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: 1043275
Sex: F
Age: 73
State: OH

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

Lab Data:

Allergies: Latex, dust and mold

Symptom List: Dysphagia, Epiglottitis

Symptoms: Immediately after vaccination patient felt experienced stomach upset, then tingling around the mouth. No respiratory issues, but had facial flushing nd mild redness and swelling around the eyes with some itching. Benedryl capsule PO given and responded with in 15 minutes. Driven home by husband and advised to seek ER RX if needed. Advised not to seek 2nd does of vaccine.

Other Meds: Lisinopril, Lipitrol Gabapentin, and Seroquel

Current Illness:

ID: 1043276
Sex: F
Age: 69
State: FL

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None known

Symptom List: Anxiety, Dyspnoea

Symptoms: Severe pain and itching in vaccinated arm. Large, round, red, swollen blotch at vaccination site.

Other Meds: Paxil, Magnesium, Vitamin B complex, Vitamin D, Probiotic, Presar Areds 2

Current Illness: None known

ID: 1043277
Sex: M
Age: 70
State: FL

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Woke up every 1 1/2 hour all night. Sore joints, headache, body aches , tiredness, weakness,

Other Meds: Lorsartan amlodipine pantoprazole

Current Illness: None

ID: 1043278
Sex: F
Age: 66
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pain, tenderness, hardness at injection site for 7 days. Fatigue, muscle and joint pain for 36 hours. Full recovery from all adverse events.

Other Meds: Venlafaxine ER 75 mg cap Bupropion SR 100 mg tab

Current Illness:

ID: 1043279
Sex: F
Age: 74
State: CO

Vax Date: 01/30/2021
Onset Date: 02/05/2021
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: Lipitor, Nickel

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

Symptoms: Patient present with growing, Red, rasied area L Upper arm beginning 6 days post Moderna COVID vaccine #1. Vaccine given 1/30/2021. Began with redness/itching on Fri 2/5/2021. Denies fever, no change energy - did a vigorous hike yesterday. Notes some itching. No pain. Never had reaction to any vaccine in past.

Other Meds:

Current Illness:

ID: 1043280
Sex: M
Age: 87
State: VA

Vax Date: 01/30/2021
Onset Date: 02/16/2021
Rec V Date: 02/20/2021
Hospital: Y

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: None

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

Symptoms: TIA like symptoms roughly 3 weeks after administration

Other Meds: Aspirin, metoprolol, Norvasc, Tylenol, Lipitor, senna, multivitamin

Current Illness: None

ID: 1043281
Sex: F
Age: 69
State: CA

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Approximately 10.5 hrs after receiving the vaccinet, I completely lost control of my bladder function. Urine came out of my body and I was not able to control it. This lasted about 5 hrs.

Other Meds: Blood pressure and arthritis

Current Illness: Depression, asthma

ID: 1043282
Sex: F
Age: 79
State: IN

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Patient presented with shakiness/tremors about 15-20 min after receiving first dose of Moderna vaccine. Patient was alert and oriented. Patient representative stated patient does have issues with tremors, but not usually this bad. Patient rep also stated patient had history of heart issues and anxiety. Emergency services were called and patient was taken by ambulance for further evaluation.

Other Meds:

Current Illness:

ID: 1043283
Sex: F
Age: 80
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Iodine Latex demerol

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Got shot at 8:15am and got reaction at 9:45pm with violent chills-got into hot shower & got temp up to 95 degrees; went to bed with several blankets; temp went up to 100 degrees about 11pm with stomach ache, horrible headache, & loose stool; lasted all night all next day; day 3 Saturday 4am got up to pee dizzy & faint & fell into glass closet doors then into wooden door then to floor & broke nose & bruised several other areas besides face. Now 11am still dizzy & sick to stomach & loose stool so called CDC but no help so took meds on hand. Zofran 4mg & Loperamide 2mg.

Other Meds: 1 Zyrtec 2 Tylendol

Current Illness: None

ID: 1043284
Sex: F
Age: 47
State: AZ

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: mushrooms

Symptom List: Diarrhoea, Nasal congestion

Symptoms: my face swollen and painful

Other Meds: lexapro 20 mg,sprironolactone 150mg, amitriptyline 50mg, zinc, vitamin D,C, multivitamins, biotin,

Current Illness: no

ID: 1043286
Sex: F
Age: 38
State: OR

Vax Date: 02/14/2021
Onset Date: 02/15/2021
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: Codeine

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

Symptoms: Fever 101.6, chills, sweats, nausea, muscle aches and pain, exhaustion,swollen itchy red ears, hives all over body

Other Meds: None

Current Illness: None

ID: 1043287
Sex: F
Age: 67
State: GA

Vax Date: 02/11/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Nausea, throwing up (for 6 hours), dizzy, no fever, injection sight started to hurt Spoke with Drs office - Bed rest, liquids and Zofran (treated like a stomach virus) Drs office suggested I fill out this form since I had same symptoms exactly one week after first dose of vaccine

Other Meds: Synthroid, Cytomel , Calcium, Prednisone

Current Illness:

ID: 1043288
Sex: M
Age: 63
State: NV

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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: None

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

Symptoms: Shoulder pain that does not subside and go away completely

Other Meds: None

Current Illness: None

ID: 1043289
Sex: F
Age: 74
State:

Vax Date: 02/05/2021
Onset Date: 02/19/2021
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:

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

Symptoms: COVID-19 Vaccine EUA. Although the injection itself was very painful, my arm did not swell at first. I did feel weak following the shot, but that went away within 20-30 minutes. Exactly two weeks after I received the shot, I developed delayed cutaneous hypersensitivity. The morning I started having the reaction, my arm just itched. By the end of the day, I had started developing a rash which felt hard. The next day (today), the rash has grown to a few inches in size; however, it is not painful. Please note: correct birthdate is 08/03/1946. Have attempted multiple times to change it to the correct date on the form, but the form keeps switching it to 08/02/1946.

Other Meds:

Current Illness:

ID: 1043290
Sex: F
Age: 69
State: NY

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

Lab Data:

Allergies:

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

Symptoms: 10 pm Feb 18th, the evening of the vaccine I started having body aches, uneasiness, tiredness and possibly a slight fever which lasted thru fri, Feb 19.

Other Meds: pravastatin 40mg

Current Illness: intestinal cramps, diarrhea, vomiting, pain in abdomen from intestinal virus (1 week prior)

ID: 1043291
Sex: M
Age: 56
State: FL

Vax Date: 02/09/2021
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: None

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

Symptoms: About 9 days after first dose I started to notice hives and redness on both side of my stomach, on both front lower legs and arms. Went to primary care Dr and he said he didn?t know we?re it came from but to take allergy med. which I have been doing and it started to clear up some but then I got my second dose and it really came on after that. It is not really a itch rash but taking a shower seems to make it worse and itchy. It has not gotten any better and seems to burn a little bit at times. I plan on giving it another week are so and if not better will be going to dermatologist. As far as I can remember I have never had a rash besides poison oak. I do not nor can I find any information online about a rash starting several days after vaccine unlike the allergic reaction some people are having soon after receiving vaccine. So it does have me a little worried mainly because I do not know what it is but I?m pretty sure it is from the vaccine considering the fact it started 9 days after first dose and never really went away and the second dose seems to have aggravated it to we?re it is worse.

Other Meds: None

Current Illness: Had rash from first vaccine that never really went completely away. Second dose seemed to aggravate it more

ID: 1043292
Sex: F
Age: 54
State: OH

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

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Allergy to PCN

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

Symptoms: I have a complete timeline of my series of events. I believe the Moderna, dose 1 may have contributed to my current medical diagnosis of severe Cardiomyopathy, EF 12, L bundle branch block. I would like for someone to look into this possibility. I am an O positive individual who has never been positive for CoVid-19. I have also been anti-body tested twice with no positive antibody results. Please call me if there is any relationship for cardiomyopathy and the Moderna vaccine. I have done a lot of research and am seeking any further information to help with my present medical condition.

Other Meds: Apple cider vinegar, b-complex vitamin, calcium, ceterizine, hctz 50mg po qd, Avapro 300mg po qd, Asa 325mg po qd, Myrbetiq 25mg po qd, tumeric oral, zinc oral.

Current Illness: Sinus, allergies-mold, Diastolic Htn

ID: 1043293
Sex: M
Age: 55
State: NJ

Vax Date: 02/11/2021
Onset Date: 02/16/2021
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: Bextra/Celebrex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 16-17 Feb: low fever (99.8), chills, headaches, dizziness, gas; no meds taken 18 Feb: intermittent abdominal pain for first 3 hrs upon waking, hasn't re-occurred, no meds taken 19 Feb: rash on chest, triceps, ankles, dissipated by end of day, no meds taken 20 Feb: upon waking had hives in groin area, inside of right arm, wrists, around waist area, dissipated after ~6 hrs, no meds taken 20 Feb: upper lip swollen, so far for 3.5 hrs, 25 mg Benadryl taken at 3 hr mark (1 hr ago), no impact yet

Other Meds: None

Current Illness: None

ID: 1043294
Sex: F
Age: 47
State: MI

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: started to get sore the same night of the shot. When I woke up in the morning I was getting stomach cramps (lasted for several hours), nausea, temperature, extremely tired, terrible body aches in arm pits, knees, groin area, neck, back, everywhere, Temperature of 100.4 chills. This lasted for 24 hours. Started to feel a little better, but then started to get pain in my neck, shoulder, and arm. The same side as the injection site. The neck on my right side was swollen and body ached. Saturday afternoon, 3rd day after the shot I am still experiencing body aches and my neck is sore on both sides.

Other Meds: welbutrin emgality straterra

Current Illness: none

ID: 1043295
Sex: F
Age: 57
State: WI

Vax Date: 02/03/2021
Onset Date: 02/04/2021
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: NA

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

Symptoms: Soreness in the left arm/shoulder that required pain medication to tolerate. Back ache, muscle aches in legs, chills. I was scheduled to work the day after the second shot and worked the full shift with all the symptoms; we are a small facility and had no fill in coverage available, the fill in /prn staff quit working due to the pandemic due to over age 65 for one and another due to having an autoimmune disorder and not preferring to work.

Other Meds: D-mannose, multivitamin, calcium 600

Current Illness: NA

ID: 1043296
Sex: F
Age: 70
State: CA

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

Lab Data:

Allergies: Walnuts

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

Symptoms: Moderna COVID-19 Vaccine EUA Injection site swelling and redness. Extreme fatigue (slept 15 hours), frequent chills, bad headache, and nausea on1st day after shot. Lasted all day and into night. 2nd day after shot: Better- not as tired but still having some chills. Injection spot still swelled, red, and itching.

Other Meds: Losartan Protonix

Current Illness: Sinus Infection

ID: 1043297
Sex: M
Age: 70
State: FL

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: IVP Dye; Clavulanic acid; Lactose

Symptom List: Unevaluable event

Symptoms: Feb 11: Sore arm at injection site that lasted about 10 - 12 hours. Feb 11: Was very tired in the afternoon and took a 2 hour nap; I do not usually take any naps. Feb. 12, afternoon: Temperature 100?F, mild sniffles similar to cold or pollen allergy, sinus headache; felt tired but not enough to nap. I took 2 aspirin. The fever subsided within an hour. I took 2 more aspirin every 6 hours on Feb. 12 and Feb. 13. Feb. 13: I still felt a little tired but not enough to take a nap. Outcome: The aspirin resolved the fever and it did not recur. The headache was very mild and I did not treat it after I stopped taking the aspirin on Feb. 13. The sniffles and mild cold symptoms went away after a few days and did not require any treatment.

Other Meds:

Current Illness:

ID: 1043298
Sex: F
Age: 43
State: TX

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

Lab Data:

Allergies: None

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

Symptoms: Patient experienced Diaphoresis, Hypotension with Light headedness.

Other Meds: High blood pressure medication (unknown)

Current Illness: None

ID: 1043299
Sex: F
Age: 69
State: TX

Vax Date: 02/03/2021
Onset Date: 02/03/2021
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: Ciprofloxicin Erythromycin Ace inhibitors ARBs Cats Adhesive tape

Symptom List: Injection site pain, Pain

Symptoms: Developed severe photosensitivity to sunlight with visual disturbances of acuity. Lasted 24 hours and seemed to resolve ( but could be because there was an absence of sun light) UNTIL 2/19/21 and then was unable to go outside because of the sunlight could not keep eyes open or leave house. Mild problem with computer/iphone but No problem with LED, home lighting or TV light

Other Meds: Symbacort Diltiazem Alda tone Menest Vyvance Adderall

Current Illness: Diarrhea since 8/2020. Suspected samonella from infected onions purchased in July 2020

ID: 1043300
Sex: F
Age: 90
State: FL

Vax Date: 02/13/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Injection site pain, Menorrhagia

Symptoms: swollen and sore arm, swollen wrists, lethargic, neck pain, crying due to pain

Other Meds: Eliquis, Carvedilol, Lipitor, Keppra, Levothyroxine, Vit D

Current Illness: none

ID: 1043301
Sex: F
Age: 33
State: CA

Vax Date: 02/10/2021
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: Peanuts

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

Symptoms: Arm became sore again 8-10 days after the vaccine. No other accompanying side effects, just a sore arm that hurts to raise.

Other Meds: Birth control, vitamins

Current Illness: None

Date Died: 02/11/2021

ID: 1043302
Sex: M
Age: 73
State: TX

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: My dad received the Pfizer vaccination on 2/5/21. He was admitted into the hospital the next day for C-Diff bacterial infection. He had been on dialysis treatments for kidney failure treatment since 2017 and had recently been diagnosed with stage 3 colon cancer in June 2020. He had completed his final treatment of chemotherapy on 2/4/21 and several weeks prior had been determined cancer free. On Tuesday 2/9/21 he was released from the hospital and went home. Early Thursday morning 2/11/21 @ approximately 1:30 am CST his eyes rolled back in head and he stopped breathing and was non responsive. My mother called 911 and attempted CPR. Paramedics arrived and were able to successfully get a pulse then transferred him to the hospital. He was put on a ventilator @ the hospital and then transferred to a different hospital a few hours later. He lost pulse/heartbeat several times @ the 2nd hospital he was transferred to. We were not allowed to travel with him or see him b/c of all of the COVID restrictions. We were communicating with the ICU doctor by phone who ultimately communicated to us that there was nothing further that could be done to save his life. He subsequently passed away @ approximately 8:55 am CST on 2/11/21.

Other Meds:

Current Illness:

ID: 1043303
Sex: F
Age: 38
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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 recovered from covid virus 6 months prior. First day and a half after vaccine dose 1: Injection hurt so bad, arm was immobile. Headache, nausea, fatigue, dizziness. (Felt like covid again) Second day: arm recovered to normal post flu shot soreness. Other symptoms subsided Third day: completely recovered

Other Meds:

Current Illness:

ID: 1043304
Sex: F
Age: 77
State: CA

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: None

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

Symptoms: Very low energy upon waking on morning after the vaccine. Lasted all day. Felt feverish but no fever. Slept most of day until late afternoon when I finally took 2 aspirin. Injection site tenderness.

Other Meds: None

Current Illness: None

ID: 1043305
Sex: F
Age: 47
State: CA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
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: RA

Lab Data:

Allergies: Codine Rash

Symptom List: Nausea

Symptoms: Pt has IM phizer injection one day later developed fevers, headaches body aches that lasted ten days. Was not able to work. I called her up early February and she had recovered from these.

Other Meds:

Current Illness: no, but had symptoms attributed to Covid 19 Mid December

ID: 1043306
Sex: F
Age: 66
State: AK

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: EES

Symptom List: Injection site pain

Symptoms: Sore arm, nausea, muscle and joint pain, chills ,headache and tiredness.

Other Meds: Lisinopril, Gabapentin, Baclofen,Triamterene,Allopurinol and Labetalol

Current Illness: N/A

ID: 1043307
Sex: F
Age: 73
State: ID

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: LA

Lab Data:

Allergies: None known

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

Symptoms: First occurred the night of vaccination, about 9 hours afterwards. Came on very suddenly and fairly strong as I was doing some physical therapy exercises. I would describe it as fairly strong vertigo. I immediately checked to see if the EUA listed dizziness as a primary symptom, which it did not. Nor did a google search turn up any reports of dizziness or vertigo. Not moving my head helped some and I went to bed. Slept OK. Was very careful when getting up to use the toilet. By morning it was better, but still felt my equilibrium was a little off. I tried doing a test for positional vertigo to see if one ear might be the problem instead of a vaccination side effect and that was negative. By evening, I was back to normal. My biggest concern was that I was developing an inner ear problem as this was not a reported side effect. Then this morning I searched the CDC and found 96% of 302 Moderna adverse effects reported as of 2/12/2021 were for "dizziness." I am submitting this report in hopes that dizziness or vertigo be included in the list of possible side effects. It was disconcerting to not find it mentioned as positional vertigo is a very real problem for older people.

Other Meds: Gabapentin

Current Illness: None

ID: 1043308
Sex: F
Age: 82
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: peanuts

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

Symptoms: symptoms: aches, fatigue 2 days

Other Meds: aciphex losarten metoprolol vesicare multivitamin calciumm

Current Illness: none

ID: 1043309
Sex: F
Age: 75
State: NY

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Large red circular itchy ring at injection site

Other Meds: None

Current Illness: None

ID: 1043310
Sex: F
Age: 69
State: MO

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Vanish Point syringe malfunction first dose only administered 0.1 ml and 0.4 ml leaked out of syringe at Hub. Full dose of 0.5 ml administered in opposite . No adverse reactions noted.

Other Meds:

Current Illness:

ID: 1043311
Sex: F
Age: 72
State: FL

Vax Date: 01/21/2021
Onset Date: 01/29/2021
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: After 8 days a large , about 6-8 inches, red rash appeared at the injection site. It was tender to the touch for the first several days, and then the rash appeared for about a week. The rash disappeared with not other side effects.I received the second dose on 2/18/2021 and have tenderness, slight swelling in arm and red rash about the size of a quarter. I have not reported this to my physician or the pharmacy.

Other Meds: Amlodipine 5 mg, Desmopressin .1 mg 2x, Vit B12 2500mg, Calcium 1200 mg +VD3 25 mcg, Vit D 5000 IU, zinc 50 mg,

Current Illness:

ID: 1043312
Sex: M
Age: 45
State: UT

Vax Date: 01/16/2021
Onset Date: 01/17/2021
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: Large swollen lump at injection site. Tender to touch and hot. Lasted 7 days after injection the swelling Reduced and pain left.

Other Meds: Omeprazole caps 40 mg 1x daily Metoprolol succ(toprol)er tab 200 mg 1x daily LOSARTAN/HCTZ 100/25MG TABLETS 1 x daily METFORMIN 850MG TABLETS 2xdaily Allopurinol 300 mg 1x daily

Current Illness: None

ID: 1043313
Sex: F
Age: 67
State: PA

Vax Date: 02/11/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, Compazine Pomegranates

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Nine days after my first injection of?Moderna COVID-19 Vaccine EAU?, I awoke with severe itching and redness at and around my injection site. I called my PCP and he told me Advil at morning and night and use warm compresses on it. If no better two days later, I am to see him in his office.

Other Meds: Nexium, Fenofibrate, Probiotic, Centrum Silver, Vt. B complex, Cold Pressed Hemp Oil with Omegas 3,6,9, Ditropan, Klonopin, Effexor, Simethicone, Fibercon

Current Illness: Nobe

ID: 1043315
Sex: F
Age: 46
State: PA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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:

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

Symptoms: PATIENT STATES RECEIVED SHOT AROUND 430PM 1/27/21. BY130AM WOKE UP WITH EXTREME PAIN ALL OVER BODY, JOINTS FELT LIKE THEY WERE ON FIRE, MIGRAINE, INTENSE NAUSEA , DIZZINESS, CHILLS, FEVER DIARRHEA, AND WAS NOT ABLE TO STAND UP OR SIT UP OR ABLE TO EAT FOR 2 DAYS. STATES SHE WAS STILL SHAKY AND WEAK AND STILL HAD A HEADACHE ON FEBRUARY 2, 2021. PATIENT ALSO TOLD ME THAT SHE HAD COVID IN NOVEMBER.

Other Meds:

Current Illness:

ID: 1043316
Sex: M
Age: 78
State: AL

Vax Date: 02/15/2021
Onset Date: 02/16/2021
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:

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

Symptoms: redness at an angle 2 inches wide and 6 inches long and has increased in size since first noticed but about the same today. Maybe somewhat redder today

Other Meds:

Current Illness:

ID: 1043317
Sex: M
Age: 77
State: CA

Vax Date: 02/14/2021
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:

Symptom List: Pain in extremity

Symptoms: Next morning, after 2d dose, flu like feeling, mild aches etc. Late morning, noon, rested, fell asleep for about 2 hours, woke refreshed. Arm still a bit sore but feeling great.

Other Meds: Valsartan isososorbide teresozin finasteride hydrochloride atorvastatin aspirin

Current Illness:

ID: 1043318
Sex: F
Age: 70
State: WA

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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: I am gluten intolerant and sensitive to a variety of foods, wheat & gluten & dairy but not yogurt. Bad reactions to some medications like Cipro family of medicines

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

Symptoms: As I was cleaning my face the second evening after receiving the vaccine, I noticed the skin on my face had gotten very bumpy underneath the surface. By the next morning I noticed that certain areas of my face, neck and arms had gotten a bit of a rash and itched. It's now four days later and the bumpiness has not disappeared but the itch seems to have subsided.

Other Meds: Thyroid medication for hypothyroidism. HRT creams applied nightly Had just completed a round of prednisone (10 mg) two days before reaction for L4 dislocation. I specifically did not take any vitamins or probiotics for a few days prior to t

Current Illness: None.

ID: 1043319
Sex: F
Age: 65
State: NC

Vax Date: 02/02/2021
Onset Date: 02/05/2021
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: NO

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

Symptoms: On the second day of receiving the shot my arm began to feel heavy, I had a pain in my back around my shoulder blade, that went around my side near my breast, the area was swollen, the pain then went from my shoulder down to my elbow. It felt like gas, so I had someone on week 2 to press the areas that was hurting. I felt the pain move about so I took 3 antacid (tums). I ate a sandwich and soup, needed to use the bathroom, which I did and passed gas, the area went do to the size of my right side, I thought it was better but not so. I have been awaked 3pm with my arm hurting , a feeling as if it needs to pop, or something needs to move or be released. It's been 3 weeks now. I've also noticed the nerves in hand were tingling constantly.

Other Meds: Trulicity, vitamin B

Current Illness: NO

ID: 1043320
Sex: F
Age: 59
State: OR

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

Lab Data:

Allergies: N/A

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

Symptoms: Covid arm- rash, itching, hot to touch, appeared the following morning after vaccine.

Other Meds: Alrex eye drops

Current Illness: N/A

ID: 1043321
Sex: F
Age: 69
State: AZ

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Amoxicillin

Symptom List: Vomiting

Symptoms: Rash at injection site

Other Meds: Fluvoxamine, Levothyroxine, Rosuvastatin, Pripanolol, Multiple Vitamin, Coenzyme Q10, Lutein, Magnesium, Calcium, B Complex, Vitamin C Gummy

Current Illness: None

ID: 1043323
Sex: F
Age: 74
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: adhesive tape, Cephlosporins, Ceftin, Penicillin, sulfa, muscle relaxant (unsure of name, maybe flexeril), ibuprofen, aspirin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 20-25 minutes after the receiving the vaccine patient started having lip tingling and tongue itching. Then approximately 5 minutes last she had itching around nasal area and cheekbone.

Other Meds: Amlodipine 5mg, omega 3, multivitamin, COQ-10, vitamin C zioptan eye drops- night prior to vaccine

Current Illness: none

ID: 1043324
Sex: F
Age: 53
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Prolonged fever, headache, fatigue, gen weakness, vomiting/diarrhea

Other Meds:

Current Illness:

ID: 1043325
Sex: F
Age: 63
State: FL

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/20/2021
Hospital: Y

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: Chills comes and goes but not like it was Exhaustion still prolonging Stabbing head pain for the most part has resolved Sensitive teeth

Other Meds: Propranolol

Current Illness: Multiple Sclerosis

ID: 1043326
Sex: F
Age: 68
State: TX

Vax Date: 02/02/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: 2 days after the vaccine, I started having severe pain in my knees down my legs. I'm on day 17 and it is at times unbearable. My knees don't want to bend. I can't take an anti-inflammatory because I'm on a blood thinner. So far just taking Tramadol and Tylenol Arthritis. Doesn't touch the pain. Still working with doctor to figure out what to do next.

Other Meds: Vit D, Magnesium, Zinc, Quercetin, CoQ10, OccuForce, Berbe, Hawthorne Berry, Metoprolol, Eloquis, Amlodopine

Current Illness: none

ID: 1043327
Sex: F
Age: 64
State: WI

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: Morphine based drugs

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

Symptoms: extreme muscle pain (first 24 Hours) severe headache (first 24 Hours) Dull headache (Second and Third day) Fatigue (every day) Nausea (first 24 Hours) Dizziness (every day) Took Tylenol on first day, later in the evening, and It really helped

Other Meds: Tylenol Multi Vitamin Ginger Root Flonase and Cetirizine Hydrochloride (allergy relief) Metoprolol 25mg once a day

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm