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: 1036491
Sex: F
Age: 74
State: FL

Vax Date: 02/05/2021
Onset Date: 02/09/2021
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: Benadryl, Vasotec, Motrin, Flexeril

Symptom List: Dysphagia, Epiglottitis

Symptoms: First I noticed some red spots on my left thigh and then the next morning when I got up they had spread. Which happened on a Tuesday night and Wednesday morning I called the doctor but I couldn't get in that day so I got an appointment for that Thursday. Every day they were spreading more on my inner and outer left thigh and my left buttock. They didn't go above my waist and they just stayed on my lower left thigh but didn't go up to my stomach and I didn't have any on my stomach. My doctor told me it was shingles.

Other Meds: Atorvastatin 20 mg 1 per day, Amlodipine/valsartan 10 mg, B6, Vitamin C and D, 81 mg Aspirin

Current Illness: No

ID: 1036492
Sex: F
Age: 32
State: NY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
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: No

Symptom List: Anxiety, Dyspnoea

Symptoms: I had fatigue on the first day that continued to the next day. I then had body aches.

Other Meds: No

Current Illness: No

ID: 1036493
Sex: F
Age: 67
State: WA

Vax Date: 02/02/2021
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: none

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

Symptoms: Two days after receiving the 2nd shot, i developed shingles.

Other Meds: Vitamin D, Lysine - 500 mg.

Current Illness: none

ID: 1036494
Sex: F
Age: 31
State: HI

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Symptoms: c/o ?dizziness, palpitations, lightheadedness, feeling of a rush? Intervention: VS stable. Stayed an additional 15 minutes, total 30 min. Symptoms subsided.

Other Meds:

Current Illness:

ID: 1036495
Sex: M
Age: 81
State: NY

Vax Date: 02/12/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Leg weakness/collapse leading to falls, ongoing. Hiccups, began at 24 hrs continued for 2 days .

Other Meds: Sinemet, metformin, Carbidopa, pravastatin, Valsartan, donepezil, alfuzosin, mirabegron, amantadine, cholestyramine, vitamin D, aspirin, acetaminophen, turmeric, magnesium

Current Illness:

ID: 1036496
Sex: F
Age: 23
State: PA

Vax Date: 02/15/2021
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: Seasonal

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

Symptoms: Approximately, 29 hours after being vaccinated developed rash on face and fever.

Other Meds: Birth control

Current Illness: N/A

ID: 1036497
Sex: F
Age: 56
State: FL

Vax Date: 02/04/2021
Onset Date: 02/05/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Headache, profuse sweating and shivering, body pains followed by body aches as the day wore on, dry heaving. Lasted 24 hours. Took Tylenol every 4 hours.

Other Meds: Humalog insulin Montelukast Levothyroxin Losartan Avorastatin Duloxetine Gabapebtin Vitamin C Vitamin D3 Zinc CBD cream

Current Illness: Diabetes Hyperthyroid

ID: 1036498
Sex: F
Age: 64
State: AK

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

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

Lab Data:

Allergies: doxycycline compazine PCN phenergan

Symptom List: Pharyngeal swelling

Symptoms: According to the information I have gathered, she became dizzy, nauseated, vomiting later in the day. This continued for nearly two weeks. She then presented to an emergency room and was diagnosed with a cerebellar stroke that likely started on the same day as her vaccine per that physicians report.

Other Meds: humira vitamin d restasis erythromycin opthalmic flonase folic acid lisinopril c hctz plaquenil synthroid methotrexate rybelsus zocor

Current Illness: unk

ID: 1036499
Sex: F
Age: 84
State: SD

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

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

Lab Data:

Allergies: Celebrex, egg

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient reports her symptoms started on 2/16/2021 with fevers, generalized weakness, mild disorientation, and dizziness when she presented to the ER.

Other Meds: losartan, zinc sulfate, carBAMazepine, metoprolol tartrate, triamcinolone, atorvastatin, Synthroid, alendronate, multivitamin, cholecalciferol, vitamin D3, CALCIUM

Current Illness: cellulitis after first COVID injection

ID: 1036500
Sex: M
Age: 51
State: NY

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: felt rush in chest and then "felt Off"

Other Meds: atorvastin

Current Illness: ht

ID: 1036501
Sex: F
Age: 32
State: PA

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

Lab Data:

Allergies: cillian family of medicine

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

Symptoms: headache 24 hours following vaccine increased heart rate and anxiety following vaccine (normal RHR is ~70 and it increased to 87-90) and lasted one week 4 days post-vaccine a rash appeared on the trunk of the patient - both L and R side and onto the back of the trunk (rash still remains but the pain of it subsided around day 8) left armpit lymph node was slightly swollen (began day 4 and lasted to day 8) left ear was painful and throbbing (began day 4 and lasted to day 6) left pinky toe painful to the touch and throbbing (began day 4 and lasted to day 8) right big toe painful to touch and throbbing(began day 4 and lasted to day 8)

Other Meds: zinc, Vit D, Vit C, Sertraline

Current Illness: none

ID: 1036502
Sex: F
Age: 21
State: PA

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: SYR
Vax Site: RA

Lab Data:

Allergies: chocolate

Symptom List: Rash, Urticaria

Symptoms: Patient was very anxious before vaccination and stated that the shot would probably cause an asthma attack. Vaccine administration proceeded without complication. Shortly after receiving vaccination, while the patient was in the waiting room during observation she stated that her chest was feeling tight and her heart was racing. Pharmacist brought her back into clinic room so she could breath freely without her mask and take a puff of her proair inhaler. After 5-10 minutes, she stated that her chest was still tight and her back hurt. Family members were called to take her home/to ER. She did not want to wait so a store employee drover her to patient's preferred emergency room for a breathing treatment.

Other Meds: Proair, hydroxyzine, sprintec

Current Illness: unknown

ID: 1036503
Sex: F
Age: 72
State: FL

Vax Date: 02/10/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Rash on upper body, bruising

Other Meds: Effecxor75 g Synthroif .75 mcg Claritin

Current Illness: Excema

ID: 1036504
Sex: M
Age: 65
State: NH

Vax Date: 02/01/2021
Onset Date: 02/04/2021
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: no known allergies

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

Symptoms: Patient called on 2/4/21 with complaints of eye irritation, drainage at the time of visit patient treated for conjunctivitis, given abx eye drops, no improvement, patient seen at eye care on 2/11/21 diagnosed with herpes simplex keratitis os stopped abx, started on valacyclovir po

Other Meds: albuterol, aspirin, fluticasone, Zirgan, losartan, metformin, multi-day plus minerals, omega-23, pravastatin, valacyclovir

Current Illness: dyspnea on exertion, ekg reassuring

ID: 1036505
Sex: F
Age: 62
State: GA

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: 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: Swollen lt. arm, severe body aches and pain, headache, excessive sweating for 14 hrs. Missed work on 1/27/2021. 8 hrs.

Other Meds: D3, vitamin for hair and nails, Wellbutrin XL, Nuvigil, Teffid

Current Illness: none

ID: 1036506
Sex: F
Age: 31
State: NE

Vax Date: 02/12/2021
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: Penicillin, Sulfa, Doxycycline, Cefdinir

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

Symptoms: My injection site became itchy within 20 minutes after injection was given. At about 8pm that same night the injection site was red, raised, swollen, warm to touch and very painful. At this same time I developed a fever of 101.5. The rash became bigger and more swollen into Sunday (02/14/21). I also had fatigue, severe body aches, headache and jaw pain. The fever lasted 24 hours and subsided Saturday night at 8pm (02/13/21). I felt ill into Tuesday (02/16/21). As of now 2pm on 02/17/21 my only side effect left is the injection site is very itchy. The redness has gone away.

Other Meds: Microgestion Birth Control, Zyrtec, Tylenol

Current Illness:

ID: 1036507
Sex: F
Age: 33
State: NC

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: Erythromycin

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

Symptoms: Sore arm at injection site. Within 2 hours. Headache and sore neck in 4 hours

Other Meds: None

Current Illness: None

ID: 1036508
Sex: F
Age: 73
State: MI

Vax Date: 02/06/2021
Onset Date: 02/07/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Approximately 36 hours after injection I became dizzy, could not sleep due to constant dizziness, off-balance and found it difficult to rise from a sitting/laying position without being overcome by dizzy spells. Also felt slight tightness in my head. I begin to take my blood pressure which was well over what was normal for me. BP ranged from highest of 155/84 to 145/78. Blood pressure begin to lower as I begin to take my Blood Pressure medication doubling the dose from 5mg to 10mg Amlodipine. I also take the medication at night, versus my normal routine to take medication during the day. Not sure if this was just a coincident or precipitated by the vaccine.

Other Meds: Amlodipine Besylate 5mg, Rosuvastatin 10mg

Current Illness:

ID: 1036509
Sex: F
Age: 66
State: FL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
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: MILD ALLERGY TO PEANUT BUTTER>CAUSES A COUGH

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Client reported that her face felt like it was burning and she felt "odd". Client wanted to sit outside to get fresh air. Client stated that she was very nervous about getting the vaccine. After sitting outside x 15 minutes, client felt much better and wanted to leave. Client called on 2/11/2021 to report redness and warmth to injection site. Client could also feel a lump that was slightly smaller than the palm of her hand. Recommended client follow up with her PCP.

Other Meds:

Current Illness: NONE

ID: 1036510
Sex: F
Age: 65
State: CA

Vax Date: 02/09/2021
Onset Date: 02/11/2021
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: None that I'm aware of.

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

Symptoms: On February 11, 2 days after my vaccination, I woke up with pain and swelling under my left eye. Over the next 2 days, the left side of my face under the eye experienced redness and swelling then subsided and localized into a large stye on the lower left eyelid. Now, a week later, the stye is still red and pus filled but has improved and is slowly resolving. I would not normally think that this affliction had anything to do with getting a vaccine but it does seem strange that something like this could occur in someone who is very healthy and and does not experience any side effects from vaccines. The last time I had a stye was in my 20's and it wasn't nearly as bad as the one I am now experiencing. Since the Covid vaccine is so new and however unrelated this coincidental affliction seems, I thought I should report it regardless.

Other Meds: Multivitamin, calcium, astaxanthin, and probiotic.

Current Illness: None

ID: 1036511
Sex: M
Age: 87
State: FL

Vax Date: 02/12/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NA

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

Symptoms: EMS WAS CALLED PATIENT BECAME WARM BUT CLAMMY, PALE AND LETHARGIC WHEN EMS ARRIVED PATIENT WAS ALERT AND RESPONSIVE

Other Meds:

Current Illness:

ID: 1036512
Sex: F
Age: 61
State: NH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: Oxybutynin Sulfa Rubber Adhesive tape

Symptom List: Unevaluable event

Symptoms: The night after receiving the vaccine the patient states her tongue and inside of lips were swollen and painful. She was even unable to remove her dentures due to the tightness. This continued into the next day. No shortness of breath reported. She took some Benadryl which she reports helped however it has been 5 days now and she continues to have poor taste and tongue is still feeling strange. She also states today she is developing the tongue and lip swelling again, she denies trouble breathing and is aware if at any time this begins or there is any concern this may start to call 911 for emergency care. She is taking Benadryl again now which has helped with this since the immunization and has left a message with her PCP. I am currently calling her PCP to report this also.

Other Meds: Atorvastatin 20mg once daily at bedtime Cyanocobalamin 500mcg under the skin once monthly Pantoprazole 40mg delayed release tablet once daily Gabapentin 600mg three times daily, may take an additional tablet at bedime Ipratropium 0.03% nas

Current Illness: Sinus infection

ID: 1036513
Sex: M
Age: 32
State: NY

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: Severe chills, vomiting (approximately 4 times over several hours starting around midnight the day after vaccination), mild fatigue for several days after.

Other Meds: None

Current Illness: None

ID: 1036514
Sex: F
Age: 39
State: TN

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Rash covering all of back Arm pain severe Fever of 100.8 for 24 hours Body pain severe

Other Meds: Probiotics, milk thistle, ginger root, turmeric, nexium

Current Illness: None

ID: 1036515
Sex: F
Age: 37
State: CA

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

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

Lab Data:

Allergies: Compazine - Anaphylactic reaction about 20 years ago; similar reactions to Opioid type products Bee Stings

Symptom List: Injection site pain, Menorrhagia

Symptoms: About 40 minutes after, I started itching: on face and scalp primarily. But also arm. I didn't have any rash, bumps or redness. No visible symptoms. I emailed my Dr. and the nurse supervisor and they were messaging with me to tell me what to take. Over the next hour, it progressively got worse. After I got home - about an hour or so after symptoms beginning, I took 50 mg Benadryl. After about an hour or two later, I took Zyrtec. Before bed, I repeated dose of Benadryl. I was up at night with itching. In morning, I may have taken a third Benadryl very early morning and so when I woke up for the day, I didn't take it. And the itching resolved about 12:00 or 1:00 pm that next day. I did have a sore arm the day after the vaccine. I took ibuprofen about noon the following day of the vaccine. At 7, I noticed fatigue; chills and body aches. was very tired, as well. At 10:00 I took another dose of ibuprofen for these symptoms and I felt much better after that and the next day, I was fine.

Other Meds: Crestar

Current Illness: No

ID: 1036516
Sex: F
Age: 75
State: FL

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

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

Symptoms: Once again, as with the first shot (dated 2/3/2021) I got an itch on my arm in the area where the shot was given. This time, however, it came about 11 hours after getting the vaccination. It lasted about 4 or 5 days.

Other Meds: None

Current Illness: None

ID: 1036517
Sex: F
Age: 64
State:

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

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: berries, cherries, red dye

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Right after the vaccine was administered, started with a cough that did not improve for the next few minutes. Needed respiratory therapy

Other Meds: NO

Current Illness: NO

ID: 1036518
Sex: F
Age: 72
State: OH

Vax Date: 02/07/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Chantix, Zyban, Pravachol, Augmentin, Bupropion, Norvasc

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 2 inch red, raised, warm, itchy area at injection site appeared on the 8th day following 1st dose Moderna vaccine. This reporting is on the 3rd day of the reaction with no improvement yet noted to area. Will notify physician if no improvement on the 4th day. I was given the yearly flu vaccine approx 2 wks prior to the Covid vaccine. I do not know the vac name or lot #

Other Meds: Aldactone 25mg, Lipitor 40mg, Eliquis 5mg, Lasix 20mg, Lisinopril 5mg, Toprol ER 125mg, Tikosyn 250mg, Buspirone hcl 15mg, Spiriva Respimat, Symbicort 160/4.5. Nasonex, Colace 100mg, Aspirin 80mg.

Current Illness: None

Date Died: 02/17/2021

ID: 1036519
Sex: M
Age: 65
State: IN

Vax Date: 02/16/2021
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: RA

Lab Data:

Allergies: NKDA

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

Symptoms: Received first SARS-CoV2 vaccination yesterday at local store Experienced new symptoms of chills, nausea as well as worsening from baseline dyspnea at night. Wife states he had rough morning breathing and had sudden loss of consciousness and unresponsiveness and failed to respond to bystander CPR. He expired at his home.

Other Meds: Albuterol-ipratropium, warfarin, hydrochlorothiazide-triamterene, budesonide-glycopyrroltate-formoterol, atorvastatin.

Current Illness:

ID: 1036520
Sex: F
Age: 31
State: VA

Vax Date: 11/12/2019
Onset Date: 11/12/2019
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: novacaine: oral edema acyclovir: oral edema No history of intolerance or allergy to any foods, natural rubber latex or stinging insects.

Symptom List: Nausea

Symptoms: The patient is a healthy 32 yo female with a history of continued left shoulder pain s/p IIV. She received Afluria (SEQ P100136349) on 12 NOV 2019. She recalls her arm being unusually sore. She states placement was OK, and still has a bluish discoloration at the site. She was sitting and the vaccinator was standing. She states she had a PT test 2 or three days after receipt. She had practiced pushups the day before and then performed her test. She states the day after her test she awoke with severe shoulder pain, 9/10, burning, sharp, worse motion (which was severely limited) radiating to her fingertips, with numbness, but no paresis . She had difficulty dressing, reaching. She denies any previous or new specific injury. She did self care with ROM, home PT and NSAIDS. She saw PCP day 14 and requested acupuncture and again on 30 JAN with minimal improvement. COVID disrupted followup. She was in school and is now. She currently has 85-90% of function, most of her ROM. She did not pursue a profile and her subsequent PT tests have been delayed, but thinks she could pass. PCP note 26 NOV states w/ onset following immunizations though increased shoulder muscle use in prep for and doing PRT more likely the precipitating cause. Has mixed picture of findings. Several findings suggest rotator cuff impingement, also w/ + scarf but no AC joint tenderness. Accupuncture note 27 NOV 20 Exam shows tenderness on the distal biceps tendon and worsening pain with resisted biceps action, suggesting a distal biceps tendinopathy. Follow up late January stated Minimally improved over the last few months. Suspect pain is isolated to the anterior deltoid based on physical exam.

Other Meds: Tylenol PRN Ketoconazole shampoo PRN dandruff Tretinoin 0.025 cream for ace Ibuprofen PRN Rizatriptan PRN Cetirizine daily Mometasone daily Concerta 18MG daily Ritalin short-acting dosing when needed.

Current Illness: none

ID: 1036521
Sex: F
Age: 39
State: IN

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

Symptom List: Injection site pain

Symptoms: Pfizer was administered as a second dose vaccine instead of Moderna

Other Meds:

Current Illness:

ID: 1036522
Sex: M
Age: 72
State: GU

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital: Y

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

Lab Data:

Allergies: Zoloft, Ambien, Lisinopril, Gabapentin

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

Symptoms: Patient had vaccine on the 12th, Stelara shot on 15th, and symptoms of diffuse erythroderma on the 16th. Seen in ER on 18th and admitted for further treatment.

Other Meds: Stelara, amlodipine, aspirin, paroxetine, buspirone

Current Illness: Psoriasis Had COVID-19 in November of 2020

ID: 1036523
Sex: F
Age: 28
State: RI

Vax Date: 02/01/2021
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: NKA

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

Symptoms: lightheaded Tachycardia

Other Meds: amitryptiline

Current Illness: N/a

ID: 1036524
Sex: F
Age: 39
State: IN

Vax Date: 02/17/2021
Onset Date:
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: Pfizer was administered as a second dose vaccine instead of Moderna

Other Meds:

Current Illness:

ID: 1036525
Sex: F
Age: 43
State: FL

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

Lab Data:

Allergies: NON

Symptom List: Erythema, Pruritus

Symptoms: PATIENT CALLED AT 9AM 2/17 NUMBNESS TO FINGERS, VEINS IN HANDS EXPOSED AND SWOLLEN. BURNING SENSATION TO HANDS. REDNESS TO UPPER LEFT ARM.

Other Meds: NON

Current Illness: NON

ID: 1036526
Sex: F
Age: 39
State: IN

Vax Date: 02/17/2021
Onset Date:
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: Pfizer was administered as a second dose vaccine instead of Moderna.

Other Meds:

Current Illness:

ID: 1036527
Sex: M
Age: 46
State: GA

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: LEFT ARM PAIN, OVER ALL MUSCLE WEAKNESS AND PAIN, & FATIGUE.

Other Meds:

Current Illness:

ID: 1036528
Sex: F
Age: 22
State: MA

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

Lab Data:

Allergies: Amoxicillin and penicillins

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I vomited 4 times the day following the vaccine.

Other Meds: Minipill birth control

Current Illness: None

ID: 1036529
Sex: U
Age: 87
State:

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: 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: Nausea, lightheaded, malaise

Other Meds:

Current Illness:

ID: 1036530
Sex: M
Age: 69
State: FL

Vax Date: 02/15/2021
Onset Date: 02/15/2021
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: none

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

Symptoms: Received the vaccine on 2/15/21 at 10:15 am in Left upper arm. Went to bed at approximately 11:00 pm. Started with body chills at approx. 11:00 pm. off and on during the night. Woke up the next morning with muscle and joint aches and feeling weak. Took an Arthritis Strength Tylenol at approx. 8:30 am. on 2/16/21. Felt better but still weak and some muscle aches. So took another Tylenol Arthritis Strength at appprox. 4:30pm. Improved that evening. The next morning symptoms of slight weakness only. Did not take any more medication other than regular daily meds.

Other Meds: Pioglitazone/Metformin15/500mg. 1 tab. daily, Atorvastatin 20mg. 1 tab. daily Telmisartan 20mg. q tab. daily Complete MVI for Men over 50 once daily Glucosamine/Chondroitin 1500/1200mg.

Current Illness: none

ID: 1036531
Sex: F
Age: 39
State: IN

Vax Date: 02/17/2021
Onset Date:
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: Pain in extremity

Symptoms: Pfizer was administered as a second dose vaccine instead of Moderna

Other Meds:

Current Illness:

Date Died: 02/16/2021

ID: 1036532
Sex: F
Age: 93
State: MA

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Patient was found unresponsive the following day and then pronounced deceased

Other Meds:

Current Illness:

ID: 1036533
Sex: F
Age: 73
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: 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: COVID Arm as identified in the literature. 1 week( 2/17/21) after shot reddened raised area about 3x5 oval shape on the R upper arm where shot was given. it is very itchy. not painful

Other Meds: Aspirin 81 mg, Vitamin C 100mg. B12 3000mcg Irbesartan 150 mg B Stress complex Vitamin D Citracal with Vitamin D

Current Illness: none

ID: 1036534
Sex: M
Age: 67
State: KS

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

Lab Data:

Allergies:

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

Symptoms: Administered Pfizer 2nd dose. Needed Moderna 2nd dose. No adverse effects noticed.

Other Meds:

Current Illness:

ID: 1036535
Sex: F
Age: 40
State: KY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: Gastric Allergy to zucchini

Symptom List: Vomiting

Symptoms: Days 1-2 after injection: tightness and ache in chest, collar bones, and ribs. Day 3: rash in left armpit Day 4: rash grew, swollen lymph node in left armpit noticeable Day 5: swelling and rash receding, still notable

Other Meds: Wellbutrin, Valium

Current Illness: None

ID: 1036536
Sex: F
Age: 85
State: MA

Vax Date: 01/30/2021
Onset Date: 02/03/2021
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: NKA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Left arm developed itchiness at site of injection on 4th day after vaccine with swelling and rash. 2/13 - bilateral leg rash, had some swelling to BLE. Pt states used compression stockings, and that it helps with swelling, pt states has bilateral leg swelling at baseline. Pt reports rash is improving, but still present, not spreading. Denies any fevers, red streaks, spreading redness/swelling, CP, SOB, dizziness/weakness, drainage, open areas, or any other associated symptoms. Pt states has been using cool compresses

Other Meds: metoprolol xl 100 mg warfarin 1 mg diltiazem 180 mg XR pravastatin 40 mg multiple vitamins calcium - vit D

Current Illness: n/a

ID: 1036537
Sex: F
Age: 46
State: AL

Vax Date: 02/04/2021
Onset Date: 02/13/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Vaccination right deltoid on 2/4/2021. Reports awakened on 2/13/2021 and right arm was tingling and was unable to lift. Seen in office 2/17/2021 and had improved some, can raise arm but unable to grasp pen, significantly weaker than left hand. Reports right hand dominant and unable to type or write at work. Reports some nausea and diarrhea initially following vaccine given on 2/4 that resolved a few days later/

Other Meds: None

Current Illness: None

ID: 1036538
Sex: F
Age: 0
State: WI

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Sore arm, headache, fatigue for 28 hours and self resolved. However I have had what can only be described as ?brain fog? since getting the vaccine. I am normally very on top of my game and have just noticed minor but very atypical changes in my thought processes.

Other Meds: Mesalamine

Current Illness: NA

ID: 1036539
Sex: M
Age: 29
State: IN

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: RA

Lab Data:

Allergies: Penicillins

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

Symptoms: Stiff arm started one hour after injection. Woke up this morning with chills but no fever. Have had chills and fatigue all day.

Other Meds:

Current Illness:

ID: 1036540
Sex: F
Age: 32
State: WA

Vax Date: 02/09/2021
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: NKDA

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

Symptoms: Fatigue (onset: 10 hours post-dose; length of AE: 12 hours) Body Ache (onset: 10 hours post-dose; length of AE: 12 hours) Headache, severe (onset: 10 hours post-dose; length of AE: 12 hours, took 600mg ibuprofen which relieved the headache)

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm