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: 1043172
Sex: F
Age: 59
State: CO

Vax Date: 02/13/2021
Onset Date: 02/20/2021
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: LA

Lab Data:

Allergies: Erythromycin

Symptom List: Dysphagia, Epiglottitis

Symptoms: On day 7 after first dose of Moderna, injection site has a bumpy, itchy rash the size of a quarter.

Other Meds: Restasis eye drops; multi-vitamin; vitamin d supplement; evening primrose oil; digestive enzyme; CoQ10

Current Illness: None

ID: 1043173
Sex: F
Age: 58
State: IL

Vax Date: 02/12/2021
Onset Date: 02/19/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Arm is itchy, red, and a little swollen.

Other Meds: vitamin D3 5,000 units daily

Current Illness: None

ID: 1043174
Sex: F
Age: 78
State: MA

Vax Date: 02/11/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa; dairy and gluten intolerance; also the food preservative called sodium tripolyphosphates

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

Symptoms: Did NOT occur until 1 week AFTER injection: pain, tenderness, swelling in upper arm & pain, hardness and redness; these were preceded by diarrhea and fatigue. Better in 2/3 days.

Other Meds: Lisinopril, aspirin, Atenalol, Norvasc, Atorvastatin,metformin, glipizide, Ozempic, Vitamins: D3, B12,C and Multivitamin

Current Illness: None

ID: 1043175
Sex: F
Age: 76
State: CA

Vax Date: 02/15/2021
Onset Date: 02/16/2021
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: Thiomersal, sulfa drugs

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The area around my eyes turned red and puffed up for at least 48 hours. I have never had Botox or any other injections around my eyes. This happened after the first dose, also.

Other Meds: Covid vaccination

Current Illness: none

ID: 1043176
Sex: F
Age: 68
State: AZ

Vax Date: 02/19/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Nsaids, Iodine, Wheat, Spices, Peppers, Berries, Red Grapes

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

Symptoms: Eight days after the first injection a slight, itchy rash developed under the site. The morning after the second dose I woke with a headache, which I still have four hours later and the injection site is more sore than the first injection.

Other Meds: Lisinopril 10 mg, Multi-Vitamin, Probiotic

Current Illness: None

ID: 1043177
Sex: M
Age: 73
State: MI

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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: Occasional mild eruption associated with the use of bandaids. When present, always confined to the areas exposed to adhesive.

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

Symptoms: Puritic Confluent erythematous eruption left arm. Worsened over the course of one week then resolved over 2 days. There were no systemic symptoms.

Other Meds: Metoprolol 100mg qd, spironolactone 25mg qd, Lisinopril 25mg qd, Stimvastatin 40mg qd, and Eloquis 5mg bid.

Current Illness: None

ID: 1043178
Sex: M
Age: 38
State: MN

Vax Date: 02/20/2021
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: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Approximately 15 minutes post injection, PT began complaining of severe itching on back and shoulders, but not about the injection site. PT promptly began to itch himself aggressively. No visible rashes or hives appeared anywhere; no involvement of the face, lips, or throat. Staff at the care facility in which the PT resides attested to this being a typical behavior of this patient when he is experiencing stress or anxiety. Nevertheless, the patient was monitored until his agitation subsided. Epinephrine was not administered.

Other Meds:

Current Illness:

ID: 1043179
Sex: M
Age: 83
State: CT

Vax Date: 02/20/2021
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: LA

Lab Data:

Allergies: Not listed in VAMS

Symptom List: Pharyngeal swelling

Symptoms: Both pt and his wife were sitting in observation after receiving their COVID19 vaccination. They both reported feeling tingling in their throats and a strange taste in their mouths. Trinity EMS was already available in clinic. They evaluated both recipients who then reported feeling better. Both recipients signed refusal for transport to the hospital.

Other Meds: Not listed in VAMS

Current Illness: unknown

ID: 1043181
Sex: M
Age: 70
State: NJ

Vax Date: 02/17/2021
Onset Date: 03/17/2021
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: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: arm nearly paralyzed and very painful for about 35 hours post injection; fever 101 for 24 hours: chills and mild night seat occurred during evening for 2 nights post; 2 days of tolerable fatigue; now, while almost 3 full days after injection, i'm feeling about 95% recovered, experiencing only very mild pain at injection site only. tested positive for covid on 10/22/2021 qualitative naat; tested negative on 11/05/2021 qualitative naat; symptoms worse with injection then with actual infection with covid 19 virus.

Other Meds: metoprolol tartrate; atorvastatin; baby aspirin; ground flax seed; turmeric powder;

Current Illness:

ID: 1043182
Sex: F
Age: 62
State: MN

Vax Date: 02/17/2021
Onset Date: 02/19/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I have a large red area on my arm that is about 5x5 inches. It feels hard and warm and sore to the touch. It starts about 2 inches below the vaccination site and goes down almost to the elbow bend. I first noticed 1 1/2 days after I received the vaccine and has gotten bigger than when I initially noticed it. As of now, it has been present for 1 1/2 days. It has recently become itchy. I did have the other typical symptoms for 24 hours starting the morning after receiving the vaccine-sore arm, body aches, nausea, headache-but those have gone away. I have not contacted a physician or had any treatment.

Other Meds: none

Current Illness: none

ID: 1043183
Sex: F
Age: 76
State: IL

Vax Date: 02/14/2021
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: No known allergies

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

Symptoms: Loose bowels, cramping (Thursday); Diarrhea, cramping, vomiting (Friday); cramping (milder) and loose bowels (Saturday/today). Talked with nurse at doctors office, they pointed me to the COVID hotline.

Other Meds: Vitamin B6, B12, Calcium, D3, Escitalopram, Atorvastatin. Received Eventis osteoporosis shot in both arms on Wednesday, February 17th, the day before symptoms arose. Practitioner told me my COVID vaccine was not a contraindication.

Current Illness: None

ID: 1043185
Sex: F
Age: 33
State: ID

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: NKDA

Symptom List: Rash, Urticaria

Symptoms: Patient did receive 1st dose of eyes or vaccine and after roughly 7 minutes patient reports she started to feel anxious, dizzy, sweaty and pale. Patient was triaged this provider. Able to speak in full sentences without difficulty. Patient felt this way for roughly 5 minutes. Throughout the entire encounter patient never reported having any difficulty breathing, facial swelling, tongue swelling, throat closing sensations, rash, hives. Patient does report that she has had this reaction previously with other injections or blood draws. Patient was given water and apple juice which does seem to help calm her down greatly and after roughly 5 minutes patient reported feeling normal however did feel nauseous for roughly 10 minutes after vaccine. Patient was observe for additional 20 minutes which time patient felt like she had complete resolution of all of her symptoms. No further intervention was had during this encounter. Vital signs were taken and oxygen was 99 percent and heart rate varied between 90 and 110. Prior to discharge patient's heart rate was less than 90. Of note patient reports that she is 12 weeks pregnant. Saw OBGYN yesterday and denies any known complications associated with current pregnancy. Denies any abdominal pain, vaginal bleeding.

Other Meds: NONE

Current Illness: NONE

ID: 1043186
Sex: U
Age: 72
State: KY

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: Morphine

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

Symptoms: 1st vaccine 2/19/21; developed fever, SOA, and chills same day; seen in ED on 2/20/21 for continued symptoms. Had a lithotripsy 2/18/21.

Other Meds:

Current Illness:

ID: 1043187
Sex: F
Age: 43
State: OR

Vax Date: 01/31/2021
Onset Date: 02/10/2021
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: penicillin and compazine,

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

Symptoms: Started with hives on my left hand, then hives on my right hand. Put some cortisone cream. Over 4-5 days the hives got increasingly worse and spread to my ears, nose, cheeks, eyebrows, face and neck. Monday 2/15/2021 it was beyond uncomfortable and it felt like a pea sized lump was in my throat causing me to worry my breathing might be affected. Went to the ER/Urgent care. I was given a shot of solumedrol, and a predisone pack and given an ointment for the rashes, Triamcinolone. I saw my PCP the following day as it was a scheduled appointment but wanted to see her to update her on this event. I then developed allergies to the ointment worsening the rash. She advised on 2/19/2021 I stop taking the predisone pack and gave me 7 days of 20 mg predisone instead and prescribed a different ointment that is not due to arrive until Monday 2/22/2021. As of today 2/20/2021 the rash is still growing up my arm over my elbow and now I have some hives on my legs and back.

Other Meds: one 25 mg of benedryl and two tylenol

Current Illness: none

ID: 1043188
Sex: F
Age: 66
State: NH

Vax Date: 09/08/2017
Onset Date: 09/15/2017
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: Penicillin, balsam topical, Bactria, sulfa salazine, chocolate, citrus

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

Symptoms: Symptom onset began one week after vaccination. First symptoms were extreme sensitivity in both hands and inflammation, cracking, erythema, soreness of cuticles on all fingers on both hands. Was seen by NP at primary care office, was misdiagnosed and recommended to soak hands in warm water. Went to Urgent Care about a week later, because problem persisted and new symptoms of Scalp itchiness, redness, sensitivity of scalp started. MD told patient to see a dermatologist. Patient made an appointment with a dermatologist, Dr., has blood work, scalp biopsy, examination, allergy scratch testing done. Diagnosed patient with dermatomyositis, which was confirmed with Dr. and second Dr. Started patient on hydroxychloroquine. Later was started on methotrexate. Patient was referred Dr. and started IVIG therapy. Symptoms persist despite these treatments.

Other Meds: None

Current Illness: None

ID: 1043189
Sex: F
Age: 73
State: FL

Vax Date: 02/12/2021
Onset Date: 02/16/2021
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: Sulfa

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

Symptoms: Several canker sores appeared. Has been 6 days and still have them. Seems as if a couple more are developing.

Other Meds: 20mg bystolic, 100 mg losartan,10mg zeta, 25 mg spironolacton

Current Illness: None

ID: 1043190
Sex: F
Age: 20
State: IL

Vax Date: 02/12/2021
Onset Date: 02/20/2021
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:

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

Symptoms: Large red circle surrounding vaccination site. Warm to the touch. First noticed about one week after vaccination.

Other Meds:

Current Illness:

ID: 1043192
Sex: F
Age: 68
State: NC

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Tenderness at injection site early morning 2/20/2021. Feeling a little tired. Felt warm so I took my temperature around 12:30 PM today and it is reading 101.0

Other Meds: 100 MCG Levothyroxine daily 20 mg Simvastatin daily 2 tablets 600mg calcium with Vitamin D 1 tablet D3 1000 IU 1 tablet 50 mg zinc 1 tablet 1000 mg

Current Illness: None

ID: 1043193
Sex: F
Age: 27
State: IL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Fruit

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 1st - pain at site, nausea, swollen lymph node, fatigue, muscle soreness 2nd - headache, shortness of breath, fatigue, muscle/joint soreness, fatigue

Other Meds: Bupropion Adderall

Current Illness: None

ID: 1043194
Sex: F
Age: 65
State: WV

Vax Date: 01/28/2021
Onset Date: 01/31/2021
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: Alive E-emergenC Sulfer based drugs

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

Symptoms: Fatigue, headache, followed by chills and fever of 101.4. Lasting about 24-30 hours. I recovered quickly, by staying hydrated., although I did not want to eat. Since my fever didn?t reach 102 I avoided taking an medication. This reaction was to my FIRST shot so I was wondering about my second shot which is scheduled for 2/25/2021... six days from now.

Other Meds: Oxybutynin 10 mg Fenofibrate 145 mg

Current Illness: None

ID: 1043195
Sex: F
Age: 41
State: IL

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Pt called several hours after her vaccine was given and reported that she developed hives on her face at approximately 5:30, 3 hrs and 15 minutes after administration. Instructed her to go directly to the ER by ambulance or get a ride from a friend or family member. She was agreeable to these instructions.

Other Meds: None

Current Illness: None

ID: 1043196
Sex: M
Age: 73
State: WI

Vax Date: 02/05/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Lethargy. Multiple unformed stools. Eyes feel ?heavy.? Mental foggiest. Decreased appetite. Decreased motivation - hard to get going. Feeling cold but no fever.

Other Meds: Levothyroxine, Atorvastatin, COQ10, Vitamin D, multivitamin

Current Illness: None

ID: 1043197
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
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: Darvon, darvocet, valsartan,

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

Symptoms: Rapid heart, increases BP, fainting, heady feeling, nausea,

Other Meds: Levothyroxin, Edarbi, diltiazem, chlorothalidon, vit. D, warfrin

Current Illness: None

ID: 1043198
Sex: F
Age: 69
State: FL

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NA

Symptom List: Injection site pain, Pain

Symptoms: Upper arm red, swollen , hot, itching, and hard at injection site and painful at injection site.

Other Meds: nexium, crestor, Olmesartan HCTZ, vitamin D

Current Illness: None

ID: 1043199
Sex: F
Age: 30
State: MD

Vax Date: 02/11/2021
Onset Date: 02/17/2021
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: Levothyroxine gave me hives.

Symptom List: Injection site pain, Menorrhagia

Symptoms: Area around injection site swollen, warm, itchy, and sensitive to touch. Sort if like a large bug bite. Symptom still persists today.

Other Meds: Metoprolol Junel Zyrtec Omeprazole Women's daily vitamin

Current Illness: Suspected hashimoto's (unconfirmed)

ID: 1043200
Sex: F
Age: 66
State: AZ

Vax Date: 02/19/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Possible strawberry allergy

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

Symptoms: Nausea, vomiting, chills, diarrhea, myalgias. Insomnia during the 3 hours that nausea , vomiting and diarrhea were occurring. Those symptoms now resolved but myalgias persist.

Other Meds: Vitamin D 1000 units

Current Illness: None

ID: 1043201
Sex: F
Age: 77
State: IN

Vax Date: 02/18/2021
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: LA

Lab Data:

Allergies: penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I received my injection on Thursday at 2:00 PM. Upon waking the next day, around 8AM, Friday, I had a bad headache, body aches, weakness, could not get warm. I laid on the couch all day and didn't eat anything until 4 in the afternoon, a little soup. Later in the day I got a fever and was so weak I could barely walk, I fell when trying to get up, fortunately I fell onto the couch, I made it to the bed and didn't get up until about 8 the next day. Saturday. I felt much better then but am still weak.

Other Meds: Carvedilol, Levothyroxin Spironolactone-hydrochlorothiazide Oxybutynin Red yeast rice, COQ10

Current Illness: none

ID: 1043202
Sex: F
Age: 66
State: MI

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: Patient has general malaise unknown cause . Onsite EMS was called vitals BP 154/91 100% O2 room air Patient Treated, Transported by the EMS to the hospital.

Other Meds:

Current Illness:

ID: 1043203
Sex: F
Age: 42
State: TX

Vax Date: 02/11/2021
Onset Date: 02/01/2021
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:

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

Symptoms: Welt/red mark on arm at injection site

Other Meds:

Current Illness:

ID: 1043204
Sex: F
Age: 44
State: IN

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Rapid heartbeat, shortness of breath from 11:30pm-1:45AM on 2/20. Very sore arm for 2 days and headache, chills. No fever. Stiff joints/ tired. Felt much better the following morning.

Other Meds: Spiralactone

Current Illness: None

ID: 1043205
Sex: F
Age: 24
State: KY

Vax Date: 02/08/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Injection site pain

Symptoms: 1st vaccine 1/18/21; 2nd dose 2/8/21; seen at ICC 2/20/21 for RLQ abdominal pain onset 2/18/21.

Other Meds:

Current Illness:

ID: 1043206
Sex: F
Age: 76
State: CT

Vax Date: 02/20/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Levoquin = hives Prevnar 13= redness and swelling at the injection site a day later per pt

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

Symptoms: While pt was sitting in observation for about 15 minutes she reported feeling excessive nasal congestion. EMS was on site, Pt's BP was 224/112, came down to 203/108. Pt reported nasal congestion seemed to be getting better. Pt denied headache, dizziness, visual changes, chest pain, sob, swelling, tingling. Pt reports she usually has normal BP. Pt did not want to go to the hospital. She signed a refusal for transport to the hospital with EMS. Pt was advised to call her doctor when she got home. Pt was advised on ED precautions and when to call 911. Pt verbalized understanding.

Other Meds: Not listed in system

Current Illness: Unknown

ID: 1043207
Sex: F
Age: 69
State: IL

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: RA

Lab Data:

Allergies: Penicillin

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

Symptoms: Fatigue, headache 8 days later. Gone day 9. Nausea day 9.

Other Meds:

Current Illness:

ID: 1043208
Sex: F
Age: 22
State: WA

Vax Date: 01/13/2021
Onset Date: 02/10/2021
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: Tremor

Symptoms: pityriasis rosea

Other Meds: none

Current Illness: none

ID: 1043209
Sex: F
Age: 73
State:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: more than 24 hours after 2nd injection, I began to feel achy and very cold. I had a fever of 100. I took two Tylenol at 8PM and again at 11PM. Today, I feel hazy and a little achy.

Other Meds:

Current Illness:

ID: 1043210
Sex: F
Age: 56
State: OH

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: Cipro, Augmentin, latex, garlic, anaphylaxis to CT dye

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

Symptoms: Pt reports feeling of throat swelling up and typically takes prednisone and Claritin for allergic reaction. She gave patient loratadine at 8:45am and patient was feeling okay by 9am.

Other Meds:

Current Illness:

ID: 1043211
Sex: F
Age: 39
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: Low grade fever started 12 hours after the injection lasting approximately 24 hours. After the fever broke noticed lymph nodes under arm of injection site where swollen and sore. Injection site arm also sore and tender occasionally itchy after fever broke the following two days was a little lethargic Saturday February 20th still feeling a little lethargic went for a short walk and is experiencing a little shortness of breath

Other Meds: Humira Balsalazide

Current Illness: N/A

ID: 1043212
Sex: M
Age: 74
State: TX

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: Tetracycline, Ciprofloxacin, and no foods or other products

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Initial feeling of moderate deep pain at injection site, not dissimilar from the first injection. On this second of two injections. Approximately 12 hours later, feelings of hyperpyrexia, chills, tachycardia, and moderate to extreme dizziness. Increased with rising to go to bathroom. Urine normal in amount and color. Symptoms limited to feelings of fever, heart rate, and dizziness. Now, at 28 hours post injection, Pulse of 90 seated, 120 on rising, dizzy on rising. BP 118/78 P-95 seated. BP 137/77 P-161 by home automated device.

Other Meds: Astrovastin, HCTZ, Losartan, Silodosin, Floconazone, Niacin, U

Current Illness: URI approximately 30 days ago RX with Z-Pack.

ID: 1043213
Sex: F
Age: 52
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: penicillin

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

Symptoms: "Pfizer-BioNTech COVID 19 Vaccine EUA" Severe pain at point of injection within 3 hours of shot; next day, around 24 hours after show, aches, tired, chills, fever, severe headache, nausea. had for 24 hours. Then, 36 hours later had headache. Patient did have COVID July of 2020. Was sick for 18 days with fever and severe body aches, headache, fever. Lost consciousness at one point and went to hospital. Released and told to come back if shortness of breath occurred or symptoms worsened.

Other Meds: Estrogel, progesterone, vitamin d, b12, turmeric supplements, coq10, zinc

Current Illness: none

ID: 1043214
Sex: F
Age: 31
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/17/2021
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: None

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

Symptoms: Body aches, fatigue, fever for first 48 hours. Severe heartburn, nausea, stomach cramps. Vomiting. Headache on and off. These symptoms also lasted 48 hours. Still feeling slight body aches and fatigue 96 hours later, nausea comes and goes.

Other Meds: None

Current Illness: None

ID: 1043215
Sex: F
Age: 36
State:

Vax Date: 02/13/2021
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: Sulfa drugs

Symptom List: Pain in extremity

Symptoms: Fever, muscle aches throughout whole body, extreme fatigue

Other Meds: Multi vitamin

Current Illness: None

ID: 1043216
Sex: F
Age: 64
State: NC

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/20/2021
Hospital:

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

Lab Data:

Allergies: Aledronate

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

Symptoms: Hives ongoing since vaccine - taking Zyrtec, Prednisone, Pepcid, Benadryl

Other Meds: Irbesartan, metoprolol, metformin, vitD, Calcium, Lipitor, ASA

Current Illness: None

ID: 1043217
Sex: F
Age: 70
State: CT

Vax Date: 02/10/2021
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: None

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

Symptoms: COVID Arm Cutaneous Hypersensitivity Red, raised area 2?x4? at injection site Sore, itchy, warm to touch

Other Meds: Carvedilol Magnesium

Current Illness: None

ID: 1043218
Sex: F
Age: 35
State: MN

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

Lab Data:

Allergies: No

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

Symptoms: 20 mins after receiving vaccine I had horrible chills for like an hour. Headache -still Anxiety-still 7 days after vaccine got a large raised red mark on arm where the injection was. Felt hot, itchy and painful. Getting bigger.

Other Meds: Estradiol patch Vitamin D Sertraline Vitamin C and zinc

Current Illness: No

ID: 1043219
Sex: F
Age: 69
State: MI

Vax Date: 02/16/2021
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: Latex

Symptom List: Vomiting

Symptoms: Around 4 am on 2/19/2021 woke with a pressure in mid abdomen. Had watery diarrhea approximately a gallon, then vomited short time later. have had low grade fever 99.8 and chills. muscle aches. Have not been able to eat although could sip water. Still every few hours have had watery diarrhea. Not sure if this is related to the vaccine because of the GI nature. I suppose it could be food poisoning from eating Tyson frozen chicken product evening before for dinner. Obviously cooked. I rarely get sick with colds or GI symptoms. so that this occurred so close to vaccine reception wanted to report.

Other Meds: liothyronine 5 mg q am, Hydrochlorothiazide 25 mg qd, Vitamin c 500mg qd, Calcium 100mg/magnesuim400mg/zinc 25mgqd, potassium glucanate 99mg, Vitamin D 2000 iu qd, Maharishi Amrit Kalash nectar and Ambrosia. B12 2500 mcg SL qd

Current Illness: none

ID: 1043220
Sex: F
Age: 46
State: TX

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient was anxious, hypertensive with shallow breathing and elevated heart rate.

Other Meds: Albuterol, Insulin, Blood pressure med (unknown)

Current Illness: Asthma, Diabetes

ID: 1043221
Sex: F
Age: 35
State: PA

Vax Date: 02/18/2021
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: Sulfa drugs Asprin Potatoes Fresh Fruit Fresh Tomatoes

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

Symptoms: Fever (102.3) Chills Sweats Dizziness Aches Fatigue Lethargic Soreness at injection site (radiating through arm) red and raised bump at injection site warm to touch on injection site

Other Meds: Olly women's daily gummy vitamins Birth Control (pills) Zoloft Allegra Advair

Current Illness: None

ID: 1043222
Sex: F
Age: 44
State: NY

Vax Date: 02/03/2021
Onset Date: 02/15/2021
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: Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Rash at injection sight. Redness, itchy, warm to the touch. Looks like 2 large red rings

Other Meds:

Current Illness:

ID: 1043223
Sex: F
Age: 69
State: CT

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, get rash

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

Symptoms: Eight days after the vaccine, I got a rash on my upper right arm. It is itchy, red, and painful.

Other Meds: Multiple vitamin, fish oil, magnesium, eye vitamins (AREDS), calcium, probiotics, vitamin d, Duloxetine, Raloxifene, Vagifem, Estrace

Current Illness: None

ID: 1043224
Sex: M
Age: 89
State: NY

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

Lab Data:

Allergies: none

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

Symptoms: Severe pain in all joints, headache, loss of balance , fatigue .

Other Meds: allopurinol, pravastatin, carvedilol, folic acid, coq10, vitamin b12, furosimide, silodosin, ecotrin,

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm