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

Date Died: 01/18/2021

ID: 1036748
Sex: M
Age: 83
State: IL

Vax Date: 01/13/2021
Onset Date: 01/18/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Sent to ER 1/14/2021 due to drop in blood pressure with LOC during dialysis. Imaging revealed right lower lobe pneumonia given script for amoxicillin. According to staff patient was on dialysis had pneumonia and was on hospice, dialysis stopped resulting in death.

Other Meds: Tylenol prn; aspirin daily; atorvastatin daily; calcium carbonate daily; cholecalciferol twice daily; diltiazem; eliquis; ferrous sulfate; norco; melatonin; miralax; namenda; tamsulosin; tramadol every 6hrs.

Current Illness: ER visit 1/7 due to fall, CT negative current Dialysis, pneumonia, hospice patient.

ID: 1036749
Sex: F
Age: 44
State: MI

Vax Date: 02/05/2021
Onset Date: 02/16/2021
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: Allergic to penicillin, amoxicillin, and sulfa drugs

Symptom List: Anxiety, Dyspnoea

Symptoms: On day 1-3 fatigue and injection site soreness On day 11 large itchy hot welt around injection site

Other Meds: Generic Claritin OTC, vitamin d , daily vitamin

Current Illness: None

ID: 1036750
Sex: F
Age: 74
State: GA

Vax Date: 02/15/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Moderna COVID 19 Vaccine EUA . VERY TIRED/ some weakness, no appetite

Other Meds: Omeprazole Atorvastatin Duloxetine Montelukast Citracal maximum plus 3D Ipratropium Bromide Meloxicam

Current Illness:

ID: 1036752
Sex: F
Age: 36
State: WI

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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 12/16: 1200 - dizziness 1700 - headache, fatigue 2000 - 101.9 fever, body aches, fatigue, dizziness, nausea 12/17: 0600 - dizziness, nausea 0800 - nausea, diarrhea - lasted throughout whole day

Other Meds: None

Current Illness: None

ID: 1036753
Sex: F
Age: 67
State: PA

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: multiple adverse drug reactions: Zoloft, hydroxychloroquine, simvastatin, ACE inhibitors, metronidazole, prednisone, moxifloxacin, cefpodoxime, all novel oral anticoagulants, heparin, Lovenox, Zocin, lidocaine, EMLA cream, cadexomer iodine, multiple wound covers and topical treatments, multiple antifungals.

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

Symptoms: Neck pain and stiffness, headache unlike any previous headache, fever, myalgia, somnolence, mental confusion, anorexia, eye pain, photophobia: worst during the first 24 hours after vaccination, but ongoing to present. Feels like meningitis symptoms.

Other Meds: fondaparinux nebivolol

Current Illness: Sjogrens with vasculitis multiple clotting disorders immunodeficency Antiphospholipid Syndrome

ID: 1036754
Sex: F
Age: 56
State: CA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
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: sulfa vicodin

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

Symptoms: massive headache, 11 hours post vaccination at midnight. Extreme arm pain, throbbing, burning, joints felt swollen, extreme abdominal pain (like someone wrenching my intestines and organs), aching neck, body pains and felt like I was freezing btwn midnight and 3 am. Had lay still in a fetal position for it to calm down at 3am.

Other Meds: estradiol, progesterone, pregnenalone, vitamin D vit c melatonin

Current Illness:

ID: 1036755
Sex: F
Age: 54
State: FL

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: stadol

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: ?Moderna COVID-19 Vaccine EUA, NAUSEA AND WAS FOUND TO HAVE A BLOOD PRESSURE OF 84/55, HEADACHE, WEAK, BRAIN FOG. HAD SYMPTOMS FOR SEVERAL DAYS. EVEN 5 DAYS AFTER THE EVENT I AM NOT ABLE TO TAKE MY FULL DOSE OF BLOOD PRESSURE MEDICATION AS IT DROPS MY BLOOD PRESSURE. ALSO HAD A SIGNIFICANT REACTION AT THE INJECTION SITE.

Other Meds: amlodipine 10mg qhs, omeprazole 40mg qhs, synthroid 200mcg q am, estradiol 1mg qhs, progesteron 100mg po qhs, escitalopram 20mg qhs, robaxin 1000mg qhs

Current Illness: none

ID: 1036756
Sex: M
Age: 73
State: MI

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Chills, fever of 100.00

Other Meds: None

Current Illness: None

ID: 1036757
Sex: F
Age: 49
State: VA

Vax Date: 02/03/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Developed rash at the injection site one week after the injection that lasted for about a week. Then, developed a larger rash on towards the inside of the same arm. This rash did not appear until two weeks after the injection.

Other Meds: Estradiol

Current Illness: None

ID: 1036758
Sex: F
Age: 58
State: MA

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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient received COVID-19 vaccine. AFter 5 minutes of observation she got itchy and started getting a red rash on her throat area. She was very calm and asked for help. Paramedics noticed she was turning discolored and provided Benadryl p.o 4mL. They asked to transport her to a nearby hospital and she agreed. They were in transport at 4:35pm to the hospital to get her treatment for adverse reaction.

Other Meds: unkown

Current Illness: unkown

ID: 1036759
Sex: F
Age: 74
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA or Food Allergies

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

Symptoms: Patient was previously in a rehab facility who was in communications with the patients long term care facility. However, the patient received her first dose of the COVID vaccine (Moderna) through the rehab facility on 1/27/2021, which they did not communicate with the long term care facility. Therefore, when the COVID vaccine clinic team went to the long term care facility for our second trip (first trip was 1/20/21), the patient was listed as getting dose 1. Therefore, the patient got the vaccine on day 21. No adverse events have been reported.

Other Meds: Unknown

Current Illness: Unknown

ID: 1036760
Sex: F
Age: 23
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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: None.

Symptom List: Rash, Urticaria

Symptoms: Employee states that adverse events started on the second day after vaccine( Feb. 9th) and they continue to persist as of today. She has following symptoms: Hives on the left arm (injection site), face is swollen, upper lip is swollen, mouth is really itchy, chills, sweats.

Other Meds: None.

Current Illness: None.

ID: 1036761
Sex: M
Age: 68
State: NC

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: IM
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: 2/12/21 - Recieved the Covid 19 vaccine 2/13/21 - 5 pm. Fever, chills, no appetite, no taste, no smell, fatigue - was gone by 8 am the next day. Took Tyenol and rest. Taste and smell returned. 2/14/21 - 5 pm. Was eating and had a sip of wine. Felt like I was choking and had a strange sensation in the head. Felt like I blacked out for 2 seconds and was drolling. This is the only time that I have experienced this.

Other Meds: Lisinopril astorvastin

Current Illness: Hormone shot taken 02/04/21 for prostate cancer Tested positive for COVID on 1/22/21

ID: 1036762
Sex: F
Age: 40
State: CA

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

Lab Data:

Allergies: None reported

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

Symptoms: Approx 10 minutes post vaccine patient reported she felt a c " cold rush" through her whole body, felt like she was shaking, developed hand tremors and then bilateral feet and calf numbness

Other Meds: Unknown

Current Illness: None reported 2 weeks prior to vaccination

ID: 1036763
Sex: F
Age: 41
State: MN

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Milk and Cipro

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

Symptoms: Went to get the vaccine, sat down and received it in her left arm, and while waiting for the 15 minutes and after 10 minutes she stood up and coughed, a nurse came to her and asked if she could help her, she grabbed her throat and told her she could not breathe. She gave her an Epi-pen shot in her right thigh and then she put oxygenation on her finger, around 5 minutes later they took her to the ER. She felt fine immediately after the. The nurse then gave her an IV but they did not give her any medicine. She also had her BP monitored and checked her vitals signs, and a doctor talked to her and kept her for an hour for monitoring, and then released from the ER.

Other Meds: Centrum adult, Vitamin D3, Hydroxyzine HCL, Sluvoxamine Maleate.

Current Illness: None.

ID: 1036764
Sex: F
Age: 35
State: CA

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 02/17/2021
Hospital: Y

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- unknown reaction Shellfish- anaphylaxis

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

Symptoms: Lower back pain that then was only localized to the right flank. Worse when breathing. Ibuprofen helped with symptoms a bit. I visited the ED and on US a gallstone was detected, not obstructing ducts but the decision was made to have it removed.

Other Meds: None

Current Illness: Crohn's disease

ID: 1036765
Sex: F
Age: 23
State: PA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
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: Avocado Acidic Fruit Seasonal

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

Symptoms: Chest pain

Other Meds: None

Current Illness: None

ID: 1036766
Sex: M
Age: 78
State: OH

Vax Date: 01/25/2021
Onset Date: 02/16/2021
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: 22 days after injection, my right arm muscle started to hurt seriously. Any movement caused pain. On the second day, the pain comes only when I flex that muscle. There is no pain in my other my arm.

Other Meds:

Current Illness: none

ID: 1036767
Sex: F
Age: 79
State: CA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/17/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 4 seizure type episodes (including shaking, eyes rolling back for about 15-30 seconds long) after being moved out of bed - lasted 4 days Fever up to 102.5 - lasted 5 days Could not stand - 8 days Body aches - 8 days Could not walk - 9 days Weakness - on going since vaccine Shaking - on going since vaccine

Other Meds: BASAGLAR 100 UNIT/ML KWIKPEN INSULIN PEN ? 21 units JANUMET XR 50-1,000 MG TABLET, ER MULTIPHASE ? ? tablet

Current Illness: n/a

ID: 1036768
Sex: F
Age: 51
State: CA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: dust, grass/tree pollen, cats, dogs

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

Symptoms: pain at injection site, muscle and joint aches, headaches, foggy feeling, chills, tiredness (much flu-like) - for about 48 hours

Other Meds: none

Current Illness: none. Please note, that this was a second vaccination for COVID-19.

ID: 1036769
Sex: F
Age: 19
State: CO

Vax Date: 02/12/2021
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: 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: Patient fainted in the chair shortly after vaccine administration. Patient regained consciousness 4 or 5 seconds later. She was nauseated for a short time, then was completely recovered. She had a friend with her because she has fainted before after a vaccination. She waited with her friend for 30 minutes outside the pharmacy. She was feeling fine when she left.

Other Meds: none

Current Illness: none

Date Died: 02/10/2021

ID: 1036770
Sex: F
Age: 90
State: OH

Vax Date: 01/19/2021
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: LA

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: Feb 10th died in her sleep. No apparent reason.

Other Meds: generic multi vitamin

Current Illness: none

ID: 1036771
Sex: F
Age: 54
State: MN

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: NO

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: After vaccination, a reconstitution error was discovered, the vaccination received was slightly more concentrated. The employee has been contacted, made aware of the incident, educated on reporting signs and symptoms.

Other Meds: NO

Current Illness: NO

ID: 1036772
Sex: F
Age: 59
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Clindamycin, Ciprofloxacin,codein, iodine, ketamine,levaquin,

Symptom List: Injection site pain, Pain

Symptoms: Patient developed tachycardia almost immediately after she was given the vaccine. She recorded a heart rate of 142. She was further evaluated where she was noted to be dyspneic (diffuse wheezing in pt with history of asthma) and was noted to have a labile heart rate. Her heart rate increased from 80s at rest to 139 with ambulation. Given her dyspnea and very labile heart rate she was encouraged to go to the ED for further evaluation but patient declined. Cardiologist office alerted and she will follow up with him. EKG showing sinus tachycardia. Of note the pt is actively being treated for an arrythmia and recently adjusted her beta blocker.

Other Meds: Levothyroxine, lisinopril, Unknown name of beta blocker

Current Illness:

ID: 1036773
Sex: F
Age: 67
State: WI

Vax Date: 02/14/2021
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: Allergic to all cephalosporins Iodine sensitivity to eggs Allergy test / referenced

Symptom List: Injection site pain, Menorrhagia

Symptoms: After making my PCP aware of my allergies and got the ok I got a shot a covid - 19 shot. I made person who administered the shot that I had allergies and that it was best to stay for 30 minutes. The people at this facility were great and I left at 4:40.( no symptoms ) My arm was tender Sunday night but I didn't think anything of it. The next morning it was very sore and sleeping was difficult but I really didn't investigate till Tues 10AM when I felt a lump on the injection sight. ( It was 12 straight days of freezing temps so I was bundled up)) I called my PCP and spoke with and was not happy with the response that this happens a lot and nothing to worry about. (Covid - Arm 2% / 9% ) I read up on adverse effects and what to do on the internet and started an ice pack, and took an IBprophine and a Benadryl. Which Dr concurred per MyChart after viewing the picture of the injection site I sent her. So its day 3 and I will continue observation.

Other Meds: DESVENLAFAXINE SUCCNT ER 50.mg Melatonin 2 mg DESVENLAFAXINE SUCCNT ER 25.mg Dexmethylphenidate Hydrochloride 20 mg DILTIAZEM 30mg BUSPIRONE HYDROCHLORIDE 7 mg

Current Illness: none

ID: 1036774
Sex: F
Age: 25
State: WI

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: No known allergies

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

Symptoms: Soreness in arm has not subsided in just under two weeks. Patient has tried OTC analgesics, ice, and was referred to a Physical Therapist.

Other Meds: Microgestin (Oral Contraceptive)

Current Illness: No known illnesses

ID: 1036776
Sex: F
Age: 75
State:

Vax Date: 02/12/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Worsening shortness of breath over 4 days with accompanying vomiting and chills

Other Meds:

Current Illness:

ID: 1036777
Sex: F
Age: 28
State: CA

Vax Date: 02/13/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Burning at injection site

Other Meds:

Current Illness:

ID: 1036778
Sex: F
Age: 28
State: CT

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: RA

Lab Data:

Allergies: Sulfa, cefzil

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

Symptoms: Nausea, diarrhea, abdominal pain

Other Meds: Allegra, Jolessa, Sertraline, multivitamin

Current Illness: No

ID: 1036779
Sex: M
Age: 41
State: AZ

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: None

Symptom List: Nausea

Symptoms: Pt reported throat feeling tingly and tighter ~20 minutes after vaccine, thought it was normal. Later that day, pt experienced tongue swelling and trouble breathing. Went to urgent care, got steroid treatment. Still lasted after several days. Went to the hospital, got more steroid treatment. Pt reports it is "on and off" now, 4 weeks after first dose. No history of allergic reactions to other meds/vaccines.

Other Meds:

Current Illness:

ID: 1036780
Sex: F
Age: 54
State: IN

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

Lab Data:

Allergies: PCN

Symptom List: Injection site pain

Symptoms: Cellulitis at injection site with warmth, redness and pain. Continues even today but swelling is going down and it is not as red but it itches.

Other Meds: Aderral, lamictal, clonopin, celexa, wellbutrin, tylenol and bendryl

Current Illness: none

ID: 1036781
Sex: F
Age: 55
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: Itchy feeling all over back and down arms. Feeling comes and goes. Feels like I'm wearing a very uncomfortable wool sweater.

Other Meds: Furosemide, Topiramate, B12, D3, MultiVitamin with Omega 3, Tumeric

Current Illness: no

ID: 1036782
Sex: F
Age: 65
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: IM
Vax Site: RA

Lab Data:

Allergies: Insect bite

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

Symptoms: Fever Chills Body ache

Other Meds: Metformin Losartan Sim vastatine

Current Illness: No

ID: 1036783
Sex: F
Age: 78
State: FL

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Fever chills achy headache lightheaded

Other Meds: Amlopidine, Atorvastatin Eliquis Zetia IsosorbideER Lomotil Losartan-HCTZ Paroxetine Sotolol Synthroid Liw dose aspirin Xyzal Azelastine nasal spray Fluticasone nasal spray Breo Ellipta. Culturelle probiotic

Current Illness: None

ID: 1036784
Sex: M
Age: 43
State: MN

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

Lab Data:

Allergies: NO

Symptom List: Erythema, Pruritus

Symptoms: After vaccination, a reconstitution error was discovered, the vaccination received was slightly more concentrated. The employee has been contacted, made aware of the incident, educated on reporting signs and symptoms.

Other Meds: NO

Current Illness: NO

ID: 1036785
Sex: F
Age: 51
State: NM

Vax Date: 02/13/2021
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: food sensitivity to eggs and some other foods, but not actual allergies.

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

Symptoms: My throat was a little itchy and I got a few hives on different parts of my body including arms, stomach, back and legs. There were only a few on each area and not all at the same time. Different patches on different days. I thought it could be allergies, so cleaned my house (I have a cat), but it persisted. On Tuesday night, I realized what was going on and took two Benedryl, which helped.

Other Meds: none

Current Illness: none

ID: 1036786
Sex: F
Age: 32
State: AZ

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: Sulfa

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

Symptoms: Pt experienced dizziness, and arm tingling 20 minutes after administration of vaccine

Other Meds: Januvia, Ibuprofen, Vit C, Omeproxzole, cefdinir, Tylenol, Flonase, Proventil, Labatalol

Current Illness: Diabetes

Date Died: 02/05/2021

ID: 1036787
Sex: F
Age: 78
State: MN

Vax Date: 02/03/2021
Onset Date: 02/05/2021
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: passed away 2 days after vaccine was given

Other Meds:

Current Illness:

ID: 1036788
Sex: M
Age: 68
State: FL

Vax Date: 01/19/2021
Onset Date: 01/19/2021
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: none

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

Symptoms: 4 hours after shot, patient's underarm lymph node swell. He is continuing to see his doctor regarding the lymph node. The lymph node is still swollen with not much improvement per patient.

Other Meds: don't know

Current Illness: none

ID: 1036789
Sex: F
Age: 53
State: AL

Vax Date: 02/06/2021
Onset Date: 02/06/2021
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: I do have atopic eczema so soaps, detergents can irritate my skin Tongue swelled in the last 3 years with tamiflu, crestor, and augmentin

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

Symptoms: On evening of day of vaccine (Feb 6th) my left arm started to swell and got red and very sore at site. Arm did not hurt to move just hurt when touched at site. It continued to swell for 48 hours. I treated with Benadryl, zyrtec, tylenol, and ice. All went away by Tuesday Feb9th. It grew to be about the size of an orange. Then when I woke up Saturday Feb 13th, I noticed my arm was itchy at site and looked in the mirror and noticed that it was red and starting to swell again. Again treated the same way and the swelling and redness lasted until Monday Feb 15th. Did not swell as large as last time. Now it looks just like a purple bruise the size of a small tangerine/small apple around the site.

Other Meds: zyrtec atirvastatin losartan vitamin D Zinc, Calcium, Magnesium supplement Elderberry Vitamin C occasionally a benadryl---was given one before my shot due to reactions to medicines in the past 3 years

Current Illness: none

ID: 1036790
Sex: F
Age: 55
State: CA

Vax Date: 02/06/2021
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: none

Symptom List: Pain in extremity

Symptoms: on day 7 my arm where I received the injection, swelled up, was red, warm to touch and it was itchy. The swelling was about 3 inches by 2 inches at the site. The reaction lasted about 36 hours total.

Other Meds: none

Current Illness: no

ID: 1036791
Sex: F
Age: 47
State: NC

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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: sulfa drugs

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

Symptoms: roughly 30 minutes after injection, you started to notice difficulty swallowing, tongue swelling. took benadryl which improved tongue symptoms, but throat still felt different x 3 hrs. back normal 10-12hr after injection.

Other Meds: lamictal

Current Illness: none

ID: 1036792
Sex: M
Age: 54
State: MI

Vax Date: 01/10/2021
Onset Date: 02/12/2021
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

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

Symptoms: vagus nerve neuropathy - began one month after vaccine; dysphagia; vocal cord partial paralysis

Other Meds: insulin; synthroid; aspirin; lisinopril; zinc

Current Illness: none

ID: 1036793
Sex: F
Age: 45
State: MN

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

Lab Data:

Allergies: NO

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

Symptoms: After vaccination, a reconstitution error was discovered, the vaccination received was slightly more concentrated. The employee has been contacted, made aware of the incident, educated on reporting signs and symptoms.

Other Meds: NO

Current Illness: NO

ID: 1036794
Sex: F
Age: 33
State: OH

Vax Date: 02/08/2021
Onset Date: 02/15/2021
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: Both eyelids feel and look puffy. I Have to make an effort to open my eyes all the way. This occurred after the first dose, I thought it was due to old make up. After the second dose it is occurring more often and is more bothersome.

Other Meds: Klonopin

Current Illness:

ID: 1036795
Sex: F
Age: 38
State: IL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: sensitive to codeine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Day of injection: Sore arm at injection site, but extended length of the arm for the next three days. Hurt to even lift arm or lay on it. Day after injection: Pain on same side as injection from left ear all the way down left leg, headache, drowsiness, body aches. Slept about 12 hours that night.

Other Meds:

Current Illness:

ID: 1036796
Sex: F
Age: 25
State: CA

Vax Date: 02/13/2021
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:

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

Symptoms: Headache; BP 135/83 (pulse 72); repeat BP 126/80 (pulse 80).

Other Meds:

Current Illness:

ID: 1036797
Sex: F
Age: 61
State: CA

Vax Date: 01/25/2021
Onset Date: 02/03/2021
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: Meds: Augmentin, sulfa No food or environmental allergies.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: "Covid arm" - delayed cutaneous hypersensitivity Large red circle patch, about 8" in diameter, itchy and hot to the touch. It lasted six days before it was completely gone. I used tylenol, aloe vera gel, hydrocortisone cream, and ice packs to ease symptoms.

Other Meds: Levothyroxine, vitamins C, D3, calicium, turmeric, DLPA, Bromelein, multi-vitamin

Current Illness: None

ID: 1036798
Sex: F
Age: 82
State: CA

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: Aspirin, alendrenolate, hydrolizine

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

Symptoms: Patient received first dose of vaccine and felt dizzy about 15 minutes after administration. She felt like she was going to "pass out." She did not lose consciousness and her vital signs remained stable.

Other Meds: Lisinopril, diltiazem, latanoprost, trospium, flurandrenolide

Current Illness: None noted

ID: 1036799
Sex: F
Age: 47
State: CA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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:

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

Symptoms: Pt reported feeling throat tightness and difficulty swallowing, chest warmness, tachycardia and nausea with both legs elevated. Pt vomited and dry heaved. At 6:05pm, pt reported resolution of tightness. Be advised that the person involved requested to be released and denied further treatment by going to ER. Signed written document stating despite recommending being seen at ER, she wanted to leave on her own free will.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm