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: 1039996
Sex: F
Age: 45
State: NC

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: lemons and shellfish leads to itching and swelling.

Symptom List: Dysphagia, Epiglottitis

Symptoms: 3:30 shot received. 4:00 tongue numb, tingling in mouth. 4:25pm 50mg Benadryl. 4:29pm 200/100mmHg. 4:25pm pulse 108bpm 98%sp02. 4:35pm 230/104mmHg, 116bpm, 98%sp02. 4:40pm slight trouble breathing, 98%sp02, 105bpm. 4:43pm 240/150mmHg. 4:44pm 230/130mmHg.

Other Meds:

Current Illness: pt normally has 192/89mmHg

ID: 1039997
Sex: F
Age: 71
State: GA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: Sulfa, Keflex, PCN

Symptom List: Anxiety, Dyspnoea

Symptoms: 1222 : C/O HEART RACING, FEELING LIGHTHEADED. P 120 INITIALLY. COLOR OK. BP 180/90, P 96. MOVED TO EXAM ROOM SO PT COULD LIE DOWN. HUSBAND PRESENT. 1227 : BP 172/90, P 88 OXY SAT 98%, RR 16. 1232 : 160/90, P 92, R16. STARTING TO FEEL A LITTLE BETTER. C/O SLIGHT HEADACHE. OFFERED WATER. TOLERATING WATER. NO PROBLEMS SWALLOWING. NO OTHER COMPLAINTS. 1238 : 168/90, P 88 RR, 16. 1245 : 158/88, P 75, RR 16. STATES THIS IS CLOSER TO WHAT HER BLOOD PRESSURE HAS BEEN RUNNING LATELY. FEELING MUCH BETTER. 1251 : BP 140/82, P 80, RR 16, OXY SAT 96%. LEFT WITH HUSBAND.

Other Meds: HTN medication

Current Illness: none known

ID: 1039998
Sex: M
Age: 47
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: Previous topical reaction to 1st COVID-19 vaccine - rash

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

Symptoms: Pt. Report ?warm? feeling in neck, upper chest, upper back. Started ~15 minutes post vaccine. V/S - 140/79, 98%-O2, 77-HR, 18-Resp. Pt. in 30 min. observation due to reported topical allergic reaction post 1st dose. Pt. reports ?warm? feeling subsided, released to home. Education is feeling worsens to report to urgent care or PCP. If issues with breathing notify EMS. Patient expresses understanding.

Other Meds: None

Current Illness: None

ID: 1039999
Sex: M
Age: 44
State: CA

Vax Date: 02/02/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 10 days following vaccination with first dose of Pfizer-BioNTech vaccine, individual reported to the vaccine clinic that he developed symptoms of Bell's Palsy. Specific symptoms included facial droop and inability to close eye on one side. Individual sought urgent medical treatment and was diagnosed with Bell's Palsy and placed on a course of antiviral and steroids. Individual was advised by outside provider to not receive second dose of vaccine.

Other Meds: Unknown

Current Illness: Unknown

ID: 1040000
Sex: F
Age: 65
State: AZ

Vax Date: 01/21/2021
Onset Date: 02/01/2021
Rec V Date: 02/18/2021
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 known (BUT - reaction to Pfizer COVID vaccine - rash/hives/swelling of face)

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

Symptoms: Rash/hives over most of body, particularly torso after dose 1. Treatment with methyl prednisone; hydroxyzine; Increased rash/hives following dose 2 plus swelling of cheeks/face. Rx written today (Feb 18) for additional steroids and hydroxyzine following telemedicine visit with primary care provider

Other Meds: Insulin (hum along (Lispro u-100); benazepril w/HCTZ; levothyroxine; atorvastatin; baby aspirin; zolpidem; multivitamin; AREDS2; Calcium +D; milk of magnesia

Current Illness: None

ID: 1040002
Sex: F
Age: 78
State: GA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/18/2021
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: Lost muscle control, could not raise up out of bed, could not walk, lost bladder control, slept 24 hours, no appetite, weakness, headache, fatigue

Other Meds: 81 ml aspirin 125 mcg vitamin D Multivitamin Equate for 50 yrs or older Tylenol PM 20 mg Rosuvastatin 0.125 Digoxin .5 Metoprolol 2X daily elderberry 1 tsp 10 mg Cetirizine

Current Illness: heart disease lung cancer treated and released copd shingles

ID: 1040003
Sex: F
Age: 26
State: CA

Vax Date: 01/28/2021
Onset Date: 02/02/2021
Rec V Date: 02/18/2021
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: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Red rash that started on left shoulder and neck that radiated to upper torso. Sxs began on 2/2/21. (Had nausea, fever, body aches and chills that began day of vaccine.)

Other Meds: One a day vitamin

Current Illness: None

ID: 1040004
Sex: F
Age: 27
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Pharyngeal swelling

Symptoms: Pt received Covid vaccine on 2/10/2021. Pt stated she began having headache, fever, chills, body aches, and nausea on 2/11/2021. And today (2/18/2021)Pt stated she is having chills, body aches, and headache. Today Pt c/o chills, body aches and headache. Pt was seen by her Provider yesterday and no medications were prescribed. Pt was seen by Provider here at the clinic today and advised Pt to go home and rest and drink plenty of fluids and eat light.

Other Meds: unknown

Current Illness: unknown

Date Died: 02/17/2021

ID: 1040005
Sex: F
Age: 72
State: NY

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
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 known allergies

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient was found unresponsive and had passed away.

Other Meds: Unknown

Current Illness: Unknown

ID: 1040006
Sex: F
Age: 31
State: NY

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
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: The symptoms started on the morning of Tuesday Feb 16th with fevers and chills, a headache, pain in my joints especially my left hand. I've had extreme fatigued and slept 14 out of 24 hours on Tuesday into Wednesday. I took Wednesday and Thursday off from work. Currently (Thursday Feb 18 5:30pm) I am experiencing swelling in my face and numbness on the right side. My breathing is fine but my head is foggy and my words are slurred.

Other Meds: None

Current Illness: None

ID: 1040007
Sex: F
Age: 66
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: 10 minutes following Pfizer first dose vaccination patient c/o dizziness and flushing. Vitals showed elevated blood pressure 171/80. Patient was given cool compresses and water and felt some improvement in symptoms. She then noted shakiness and had intermittent shaking in her hands or lips. She was given apple juice and felt symptoms of shakiness resolve within 10 minutes. After another 15 minutes patient reported that flushing resolved completely and dizziness had largely resolved. Repeat BP showed: 178/80, 162/71 largely unchanged when measured standing. We recommended ambulance transport due to persistently high BP which patient refused. She will seek urgent care and discuss with primary care. Ambulance transport was strongly recommended, but patient refused and left clinic by wheelchair with husband.

Other Meds:

Current Illness:

ID: 1040008
Sex: F
Age: 67
State: CA

Vax Date: 01/27/2021
Onset Date: 01/30/2021
Rec V Date: 02/18/2021
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: Latex

Symptom List: Rash, Urticaria

Symptoms: Intense pain in lower left quadrant of abdomen, lasting approx. 8 days, but lessening each day; also constipation for 5 days, then 3 days of diahrea before becoming regular again.

Other Meds: levothyroxin 100mg, progesterone 200mg, B-17 500mg,

Current Illness: Had taken valacyclovir for a cold sore that felt like it was going to start on my lip, but stopped taking it at least 3 days before the 1/27/2021 first dose of the Pfizer vaccine.

ID: 1040009
Sex: F
Age: 68
State: CA

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: I received my 1st covid shot on Friday, February 5th. My left upper arm was sore for a few days but no issues. On Friday, February 12th (a week later), my left upper arm began hurting again. On Saturday, February 13th my arm was sorer and itchy with 2 red spots at/near the site of the injection that were "hard" compared to the rest of my upper arm. On Sunday morning, February 14th the area was still red, itchy, and by mid-afternoon both areas seemed to be merging. Monday, February 15th, my upper arm was still a bit itchy, less red, and spreading (now 5" long compared to Sunday morning at 4") Tuesday, February 16th, the area is less red/itchy. It seems to be fading.

Other Meds: levothyroxine 88mcg, fenofibrate 160mg, sertraline 50mg,

Current Illness: n/a

ID: 1040010
Sex: F
Age: 55
State: PA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: Unknown

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

Symptoms: Pt possibly received normal saline diluent instead of the Pfizer vaccine. There was an error in preparation. Pt was contacted on 2/16/21. No adverse reaction reported.

Other Meds: Unknown

Current Illness: Unknown

ID: 1040011
Sex: F
Age: 16
State:

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: Monday, Feb 15- Mild Headache, Feb 16 - mild body ache, Feb 17 - symptoms resolved

Other Meds: none

Current Illness: none

ID: 1040012
Sex: F
Age: 30
State: IN

Vax Date: 01/12/2021
Onset Date: 01/20/2021
Rec V Date: 02/18/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: For a couple days right after the injection, my arm was sore. Then more than a week after, my arm got really red, swollen, hot, and itchy. It lasted for 3-4 days and then gradually eased up, the itching lasting the longest.

Other Meds: Wellbutrin, metformin, hydrochlorothyazide, Zyrtec, omeprazole, magnesium, probiotic

Current Illness: No

ID: 1040013
Sex: F
Age: 46
State: VA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: Lips felt big to client ?5-10 min, also was wearing 2 masks,throat felt ok, history face swelling with ibuprophen,

Other Meds:

Current Illness:

ID: 1040014
Sex: F
Age: 27
State: AZ

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Nausea and vomiting and bodyache

Other Meds: none

Current Illness: none

ID: 1040015
Sex: F
Age: 59
State: MA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Unkown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient was in the observation area and approximately 10 minutes after injection she developed a rash up her right arm. She felt fine otherwise. She reports she never gets an vaccines and was getting nervous. Paramedics responded patient sat for a long time and the rash disappeared, her vitals were received and she refused further treatment.

Other Meds: Unkown

Current Illness:

ID: 1040016
Sex: M
Age: 71
State: CA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Sulpha, iodine, onion, garlic, shellfish, broccoli, cabbage, peppers (green, orange and red),

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

Symptoms: None stated.

Other Meds: Lansoprazole (30 mg), Magnesium Bisglycinate Chelate (400 mg)

Current Illness: Hypoglycemia, Heart Arrhythmia, Acid Reflux

ID: 1040017
Sex: F
Age: 72
State: VA

Vax Date: 02/01/2021
Onset Date: 02/10/2021
Rec V Date: 02/18/2021
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: Fluoroquinolones

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

Symptoms: Ten days after vaccination, after initial mild swelling, and pain resolved, a large red area that was in the same place as the original redness and swelling, appeared on my arm. No discomfort or itching. Lasted about a week and is fading 8 days later.

Other Meds: Atorvastatin, Flonase, Singulair, Claritin, Metformin, Calcium/Vitamin D, Baby aspirin, Zoloft, Synthroid, Micardis CPAP

Current Illness: None

ID: 1040018
Sex: M
Age: 37
State: NE

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
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: Patient reported he was not feeling well to this nurse, c/o pain in chest and felt like he was going to pass out. Patient assisted to lay down on floor by 3 staff, knees bent. Patient alert, pink, warm, dry, c/o dizziness and discomfort in chest. Breathing unlabored, VS noted pulse 66, O2 sats 97%, BP 143/81 left arm auto cuff. Patient skin assessed, no rash or hives noted, mask removed, lips and tongue normal shape and appearance. Patient denies any difficulty breathing. Reports feeling better laying down. Patient reports not eating lunch today as he normally would. Denies diabetes or hypoglycemia issues. 1229 Pulse 62, 98% O2 sat on RA, BP 149/93 auto cuff lying down. Patient assisted to sit up, denies dizziness, given granola bar and 6 oz apple juice to eat and drink. Patient reports feeling in his chest is gone while eating. Patient reports feeling better eating. At 1233 BP 154/99 sitting with pulse of 69. Patient assisted to stand, denies dizziness, BP 149/98 standing, pulse 73. Patient denies dizziness or pain, states feels better. Patient was d/cd walking with staff escorting and wheelchair at standby at 1238. Reviewed patient's situation with caregiver and what to monitor for at home.

Other Meds:

Current Illness:

ID: 1040019
Sex: F
Age: 79
State: NC

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
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: penicillin, sulfa drugs

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

Symptoms: Extreme weakness leading to patient falling and unable to get up. Nausea, headache, large itchy welt on arm lasting 7 days.

Other Meds: Armour thyroid, chemotherapy 3 weeks before vaccination, lovastatin

Current Illness:

ID: 1040020
Sex: M
Age: 88
State: AZ

Vax Date: 02/13/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital: Y

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: Shortness of breath beginning 4 days after vaccination. Pacemaker was checked per wife and it was fine.

Other Meds:

Current Illness:

ID: 1040021
Sex: F
Age: 27
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt stated she began having headache, fever, chills, body aches, and nausea on 2/11/2021. And today Pt stated she is having chills, body aches, and headache. Pt stated she had a telephonic appt with her Provider yesterday and was told to inform the clinic where she received the vaccine. Pt stated no medication was prescribed. Pt was seen by a Provider at the clinic and was advised to go home, rest, drink plenty of fluids and eat light.

Other Meds: unknown

Current Illness: unknown

ID: 1040022
Sex: F
Age: 54
State: HI

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/18/2021
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: Patient experienced dizziness after 1st dose of covid vaccine, BP was 153/68 and reported feeling anxious. Was taken to ED due to complaints of tongue and throat swelling wit some shortness of breath. No rash, abdominal pain, vomiting, or diarrhea. In the ED patient received diphenhydramine 50mg IV, epinephrine 0.3mg IM, famotidine 20mg IV, methylprednisolone 125mg IV, and 1000mL of normal saline. Discharged home with an EpiPen and 5mg prednisone daily for 5 days.

Other Meds:

Current Illness:

ID: 1040023
Sex: F
Age: 76
State: MD

Vax Date: 02/02/2021
Onset Date: 02/09/2021
Rec V Date: 02/18/2021
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: Erythromycin & avocados

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: A feeling of extreme tiredness , & semi nauseous . High temperature 100.2 . ache all over . My arm ached but not too much but my body ached all over like you get with the flu which I've never had. I was like that for 2 days. I didn't want to eat or do anything. Then I tried to keep eating a little & drinking anything water, coffee,& tea hot & iced . On the 3rd day I felt better not well but better.

Other Meds: Tessalon Perls, Lisinopril 2.5, Fish Oil, multivitamin,Vitamin D3. Flaxseed oil , aspirin

Current Illness:

ID: 1040024
Sex: F
Age: 41
State: AZ

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: After receiving the shot, I had an initial burning sensation that went away within 30-45 seconds. After about 1.5 to 2 hours after the shot, I noticed a small, hard bump at the injection site. By the next morning (2/17), the bump was larger and warm to the touch, and painful, but tolerable. By mid morning, I had aches in my upper back/neck. By noon, all of my joints were aching and I had muscle pain all over my body. By early that evening, I had a mild fever (100.3), significant increase in pain with the muscle/joint aches, and very tired. By midnight that night, my fever had broken and the majority of the achiness had subsided. By morning of 2/18, there was little to no more aches/pains, however, the lump on my arm at the injection site is still hard, warm to the touch, but significantly less painful. By mid afternoon, the bump has spread out but softened, skin is still warm to the touch.

Other Meds: Low-dose asprin 5mg Lisinopril daily Multivitamin w/Omega 3 Vitamin C Biotin & Collagen supplement Fish oil Lutein

Current Illness: none

ID: 1040025
Sex: F
Age: 42
State: ME

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: No

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

Symptoms: Hot, sweating. Ice cold freezing, body aches, slight headache. For about 12 hours

Other Meds: Lantis, humalog

Current Illness: No

ID: 1040026
Sex: F
Age: 77
State: WA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Latex Benedryl Nortryptiline Ultram, most narcotics

Symptom List: Nausea

Symptoms: arm redness and swelling

Other Meds: Cholestyramine Levothyroxine Baclofen Gabapentin

Current Illness:

ID: 1040028
Sex: F
Age: 72
State: VA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Sulfa

Symptom List: Injection site pain

Symptoms: Initially just a sore hot arm. By the next day, 2/17, I was dizzy severe headache sweats, could not get out of bed without falling down. Could barely move I was so weak. Could not eat or drink. Sore throat. Bad stomach pains. Ate two pieces of toast and yogurt anyway and threw up. Had diarrhea. Took two Tylenol, five hours apart three times.Didn?t help. Kept falling asleep and waking up every hour in a sweat. Very bad headache and blurry vision.

Other Meds: D3 vitamin C zinc metformin multivitamin

Current Illness: None

ID: 1040029
Sex: F
Age: 88
State: PA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: Pt possibly received normal saline diluent instead of the Pfizer vaccine. There was an error in preparation. Pt was contacted on 2/16/21. No adverse reaction reported.

Other Meds: Unknown

Current Illness: Unknown

ID: 1040030
Sex: F
Age: 60
State: CO

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/18/2021
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: NKDA

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

Symptoms: Toes are showing skin changes and having tingling sensation

Other Meds: none

Current Illness: none

ID: 1040031
Sex: F
Age: 41
State: AR

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
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: Swelling, large knot, itching, headache, and low grade fever

Other Meds: Losartan, Zoloft

Current Illness: Stomach virus

ID: 1040032
Sex: F
Age: 66
State: GA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: Penicilin Sulfur drugs Isocyanate ingredient (in paints_ dairy

Symptom List: Erythema, Pruritus

Symptoms: injection site swelling nausea headache chills fatigue

Other Meds: Synthroid (175mg) Nexium (22.3 mg) Zinc (50 MG) Klor-con (10 MEQ ER) Atorvastatin (10mg) Advil (200

Current Illness: none

ID: 1040033
Sex: F
Age: 53
State: IA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: none

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

Symptoms: Pre-vaccine, pt stated had broken out in a rash on Feb 12th, went to a walk-in clinic 02.13 and had been told to take Benadryl, 02.16 had Dr appt, continue Benadryl & added topical triamcinolone. Dr advised pt could get 2nd dose of vaccine. 15 minutes after second dose, pt presented with hives on both arms and back. Had not had Benadryl 02.18. Gave 1 dose of 25mg. No nausea, wheeze, thickening of tongue etc. 15 minutes later no change; at 30 minutes took 2nd Benadryl 25mg ( pt had been taking 2 per dose previously). Was given a rise home, lives with mother. Pt contacting Dr this afternoon for follow-up.

Other Meds: unknown

Current Illness: rash that started 02.12

ID: 1040034
Sex: F
Age: 70
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: PCN, sulfa

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

Symptoms: Lightheaded. Did not have anything to eat all day. Felt better after eating banana. BP 140/63, HR 99 at 14:25. BP 129/60, HR 92 at 14:40 upon discharge.

Other Meds: Gabapentin, cymbalta, meloxicam, rosuvastatin, metoprolol, estradiol, trazadone. Oxycodone, benzonatate prn.

Current Illness:

ID: 1040035
Sex: F
Age: 48
State: AL

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
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: Peanuts

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever that eventually reached 104 F; achy all over; nausea; headache; worst I have felt in years.

Other Meds: Effexor Estrogen

Current Illness: None

ID: 1040036
Sex: M
Age: 97
State: MT

Vax Date: 01/23/2021
Onset Date: 02/08/2021
Rec V Date: 02/18/2021
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: Systemic: Confusion-Severe, Additional Details: Although date of ADR is several days from vaccination this occurred with 3 people at the same facility.

Other Meds:

Current Illness:

ID: 1040037
Sex: F
Age: 66
State: MN

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/18/2021
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: cephalexin codeine Darvocet ibuprofen morphine msg neomiasine sulphites met sulfites thimerosal tropomyosin incomplete list

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

Symptoms: I started experiencing spasms in the right side of my face. I had a weird feeling in my veins that went up and down my arms and by Saturday it was up in my head. this lasted for 4 hours. I had a bright white light in my right eye that was like a burst of light every time I blink. I went to the eye doctor on 2/5 and they gave me an eye dilation drop and he said that when the lining of the eyeball pulls away from the eyeball it catches the light coming into the eye and reflects down into the eye very bright. I started swelling and had a red rash on my neck, back of my neck, jaw, arms and kegs and belly. it started itching and had raised dots. about 12 dots on each limb/surface. I took Claritin and Famotidine. I woke up with more itching and a cold wave over my body. I took more Claritin and famotidine. My arms, legs, belly, and back started itching again. I had chills. The skin on my arm was hard in spots. I took half a Benadryl on Monday the 8th at 5 am. at 8am I was still itching. it died down but then flared up again and I took Zyrtec at 8pm. Tuesday the 9th I woke at 5am with more itching. I ate food and had more itching. Wednesday I had pain in my jam and my tmj flared up and I had pain in my molar but the Dentist said there was nothing wrong with my tooth. On 2/9 I had a blood draw and everything was normal. the only thing not normal was the carbon dioxide in my system. On 2/16 I was still feeling weird.

Other Meds: tylenol siclobenzo cream

Current Illness: tooth ache

ID: 1040038
Sex: F
Age: 37
State: CA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Pain in extremity

Symptoms: 37 year old female, 7 months pregnant received first dose vaccination with Pfizer-BioNTech vaccine. Approximately 18 hours after receiving the vaccination, the individual developed dizziness, hives at site of injection, and was near to losing consciousness. She sought medical attention in an emergency room (tests were run but no medication was given). Discharged from emergency room but with ongoing labile blood pressure and continued vertigo. Advised by OBGYN to not receive second dose of series.

Other Meds: Unknown

Current Illness: Unknown

ID: 1040039
Sex: F
Age: 45
State: KY

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Albuterol

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

Symptoms: Inflammed lymph nodes around ear, jaw, chin, neck, upper chest wall and axillary from day. Received injection on 1-7-21 Fever on 103 for 2 days then lymph nodes swollen on1-9-21 and have not resolved since then todays date is 2/18/21

Other Meds: Synthroid, Losartan, Hydrochlorothiazide

Current Illness: Hypertension

ID: 1040040
Sex: F
Age: 59
State: AZ

Vax Date: 01/21/2021
Onset Date: 02/20/2021
Rec V Date: 02/18/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Pt reports developing a red rash on both of her cheeks 2 days after receiving her first dose of Moderna COVID-19 vaccine. Pt reports taking Benadryl for 3 days absent any results. The rash still persisted. Pt did not see a provider or take any other medications. Pt presented today for her second dose, 28 days later, with some noticeable redness on her cheeks. Pt requested 2nd dose, which I administered after discussing risks and benefits. Advised pt to take some Benadryl and see a PCP in regards. Pt did not report having any swelling of her lips, face, tongue or throat or developing hives. Pt verbalized understanding.

Other Meds: None. Pt reports she developed a red rash on her face 2 days after receiving the Moderna COVID-19 Vaccine 1st dose. Pt reports taking Benadryl to help with the s/sx but it did not go away. Pt returned to receive 2nd dose and reported these

Current Illness: None

ID: 1040041
Sex: F
Age: 73
State: KY

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/18/2021
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: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)

Other Meds:

Current Illness:

ID: 1040042
Sex: F
Age: 50
State: CA

Vax Date: 12/19/2019
Onset Date: 01/02/2021
Rec V Date: 02/18/2021
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: NKDA

Symptom List: Vomiting

Symptoms: Tinnitus persists

Other Meds: new-onset bilateral tinnitus approx. 2 weeks after COVID vaccination, first dose. Tinnitus has perissted to date, no improvement of symptoms.

Current Illness: Left breast cancer with Mets tx'd w/ radiation & surgery, s/p breast surgery, reconstruction; Lymphedema: Arthritis L hip.

ID: 1040043
Sex: F
Age: 57
State: WA

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/18/2021
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: Seasonal allergic rhinitis, codeine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Acute Necrotizing Ulcerative Gingivitis (swelling, pain, ulceration involving lower teeth, gums, tongue and lips)

Other Meds: Plaquenil, amoxicillin, flonase nasal, Vit B12, Zyrtec,

Current Illness: Sjogren's syndrome

ID: 1040044
Sex: F
Age: 63
State: AL

Vax Date: 02/09/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
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: Penicillin, Lortab, Phenergan, Niacin, NSAIDS, Statins

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

Symptoms: I have small round spots coming up on my wrists and legs-they look like bruises but are not-they are not painful or itchy

Other Meds: Plavix, Celexa, Altace, Fenofibrate, Spirolactadone, Vitamin D, Sythroid, allopuriol, Albuterol prn, Advair prn, Benadryl prn, Tylenol prn, Clonidine prn, and vistaril prn.

Current Illness: Hx of stroke, CKD Stage IV, Hypothyroidism, Gout, Anxiety, high cholesterol, HTN

ID: 1040045
Sex: F
Age: 17
State: SD

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I gave the Moderna vaccine to this patient and she is not 18 yet. She will turn 18 on 4/8/2021. Cheif Pharmacist contacted the Moderna company and was advised to continue with Moderna for 2nd dose.

Other Meds: Levothyroxine

Current Illness: none

ID: 1040046
Sex: F
Age: 62
State: MO

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Levaquin

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

Symptoms: 5 hours after injection, had tingling in feet. Still have tingling in feet and hands on Feb. 18. I have experienced this symptom before, but it has been a couple years since I have experienced it.

Other Meds: vitamin D, B12, C

Current Illness:

ID: 1040047
Sex: F
Age: 56
State: AZ

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
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: Sulfa

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

Symptoms: Fever 99.9, freezing cold, body aches, very sore left arm. It started late night the day of my vaccine and I took my temperature at 2:30 am when I was so cold. Taking ibuprofen which helps aches but not really helpful with fever yet. I still have a fever now so it?s been at least 13-14 hours. I went to work this morning but left after 3.5 hours because I was FREEZING.

Other Meds: Wellbutrin, buspirone, s?roquel, baby aspirin, vitamin D gummies

Current Illness: I was diagnosed with covid on 12/31/2020 and still experiencing lingering symptoms a month ago.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm