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: 0937973
Sex: F
Age: 37
State:

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: Dizziness, Headache, NauseaVomiting, Red/swollen below injection site x 12 days. No vomitting 1/4/21 Went to employee health. No treatment-will follow up w/PCP

Other Meds:

Current Illness:

ID: 0937974
Sex: F
Age: 58
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

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

Other Meds:

Current Illness:

ID: 0937977
Sex: F
Age: 35
State:

Vax Date: 12/27/2020
Onset Date: 12/28/2020
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: Headache, NauseaVomiting, tired, sleeping more Narrative:

Other Meds:

Current Illness:

ID: 0937978
Sex: F
Age: 54
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Headache, Myalgia, CHILLS/ LETHARGY/ SORE THROAT / PERIOD OF SHORTNESS OF BREATH Narrative:

Other Meds:

Current Illness:

ID: 0937980
Sex: M
Age: 53
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Diarrhea, NauseaVomiting, chills, injection site pain

Other Meds:

Current Illness:

ID: 0938182
Sex: F
Age: 53
State:

Vax Date: 12/28/2020
Onset Date: 12/28/2020
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, Rash, Red circular area approx. 5cm that first appeared on 12/28/2020, she also reports itching at site.

Other Meds:

Current Illness:

ID: 0939698
Sex: F
Age: 51
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: Pyrexia, White blood cell count decreased

Symptoms: Headache, Diarrhea, NauseaVomiting, lethargy, fever

Other Meds:

Current Illness:

ID: 0939699
Sex: M
Age: 36
State:

Vax Date: 12/28/2020
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: Myalgia, Arthralgia, SkinRash, Warmth, itching, and swelling at injection site. Narrative: On 2nd - 5th day post vaccination, employee experienced arthralgia and myalgia. On 6th post vaccination, employee developed swelling, itchiness, and redness at injection site.

Other Meds:

Current Illness:

ID: 0939700
Sex: F
Age: 58
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: CoughWheeze Throat swelling, lump in throat

Other Meds:

Current Illness:

ID: 0939701
Sex: F
Age: 48
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: cellulitis and lymphadenitis Narrative: emp developed redness and axillary lymphadenopathy in her lt axilla

Other Meds:

Current Illness:

ID: 0939702
Sex: M
Age: 41
State:

Vax Date: 12/24/2020
Onset Date: 12/25/2020
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: Dizziness, Headache, Myalgia & fever Narrative:

Other Meds:

Current Illness:

ID: 0939703
Sex: F
Age: 34
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: redness, swelling, warmth to injection site

Other Meds:

Current Illness:

ID: 0939704
Sex: F
Age: 26
State:

Vax Date: 12/23/2020
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Headache & Myalgia

Other Meds:

Current Illness:

ID: 0939705
Sex: F
Age: 39
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Angioedema & UrticariaPruritus

Other Meds:

Current Illness:

ID: 0939706
Sex: M
Age: 71
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 Narrative:

Other Meds:

Current Illness:

ID: 0939707
Sex: M
Age: 46
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Rash Cellulitis

Other Meds:

Current Illness:

ID: 0939708
Sex: M
Age: 43
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
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: Dizziness, Fever & NauseaVomiting

Other Meds:

Current Illness:

ID: 0939709
Sex: F
Age: 48
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
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, Myalgia, Diarrhea & NauseaVomiting

Other Meds:

Current Illness:

ID: 0939710
Sex: F
Age: 46
State:

Vax Date: 01/02/2021
Onset Date: 01/02/2021
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: Headache, Myalgia, Fever, UrticariaPruritus, NauseaVomiting, temp 101.0 then 99.5 Chills Narrative:

Other Meds:

Current Illness:

ID: 0939711
Sex: F
Age:
State:

Vax Date:
Onset Date: 12/27/2020
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: tired, muscle aches, sore arm, joint pain

Other Meds:

Current Illness:

ID: 0939712
Sex: F
Age: 67
State:

Vax Date: 12/28/2020
Onset Date: 12/30/2020
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: Headache fatigue Narrative: vaccine date 12/28. On 12/30 in the afternoon developed severe headache, fatigue.

Other Meds:

Current Illness:

ID: 0939713
Sex: M
Age: 70
State:

Vax Date: 12/30/2020
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: NauseaVomiting fatigue, hot flashes

Other Meds:

Current Illness:

ID: 0939714
Sex: M
Age: 59
State:

Vax Date: 12/28/2020
Onset Date: 01/02/2021
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: Arthralgia Inflammation under axilla on 1/2/2020 arounf 10am

Other Meds:

Current Illness:

ID: 0939715
Sex: F
Age: 56
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Headache, Myalgia, Fever, NauseaVomiting, T 99.6, chills

Other Meds:

Current Illness:

ID: 0939716
Sex: F
Age: 63
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache fatigue

Other Meds:

Current Illness:

ID: 0939717
Sex: F
Age: 54
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia & Fever Narrative:

Other Meds:

Current Illness:

ID: 0939718
Sex: F
Age: 57
State:

Vax Date: 12/29/2020
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: hives, burning sensation around mouth

Other Meds:

Current Illness:

ID: 0939720
Sex: F
Age: 58
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: unilateral swollen glands (right side) Narrative:

Other Meds:

Current Illness:

ID: 0939722
Sex: F
Age: 34
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Headache Narrative:

Other Meds:

Current Illness:

ID: 0939816
Sex: F
Age: 53
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: NauseaVomiting dizziness

Other Meds:

Current Illness:

ID: 0939839
Sex: F
Age: 0
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: warm sensation chest area

Other Meds:

Current Illness:

ID: 0939854
Sex: F
Age: 55
State:

Vax Date: 12/22/2020
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: Rash Narrative: large rash at site of vaccine in left arm upper

Other Meds:

Current Illness:

ID: 0939862
Sex: F
Age: 24
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Headache, NauseaVomiting, chills, fatigue Narrative: reports about 30 hours after vaccine developed a headache. about 48 hours had flu-like s/s, chills, nausea, fatigue, denies other s/s. These flu like s/s resolved within 24 hours, but headache continues, in milder form.

Other Meds:

Current Illness:

ID: 0939867
Sex: F
Age: 32
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Headache, Myalgia, Fatigue

Other Meds:

Current Illness:

ID: 0939871
Sex: F
Age: 62
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Headache tingling hands and lips, tongue felt thick/swollen Narrative: 12/30 given vaccine in the ED due to a shellfish allergy for which she carries an epipen. Pt experienced mild symptoms c/w allergic reaction after receiving Pfizer COVID vaccine #1. Symptoms included tingling lips and sensation of swollen tongue. She was given Diphenhydramine 50mg PO. Condition did not progress and her symptoms resolved within about one hour of oral Diphenhydramine. She was observed for 3 hours and discharged to home with prescriptions for an epipen and benadryl. Employee states - "15 min after the vaccination my hands got tingly on the palms. 5-10 min after that the front of my lips were tingly then my tongue felt thick. I also got a headache They gave me benadryl pills in the ED and within 10 min tingling on my lips went away and my tongue felt normal. My headache also went away." She was discharged from the ED back to work and reports no other symptoms.

Other Meds:

Current Illness:

ID: 0939877
Sex: F
Age: 63
State:

Vax Date: 12/29/2020
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: Headache & Fever

Other Meds:

Current Illness:

ID: 0939885
Sex: M
Age:
State:

Vax Date: 01/28/1983
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: LA

Lab Data:

Allergies:

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

Symptoms: Headache & NauseaVomiting

Other Meds:

Current Illness:

ID: 0939892
Sex: F
Age: 34
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Dizziness, Headache & NauseaVomiting

Other Meds:

Current Illness:

ID: 0939897
Sex: F
Age: 62
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

Other Meds:

Current Illness:

ID: 0939905
Sex: F
Age: 57
State:

Vax Date: 12/31/2020
Onset Date: 12/30/2020
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: Headache & Fever

Other Meds:

Current Illness:

ID: 0939910
Sex: F
Age: 61
State:

Vax Date: 12/22/2020
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: Pain in extremity

Symptoms: L arm cellulitis

Other Meds:

Current Illness:

ID: 0939913
Sex: M
Age: 35
State:

Vax Date: 01/04/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Myalgia Narrative: Employee reports all over muscle soreness and almost immediate onset s/p injection. Symptoms resolved within 36 hours.

Other Meds:

Current Illness:

ID: 0939917
Sex: F
Age: 45
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Myalgia, Fever, Pain in arm and armpit, swelling at injection site

Other Meds:

Current Illness:

ID: 0939945
Sex: F
Age: 56
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Headache & Myalgia Narrative:

Other Meds:

Current Illness:

ID: 0939950
Sex: F
Age: 50
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: CoughWheeze fatigue, runny nose, chest congestion Narrative:

Other Meds:

Current Illness:

ID: 0939958
Sex: F
Age: 46
State:

Vax Date: 12/24/2020
Onset Date: 12/24/2020
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: swelling of left axilla with redness, and hot to the touch

Other Meds:

Current Illness:

ID: 0939976
Sex: F
Age: 51
State:

Vax Date: 12/30/2020
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: Arthralgia, Diarrhea, NauseaVomiting, Chills, fatigue, Positive COVID test 9/11/2020

Other Meds:

Current Illness:

ID: 0939980
Sex: M
Age: 35
State:

Vax Date: 12/28/2020
Onset Date: 12/28/2020
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: Fatigue, Cough Narrative: On the day of vaccination patient reported cough and fatigue. Went and received a chest x-ray.

Other Meds:

Current Illness:

ID: 0939982
Sex: F
Age: 49
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Myalgia,SkinRash, Rash, HYPERtension, Pain at the insertion site, myalgia, rash to neck & back, itchiness to the throat Narrative: Developed pain at the insertion site and myalgia on 12/31/2020 1 hour after vaccination. On 01/01/21 developed rash to the neck & back and itchiness to the throat. She was seen at ER on 01/01 with a temp of 36.8 C, B/P 175/90, and HR 102. She was given Solu-u-Medrol 125mg IVP, Pepcid 20mg IVP, and Benadryl 25mg IVP. Symptoms resolved and B/P post treatment 125/80. Discharged home with Prednisone 40mg x 5day PO, Vistaril 25mg Q 6 hours PRN, and Pepcid 20mg x 5 days PO. Reports today 01/2/21 rash completely resolved. Has a history of allergic reaction to antibiotics. Reports had an anaphylaxis reaction to cephalosporin 4 years ago requiring a Epi injection in the ER. Reports history of allergic reaction to antibiotics; PCN, Macrolide, and Fluoroquinolones treated with High Dose Steroids.

Other Meds:

Current Illness:

ID: 0939992
Sex: F
Age: 39
State:

Vax Date: 12/23/2020
Onset Date: 12/30/2020
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: Redness, warmth to injection site; 5x6cm area of redness, warmth on left deltoid when seen by EOH on 12/21/2020.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm