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: 1035908
Sex: F
Age: 62
State: VT

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
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: Sensitive to aspirin and sulfa drugs

Symptom List: Dysphagia, Epiglottitis

Symptoms: Started with headache and the developed chills and body aches

Other Meds: Ativan, vitamin D, multi vitamin

Current Illness: None

ID: 1035909
Sex: M
Age: 19
State: VA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/17/2021
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: Seasonal allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: It started off with a headache and later in the night severe headache with chills. I also started exp palpitations. The next morning 2/2 still exp symptoms from the day before and fever of 102.4 with a lingering cough.I still have the cough ad all other symptoms lasted 48 hours.

Other Meds: Metoprolol,Prozac

Current Illness: No

ID: 1035910
Sex: F
Age: 47
State: WA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
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: pistachios, juniper

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

Symptoms: When I returned home, approx. 30 mins after the vaccine was administered, I felt numbness in my face and the roof of my mouth. The best way to describe it is that my "face meat" felt numb. So, not the surface skin, but deep down in the muscles. Almost like when you are numb from dental work. I am still feeling the face numbness today. Not in the roof of my mouth so much, but in my face meat.

Other Meds: Vitamin C, Vitamin B, Probiotic Gummie, Calcium Gummies

Current Illness:

ID: 1035911
Sex: F
Age: 44
State: NH

Vax Date: 01/29/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The patient started with symptoms of numbness and tingling of her left foot two weeks post COVID vaccination , now has absent left ankle reflex and ascending symptoms of her bilateral LE and UE. Has diminished position sense. No respiratory muscle weakness.

Other Meds: None

Current Illness: None

ID: 1035912
Sex: M
Age: 59
State: ME

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: PENICILLIN

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

Symptoms: HIVES ALL OVER BODY

Other Meds: ADVIL MARIUANA

Current Illness:

ID: 1035913
Sex: F
Age: 72
State: DE

Vax Date: 02/09/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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: Penicillin

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

Symptoms: Red and swollen and painful at injection site one week post shot.

Other Meds: Lisinopril, crestor, vitamin D, sodium bicarbonate

Current Illness:

ID: 1035914
Sex: F
Age: 56
State: MD

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
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: numbness around vaccine site. nausea. typical reaction she has with vaccines. feels better after 10 mins

Other Meds:

Current Illness:

ID: 1035915
Sex: F
Age: 45
State: IA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin - unknown

Symptom List: Pharyngeal swelling

Symptoms: Patient had numbness and tingling in left hand and fingers. Held patient for an additional 15 minutes and symptoms got worse. Staff took vitals BP: 152/107 and pulse: 75. Patient taken to ER for examination via wheelchair. At ER, pt stated that after receiving her first dose of the COVID vaccine, she the fingers of her left hand became tingly and then blood pressure became elevated while at the clinic. Patient stated she does have a history of anxiety and that taking shots does make her nervous and upset. She does have Xanax at home that she can take but she has not taken any today. She also does have a history of high blood pressure and does have high blood pressure medicine which she did take today. Pt discharged home, with instructions to follow up with primary care provider, return to clinic in 4 days if no better, or return sooner to clinic/ER if worsening symptoms. 1/29/21: Pt received the 2nd dose of vaccine with no issue.

Other Meds: Allegra-D 12 hr 1 tab PO Q12h Naproxen 275 mg PO Q8h PRN Escitaloram 10 mg PO QD Omeprazole 40 mg PO QD Promethazine 25 mg PO Q4hr PRN Phentermine 30 mg PO QD Valacyclovir 1 g PO QD Alprazolam 0.25 mg PO TID PRN

Current Illness:

ID: 1035916
Sex: F
Age: 66
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient began to feel flushed, hot. No nausea or vomiting. No shortness of breath or light headed ness. O2 sat 100%, resp 18, BP 140/76, heart rate 67. Symptoms resolved and patient discharged from clinic

Other Meds:

Current Illness:

ID: 1035917
Sex: F
Age: 70
State: CA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/17/2021
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: none known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Within an hour of injection arm was very uncomfortable shoulder to wrist with throbbing pain which continued for 2 days. Today is day 10 and arm continues to have approximately a 3" area of redness around the injection site and are is still sore as if bruised. I can touch that area without pain but any pressure is still uncomfortable. Redness seems to be getting worse instead of better. Need to know if I should not get the 2nd dose understanding that reactions are more intense on the 2nd dose.

Other Meds: levothyroxine

Current Illness: none

ID: 1035918
Sex: F
Age: 73
State: TN

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Starting the day after the immunization patient had a runny nose, felt sick to her stomach and is dizzy. Still does not feel well today.

Other Meds:

Current Illness:

ID: 1035919
Sex: F
Age: 70
State: NY

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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: Penicillin?

Symptom List: Rash, Urticaria

Symptoms: Hives began approximately 88 hours after vaccine #2 at 2am on 2/16, worsening by 10am same date. I went to my primary MD, who suggested Loratidine during the day and Cetirizine during the evening as needed. He also gave me a Rx for Prednisone to be used only if respiratory symptoms develop. I took my first Loratidine at 1:00pm, and have taken a second dose today at 11:00am, due to hives starting again. I did not take any Cetirizine, and I have not needed the Prednisone.

Other Meds: Omeprazole, Calcium (Tums), Vitamin D

Current Illness: none

ID: 1035920
Sex: M
Age: 80
State: IL

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/17/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Reaction occurred on 2/7/21 (about 48 hours after first dose): Severe dizziness and blurred vision for 10 minutes. Patient has no prior history of dizziness, vertigo, or blurred vision.

Other Meds: hydrochlorothiazide 12.5 MG Tabs, metFORMIN HCl 1000 MG Tabs, dilTIAZem HCl 90 MG Tabs, tamsulosin HCl 0.4 MG Caps, Pantoprazole Sodium 40 MG Tbec, Clopidogrel Bisulfate 75 MG Tabs, atorvastatin 40 MG Tabs, carvedilol 3.125 MG Tabs.

Current Illness: None.

ID: 1035921
Sex: M
Age: 28
State: IN

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
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: N/A

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

Symptoms: Body/head/muscle aches, nausea, dizziness, chills, mild shaking, poor attention/concentration.

Other Meds: Lexapro 2mg

Current Illness: None

ID: 1035922
Sex: F
Age: 65
State: AL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/17/2021
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: AT 30 MINUTES HEADACHE,SEVERE SINUS PRESSURE,CONGESTION COLOR OF GREEN,DRAINED FEELING,LOW FEVER

Other Meds: MULTI VITAMAN

Current Illness: NONE

ID: 1035923
Sex: F
Age: 28
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
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: NKDA

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

Symptoms: Syringe malfunction and patient did not receive complete dosage. Less than half of the recommended dose is estimated to have been given. Patient monitored x 15 min after injection, no untoward effects. The manufacturer was contacted- an additional dose was not recommended.

Other Meds: None listed in EMR

Current Illness: None listed in EMR

ID: 1035924
Sex: F
Age: 52
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
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: None

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

Symptoms: Swollen on left hand for 6 days, got some temperature the 1st 3 days. Hard touch on the left hand.

Other Meds: Vitamine C, D3, B, multi vitamin 1 a day women (Centrum silver). metformin 500mg, losartan potassium 50, Atorvastatin, Montelukast 10mg

Current Illness: No

ID: 1035925
Sex: M
Age: 68
State: OH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Milk, chocolate, bee stings (carries epi-pen), iodine in IVP dye, band-aides with latex.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Got the vaccine, there was no pain, the shot was fine, no reaction. Waited for 30 minutes due to his extensive allergies. Went home and about 2 hours later he noticed when he was moving around it started to get painful just opening a door, etc. It continually got worse, and maybe 3 hours later in the evening the pain got really bad, and it seemed to be more in his shoulder area. Gave the shot kind of high, and the pain was real bad in the shoulder and could not raise the arm or use it much at all. It was also a throbbing pain where he could feel his pulse with the pain in the shoulder. It was almost like they hit a nerve. He is still trying to get over it on day #5. Each day it is starting to get better. By Sunday the pain was letting up so that he could use his arm. He is doing stretching exercises walking up the wall and it's complicated. He has a history of shoulder surgery and had a total replacement in the right shoulder, and wonders if his pain is related to the bad shoulder and the cartilage being bad in that shoulder. He is supposed to have surgery on it. But the arm is better, can lift it 75%.

Other Meds: Multivitamin, coQ10, Flomax, Telmisartan, fish oil.

Current Illness: None.

ID: 1035926
Sex: F
Age: 27
State: CA

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: About a few days after the shot my arm was very warm, sore, and red. Since then my arm has had two ring like circles around the injection site. It?s becomes itchy on and off but it does not hurt.

Other Meds: None

Current Illness: No

ID: 1035927
Sex: F
Age: 35
State: IA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Pfizer COVID-19 Vaccine When given vaccine, had initial burning in deltoid. Right after flushing and sweating palms, along with nausea. Lasted 5 minutes. Next day fatigue, nausea, and sweats/chills. 3rd day same. 1/27/21: Pt received 2nd dose of COVID vaccine with no issue.

Other Meds: Escitalopram 20 mg PO QD Alprazolam 0.5 mg PO BID PRN Trazodone 50 mg PO QHS PRN

Current Illness:

ID: 1035928
Sex: M
Age: 75
State: FL

Vax Date: 02/08/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
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: paralysis in left side of face (eye and mouth)

Other Meds: amlodipine besylate gemfibrozil levothyroxine metoprolol lisinopril

Current Illness: none

ID: 1035929
Sex: F
Age: 66
State: FL

Vax Date: 02/01/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Antibotics

Symptom List: Unevaluable event

Symptoms: I started with diarrhea a few days after I received my second dose of the vaccine. It has got worse over the course of a week. I took immodium and peto bismol with some relief. I also have pains in my intestines. The pains only started in the last couple of days. I have a Dr. Appt today 2/17/21

Other Meds: Vitamin C,D,B12. Elderberry. Pepcid

Current Illness: Gerd

ID: 1035930
Sex: F
Age: 72
State: FL

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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: RED SKIN INFECTION/NAUSEA FEVER 100.9 /VOMITING

Other Meds: Zyrtec and Benadryl

Current Illness:

ID: 1035931
Sex: F
Age: 70
State: IL

Vax Date: 02/09/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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: surgical tape

Symptom List: Injection site pain, Pain

Symptoms: rash on right arm and achiness in area around where shot was received

Other Meds: Vitamin D3

Current Illness: none

ID: 1035932
Sex: F
Age: 86
State: VA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: pt has received 3 covid 19 shot each 21 days apart

Other Meds:

Current Illness:

ID: 1035933
Sex: F
Age: 60
State: IN

Vax Date: 02/11/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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: 2nd dose pizer 2/11; 2/12 fatigue, body aches, 2/16 rash noticed 5PM (bra line, breast, back, legs, down thighs at bedtime, under arms), rash was spreading, pt put calamine lotion on rash, woke up 2/17/21 and rash is gone.

Other Meds:

Current Illness: pt has sores/crusty nose

ID: 1035934
Sex: M
Age: 31
State: MI

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient Complained he was weak and being anxiuos. EMS was called vitals were taken BP 105/75 95% O2 room air HR 68. He recovered and released to go home.

Other Meds:

Current Illness:

ID: 1035935
Sex: F
Age: 89
State: TX

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fatigue, unable to tolerate solids or liquids all day, nausea

Other Meds:

Current Illness:

ID: 1035936
Sex: M
Age: 74
State: OH

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/17/2021
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: none

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

Symptoms: chills, myalgia, low grade temp 99.5, loose stool, premature vent beats, fatigue

Other Meds: diltiazem, terazosin, hydrocortisone, atorvastatin, clarithromycin, magnesium, calcium, melatonin, aspirin

Current Illness: none

ID: 1035937
Sex: M
Age: 49
State: AZ

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Testosterone shot Ed

Symptom List: Nausea

Symptoms: Throwing up , diarrhea, body rash and difficulty breathing

Other Meds: Atorvastatin, amlodipine, amjovy, folic acid,

Current Illness:

ID: 1035938
Sex: F
Age: 76
State: NE

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Injection site pain

Symptoms: Approximately 10 minutes after receiving 2nd dose of Covid-19 Moderna vaccine, patient began to have difficulty breathing. Husband reported that she has a history of panic attacks. No swelling in throat was noted. Instructed patient to take slow deep breaths. 911 was called. Vitals obtained with blood pressure 118/80, respirations 30-35 per minute, SP02 at 97% on room air. Patient was transported via ambulance to Hospital. Spoke with the ER and she reports that patient is doing fine, they diagnosed as anxiety and gave her Ativan . Patient discharged back home.

Other Meds: Unknown

Current Illness: Unknown

ID: 1035939
Sex: F
Age: 64
State: WI

Vax Date: 02/10/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Received 2nd COVID vaccine on 02/10/2021. Started with increased redness at injection site on 2/14 and yesterday started itching. No resp issues. No other areas of redness or itching

Other Meds:

Current Illness:

ID: 1035940
Sex: F
Age: 82
State: VA

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
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:

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

Symptoms: pt received 3 doses of vaccine 21 days apart

Other Meds:

Current Illness:

ID: 1035941
Sex: F
Age: 20
State: PA

Vax Date: 02/09/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
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: Tremor

Symptoms: I have "covid arm" but it's in my neck/upper back. It is sore, swollen, and tender, with a raised bump and discolored skin.

Other Meds: fluoxentine, Blisovi Fe

Current Illness:

ID: 1035942
Sex: F
Age: 36
State: NM

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Pt called public health office on 2/17 and reported she had recieved the vaccine on 2/5/21 but did not develop symptoms until 2/12/21. She stated on 2/12 she developed redness at the injection site that has spread down her arm with mild itching. She said she self medicated with Benadryl with no change in symtoms. She states today on 2/17 that redness is still present. Instructed pt to report on vsafe website adn that I would make report into VAERS system. Instructed pt to make appt with her PCP for further evaluation and recommendations for treatment

Other Meds: unknown

Current Illness: None

Date Died: 02/13/2021

ID: 1035943
Sex: M
Age: 67
State: CA

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Patient had no reaction at the time of vaccination. Waited the required 15 minutes and was allowed to go home.

Other Meds:

Current Illness:

ID: 1035944
Sex: F
Age: 64
State: CA

Vax Date: 02/14/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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: adverse reactions to fentanyl, iodine, diphenhydramine, dimenhydrinate, clarithromycin, prednisone, sulfadiazine, pantoprazole, amoxicillin, levothyroxine, xeroform petrolatum overwrap, Fixodent

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

Symptoms: I woke up 37 hours after first dose of vaccine with dizziness, which became dizziness. I began vomiting within a couple hours. Around noontime I vomited twice more. I got worse, could not walk around. I felt extremely sick but felt better when I lay down in bed. I was not able to go to work, had to cancel the substitute teaching assignment I had taken. I did sleep some. No doctor called me back except my daughter texted with me. She is an intern, said she wished she could be with me. My neighbor brought some Pedialyte. This morning, the next day, I am still weak and nauseous, but it is less. At the end of the day yesterday, I did eat a little rice with carrots. And I just ate a little plain oatmeal with raisins and salt. I am praying the 2nd dose will not be worse, as my daughter warned, because I can't remember when I was so sick and incapacitated. Maybe a long time ago.

Other Meds: Armour thyroid 60 mg/daily

Current Illness: none

ID: 1035945
Sex: F
Age: 43
State: MO

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
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: pt presented with erythema & swelling of face & periorbital regions C/O feeling fullness in tongue & throat & some difficulty swallowing approx 30 - 45 min following vaccine Had also eaten a english muffin with plain cream cheese just prior to symptom onset She was noted to have mild swelling of her tongue & very sl lower lip She was administered 50 mg of diphenhydramine, 20 mg famotidine & 60 mg Prednisone & cold compress to face Was able to take all orally with water & had no difficulty -- after approx 30 minutes her s/s had much improved & her facial erythema & swelling had reduced no resp distress and O2 sat was 99%

Other Meds: NONE

Current Illness: NONE

ID: 1035946
Sex: M
Age: 1
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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:

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

Symptoms: An influenza vaccine was given when not needed, no treatment, parents reassured.

Other Meds:

Current Illness:

ID: 1035947
Sex: F
Age: 34
State: NH

Vax Date: 01/14/2021
Onset Date: 01/23/2021
Rec V Date: 02/17/2021
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: No

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

Symptoms: I currently have pityriasis rosea as a result.

Other Meds: Multivitamin

Current Illness: No

ID: 1035948
Sex: M
Age: 82
State: OH

Vax Date: 01/23/2021
Onset Date: 02/08/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Pain in extremity

Symptoms: Patient was not feeling well with symptoms starting on 2/8 after receiving 1st Moderna dose on 1/23/21. On 2/10 the patient's wife had him taken to the hospital for repeated ?falls? and once he was in the hospital, he tested positive for covid-19. The patient's wife remarked he had tested positive back in December as well while in the hospital.

Other Meds: None available

Current Illness: Multiple chronic

ID: 1035949
Sex: F
Age: 76
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: iodinated contrast

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

Symptoms: UNKNOWN VACCINE BRAND; Subjective swelling of throat, swollen lips, diffuse eythematous rash on trunk and extremities, anxiety; received famotidine, NS, ativan, diphenhydramine, solumedrol

Other Meds: erythromycin opthalmic ointment, fluticasone, Allergy meds, losartan, pantoprazole

Current Illness:

Date Died: 02/15/2021

ID: 1035950
Sex: M
Age: 78
State: OH

Vax Date: 01/21/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
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: No known allergies

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

Symptoms: Patient found deceased at home on 2/15/2021. There was no known cause of death with no significant medical history.

Other Meds: Unknown

Current Illness: none reported

ID: 1035951
Sex: F
Age: 60
State: RI

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
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: Codeine - Anaphylaxis Morphine - Anaphylaxis

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

Symptoms: Within 30 seconds: Dry Throat, patient requested water, request was denied. 1 minute after vaccination: Coughing and difficulty breathing 2 minutes after vaccination: Patient refuses EpiPen administration stating she will not go to the hospital and not to call 911. 3 minutes after vaccination: Patient attempts to leave observation area to go use her own EpiPen in her apartment. 4 minutes after vaccination: Patient agrees to EpiPen administration into left leg and 911 is called. 5 minutes after vaccination: Patient continues to cough and clear throat. Patient throws herself out of her chair onto the floor while coughing. 6 minutes after vaccination: Patient hoarsely requests a second administration of EpiPen. EpiPen is administered into right leg. 7-10 minutes after vaccination: Patient is breathing easier however is forcing herself cough. 11 minutes after vaccination: EMTs arrive. Patient's HR: 141 bpm, SpO2: 96% 13 minutes after vaccination: Patient's SpO2: 99% 18 minutes after vaccination: Patient goes outside with EMTs 20 minutes after vaccination: Patient signs "Against Medical Advice" form - refusing to go to the hospital 22 minutes after vaccination: Patient is walked by to her apartment by EMTs.

Other Meds:

Current Illness:

ID: 1035952
Sex: M
Age: 75
State: NJ

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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:

Symptom List: Vomiting

Symptoms: Continuous itching & rash from neck to stomach Could not sleep whole night. Also itching & rashes other parts of body. Going to see my doctor in the afternoon.

Other Meds:

Current Illness:

ID: 1035953
Sex: F
Age: 91
State: AZ

Vax Date: 02/08/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, statins, amoxicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Swelling, redness, growing in size starting on 2/16 in area of immunization

Other Meds: gabapentin, fluticasone nasal spray

Current Illness: none

ID: 1035954
Sex: F
Age: 61
State: NJ

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
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: Codiene, Morphine, Chocolate, Bee Stings

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

Symptoms: 2 days after receiving first dose of vaccine, patient describes a pulsation/spasm on her right chest, moved to right side/stomach, and now it's on the left chest/torso (belly up to breast).

Other Meds: Spiractalone, Lopressor, Isordil, Cardura, Plavix, Lovastatin, Aspirin, Keppra, Catapres, Lasix, Vistaril, Procardia

Current Illness: Angioplasty on NYE, Pacemaker implanted- 01/03/2021

ID: 1035955
Sex: F
Age: 56
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/17/2021
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: "I am reporting a reaction to my second Moderna vaccine given on 02/05/2021 around 10 AM . Initial headache/nausea/tiredness started on 02/06/2021 and lasted for 3 days. Missed work on 02/08/2021 due to nausea/HA /tiredness. Slight Headache alone for another 4 days- through 02/12/2021. On Saturday (02/13/2021) I started feeling a bit ?off?. I was having trouble remembering things and just in general feeling slow and not right. My husband was concerned, and I was frustrated. He was checking me for TIA symptoms. Sunday I had a mild HA ( 3-4 pain scale) but it did not bother me too much. Monday 02/15/2021 I would not have been able to work if I was scheduled- nausea/HA (level 8) with visual migraine aura. I had to go to bed. I slept for 5 hours. Again today 02/16/2021. I am leaving work early because I have nausea/HA (level 8) with pressure and having trouble focusing. Feels a lot like the migraines I had 20 plus years ago. Please let me know if you have any additional questions."

Other Meds:

Current Illness:

ID: 1035956
Sex: F
Age: 70
State: MD

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
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: sob, resolved without intervention. normal vitals

Other Meds:

Current Illness:

ID: 1035957
Sex: F
Age: 36
State: OH

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/17/2021
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: No known allergies

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

Symptoms: 36 y.o. female with medical history of rheumatoid arthritis who presents the ED after allergic reaction from the Moderna COVID-19 vaccine. Patient says she received the first dose of the vaccine approximately 90 minutes prior to arrival. She did note that her face became hot and flushed and she developed a rash to her face and upper chest. she noticed tingling into her lips. She was then given a IM dose of 0.3mg epinephrine and 50mg Benadryl. She does note to having a dry throat and feels like she does not have enough secretions to swallow. At that point she was transported to the ED for further evaluation. She denies any known reaction to any food, medication, or additives.

Other Meds: Humira (Adalimumab)

Current Illness: None known

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm