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: 0937541
Sex: M
Age: 31
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
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: Myalgia, Fever, chills Myalgias chills low grade temp for 24 hrs. Returned to work and symptoms resolved

Other Meds:

Current Illness:

ID: 0937553
Sex: F
Age: 62
State:

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/07/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Headache, Myalgia, CoughWheeze, Syncope, Fatigued, chills, night sweats, mild shortness of breath, cough. Takes coumadin for protein s deficiency. Tested + for COVID on 1/4/21 Narrative: Fatigued, chills, night sweats, mild shortness of breath, cough. Takes coumadin for protein s deficiency, sees hematology. Currently taking prn tylenol, scheduled to see hematology. Tested positive for COVID on 1/4/21.

Other Meds:

Current Illness:

ID: 0937562
Sex: M
Age: 53
State:

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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:

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

Symptoms: CoughWheeze SOB, cough Narrative: Cough, SOB. Pt tested positive for covid on 1/4/21

Other Meds:

Current Illness:

ID: 0937572
Sex: F
Age: 50
State:

Vax Date: 12/29/2020
Onset Date: 01/03/2021
Rec V Date: 01/07/2021
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: Headache, Myalgia, Fever, Rash & Urticaria Pruritus

Other Meds:

Current Illness:

ID: 0937577
Sex: F
Age:
State:

Vax Date:
Onset Date: 12/24/2020
Rec V Date: 01/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: b/l weakness in numbness starting in arm receiving vaccine shot at 0846 developed numbness in arm receiving injection which gradually spread to both arms grew to include weakness. After 30 minutes symptoms began to ease and she was released without intervention. VSS throughout. BP in 130s/80s, HR 70s, sats upper 90s. Employee kept at vaccination site until symptoms began to ease.

Other Meds:

Current Illness:

ID: 0937587
Sex: F
Age: 44
State:

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/07/2021
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:

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

Symptoms: SkinRash chills Narrative: macular rash over the trunk anterior chest, abdomen, back and both arms

Other Meds:

Current Illness:

ID: 0937596
Sex: F
Age: 51
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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: Dizziness, Tachypnea, CoughWheeze, Palpitations, shortness of breath, throat tightness Narrative: VAccine administered at 12:15pm. At 1230pm, employee noted new cough and onset of sob/throat tightening. O2 sat 96-97% on RA, HR 110-120's, BP 123/90. Employee with a long history of environmental/food allergies, occasionally requiring epi-pen. Epi-pen (0.3mg) administered IM x1. 25 mg IV benadryl administered x1. Employee reported symptom improvement after this medication administration and was taken to the ED for further eval. In ED given IV famotidine 20mg x1. Employee monitored without any further adverse reaction. Discharged home with RX for Famotidine 20 mg twice a day for 5 days and Zyrtec 10 mg twice a day for 5 days.

Other Meds:

Current Illness:

ID: 0937602
Sex: F
Age: 38
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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: Pharyngeal swelling

Symptoms: Headache & Myalgia Narrative: Telephone evaluation

Other Meds:

Current Illness:

ID: 0937611
Sex: M
Age: 50
State:

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/07/2021
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: Metallic taste within 5 min of injection Narrative:

Other Meds:

Current Illness:

ID: 0937620
Sex: F
Age: 43
State:

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/07/2021
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: Headache & Fever Narrative: Employee reports experiencing headache and fevers that started a few hours after vaccine was administered, incapacitated from coming to work but not severe enough to seek medical care.

Other Meds:

Current Illness:

ID: 0937646
Sex: F
Age:
State:

Vax Date:
Onset Date: 12/28/2020
Rec V Date: 01/07/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Angioedema tingling on botton lip and chin Narrative: Patient vitals were taken on two occasions - 15 minutes apart and were stable. Patient verbalized feeling ok. No signs of edema, pain or any other discomfort.

Other Meds:

Current Illness:

ID: 0937656
Sex: F
Age: 56
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Headache chills, fatigue Narrative:

Other Meds:

Current Illness:

ID: 0937669
Sex: F
Age: 58
State:

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
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: Fevers, chills, aches & pains

Other Meds:

Current Illness:

ID: 0937671
Sex: M
Age: 42
State:

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Dizziness mild shortness of breath, asthma exacerbation Narrative: used albuterol inhaler at home which did help.

Other Meds:

Current Illness:

ID: 0937680
Sex: F
Age: 40
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Dizziness light headed, itchiness on head, ears felt hot and red, elevated BP and elevated HR Narrative: Tool Prednisone, Hydroxazine, and Zyrtec- all previously prescribed medications for general allergies.

Other Meds:

Current Illness:

ID: 0937683
Sex: F
Age: 32
State:

Vax Date: 12/27/2020
Onset Date: 12/27/2020
Rec V Date: 01/07/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Fever fatigue

Other Meds:

Current Illness:

ID: 0937688
Sex: F
Age: 39
State:

Vax Date: 12/27/2020
Onset Date: 01/03/2021
Rec V Date: 01/07/2021
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:

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

Symptoms: Myalgia, UrticariaPruritus, swelling

Other Meds:

Current Illness:

ID: 0937693
Sex: M
Age: 39
State:

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/07/2021
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: Headache, Arthralgia & Fever

Other Meds:

Current Illness:

ID: 0937694
Sex: M
Age: 41
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: neuralgia

Other Meds:

Current Illness:

ID: 0937700
Sex: M
Age: 33
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia, Fever, Fatigue

Other Meds:

Current Illness:

ID: 0937702
Sex: F
Age: 48
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: dyspnea on exertion, peaked on 12/31/20, now much improved but not completely resolved as of 1/4/21 Narrative:

Other Meds:

Current Illness:

ID: 0937718
Sex: F
Age: 37
State:

Vax Date: 12/28/2020
Onset Date: 01/02/2021
Rec V Date: 01/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Fatigue, Swollen lymph node to the right axilla Narrative:

Other Meds:

Current Illness:

ID: 0937731
Sex: M
Age: 36
State:

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Myalgia malaise Narrative:

Other Meds:

Current Illness:

ID: 0937747
Sex: F
Age: 42
State:

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Myalgia Muscle twitching and spasms Narrative: Employee reports post vaccination on 12/31/2020 about 6hrs post vaccination she developed shooting pains in right arm radiating down her arm and into her neck. She states these symptoms progressed through out her entire body into the evening. She developed muscles twitching and spasm all over.

Other Meds:

Current Illness:

ID: 0937942
Sex: M
Age: 46
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
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: Myalgia & Fever

Other Meds:

Current Illness:

ID: 0937943
Sex: F
Age: 35
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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: Dizziness & Headache

Other Meds:

Current Illness:

ID: 0937945
Sex: F
Age: 41
State:

Vax Date: 12/24/2020
Onset Date: 12/25/2020
Rec V Date: 01/07/2021
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: Headache, Myalgia, REDNESS, SWELLING, WARMTH, INDURATION TO INJECTION SITE ON LEFT DELTOID WITH PRURITUS; FATIGUE Narrative:

Other Meds:

Current Illness:

ID: 0937946
Sex: F
Age: 36
State:

Vax Date: 12/22/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
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: ErythemaMultiform urticaria/ injection site pain/swelling

Other Meds:

Current Illness:

ID: 0937947
Sex: F
Age: 41
State:

Vax Date: 11/30/2020
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia, Arthralgia & Nausea Vomiting

Other Meds:

Current Illness:

ID: 0937948
Sex: F
Age: 73
State:

Vax Date: 12/24/2020
Onset Date: 01/02/2021
Rec V Date: 01/07/2021
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: Nausea

Symptoms: ErythemaMultiform employee reports redness and warm to touch at injection site Narrative: telephone nurse triage, employee reports redness and warm to touch at injection site 9 days post vaccine administration. applied ice pack to site, but no medication or further treatment needed. employee will continue to monitor if site does not improve.

Other Meds:

Current Illness:

ID: 0937949
Sex: F
Age: 41
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
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: Headache, Fever, NauseaVomiting, T102.5 No vomitting symptoms ended x 1 day

Other Meds:

Current Illness:

ID: 0937951
Sex: F
Age: 49
State:

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
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: Myalgia, Fever, sweating Narrative:

Other Meds:

Current Illness:

ID: 0937952
Sex: M
Age: 44
State:

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/07/2021
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: Headache, Myalgia, pain in injection site

Other Meds:

Current Illness:

ID: 0937953
Sex: F
Age: 61
State:

Vax Date: 12/29/2020
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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: watery eyes, chills, sore throat

Other Meds:

Current Illness:

ID: 0937955
Sex: M
Age: 55
State:

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Myalgia pain at injection site

Other Meds:

Current Illness:

ID: 0937956
Sex: F
Age: 40
State:

Vax Date: 12/24/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
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: R AXILLARY adenopathy DAY 6- 10 RESOLVED Narrative: R AXILLARY adenopathy Day 6- 10 RESOLVED

Other Meds:

Current Illness:

ID: 0937957
Sex: M
Age: 46
State:

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
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: Myalgia, Fever, fatigue

Other Meds:

Current Illness:

ID: 0937958
Sex: F
Age: 27
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Headache, Fever, NauseaVomiting, Fatigue, Chills Narrative:

Other Meds:

Current Illness:

ID: 0937959
Sex: M
Age: 40
State:

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
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: Myalgia nerve damage, unable to move or lift arm.

Other Meds:

Current Illness:

ID: 0937960
Sex: F
Age: 55
State:

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/07/2021
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:

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

Symptoms: 2 hour right sided facial numbness around mouth

Other Meds:

Current Illness:

ID: 0937962
Sex: F
Age: 62
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
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: Headache, Myalgia, Fever, SkinRash, Rash, mild symptoms Narrative: employee reports recovering from side effects, but developed rash she feels similar to shingles she had in the past

Other Meds:

Current Illness:

ID: 0937963
Sex: M
Age: 45
State:

Vax Date: 12/21/2020
Onset Date: 12/22/2020
Rec V Date: 01/07/2021
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: Headache, Myalgia, Fever, chills Narrative:

Other Meds:

Current Illness:

ID: 0937965
Sex: M
Age:
State:

Vax Date:
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Headache & Myalgia

Other Meds:

Current Illness:

ID: 0937966
Sex: F
Age: 48
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
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: Dizziness, Headache, pins and needles injection site, one side shoulder, arm, neck pain, weakness, generalized weakness Narrative: employee considered response mild, needed a heat pack for pain relief, staying in bed on Jan 5. Taking 800 mgm ibuprofen every eight hours, has not recovered yet.

Other Meds:

Current Illness:

ID: 0937967
Sex: F
Age: 39
State:

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/07/2021
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: Headache sore arm, fatigue Narrative:

Other Meds:

Current Illness:

ID: 0937968
Sex: F
Age: 46
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache, Myalgia, Fever, neck pain, chills, lightheaded Narrative: Reports that she had chills, severe body aches, fever, neck pain, fatigue, headache, and lightheadedness

Other Meds:

Current Illness:

ID: 0937969
Sex: F
Age: 63
State:

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
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: UrticariaPruritus right eye swelling and itching employee presented to ED day after vaccine. was given prednisone and hydroxyzine.

Other Meds:

Current Illness:

ID: 0937970
Sex: M
Age: 60
State:

Vax Date: 12/28/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
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: Axillary pain and swelling left underarm 12/31/2020

Other Meds:

Current Illness:

ID: 0937971
Sex: F
Age: 46
State:

Vax Date: 12/29/2020
Onset Date: 01/29/2020
Rec V Date: 01/07/2021
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: Headache, CoughWheeze, Fatigue Narrative:

Other Meds:

Current Illness:

ID: 0937972
Sex: F
Age: 54
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
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: Headache, Arthralgia, Fever, Fatigue, Chills

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm