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: 1042570
Sex: F
Age: 56
State: WA

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Thimerisol Misoprostol Ciprofloxacin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt had itching to face, back and chest

Other Meds: Acetaminophen (TYLENOL PO) albuterol (VENTOLIN HFA) 90 mcg/puff inhaler albuterol 2.5 mg/3 mL nebulizer solution Diclofenac Sodium (PENNSAID) 2 % SOLN estradiol (VAGIFEM) 10 mcg vaginal tablet famotidine (PEPCID) 20 mg tablet guaiFENesin-co

Current Illness:

ID: 1042572
Sex: F
Age: 39
State: IN

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: Walnut allergy

Symptom List: Anxiety, Dyspnoea

Symptoms: Mild dull continuous headache(6:30am-at least 8:50pm while completing survey) Lethargic/tired (approximately 10 hours so far) Sore arm at injection site. Started about 15-30 minutes after injection.

Other Meds: Adderall, vitamin D, B complex, clariton, metformin, Wellbutrin, atavan, minocylen, zinc, albuterol

Current Illness: NA

ID: 1042573
Sex: F
Age: 32
State: TX

Vax Date: 02/11/2021
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: Sensitivity to Acetaminophen

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

Symptoms: A "knot" formed at injection site quickly but was not bothersome until day 7. It itched tremendously and after being scratched it had an irregular welt like a mosquito bite. This went down with benadryl cream. Shortly after the knot was much larger and it was hot to the touch. 18hrs the knot was much larger, probably 2in in diameter, red, and hot to the touch. 4hrs post 25mg of oral benadryl and 400mg of ibuprofen the spot was about 3.75in total diameter with a "target shape". A 1in red spot then a dull ring, then an exterior red ring about 1in thick. Still has heat but the "knot" decreased in size and hardness

Other Meds: Trintellix Lipitor

Current Illness: None

ID: 1042574
Sex: M
Age: 60
State: NJ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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: Compazine Cipro NSAIDs

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Right after the injection, I felt an electric shock feeling in my hand. This was followed by right hand numbness and tingling in the entire hand. This symptoms of numbness and tingling decreased in severity, but now has been stable: every day, I am experiencing numbness of the right hand, extending from my wrist and involving my palm and my pinky and ring finger. The feeling is not decreased by Tylenol.

Other Meds: Lisinopril Aspirin Tylenol

Current Illness: None

ID: 1042575
Sex: M
Age: 72
State: WA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever, muscle weakness and pain, sore throat,head-sinus pain, chills.

Other Meds:

Current Illness: None

ID: 1042576
Sex: F
Age: 72
State: WY

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Erythromycin (nausea for hrs after)

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

Symptoms: 02/10/2021 approx 7 min post vaccination client had an 'odd sensation' in her neck, tender, has never experienced this before. Left after 30" not worsening of s/s, 3PM still feeling odd neck sensation. Took Benadryl, called her PCP-, at 5PM called MD again, felt some tingling 'felt weird', neck sensation still there, went into office to see MD. Pt stated she still has neck sensations at this time. Pt was notified her daughter and family all tested positive for COVID, s/s started on 2/8, Pt last had 'not so close' contact w/ her daughter on 2/7, within the 48' infectious window period. Pt had negative vault test done on 2/11, approx 4 days post exposure. Instruct Pt to retest tomorrow. Pt states she kept Additional information for Item 18: kept wondering if maybe her neck sensations were related to the virus. Pt referred back to PCP re getting the 2nd vaccine dose, due 3/10. Staff told Pt if recommended to get the 2nd dose that we would want her to have it done at the hospital in case she has same/worse reaction.

Other Meds: Pravastatin, vitamins, calcium, VitD, Miralax

Current Illness: none

ID: 1042577
Sex: F
Age: 25
State: NE

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

Lab Data:

Allergies: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: The day I received my 2nd dose, Wednesday, my arm was extremely painful. I took aleve and was still in a lot of pain, had trouble sleeping due to the pain. My arm was throbbing from shoulder to fingers. The following day the pain was still uncomfortable but improved from the previous day. I also felt a little ?out of it? and tired, minor headache. I was back to feeling 100% by Friday.

Other Meds: Sertraline, OCP, alprazolam

Current Illness: None

ID: 1042578
Sex: F
Age: 37
State: NY

Vax Date: 02/18/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: After 12 hours, extreme shakes and shivers, hot and cold, fainted and possible seizure for approximately 30-45 seconds- could not move or speak- was unresponsive and panting- cognitively aware but unresponsive.

Other Meds: Sinthroid

Current Illness:

ID: 1042579
Sex: F
Age: 77
State: LA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
Hospital: Y

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

Lab Data:

Allergies: CIPROFLOXACIN

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt. recieved COVID vaccine on 4 Feb and came to hospital on 5 Feb with Chest pain; Elevated troponin; Exertional chest pain; Symptomatic bradycardia. Admitted for ACS and being treated with heparin. syncopal eisode. she was discharged on 9 Feb. Home course unknown

Other Meds:

Current Illness:

ID: 1042580
Sex: F
Age: 66
State:

Vax Date: 12/21/2020
Onset Date: 12/21/2020
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: Within 10 minutes of receiving vaccine, caregiver developed tachycardia, lightheadedness, chest tightness, and a headache, was taken to the ER and monitored and released.

Other Meds:

Current Illness:

ID: 1042581
Sex: F
Age: 77
State:

Vax Date: 02/08/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 2/15: Red rash, swelling, firm, itchy, warm to touch. Approximately 3 inches in diameter; 2/16: red rash spreads, doubling in size, still itchy. no medication taken; 2/17: no significant change. Late afternoon, experience left shoulder ache, headache. 9:00pm 1 tablet 500mg Tylenol taken; 2/18: red rash spread; itchy along edges. 2:00pm 1 tablet Benadryl taken; Headache 10:00pm 1 tablet Tylenol taken; 10:30 pm 1 tablet Benadryl taken 2/!9: swelling, red rash diminished by 60%. Slight itching. Still not resolved.

Other Meds:

Current Illness:

ID: 1042582
Sex: F
Age: 40
State:

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Chest flush with bilateral arm flush EMS evaluated. Stayed 10 minutes longer and flush started to resolve. Went home.

Other Meds:

Current Illness:

ID: 1042583
Sex: F
Age: 27
State: CA

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: No

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

Symptoms: Patient tolerated #2 Vaccine to left Deltoid. Patient to be monitored for 30 mins. Following vaccine. During the monitoring, patient developed scratchy throat - Pulse Ox 100% BP 135/78 RR 18 - Pt with some difficulty swallowing. No SOB/DOB, Denies CP; Dr. notified - arrived- evaluated patient - No wheezing, No swelling of mouth or tongue. Per standing orders 50mg Benadryl PO given - Pt w/o difficulty swallowing. Monitoring continuous. 1235 Patient developed shivering - Afebrile. Dr. notified - Orders for Tylenol 100mg PO given. Patient able to swallow w/o difficulty. 1300 BP 135/94 RR 29 even/unlabored O2 Sat 100%; Dr. reevaluated patient - cleared for d/c.

Other Meds: No

Current Illness: None

ID: 1042584
Sex: F
Age: 76
State: WY

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

Lab Data:

Allergies: KNA

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

Symptoms: RN giving injection of Moderna vaccine to client noted vaccine leaking out at the hub, RN determined the leur lock connection between the needle and syringe was loose. Unknown amount of vaccine injected into the client, rest of vaccine in syringe discarded. New dose of vaccine with new needle/syringe injected into the client at that time. RN drawing up vaccine, and RN administering the vaccine need to double check the leurlock connection is tight prior to injecting the vaccine. Syringe/needle, Hypodermic NEEDLE-PRO EDGE, Safety Device with Syringe was used, most likely from lot #432510, 3 ml/LL 25G x 1in, that was provided in the ancillary kit that came with the vaccine.

Other Meds:

Current Illness:

ID: 1042585
Sex: F
Age: 77
State: WY

Vax Date: 01/28/2021
Onset Date: 02/04/2021
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: NKA

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

Symptoms: 01/28/2021,approx day 7 post COVID vaccination noted LU arm itchy near injection site, day 11 noted redness LU arm, day 12 today 02/08/21, noted redness moving down arm to her elbow, appt sched with PCP. 02/09/2021- telehealth visit with PCP, not cellulitis, dx 'COVID Arm', not prohibiting her from getting her 2nd dose of Moderna. L arm still red, not bothering her, ct glad she will be getting her 2nd dose.

Other Meds: Rx-Estradial patch, Lexapro generic, spirolactone, statin x 2m

Current Illness: none

ID: 1042586
Sex: M
Age: 25
State: KS

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

Lab Data:

Allergies: None

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

Symptoms: COVID-19 Vaccine EUA. Painful/sore at site of injection; left arm approx. 2-3 hours after injection. Also within 2-3 lower back pain/soreness. Night of vaccine, shortness of breath, full body aches/soreness, fever, fatigue, headache, chills, and nausea which followed into next day (today).

Other Meds: None

Current Illness: None

ID: 1042587
Sex: F
Age: 54
State: HI

Vax Date: 02/12/2021
Onset Date: 02/18/2021
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: Seafood, penicillin, latex

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

Symptoms: Delayed reaction 7 days post injection. Red, warm, itchy large circle on upper right arm at injection site

Other Meds: None

Current Illness: None

ID: 1042588
Sex: F
Age: 59
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Tongue felt numb per client. No swelling or breathing problem. EMS evaluated. Stayed an extra 10 minutes. Instructed to go home. Patient plans to take Benadryl. Instruct to call 911 if gets worse.

Other Meds:

Current Illness:

ID: 1042589
Sex: F
Age: 70
State: NC

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/19/2021
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: muscle and bone pain, chills, irregular glucose levels, extreme confusion and disorientation

Other Meds: Humalog insulin, Toujeo insulin, buspirone, pravastatin

Current Illness:

ID: 1042590
Sex: F
Age: 51
State: WA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: Tetracyclines

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

Symptoms: Pt began to feel dizzy, heart racing and like she was going to pass out. Pt was lowered to the floor.

Other Meds: Unknown

Current Illness:

ID: 1042591
Sex: F
Age: 68
State: NH

Vax Date: 02/19/2021
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: iv contrast dye

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

Symptoms: vaccine recipient experienced pruritus on her arms at approximately 1551 during her post-vaccine observation period; patient experience urticaria on her neck, c/o nausea; initial HR at 1555 was 84, BP 164/90; pt has a Hx of HTN; pt denied any difficulty with swallowing or itchy throat, no angioedema; pt has a Hx of reaction to IV dye contrast; EMS called d/t urticaria worsening; pt speaks Portuguese and a Portuguese interpreter was available during the entire interaction. EMS started IV and administered IV Benadryl 50 mg; pt transported to Hospital. This nurse confirmed with Hospital Nursing Supervisor at 2030 that this pt was not admitted and was d/c at 1900.

Other Meds:

Current Illness:

ID: 1042592
Sex: F
Age: 60
State: NC

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: LA

Lab Data:

Allergies: Penicillin Sulfa antibiotics

Symptom List: Unevaluable event

Symptoms: I woke up the morning after the injection running a fever of 101.2 degrees. I had severe muscle/body aches, nausea, a severe headache, and remarkable fatigue. I spent all day in bed and was unable to eat anything. The fever broke around noon. The body aches and fatigue improved by 75% by 9:00 pm the same evening. The next day I still had a headache with some fatigue until around 2:00 p.m. on Thursday after the shot on Tuesday.

Other Meds: Testosterone cream 5mg/ml daily Estradiol 1 mg daily Progesterone 100mg daily Vitamin D3 5000 IU daily Alegra 180 mg daily Chlorophyll Complex 2-3 softgels

Current Illness: none

ID: 1042593
Sex: F
Age: 68
State: GA

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

Lab Data:

Allergies: Na

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

Symptoms: Chills on the 17th. Covid arm on the 18th

Other Meds: Na

Current Illness: Na

ID: 1042594
Sex: F
Age: 57
State: WA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: 25 minutes post vaccine community member stated that her throat felt scratchy, has a history of environmental allergies and history of anaphylaxis during allergy shot testing and was given EPI. CG took her albuterol inhaler and was given 25 mg of PO Benadryl. Monitored for approx. 1 hour post vaccine. stated that scratchy throat was gone and was driven home by family member.

Other Meds:

Current Illness:

ID: 1042595
Sex: F
Age: 72
State: IA

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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: yes

Symptom List: Injection site pain, Menorrhagia

Symptoms: Extreme heat, dizzy, impaired vision, rapid heart beat, nausea, weakness, headache

Other Meds: yes

Current Illness:

ID: 1042596
Sex: F
Age: 82
State: FL

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

Lab Data:

Allergies: None

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

Symptoms: Chills day after vaccine. Subsided after drinking cup of tea and going to bed. Itchy rash left lower arm and hand day after vaccine. Right arm and hand, right and left upper thighs, left buttock, left mid-back and abdomen. No treatment yet.

Other Meds: Enalapril, Hydrochlorothiazide, Keppra, Metoprolol XL, Vitamin D2 and Vitamin C

Current Illness: None

ID: 1042597
Sex: F
Age: 27
State: WA

Vax Date: 02/10/2021
Onset Date: 02/16/2021
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: NKDA; lactose allergy; cat allergy

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I am type one diabetic, and I have had extremely low blood sugars during the night for the last several days. Even with eating and correcting with food my blood sugar dives back down. It has been reaching values that are so low my CGM and meter cannot read them. I monitor my diabetes with a Dexcom CGM so I get woken up to the alarms, but I fear without the alarms I could have died.

Other Meds: Novolog, Levothyroxine, Adderall, Cetirizine, 2000 IU Vit D, Sertraline

Current Illness: No acute illness.

ID: 1042598
Sex: F
Age: 58
State: NY

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: iv iron possibly prosciutto

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: anaphylactic reaction, 2 hours after vaccine administration, no foods eaten after; diffuse itching, feeling can't breathe, bronchospastic cough-frequent, prolonged expiratory phase; resolved after epinephrine/albuterol/benadryl

Other Meds:

Current Illness:

ID: 1042599
Sex: F
Age:
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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:

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

Symptoms: Tingling of lips, no swelling or problems breathing. Drannk water and improved . Released to home 10:42Am.

Other Meds:

Current Illness:

ID: 1042600
Sex: F
Age: 30
State:

Vax Date: 02/15/2021
Onset Date: 02/16/2021
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: Fever for 12 hours, diarrhea, nausea, loss of appetite, chills

Other Meds:

Current Illness:

ID: 1042601
Sex: F
Age: 52
State: MO

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

Lab Data:

Allergies: None known of. Occasional intolerance to walnuts.

Symptom List: Injection site pain

Symptoms: There was pain at the location after the first shot that lasted a day or two but just a little stick when actually receiving the shot. With the second shot it hurt a lot going in, while being given the shot, right after the shot, and while waiting 15 minutes to leave after the shot. It burned a little when receiving it and while waiting afterwards. The pain gradually lessened but a different kind of pain, like the pain I felt after the first one, continued into the next day and night. That is where I am now with that. Arm is still soar. With the second shot after I left my waiting period and drove away I started to cry, during part of the drive, which was only about 7 minutes or so, I started sobbing. When I arrived at my destination, I sat in the car and sobbed. Not from pain or anything that had happened, it was just some kind of reaction my body was having. After about 10 minutes I was okay. The next day, today, I felt kind of not so happy. Not depressed or anything, just kind of blah. I don't know if that is any relation to the shot because I have days like that occasionally with spending so much time at home due to working from home during COVID. It's night time now, the day after the second shot. My arm hurts and I have some tension through my upper back.

Other Meds: None

Current Illness: Seasonal/environmental allergies of and on.

ID: 1042602
Sex: F
Age: 41
State: MN

Vax Date: 02/10/2021
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: LA

Lab Data:

Allergies: Gluten Amoxacillin

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

Symptoms: 1 week after shot developed an area of redness slight swelling and itching just below the injection site on the right upper outer arm - erythema is 5cm x 3cm. Unchanged for 3days so far.

Other Meds: MVIs Mometasone spray Metronidazole gel

Current Illness: None

ID: 1042603
Sex: F
Age: 78
State: WA

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: codeine

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

Symptoms: Pt began to complain of feeling dizzy. Initial BP was 130/80. Pt then began to complain of double vision and her head feeling "tight". BP at that time was 160/77. EMS called due to increasing BP, double vision and headache. BP when EMS arrived was systolic BP of 180. Pt also complained of nausea. EMS did not transport patient to ED per daughters request to wait at clinic under observation for 30 min in the quiet and then will go home. Pt observed for 30 min and all symptoms resolved within 30 min. Pt taken home by private care.

Other Meds: unknown

Current Illness:

ID: 1042604
Sex: F
Age: 49
State: PA

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

Lab Data:

Allergies: na

Symptom List: Tremor

Symptoms: My arm become sore and uncomfortable to move approximately 4 hours after the shot. The next morning 2/18/21 I had body aches, chillls, marked tiredness, arm soreness, headache, and nausea. These symptoms lasted until the next morning 2/19/21. I took a total of 3000mg of Tylenol during the course of 2/18/21 Please note that I had a much stronger reaction with my first dose and I did report this. I also had Covid in November 2020

Other Meds: Levothyroxine 25 mcg/daily OTC Allergy medication

Current Illness: na

ID: 1042605
Sex: F
Age: 30
State: CA

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Erythema, Pruritus

Symptoms: While waiting 15 minutes at the clinic site the sight of injection was itchy and I had dryness and bad taste in my mouth. Within first 30 minutes dizzy and lightheaded. Within first hour headache and fever of 101. Within 70 minutes nausea, tiredness, lightheaded, fever, headache, achy body. Ongoing 6 hours later.

Other Meds: N/A

Current Illness: N/A

ID: 1042606
Sex: F
Age: 72
State: MO

Vax Date: 02/05/2021
Onset Date: 02/13/2021
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:

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

Symptoms: First symptom began on 2/14/2021 with severe nerve pain in my might jaw bone. On 2/16/2021 I had a burning, painful red rash on the right side of my face side, redness, swelling , pain to the touch, Redness and pain first diagnosed by NP - Urgent Care 2/16/2021 as Shingles - prescribed prednizone and Valtrex. By 2/18/2021 redness, pain and swelling had progressed to the right eye as well and continued to have all aforementioned symptoms. I was seen by an ophthalmologist on 2/18/2021. He said it was not typical of Shingles and had no idea what it was told me to see my primary. I saw my primary that afternoon. He agree that it was not shingles but also had no idea what was causing it. While in his office, my ahnds turned bright red and painful and within 30 that resolved. Prescribed a higher dose of Prednizone, Keflex and Valtrex. Symptoms are still unresolved. No fever involved.

Other Meds: RX amytriptyline 50 mg x1 Lorsartan 25mg x1 carvedilol 25 mg x1 diclofenac 75mg x1 cyclobenzeprine 10mg x1

Current Illness:

ID: 1042607
Sex: F
Age: 52
State: IN

Vax Date: 02/10/2021
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: None

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

Symptoms: Red bullseye, swelling in deltoid, hot to touch. Left superclavicular lymph node swollen.

Other Meds: None

Current Illness: Stomach flu approximately 2weeks before vaccination

ID: 1042608
Sex: F
Age: 28
State: NH

Vax Date: 01/21/2021
Onset Date: 01/28/2021
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

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: "Covid arm", rash formed around injection site.

Other Meds:

Current Illness:

ID: 1042609
Sex: F
Age: 72
State: MN

Vax Date: 02/04/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: IV contrast

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

Symptoms: One week after, I developed a rash from my elbow to my shoulder. It is warm to the touch and a bit swollen and red. A little itchy.

Other Meds: Simvastatin Lisinopril Atenolol Hydrochlorothiazide Gabapentin Calcium Multi vitamin Vitamin C Cranberry extract Lutein

Current Illness:

ID: 1042610
Sex: F
Age: 32
State: CO

Vax Date: 02/11/2021
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: Sulfa drugs

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

Symptoms: Rash noted at injection site. No other side effects. Monitoring injection site.

Other Meds: Multi-vitamin Zyrtec Lexapro Minastrin 24 Fe

Current Illness: N/A

ID: 1042611
Sex: F
Age: 70
State: MN

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

Lab Data:

Allergies: hydrochlorothiazide, sulfa

Symptom List: Pain in extremity

Symptoms: This individual received 2 doses of Covid 19 vaccine from pharmacy on 12/29/20 and 1/26/21 at their long term care facility. After that, the individual transferred long term care facilities and received a 3rd dose of Covid 19 vaccine. Nursing home and pharmacy staff were unaware that the individual had received 2 doses of vaccine prior to transferring. The facility and provider were notified of this event. No adverse reaction has been reported by the individual due to this extra vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1042612
Sex: F
Age: 37
State: OH

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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:

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

Symptoms: Hot flashes and chills the night of 2/11 lasting that night only Severe headache around 4am on 2/12 lasting about 24 hours Very sore arm starting 3 hours after the shot for 4 days - difficulty lifting Fatigue for approximately 36 hours Rash on chest And back one week later

Other Meds:

Current Illness: Covid -19 positive test 1/3/21 - asymptomatic

ID: 1042613
Sex: F
Age: 27
State: PA

Vax Date: 02/17/2021
Onset Date: 02/19/2021
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: Don't know. I am allergic to dust, smoke, dogs, and I get seasonal allergies

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

Symptoms: I am experiencing today a supraclavicular lymph node and that is a little painful

Other Meds: No - Today I went to Urgent Care and they prescribed me Amoxicillin and Clavulanate Potassium tab, USP 875 mg/125 mg

Current Illness: no

ID: 1042614
Sex: F
Age: 67
State: CA

Vax Date: 02/17/2021
Onset Date: 02/19/2021
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

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

Symptoms: Short headache on 2/18 (30 min) took no treatment; spontaneously ended; Sore throat on 2/19 (morning only) drank hot tea and disappeared within a few hours

Other Meds: Pilocarpine, venlafaxine, gabapentin, ramatadine, vitamin D

Current Illness: None

ID: 1042615
Sex: F
Age: 43
State: MA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: Penicillin, pitted fruit, citrus

Symptom List: Vomiting

Symptoms: Chills began at 10 pm. Fever at 101.5. Back and neck pain. Headache. Morning 2/17/21 could not get out of bed. Extreme weakness, joint pain, back and neck pain, swollen gland under left armpit, pain, headache, fever up to 102.5. 2/18/21 low grade temp. 99.9. joint pain, headache. Used Tylenol, 2 pills every 4 to 6 hours.

Other Meds: Fluoxtine, multi-vitamin, iron, allegra, flonase

Current Illness: None

ID: 1042616
Sex: F
Age: 56
State: IL

Vax Date: 02/18/2021
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: Sulfa, tetanus shot, demerol, anaprox, penicillin, codeine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Sore left arm and feeling a little dizzy

Other Meds: Lasix, insulin, lisinopril, simvastatin, claritin, Vitamin D, Vitamin A, iron

Current Illness:

ID: 1042617
Sex: F
Age: 64
State: NY

Vax Date: 02/07/2021
Onset Date: 02/07/2021
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: Flagyl

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

Symptoms: Minutes after receiving the injection I felt a horrible taste in my mouth. I asked the woman who was scheduling my next vaccine if this was normal. Then began feeling dizzy, nauseous and heart was racing and felt flush in my face. They sent 2 EMS people to take my blood pressure; i actually don't remember what it was because i felt a bit disoriented. The man EMS person said the BP was high and asked me to wait. They came back 15 minutes later and took it again and it went down but I still felt my heart racing and nauseous. I waited for a half hour then called a car service to take me home. I felt extremely tired achey, and head ache for 3 and 1/2 days. The foul tase in my mouth lasted about 4 days. I spent most of the 3 days just resting. I felt back to normal after day 5 but feeling very apprehensive about getting my second dose.

Other Meds: Vit. D 10,000 IU Vit C 1000mg Zinc 15mg Multi Vitamin Nature's Plus Adult Gummies Biotin 5000mcg B-12 5000mg elite Omega 3 Fish Oil

Current Illness: None

ID: 1042618
Sex: F
Age: 39
State: OH

Vax Date: 02/16/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Amoxicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Lymphadenopathy. Painful and swollen lymph nodes in armpit, arm, above collar bone, neck and ear. Began with just armpit and the next day all the rest were painful and swollen. Ibuprofen, after 24 hours they dont feel as painful.

Other Meds: None

Current Illness: None

ID: 1042619
Sex: M
Age: 86
State: LA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
Hospital: Y

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

Lab Data:

Allergies: CODEINE; CYCLOBENZAPRINE

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

Symptoms: Pt. recieved 1st dose of Moderna vaccine on 5 Feb and presented to the ED with new onset AFIB & abdominal pain on 5 Feb. Patient was discharged on 17 Feb. Home course unknown

Other Meds:

Current Illness:

ID: 1042620
Sex: F
Age: 32
State: FL

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: Latex

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

Symptoms: Fever, severe body aches, chills, nausea, vomiting, diarrhea, extreme fatigue times 3 days. Symptoms resolved after three days

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm