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: 1042757
Sex: F
Age: 59
State: IL

Vax Date: 01/13/2021
Onset Date: 01/16/2021
Rec V Date: 02/20/2021
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: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: On January 16th I started feeling very dizzy in my eyes got blurry very dry mouth and palpitations, and I almost passed out at home, my husband had to take me to Er. They wanted to keep me in the hospital but I told him I will follow up with my doctor on Monday, I did not want to stay on the floor with covid patients the test that they had ordered at the hospital were normal they did not order a CMP they only did a basic metabolic panel and that was normal, so I followed up with my doctor on Monday which was January 18th, and she ordered CMP and all the labs, when they threw my blood my liver enzymes were very elevated over the thousands LT ASG and the and others, then the doctor ordered a second set of blood works of CMP just to make sure it wasn't a fluke, they were even more elevated they were over 1,400.

Other Meds: No

Current Illness: No

ID: 1042758
Sex: M
Age: 64
State: MI

Vax Date: 02/01/2021
Onset Date: 02/14/2021
Rec V Date: 02/20/2021
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: penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: Head ache, chills, fever, Large bruise ,site injection pain for several days

Other Meds: losartan potassium, amlodipine, levothyroxine, Nabumetone, metformin

Current Illness: none

ID: 1042759
Sex: F
Age: 53
State: FL

Vax Date: 01/01/2021
Onset Date: 01/21/2021
Rec V Date: 02/20/2021
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: NKA

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

Symptoms: Ringing in ears. Began evening of first dose and remained. After second dose on 2/18/2021 the ringing is louder

Other Meds: Vitamin C Estradiol 2mg

Current Illness: None

ID: 1042760
Sex: F
Age: 57
State: CA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: Servers allergic to Honey Bee Venom. I carry two auto injections EPI.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Severe body aches, headache, left earache pain, unable to sleep entire night, diarrhea, itching, stomachache.

Other Meds: Vitamins D, C, Gut Probiotic & Teramic.

Current Illness: I had my wisdom tooth pulled 3 days prior to my second vaccine dose.

ID: 1042761
Sex: F
Age: 47
State: IL

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: benzoyl peroxide topical = hives

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

Symptoms: 2nd dose (1st dose received 1/22/21 Pfizer Lot# EL3247): Received 2nd dose 2/18/21 at 1900. 2/19/21 woke up at 0700 with chills but afebrile. Went to work - felt fatigue and brain fog throughout the day. At 1000 experienced left arm soreness that resolved by 1900. At 2100 experienced headache, nausea & fatigue and fell asleep very early. Woke up at 0300 with increased headache and chills - remain afebrile. Menstrual cycle started 2/19/21 AM - very heavy flow which is unexpected, as cycles have been normal.

Other Meds: Progesterone 50mg D15-28, low dose naltrexone, Thyrofem, VItamin C, Vitamin D microcellized, GI Replenish supplement shake, Magnesium, FC-Cidal, Betaine HCL Pepsin Gentian Root Extract, Dysbiocide, A.D.P., Iron, MVI without iron, Beta-TCP,

Current Illness: 1/31/21 = left arm tendonitis and cellulitis of face d/t cystic acne breakout

ID: 1042762
Sex: M
Age: 51
State: NY

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/20/2021
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: Nausea Vomiting Dizziness Fever Chills Body aches Injection site soreness

Other Meds:

Current Illness:

ID: 1042763
Sex: F
Age: 32
State:

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
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: Vancomycin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I have a red spot around the injection site. It started just a bump now it is spreading.

Other Meds:

Current Illness:

ID: 1042764
Sex: M
Age: 45
State:

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/20/2021
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

Symptom List: Pharyngeal swelling

Symptoms: More than 48 hours after receiving the first dose my lymph nodes near my left clavicle swelled up and became very sore. That same night, more than 64 hours after receiving the first shot, I had a intense fever for three hours and was able to break the fever. I did have COVID-19 back in July 2020 with 2 confirmed positive tests.

Other Meds: None

Current Illness: None

ID: 1042765
Sex: F
Age: 54
State: MD

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies - hayfever, cut grass intolerance to dilantin- can't process and release it fast enough. builds up quickly

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Worst symptoms: During severe flu symptoms next day: racing heart, waking from severe joint pain in Right ankle, aching pain in abdomen. Starting after the flu symptoms resolved on Tuesday: After my fever went down I got a red ring around the injection site and stinging welts on arm, shoulder, neck, face. Prickly itches mouth, ears, scalp hands, feet. --- After injection, second dose, Saturday 3:25. NO issues, didn't even feel shot. expecting a day of flu, fever around 100 and no other issues based on 1st dose reaction (Moderna # 013L20A, 1/16/21). No respiratory symptoms this time, no runny nose, unlike last time. I didn't notice anything unusual about my heart rate. normally resting as low as 48 while sleeping, waking in the 50s per Apple watch, 100s, up to 120s with exercise. 9 AM Saturday Woke with resting heart rate of 97. Cross room to get thermometer and Tylenol. Heart rate 117. Fever 101.7 cross room to get soup from microwave and return to bed. Heart rate 123. Took 500 mg gel cap with broth and veggies. Woke 11 am. Fever 102. Drank 12 oz of water. Closed eyes, could not stay awake. Headache. Ringing in ears. very achy flu symptoms with strange symptoms, tenderness left lower abdomen palm width from Left hip. Arm felt hot, tight. My ligaments particularly in ankles felt loose. Woke with sharp ankle pain 3 times. I usually put the blankets under my feet and tucked under knees, like sleeping bag. it felt like my joints were hyper extended over the blankets. I tried to give them extra support and not move them or elevate them much. Continued gel cap of Tylenol at 3 pm (feeling dizzy and nausea started) , 9 pm (stood to get medicine and thought I was going to faint), 3 am, 9 am. Fever at 102. Sunday afternoon, felt like my GI tract had stopped. Nausea with food. Urine every few hours but no other output, even gas, until Tuesday. Heart rate closer to normal on Monday night. Pain in chest and abdomen resolved. Flu symptoms, joint pain resolving on Tuesday. Eating again. Slept most of Sunday and Monday. Moving around Tuesday Fever down to 100 Tuesday, continuing through Friday. Tuesday my Arm starts to feel worse, like the day after the first dose injection. Hot, tight, aching. Faint semicircle developed below 2nd injection site Tuesday. Stinging Welt develops 4 inches below. Other welts start and merge into pink band with pale transition zone. pale patches starting in other places. I start feeling itches on bottom of feet, in scalp, on chest, on cheeks. Wed. I call the health department and my doctor. Pink ring around 2nd injection site Stinging welts on left arm forming a band almost all the way around arm on Wed. include first injection site. Pale band below, a transition zone, hurts a lot more than the warm pink welts. Stinging welts below injection site create bands of bright pink that stings like ant stings, hot to warm temp. Pale band below and patches sting like bees, much more painful. pain like hornet sting where they overlap as band wrapped around arm. Pink stinking at back and left side of neck .Ears itching and ringing. Some stinging in areas of hand, left fingers, space between thumb and index finger. Feels like Cold cream stinging on face, left cheek large patch under left eye, smaller patches around left side of eye and three small patches on left eyelid. Began turning pink a few hours later. Mouth started itching. Pale patch the size of my hand on my left shoulder and chest aches and stings, is tender. Feels like it is going to become a big welt like the pink one below the injection site. Stinging pricks of pain very occasional on left thigh, left side of back and even on right shoulder blade, left side of neck Ibrush my hair instead of scratching at my scalp. scabs on left shoulder and chest from stratching. Prolonged fever of 100 after most flu symptoms resolved, into Friday, Thursday my dr sent me to ER. Pale transition zonethat hurt the most, below and in fold of elbow is darker, creases because there is more swelling. patch is expanding. Called ER for wait time. Went to Patient First Urgent Care. EKG normal limits. Started Methylprednisolone Pack, 6 day stepped down dosage. Told to use cortisone cream without getting in or near eye, not on lid. Told to take Benadryl. Tylenol. Friday the band on left arm signif diminished, welts forming on face are gone. Some areas still sting and itch, even without looking red. Mouth does not itch. some itches and sharp stings. Still some stinging in left eye and left eye lid. Sat. morning my temperature is below normal even for me. 96.7 Still some stings and itches. Pink ring around injection site fading. Heart rate normal. Still some chest discomfort occasionally.

Other Meds: None taken at time of vaccination in month prior, Tylenol, tums.

Current Illness: none

ID: 1042766
Sex: M
Age: 75
State: AZ

Vax Date: 02/10/2021
Onset Date: 02/15/2021
Rec V Date: 02/20/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: First fever and body aches day 2. On day 5 developed a stroke and later developed Bell's Palsy. Hospitalized because of this. Currently moved to a rehab hospital.

Other Meds: Warfarin, Levemir, Humalog, Losartan

Current Illness: N/A

ID: 1042767
Sex: F
Age: 58
State: VA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/20/2021
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: Fever, arm pain, and fatigue started about 10 hour after receiving shot. Fever, body aches, and fatigue were present for appx 30 hours after on set. Fever of 101 returned after twelve hour break. Redness at shot site cover large portion of upper arm subsided with 36 hours. Treatment with Tylenol did little to control fever and aches. Aleve worked better at providing some relief of symptoms .By 72 hours most symptoms were gone. Slight pain at injection site persist but is not bothersome.

Other Meds: Levothroxine, Janumet XR

Current Illness: None

ID: 1042768
Sex: M
Age: 66
State: MA

Vax Date: 02/12/2021
Onset Date: 02/17/2021
Rec V Date: 02/20/2021
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: Tetracycline

Symptom List: Rash, Urticaria

Symptoms: Headache, nausea, chills, fatigue Onset 5 days post dosing Resolved within 36 hours

Other Meds: Levothyroxine, cymbalta, bupropion, zyrtec, xolair, montalukast, artorvastatin, 81mg aspirin, men 50+ multivitamin

Current Illness: Nonr

ID: 1042769
Sex: F
Age: 44
State:

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: LATEX ALLERGY

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

Symptoms: SLIGHT HEADACHE, FEVER 102 IN THE EVENING, SORE ARM, NAUSEA

Other Meds: BLOOD PRESSURE MEDICATION BETA BLOCKER IODINE

Current Illness: HIGH BLOOD PRESSURE THYROID GOITER

ID: 1042770
Sex: F
Age: 57
State:

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/20/2021
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: NONE

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

Symptoms: headache, fever 100.5, body aches, fatigue Duration 12 hours

Other Meds: VIT D

Current Illness: NONE

ID: 1042771
Sex: F
Age: 74
State: SC

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
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: Due to extreme weakness unable to rise up in bed, unable to stand or walk for about 2 hours. After that able to stand and walk with assistance.

Other Meds: Acetaminophen, Desloratadin, Duloxetine, Famotidine, Methimazole, Pregabalin, Trazodone, Ziprasidone, Multivitamin, Bromelain, Calcium Citrate, Cognizin Citicoline, Vitamin D3, Glucosamine Sulfate, K-2, Mangnesium Citrate, Methylsulfonylmet

Current Illness: Graves' disease, arthritis, schizophrenia

ID: 1042772
Sex: F
Age: 37
State: NY

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/20/2021
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: minocycline. apples pears plums cherries peaches nectarines.

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

Symptoms: itchy swollen and painful after 8 days of covid injection. i was sleeping and felt it in the morning.

Other Meds: multivitamin. vitmin d3 2000. vitamin c

Current Illness:

ID: 1042773
Sex: F
Age: 39
State: CA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
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

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

Symptoms: 101.6 degree Fever, chills, body aches, headache, dizziness,

Other Meds: None

Current Illness: None

ID: 1042774
Sex: F
Age: 76
State: KS

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/20/2021
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: extreme sharp pain in vagina, intermittent - lasted about half an hour or more; no treatment; resolved and didn't return. hives: neck, chest, redness in armpits, and at temples/hairline; (appeared 48 hours after vaccine, 6 am on 2/18; worsened by morning of 2/19; gone by morning of 2/20. Treated with over-the-counter hydrocortisone topical cream.

Other Meds: Levothyroxine, multi-vitamins, Vit C, Vit D, Calcium

Current Illness: none

ID: 1042776
Sex: M
Age: 69
State: NC

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: severe pain all over;bad head ache;fever 102 lasted for two days day three felt much better

Other Meds: AMLODIPINE-10MG;PANTOPRAZOLE SOD-40MG;CELECOXIB-200MG ATORVASTATIN-20MG

Current Illness: NON

ID: 1042777
Sex: F
Age: 70
State: CO

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: penicillin, ampicillin, keflex, erythromycin, (see continued)

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

Symptoms: Feb. 26, 2021; second day: pain at injection site in right arm. My upper right arm felt as if a heavy weight was inside it, under the skin, for several days afterward. Could not lift arm above shoulder without pain. Feb. 7, 2021: 14th day after shot: a round red rash appeared around the injection site, painful and very sensitive to touch, i.e., even any loose, lightweight sleeve was painful against the upper arm. Feb. 7 through Feb. 12: painful red rash increased in size to 3 inches in diameter. I have 3 separate photos, taken on 3 different days, of the red rash increasing in size. Feb. 13 through Feb. 20: rash lessened during these days, but had itching and discomfort that diminished nearly completely by Feb. 20.

Other Meds: None

Current Illness: None

ID: 1042778
Sex: F
Age: 68
State: FL

Vax Date: 02/06/2021
Onset Date: 02/13/2021
Rec V Date: 02/20/2021
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: Sulfa

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

Symptoms: Firm, red, hot, itchy arm at vaccination site.

Other Meds: Lisinopril, Atorvastatin, Vitamin D+K, Fish Oil

Current Illness: None

ID: 1042779
Sex: F
Age: 69
State: PA

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Unevaluable event

Symptoms: Soreness- 2 days at onset Redness and swelling at injection site started on day 8. Still have on day 9.

Other Meds: Eliquis, Diltiazem, Lisinopril, Advair Calcium

Current Illness: None

ID: 1042780
Sex: F
Age: 57
State: FL

Vax Date: 01/29/2021
Onset Date: 02/02/2021
Rec V Date: 02/20/2021
Hospital: Y

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: Sulfa, peanuts

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

Symptoms: Slight Abdominal pain 0400 2/2/21. Loss of appetite. Severe abdominal pain 1400. Went to ER. Surgery and ruptured appendix 2/2/21 at 2130. Resulting in peritonitis, seven day hospital stay, multiple antibiotics, elevated abnormal labs including LFT and platelets. ,

Other Meds: Baby ASA, calcium, magnesium, zinc, Krill oil, Vit D

Current Illness: None.

ID: 1042781
Sex: F
Age: 40
State: SC

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
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: nkda

Symptom List: Injection site pain, Pain

Symptoms: after receiving the initial dose , I experienced a metallic taste in my oral cavity. The second day after injection administered soreness at the injection site.

Other Meds: none

Current Illness: none

ID: 1042782
Sex: F
Age: 69
State: PA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: sore arm, aches, fatigue lasting for about 10 hours

Other Meds: sertraline, nexium, prandin, insulin, vitamin D

Current Illness: none

ID: 1042785
Sex: M
Age: 86
State: VA

Vax Date: 01/30/2021
Onset Date: 02/01/2021
Rec V Date: 02/20/2021
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: Pain in both shoulders which has persisted for over two weeks.

Other Meds: blood pressure and colesterole

Current Illness: None

ID: 1042786
Sex: M
Age: 68
State: PA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/20/2021
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: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: sore arm for about 24 hours

Other Meds: pepsid ac

Current Illness: heartburn

ID: 1042787
Sex: F
Age: 67
State: NH

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Within hours of vaccination my injection site and then later my entire arm became extremely sore. I had a hard time moving my arm. After a few days this went away. Now, 8 days later, the soreness at the injection site is back again. However, so far not as bad as when I first got the vaccination.

Other Meds: metformin, enalapril, vit. D, vit. C

Current Illness:

ID: 1042788
Sex: F
Age: 53
State: PA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
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: Soreness at injection site

Other Meds: Valsartan Rosuvastatin

Current Illness: N/A

ID: 1042789
Sex: F
Age: 64
State:

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Fever, aches, nausea, pain at injection site, weakness

Other Meds:

Current Illness: None

ID: 1042790
Sex: F
Age: 37
State: CA

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/20/2021
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, penicillin

Symptom List: Injection site pain

Symptoms: Day after had low fever, nausea, and felt drunk and/or drugged for about 7-8 hours. When the drugged feeling stopped I developed a bad migraine for about 24 hours. 6 days after shot, injection site became swollen, itchy and warm.

Other Meds:

Current Illness:

ID: 1042791
Sex: M
Age: 66
State: NY

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: Had a reaction to the phenomena vaccine. Allergies to fragrances and bees

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

Symptoms: 6 hours after the shot I got the chills like I have never had them Shivering, teeth chattering could not get warm. That lasted about 8 hours. This morning I have lots of body aches and a headache. sore throat and cough. Body aches the next morning ( today )

Other Meds: Rosuvastatin Calcium 2.5 mg three timed a week

Current Illness: non

ID: 1042792
Sex: F
Age: 30
State: FL

Vax Date: 02/18/2021
Onset Date: 02/20/2021
Rec V Date: 02/20/2021
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: No

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

Symptoms: Extreme headache and body ache after vaccine. 36 hours after I received an early menstruation that is not expected for another 2 weeks. I am very regular, this is out of sync.

Other Meds: Prenatal, evening primrose, fiber

Current Illness: No

ID: 1042793
Sex: F
Age: 47
State: CA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/20/2021
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: N/A

Symptom List: Tremor

Symptoms: About 8 pm started to feel tired and sore took a shower and felt worse whole body ached chills and headache by 2am the pain was unbearable my body ached so bad I had fever 101.2 took Acetaminophen PM fell asleep for a bit woke up about 4am body ached could barley get up took night time cold pm slept till 7am fever was at 101.0 excruciating body aches the rest of the day sleeping 2-3hours at a time no appetite fiver up and down not higher than 101.2 by Friday 2/19/2021 at 11am felt better no aches but still had chills sweating till about 4pm

Other Meds: Aspirin

Current Illness: Afib

ID: 1042794
Sex: F
Age:
State: MI

Vax Date:
Onset Date: 02/10/2021
Rec V Date: 02/20/2021
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: Augumentin

Symptom List: Erythema, Pruritus

Symptoms: Developed shingles, given salves,valacyclovir, 1gm for 7 days, pain patches, gabapentin. Had very achy joints and very sore arm that was injection sight, which is still tender and still sore today and still suffering from shingles. Shingles rash appeared 6 days after shot. Sore arm began 11 hours after shot.

Other Meds: Aspirin 81mg, bcomplex,Zyrtec, vitD3-5000ut,vitb12-5000mcsynthroid,losartan,mesalamine,,oneaday vit,protonix,probiotic,Crestor,ambien

Current Illness:

ID: 1042795
Sex: M
Age: 65
State: NY

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/20/2021
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: fever 12 hours body aches 48 hours

Other Meds: vitamin d

Current Illness: none

ID: 1042796
Sex: F
Age: 30
State: IA

Vax Date: 02/12/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
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: Redness, swelling, itching at vaccine site, oval-shaped raised lesion at vaccine site about 3 inches in diameter

Other Meds: Sertraline, QVar inhaler

Current Illness: None

ID: 1042797
Sex: F
Age: 54
State:

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Chills began 9 hours (8:15 pm) after shot (shot at 11:20 am) and lasted for approx 8 hours(until 4 am) Chills were accompanied by nausea and extreme headache. Nausea lasted 9 am, and headache lasted until 11 pm (36 hours after shot). No adverse effect with first shot.

Other Meds: Metoprolol

Current Illness: None

ID: 1042798
Sex: F
Age: 62
State:

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
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: N/A

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

Symptoms: Fever 101+ for 12 hours and fatigue for 24 hours

Other Meds: Niacin Flonase Zyrtek

Current Illness: N/A

ID: 1042799
Sex: M
Age: 28
State: NC

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/20/2021
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: NKA

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

Symptoms: Muscle contraction over the whole body while having a fever.

Other Meds: None

Current Illness: No know illnesses

ID: 1042800
Sex: F
Age: 45
State: PA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Pain in extremity

Symptoms: Extreme bloating and debilitating gas pains, extra bowel movements, lasting for hours, headache, fatigue. Gas-X used for relief and finally helped at around 2:30am. Felt better throughout 2/19, and finally almost back to 100% on 2/20.

Other Meds: Bupropion 300 mg

Current Illness: NA

ID: 1042801
Sex: M
Age: 56
State: TN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/20/2021
Hospital: Y

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

Lab Data:

Allergies: Allergies and Adverse Reactions Summary This lists Allergies and Adverse Reactions that you entered and in your record at Medical Centers. Date Entered Allergen/Reactant Reaction/Side Effect Location Source 03/13/2015 LISINOPRIL 03/13/2015 ZITHROMAX RASH 03/13/2015 ZYBAN 09/08/2014 CODEINE 09/08/2014 SULFA DRUGS

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

Symptoms: "Moderna COVID-19 Vaccine EUA" Hypersensitivity & fleeting / flowing pains spread throughout left side of body from tip of nose across face, up and down neck and left side of head out through fingers of left hand, down left side of back, down left thigh / leg and out through toes of left foot. It was as if the left side of my body was in a different time zone than the right side. I called the nurse line; they suggested a visit to the ER. My BP was way up, and I panicked just a little; but, tried to use my mindfulness practice to observe the unfolding events, rather than being consumed by them. There was a CT of my skull wherein they found indications of "an old" stroke; so, they decided that it was possible I had a stroke. I was transferred from the Medical Center to the Stroke Center at the Medical Center under the care of Dr. Another CT with contrast and a MRI confirmed "OLD" stroke, but nothing new. I was assured the vaccine had nothing to do do with my symptoms, and that I most likely experienced a Trans Ischemic Attack (TIA), and that the situation was merely a coincidence as they believe the vaccine had nothing to do with the TIA. However, based on my personal experience of the events as they unfolded, it is my sincere belief that the vaccine was incidental to the effects as I experienced them. I was kept overnight for further observation, released the next day, and had a follow-up with my primary care physician at the Med Center. I am now taking an 81 mg aspirin, Plavix, and 80 MG Clopidogrel as a precaution, and my symptoms have been gradually fading away.

Other Meds: ? Budesonide 3 mg ? Levothyroxine (Synthyroid) 150 mcg ? Liothyronine (Cytomel) * 5 mcg ? Escitalopram Oxalate (Lexapro) 10 mg ? Simvastatin (Zocor) 20 mg ? Mon

Current Illness: N/A

ID: 1042802
Sex: F
Age: 29
State: MI

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Fever Chills Severe Headache Cough Body aches

Other Meds:

Current Illness:

ID: 1042803
Sex: F
Age: 73
State: NC

Vax Date: 02/12/2021
Onset Date: 02/18/2021
Rec V Date: 02/20/2021
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: NKDA

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

Symptoms: Patient developed an urticarial rash on chest and neck 6 days after vaccine administered

Other Meds: Lisinopril 10mg daily Metoprolol 50 mg bid Pepcid 10 mg daily

Current Illness: None

ID: 1042804
Sex: F
Age: 56
State: VA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
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: Flu vaccine Iodine Metoprolol Hydrazine Lavera lol Novocaine

Symptom List: Vomiting

Symptoms: Hives; Chest tightness; Dizziness

Other Meds: Benadryl Prednisone

Current Illness:

ID: 1042805
Sex: F
Age: 67
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
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: Latex

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Chills, headache, body aches and rosey cheeks.

Other Meds: Verapamil; Combigan, Lumigan(Both Eye Drops)

Current Illness:

ID: 1042806
Sex: F
Age: 50
State: GA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
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: Iodine in CT dye

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

Symptoms: Shortness of breath, chest heaviness immediately after receiving vaccine Dx with bronchospasm

Other Meds: Xiidra

Current Illness: None

ID: 1042807
Sex: M
Age: 84
State: NY

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/20/2021
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: Per patient, the evening after dose 1 he developed throat discomfort, difficulty swallowing, and shortness of breath. The pain was moderate but main issue was difficulty swallowing. He did not seek medical attention but took tylenol. Symptoms self-resolved.

Other Meds:

Current Illness:

ID: 1042808
Sex: F
Age: 74
State: FL

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Injection site rash, swelling and itch. Using cortisone cream for itch. 2nd day today, still there

Other Meds: Simvastatin, Metoprolol, Levothyroxine, Prolia, Vit. D, Calcium

Current Illness: None

ID: 1042809
Sex: F
Age: 65
State: ME

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/20/2021
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: Adhesive allergy Percocet- side effect: causes mild hallucinations if taken at night.

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

Symptoms: -Woke up with rigors, fever 100.8 F, shaking cold x 6 hrs, mild-mod headache 3-6/10 for pain, extreme tiredness- slept except to go to the bathroom, no appetite, body aches- lasted about 60 hrs. -Then, low grade fever continued 99.8-100 F, and diarrhea x 24 hrs. Tired, but not as profound. -Then, low grade fever continued 99.2 - 99.8 F and sore throat x 48 hrs. Symptoms treated with Tylenol and ibuprofen, throat lozenges.

Other Meds: Boniva Multiple Vitamin Vitamin D Fish oil

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm