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: 1041995
Sex: F
Age: 76
State: CO

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
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: Lisinopril

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient developed brown spots above upper lip that appeared to crust over and itch; also developed these right below lower lip; these are getting better as of 2/19/21 but are still there; patient contacted doctor on 2/18/21 re this

Other Meds: HCTZ; Atorvastatin; Omeprazole; Meloxicam; Norvasc; Ciprocal; Vitamin D3; Omega fish oil; Zinc; Probiotic; Zyrtec

Current Illness: None

ID: 1041997
Sex: F
Age: 77
State: NY

Vax Date: 02/06/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
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: morphine

Symptom List: Anxiety, Dyspnoea

Symptoms: "brain Fog", anterograde amnesia to the events of the day. lost track of what she was doing and where she was for brief moments. Noted leg weakness on the right.

Other Meds: propranolol, timolol

Current Illness: COVID +

ID: 1041998
Sex: F
Age: 36
State: AZ

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Body aches for approximately 16 hours, extreme nausea and dizziness briefly leading to a single syncopal episode. Used Tylenol for body aches, no other treatment necessary. Nurse at Obgyn's office advised me to stay hydrated and monitor temperature. Feeling normal the day after episode. I am 16 weeks pregnant with pregnancy #2, estimated due date is 8/4/21

Other Meds: Synthroid, Zyrtec, prenatal

Current Illness:

ID: 1041999
Sex: U
Age: 52
State:

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Sulpha drugs

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The day after the vaccine, in the evening, patient experienced redness and swelling at injection; arm is still sore, but patient states she has this reaction with flu shots also. Patient has had some fatigue.

Other Meds: No

Current Illness: No

ID: 1042000
Sex: F
Age: 76
State: NY

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
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: I received the Moderna vaccine on Saturday February 13th, 2021. I had no adverse event on that day. The next day when I woke up around 6:00 am I felt muscular pain in my upper left arm (arm of vaccine) when I moved my arm, and I could not raise my arm. Later that day I took an Ibuprofen and went out to eat Indian food at night. The pain went away. The following day the pain was almost all gone, and after that it went away completely.

Other Meds:

Current Illness:

ID: 1042001
Sex: F
Age: 47
State: NM

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Pt had hives, syncopal episode, and airway management issues within 30 minutes of receiving vaccine.

Other Meds:

Current Illness:

ID: 1042002
Sex: F
Age: 30
State: OH

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
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: Zithromax - get hives

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I took tylenol before I went in to get my vaccine. Around 4 pm I started get fatigued. At 9pm I started get chills, low grade fever, joint pain. I self medicated with tylenol for 14 hours around 6 pm the next day I felt better.

Other Meds: prenatal vitamin; fish oil; iron; fluoxetine 20 mg; vit B6

Current Illness: no

ID: 1042003
Sex: F
Age: 81
State: WI

Vax Date: 01/31/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin (rash of unclear severity)

Symptom List: Pharyngeal swelling

Symptoms: Severe L-sided Bell's Palsy, onset 2/15/2021. . Per CDC recommendations we are reporting this to VAERS.

Other Meds: amlodipine, aspirin, calcium supplement, multivitamin, Tums, vitamin-D, zinc

Current Illness: none significant

ID: 1042004
Sex: F
Age: 43
State: NY

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Biaxin, latex, Shea butter in products

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I had Covid from March 14, 2020- April 1, 2020. I treated positive for antibodies in May 2020. I received the first vaccine on 2/14/21 around 4:55 pm. 2/15-I awoke at 7am: sweating, headache, body aches/ pinging type sensation, fatigue, pain across my chest , no trouble breathing though. These are the same symptoms I had when I had Covid. 2/16 I was able to get out of bed, run errands, but still have headache, still feel achy, haven?t noticed a fever but I have had moments of sweating like one broke. Lymph nodes under my left arm are swollen and painful to touch. 2/17lymph nodes still very large and swollen, pings of 2/18: fatigue, weakness, 11pm- right arm became cold and numb like it was asleep, pinging muscle aches or more accurately pains where lymph nodes are located. Body seemed swollen overall too. 2/19: right arm and uncle still swollen and heavy Groin lymph area right side is painful today.

Other Meds: Paxil 40mg, Tri Lo Sprintec

Current Illness: None

ID: 1042005
Sex: F
Age: 49
State:

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 02/19/2021
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: pain in injection arm for 3 days hard lump in injection arm, appearing at day 8, gone the next day swollen lymph nodes in both armpits, lasting 2 days Moderna COVID?19 Vaccine EUA

Other Meds: none

Current Illness:

ID: 1042006
Sex: F
Age: 69
State: NM

Vax Date: 02/09/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Swelling at the site of the injection that started nine days after injection.. Area is also warm and red. Muscle pain in arm.

Other Meds: None

Current Illness: None

ID: 1042007
Sex: M
Age: 75
State: FL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: NKA

Symptom List: Rash, Urticaria

Symptoms: Patient received 1st dose Moderna ; he was in state for a dermatology appointment which happened to be on the day of his 2nd dose; he came by our drive thru clinic for vaccine administration; he forgot his vaccine record card; administering nurse verified that note had been completed but did not read the contents nor review the Immunization tab prior to administration which showed that Moderna was given in clinic Charting on the event happened after he had completed his 15 observation period. He was observed for 15 minutes as required and did not report any side effects or adverse events

Other Meds: none

Current Illness: n/a

ID: 1042008
Sex: M
Age: 70
State: MN

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/19/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: one day after vaccination; developed 4-5 days of headache, nausea, fatigue. Also had "hyperventilation" with difficulty completing deep breaths. No wheezes/ cough. No oral / throat swelling. Did have full body rash.

Other Meds: albuterol, aspirin, cetirizine, vitamin D, flexeril, fluticosone nasal spray, lysine, multivitamin, fish oil, sildenafil

Current Illness: none

ID: 1042009
Sex: F
Age: 90
State: FL

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
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: Penicillin.

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

Symptoms: I noticed it felt itchy the next morning, she does get eczema at times, and thought that's what it was. She tried cortisone cream yesterday for the itching, but it did not help. This morning when she woke up the rash had spread and was all the way up her arm. She was putting cold compresses on it as well. She went to the UC at 1:00 this afternoon, who ordered an antibiotic and told her that there seemed to be an infection at the site of the needle. Told her not to use the cortisone cream, to use the cold packs.

Other Meds: Metoprolol, Losartan, Celebrex, Buspirone HCL, Hydrochlorothiazide, Amlodipine. Eye vitamins, multivitamin, vitamin D, Biotin.

Current Illness: None.

ID: 1042010
Sex: F
Age: 86
State: OH

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: patient received a 3rd vaccination of Pfizer unknown to administrator at clinic. pt received doses on 1/8/2021 01/29/2021 and now 2/19/2021 per pharmacy records

Other Meds:

Current Illness:

ID: 1042011
Sex: F
Age: 79
State: PA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
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: heparin (bovine); Peanut; Tomato

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

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: acetaminophen 500 mg oral tablet take 2 tablets (1,000 mg) by oral route every 8 hours as needed albuterol sulfate 90 mcg/actuation inhalation HFA aerosol inhaler -- Aspir-81 81 mg oral tablet,delayed release (DR/EC) take 1 tablet (81

Current Illness: UNKNOWN

Date Died: 02/14/2021

ID: 1042012
Sex: F
Age: 51
State: NY

Vax Date: 02/01/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
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: None known

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

Symptoms: Patient died suddenly 2/14/2021

Other Meds: Cabergoline, Avalide, Valtrex, Zyrtec

Current Illness: None known

ID: 1042013
Sex: F
Age: 39
State: MA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: yes-unknown-hx of anaphylaxis x 2

Symptom List: Ear pain, Hypoaesthesia

Symptoms: rash/itching neck

Other Meds: zyrtec

Current Illness: none

ID: 1042014
Sex: F
Age: 45
State: NY

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa, Biaxin, Shell fish, mushrooms, pumpkin, eggplant, milk intolerant

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Daughter rec'd vaccine on 2/17 and she lost her voice and was unable to speak, she's had an underlying issue. She stayed for 30-45 minutes and started coughing and then lost her voice, her throat started itching and she could not speak she was very hoarse, her skin turned real dark and she went to the hospital, they gave her an EPI pen, Prednisone 40mg for 4 days, Albuteral was given, Solumedrol and Peptin, and benedryl, Ivciartin, She continues to have a deep hoarseness.

Other Meds: Yes, Prednisone, Tacrolimus, Crdvasdelol, Procardo XL, Clindamycin, Sevlamar, Replagamiroe,

Current Illness: no

ID: 1042015
Sex: M
Age: 84
State: NY

Vax Date: 02/10/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Cephalosporins and macrolides

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

Symptoms: Swelling of upper left arm to the elbow patient said it is red, doesn't really hurt but is very itchy. The redness started after the injection on 2/10/2021. Instructed patient to use ice pack on the upper arm arm and to take benadryl and use a topical anti itch cream.

Other Meds: none

Current Illness: none

ID: 1042016
Sex: M
Age: 0
State:

Vax Date: 03/26/1986
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: NKA

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

Symptoms: Patient feeling hot, flushed, diaphoresis, dry throat 15 minutes after vaccine; denies shortness of breath, rash, hives. BP 150/100, pulse 104; notes higher than normal although doesn't know normal. Given water, monitored. Continued with BP same; pulse down in high 80s, low 90s; bit better. Refused ED monitored. Monitored for another 15 minutes or so. Ambulated without lightheadedness; BP down to 140/90, pulse 90s. Felt about "80%"; stable; ready to go home. Lives with wife/children. Knows if not feeling well, seek medical attention.

Other Meds:

Current Illness:

ID: 1042017
Sex: F
Age: 54
State: OH

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: No symptoms noted at the 15 min waiting period . Returned to work; had something to eat; about 30 mins later, started feeling nauseated. Symptoms lasted about an hour.

Other Meds:

Current Illness:

ID: 1042019
Sex: F
Age: 24
State: VA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: Approximately 10 minutes into waiting after injection, patient stated she felt like she might "pass out". She then experience into post-vagal posturing with no clonic activity, no loss of bowel/bladder. After approximately 1 minute, she become coherent postictal. BP was 138/87, pulse was 66 bpm. She later reported that she has had a history of a "reaction to needles" but that she did not experience it when she got the flu shot last fall.

Other Meds:

Current Illness:

ID: 1042020
Sex: M
Age: 59
State: NH

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: ~20 minutes after vaccine patient began to have wheezing and "scratchy throat". He reported it to paramedic on scene who obtained vital signs (all normal) and got Physician Assistant. Patient non taxic appearing and had self administered 2 puffs from albuterol inhaler prior to PA evaluation. Pt states that his breathing is much improved, "almost back" to baseline. Patient still states that his throat feels scratchy. Patient given option of going to ER or getting single dose of benadryl here and monitoring at home. He chose to have benadryl ( PO here). His wife is driving and will notify 911 if not improving or getting worse over the next 2-4 hours.

Other Meds: Albuterol

Current Illness:

ID: 1042022
Sex: M
Age: 70
State: IL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Arm tenderness at injection site. Ice pack and 2 Advil 200 mg Was fine by 11:30. Woke up about 6:00 next morning felt fine. No further issues.

Other Meds: None

Current Illness: None

ID: 1042023
Sex: F
Age: 82
State: TX

Vax Date: 02/09/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
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: Penicillin, Iodine, aspirin, adhesives, Lyrica

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

Symptoms: Rash around injection site, about 2-3" in diameter, itchy, hot. Bothersome but not painful.

Other Meds: Areds2, Allegra, Omeprazole, Proprandlol, Nexium, Sertaline, Atorvestatin, Levothyroxine, Topiramate, Alendronate, Calcium Citrate, Tylenol Arthritis, Imodium

Current Illness: none

ID: 1042024
Sex: M
Age: 64
State: TX

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 02/19/2021
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: Report minor chest pain after receiving both first and second dose x 1 week later. Treatment: Visit to Cardiologist with stress test and EKG being unchanged from previous. Outcome: Continue to monitor. Employee continues to work

Other Meds:

Current Illness:

ID: 1042025
Sex: F
Age: 30
State: OR

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: latex

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever, beginning about six hours after injection (7pm) and lasting until the morning of 2/19/2021. Fever peaked at 102.5 28 hours after injection and was treated with acetaminophen and applications of cold cloths. Fever resolved the morning of 2/19/2021. Site reaction, beginning about 30 minutes after injection and persisting as of submission of report on 2/19/2021/ Site reaction is 2.5 inches vertical and 4.5 inches horizontal and hot to the touch. Other symptoms include: headache, muscle aches and cramping, nausea, and chills.

Other Meds: Ketotifiten, Vitamin D, Vitamin B, montelukast, zyrtec, escitalopram , progesterone, melatonin, 3mg of Naltrexone for pain (not addiction purposes)

Current Illness: none

ID: 1042026
Sex: F
Age: 63
State: AK

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/19/2021
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: NKA

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

Symptoms: I had the Vaccine on 1/25/21, in my Right Arm. I started having symptoms on 1/26/21, I worked half a day and went home with Chills, Joint pain, Headache and missed work on 1/27. I had joint pain in my fingers and toes, but continued to work, I tried Tylenol with the pain, On 2/3/21 while at work I got the COVID Arm symptoms, Hot arm, Red rash, Huge hard knot, ( I put an Ice pack on the site while at work and took Tylenol) I also have had more joint pain in my Fingers and Toes causing me to stay home from work on 1/4 and 1/5 and again on 1/8 and 1/9. The Burning and Sharp pain in my fingers, toes (swelling in my toes on my Right foot) and wrist have not gone away. I have been woken up from the Sharp pain in my fingers and toes, it is uncomfortable wearing shoes. I still have the COVID Arm, the red rash the Hot and the swelling of my arm, the heat comes and goes in my arm, the red rash has been continuous since it first appeared, the knot has shrunk in size.

Other Meds: pancrelipase, prazosin, morphine, estradiol

Current Illness: None

ID: 1042028
Sex: F
Age: 46
State: MT

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: Body aches, Chills, Fever, & Headache

Other Meds:

Current Illness:

ID: 1042029
Sex: F
Age: 27
State: TX

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: NKMA

Symptom List: Injection site pain

Symptoms: Axillary lymphadenopathy on ipsilateral side as injection 1 day after injection. Resolved within 1 week

Other Meds: alprazolam (XANAX) 0.5 MG tablet, Take 0.5 mg by mouth nightly as needed for Sleep., Disp: , Rfl: escitalopram (LEXAPRO) 10 MG tablet, Take 1 Tablet by mouth daily., Disp: 90 Tablet, Rfl: 0 Norgestim-Eth Estrad Triphasic (ORTHO TRI-CYCLEN,

Current Illness:

ID: 1042030
Sex: F
Age: 65
State: WA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Allergies : hay fever, dust, mold, cat, dog, sawdust Sensitive to gluten and milk, sensitive to Flonase (formaldehyde?)

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

Symptoms: Severe to VERY severe continuous lymph node/breast pain on shot side 1/27 through 2/4. Starting 2/4 intensity started to vary i.e no pain during hot shower but still severe pain majority of time. Slight reduction breast pain as spread to back pain and movement seems to help. On night of 2/3 spread to back ? shot side line of nodes paralleling spine and shoulder/neck area- back pain not as severe as original breast area and heat helps to reduce back pain Pain interferes with sleep - 2/4 finally able to get 4 hours sleep ( hot shower temporary relief while showering)( normal is 7 hrs) As of 2/5 still in moderate to severe breast area pain almost continuously. Hope I am recovering but its 10 days and still mostly constant incapacitating pain. Very slight intermittent node pain by Feb 17 when got second shot in other arm per Physician Assistant?s recommendation. So far after 51 hours 2nd shot adverse effects minimal and does not interfere with thinking or sleeping

Other Meds: On Jan 12 monthly allergy shot and one Zyrtec, Daily: 4000IU Vitamin D3, 2500 mg fish oil and Methyl care (25 mg B6, 1000 mg B12, 0.4 mg magnesium, 1.5 mg zinc), Daily 50mcg levothyroxine and 2.6 mcg liothyronine IR capsule (compounded)

Current Illness: none

ID: 1042031
Sex: F
Age: 48
State: OK

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: Unknown

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

Symptoms: 1003-c/o "feeling funny" 1005-states heart racing, chest "feels heavy" SpO2-100%, HR 90, BP 120/65 1008-pt refuses benadryl, doesn't want to feel "sleepy". Denies difficulty breathing, ShOB, no trouble swallowing SpO2-100%, HR-86 1010-Patient shaking, requesting benadryl. Benadryl Elixir given, 25 mg, PO. SpO2-100% HR-81 1012-reports chest heaviness improving, throat feels sore, no difficulty breathing, continues to shake, covered with blankets, refusing epi 1014-reports "feel funny all over" Rapid Response Team called. SpO2 100%, HR 79 1015-attempt to start 20g IV without success 1017-0.3 mg Epi IM given, rapid response team here. 1020-SpO2 99%, HR 87, patient agrees to be transported by W/C to ED 1024-patient transported to ED accompanied by spouse and rapid response team to ED room 12. 1530-attempt to call to check on patient. LVM to call back.

Other Meds: Unknown

Current Illness: Unknown

ID: 1042032
Sex: F
Age: 53
State: AR

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
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: Penicillin Erythromycin Sulfa Strawberries Kiwi

Symptom List: Tremor

Symptoms: Initially experienced severe B elbow pain on anterior side that resolved within 48 hours. Noted that clothing seemed tight- especially underwear, bras, and shirts, arms and breasts visibly swollen on both sides. Breasts itchy. Some shortness of breath noticed that was surprising x3 during week. I am 1 week post vaccine and put 2+2 together this AM. Initially thought that I must have put something in the dryer for too long, but EVERYTHING fits tightly. I recently had shoulder surgery and purchased clothing that was loosely fitting and It is now tight. My BP on home machine is 133/86, which is generally normal for me. No fever. Fatigued all week that could be attributed to this or heavy workload. Generally feel good. Distal extremities normal in size.

Other Meds: Spironolactone 50 mg Cinnamon Turmeric with Curcumin Fish Oil Calcium Citrate Niacin Turkey Tail

Current Illness: none- have not had any type of illness since lockdown in March 2020

ID: 1042033
Sex: F
Age: 68
State: MD

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
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: losartan

Symptom List: Erythema, Pruritus

Symptoms: Delayed type hypersensitivity reaction at the injection site. Site was inflamed, raised, and itched considerably. No treatment. Symptoms abated somewhat over the next few days but are ongoing particularly with exertion of that arm.

Other Meds: Amlodipine, atenolol, nature-throid, vitamin B, fish oil, glycosamine, vitamin C, vitamin D

Current Illness: none

ID: 1042034
Sex: F
Age: 73
State: WY

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
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: PCN, Erythromycin, cats

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

Symptoms: 02/03/2021- On (2/5) redness @ Inj site , itchy x 5 days, also experienced mild lip itching. Ct reported PCP did not think r/t the vaccine, 'skin irritation', lip itching not significant, ct took Benadryl after talking with PCP, symptoms resolved. PCP told ct ok to get 2nd dose.

Other Meds: Letrozole,

Current Illness: none

ID: 1042074
Sex: M
Age: 58
State: FL

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: codeine, morphine, zinc

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

Symptoms: Vaccine given by vaccinator at 1pm, pt being monitored by RN at 115pm pt had eyes open but did not respond to nurse commands, Breathing normal even, no distress noted, vitals 181/105 HR 98 96%on room air. Director of Nursing in room w/ pt &. called 911 for evaluation at 117pm pt responds to verbal command slow to move head in direction called prior to EMS arrival bp 171/105. EMS arrival at 127pm Paramedic at bedside for evaluation

Other Meds: Metoprolol, keppra, lamotrigine, seroquel, flomax, plavix, fenofibrate, insulin humalog, levamir, ativan, axtrobaxin, clonidine, kolopin,

Current Illness:

ID: 1042075
Sex: F
Age: 68
State:

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
Hospital: Y

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: Pt reports she had a covid-19 vaccine, unknown version. Two days later she was treated for NSTEMI at the hospital with minimal to no risk factors. Had normal stress test.

Other Meds:

Current Illness:

ID: 1042076
Sex: F
Age: 73
State: KY

Vax Date: 01/28/2021
Onset Date: 02/01/2021
Rec V Date: 02/19/2021
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: cipro, augmentin, adhesive tape, statins, codeine

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

Symptoms: She received her first dose of the Pfizer COVID-19 vaccine on 1/7/2021 with the second dose administered on 1/28/2021. She reports that following the second immunization she developed a large red area on the left arm which has since resolved but since less than 1 week after the immunization she has had pain in the left upper arm as well as decreased strength. Pain and decreased strength have not worsened since onset. Pain occurs with movement.

Other Meds: levothyroxine, prozac, multivitamin

Current Illness: none

ID: 1042077
Sex: F
Age: 36
State: MT

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: Body aches, Chills, Low grade fever, sore arm, & Headache

Other Meds:

Current Illness:

ID: 1042079
Sex: F
Age: 40
State: IN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Pain in extremity

Symptoms: Sever dizziness all day and body aches extreme!

Other Meds: Eliquis Lexapro

Current Illness: None

ID: 1042080
Sex: F
Age: 63
State: FL

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: Cipro

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

Symptoms: Fever, chills, body pain, headache, nausea, loss of appetite, dizzy for 1 week.

Other Meds: None

Current Illness: None

ID: 1042081
Sex: M
Age: 86
State: CA

Vax Date: 01/16/2021
Onset Date: 01/18/2021
Rec V Date: 02/19/2021
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: Triamcinoclone, Oseltamivir, dust-unspecified

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

Symptoms: Teeth and Jaw ache, upper and lower left side, also tenderness and ache left temporal mandible joint, slight tingling and numbness left lips. Suficiently severe that saw regular dentist on emergency basis 1 week after injection?X-rays taken, but no obvious infections or absesses. Dentist suggested was result of grinding of teeth and would eventually subside. No previous episodes of teeth grinding however. Now 5 weeks later, still continuous moderate jaw ache?occasionally quite painful, slight end-molar tenderness, slight tenderness in left mandible joint. Numbness in left lips gone. Only treatment has been Tylenol, 500 mg, 1 to 3 times/day.

Other Meds: Xeralto,Metoprolol, Lisinopril, Allopurinol, Finasteride, Lova

Current Illness:

ID: 1042082
Sex: F
Age: 61
State: PA

Vax Date: 02/11/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
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: none known

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

Symptoms: About six days after receiving vaccine, I developed swelling, rash and itching at injection site. It is now eight days after injection and itching is getting better, but still a swollen hard knot and large red area at injection site. Treatment: going to try Benadryl, cold compress and cortisone cream at advice of online article from Prevention

Other Meds: Synthroid

Current Illness: none

ID: 1042083
Sex: F
Age: 70
State: WA

Vax Date: 02/16/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: macrodantin, yellow fever vaccine

Symptom List: Vomiting

Symptoms: Lip and facial swelling. (With first shot and second shot on the day after the vaccine I had fatigue and diarrhea. With the second shot, I also had a fever, a headache and muscle soreness).

Other Meds: vagifem 10mg, alendrolate 70 mg, hydrochlorothiazide 25 mg, lisinopril 10 mg., calcium, vitamin D, Vitamin B-12

Current Illness: none

ID: 1042084
Sex: F
Age: 30
State: MO

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
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: not known. family history of penicillin allergy

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: low blood pressure of 82/57, patient appeared dizzy, nausea and vomiting symptoms, pale, cold to touch and sweating. blood oxygen saturation declined suddenly to 75% was alert, patient's blood glucose reader showed 140mg./dL . EMT arrived quickly she was taken out of facility and inside the ambulance for further evaluation. patient decided to not go to the hospital with EMT and left with her own car.

Other Meds: not known

Current Illness: not known

ID: 1042085
Sex: F
Age: 65
State: TX

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/19/2021
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

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

Symptoms: Woke up morning after with headache. By noon was nauseous and began throwing up. Threw up for 10 hours.

Other Meds: Levothoroxin

Current Illness:

ID: 1042086
Sex: F
Age: 46
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/19/2021
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: severe migraine headache unchanged despite Iv infusion, steroid therapy and facial nerve block

Other Meds:

Current Illness:

ID: 1042087
Sex: F
Age: 81
State: NY

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/19/2021
Hospital:

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

Lab Data:

Allergies: patients reports none

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

Symptoms: Patient reports persistent rash below vaccination site appearing the day after vaccination (2/11/21). Patient states rash was only itchy for a couple days but spread slowly until just today (2/19/21) when rash appears to be shrinking in size.

Other Meds: unknown

Current Illness: none

ID: 1042088
Sex: F
Age: 74
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
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 Strawberries

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

Symptoms: Itching, rash. rapid heartbeat, nausea, light headedness, elevated blood pressure. Received treatment at Urgent care ...EKG, steroid injection. RX Hydroxyzine, Prednisone, Ondansetron. Initial reaction appeared 10 days after vaccine. Currently experiencing intermittent out breaks of itching, numbness in lips and lower jaw and rash. When the itching begins its simultaneously in the same area right and left side. Example right thigh, left thigh etc.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm