 30 min for observation , husband remains at side. patient remains alert and oriented, smiling.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm