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: 1044341
Sex: F
Age: 59
State: CA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/21/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: My Left arm was red, hot, slight swelling and an itchy rash appeared on my arm. Within a day or so the itchy small red bumps spread from my arm to my body. The rash was mainly on the trunk of my body but did extend to my thighs and a little on my lower legs.

Other Meds: Generic for Cymbalta

Current Illness:

ID: 1044342
Sex: M
Age: 76
State: VA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/21/2021
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: hives after taking erythromycin

Symptom List: Anxiety, Dyspnoea

Symptoms: Injection site sore for two days, joints ached for two days, slightly elevated fever for two days, reduced energy for three days

Other Meds: Aspirin (325 mg), bisoprolol fumarate (2.5 mg), clopidogrel (75mg), Synthroid (150 micrograms), fiber pill, omega-3 oil pill, finasteride, Asmanex, Ventolin, Flonase, multi-vitamin, magnesium

Current Illness: none

ID: 1044343
Sex: M
Age: 89
State: TX

Vax Date: 02/14/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: sulfur drugs, penicillian

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

Symptoms: Small pin holes of about 40 in left arm and 8 in right arm. Small blood spots dried but seem to be healing.

Other Meds: lisinopril, metoprolol, pravastatin, glyburide

Current Illness: None

ID: 1044344
Sex: F
Age: 69
State: AZ

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: zero

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 5 hr after second shot ate dinner and had diarrhea. Felt ok and then went to bed. 1 AM awoke with stomach and back aching and cramping. Unable to find comfortable position. Nothing warranting intervention but clearly too uncomfortable to sleep. Some tingling on back of arms and thighs; similar to flu. May have slept briefly and woke saturday to similar tummy pain. No diarrhea or vomiting. Slight headache. Symptoms began to disappear soon with stomach ache dissipating throughout day. Able to sleep fine saturday night and 100 percent good today. Almost no symptoms after shot one; by the way.

Other Meds: zero

Current Illness: zero

ID: 1044345
Sex: M
Age: 51
State: WA

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Resting heart rate above 100 and fluctuating blood pressure

Other Meds: Multivitamin once daily

Current Illness: None

ID: 1044346
Sex: F
Age: 66
State: FL

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Erythromycin

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

Symptoms: Hard red hot swollen itchy area near injection site which measures 6 1/2" ? 4" as of today.

Other Meds: Levothyroxine 50mcg 1x daily

Current Illness:

ID: 1044347
Sex: F
Age: 67
State: FL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/21/2021
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 known allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: below the site of injection on my left arm I have experienced swelling, redness, pain, warm and tender to touch. Started 2/10 the evening I received the vaccine very light systems, next day 2/11 it was worse and uncomfortable to sleep on the left arm that night. Day three 2/12 the spot had reduced in size and the pain, other than soreness when touched, had lessened. On 2/17 the spot enlarged, redness increased and the pain and heat returned. As of today 2/21 I am still having they symptoms.

Other Meds: Prescription - Estradiol .5m OTC - calcium, biotin, vitamin D3, B12, Kirkland joint health Did not take any medication day before and day of vaccination

Current Illness: none

ID: 1044348
Sex: F
Age: 37
State: CA

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 02/21/2021
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: A delayed reaction around injection site. After no initial soreness, several days after the injection the area became painful with a large hot red area. It seemed to be progressively getting worse and on the evening of 1/12/21 when becoming very uncomfortable, the patient drew a circle around the red area and the next morning noted that it had grown significantly.

Other Meds:

Current Illness:

ID: 1044349
Sex: M
Age: 69
State: NC

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: COVID Arm; Injection site is swollen, red and itchy

Other Meds: furosemide 20 mg tablet; potassium chloride 10 mEq CR tablet; finasteride 5 mg tablet; losartan potassium 100 mg tablet; hydrochlorothiazide 12.5 mg tablet; fenofibrate 160 mg tablet; icosapent ethyl 1 g capsule; metformin 1000 MG tablet; v

Current Illness: None

ID: 1044350
Sex: F
Age: 62
State: MD

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/21/2021
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: Sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Felt tinny taste in mouth, light headed mild SOB, resolved with Trendelenburg

Other Meds: None

Current Illness:

ID: 1044351
Sex: F
Age: 67
State: FL

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache Swelling and redness of arm to elbow for 11 days fatigue nausea chills extreme pain at injection sight

Other Meds: Prevastatin Multi-vitamin Magnesium Gabapentin Zinc

Current Illness:

Date Died: 02/14/2021

ID: 1044352
Sex: M
Age: 64
State: IL

Vax Date: 02/08/2021
Onset Date: 02/14/2021
Rec V Date: 02/21/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Stomach upset, sudden heart failure, death

Other Meds: Synthroid; Cosentix; Multivitamin; Vitamin C; Omeprazole; Loratadine

Current Illness: None

ID: 1044353
Sex: M
Age: 75
State: FL

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: allergic to shellfish

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

Symptoms: Both does one and two resulted in chills, fever, and extreme weakness. The patient could not stand up. He was also quite incoherent. The first time resulted in a fall in the bathroom and subsequent hospitalization. The second he stayed in bed and recovered after 24 hours.

Other Meds: levetiracetam, tamsulosin, citalopram, solifenacin, tadalafil, Vitamin D3, Avastin infusion every three weeks

Current Illness: brain tumor since 2007, enlarged prostate

ID: 1044354
Sex: F
Age: 48
State: IL

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
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: Sulfa, Flonase, erythromycin derivative, ketoconazole, septra, raw onions

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

Symptoms: I was observed for 15 minutes and then shuttled back to vehicle. Approximately 30+ minutes after shot, I started to feel something weird in my throat area. I decided to go through a drive through to get a bite to eat and something to drink. While waiting in line, I could tell it was becoming more difficult to swallow. Was hoping the drink would help. I tried to take a bite of the chicken nugget, but about choked and had to spit it out. I live approximately an hour from where the vaccination was administered and my goal was to just head home. While driving on Road, I was talking with a friend. I told my friend what I was experiencing in my throat area and that I needed to hang up to concentrate on what was going on. I unbuckled my seat belt and pulled by coat and sweater out from throat area, wondering if they were compressing on it. That did not help and I could tell something was just not right. I was having a hard time swallowing. I then googled possible side effects from the COVID vaccination and that is when I read about anaphylaxis reactions. I was torn on what to do since by this time I was approximately 30 minutes from the testing site and just wanted to get closer to home. There really were no medical facilities along my route home. My friend called back to check on me. Explained the situation and my friend suggested I stop at a gas station to get Benadryl. I then drove to Town and took a 2 Benadryl tablets. I also knew this town had a fire department and ambulance service in case things started to turn South. I sat in my car for about 20 minutes to assess the situation. I finally felt like I could make it the rest of the way home. I had already put my family on notice in case things got worse. By the time I made it to Town, my swallowing was less difficult. My nurse friend recommended I continue to take Benadryl every 6 hours for 24 hours and then to take a Claritin. That is what I did. I did not report this to my PCP, but in hindsight... I probably should have. It was quite alarming and truly a very scary feeling to experience this, especially while driving. It kind of still feels like there is a lump in the back of my throat when I swallow, but that is something I can deal with.

Other Meds: Pro-biotic, yogi tea,

Current Illness: none

ID: 1044355
Sex: F
Age: 67
State: TX

Vax Date: 02/01/2021
Onset Date: 02/10/2021
Rec V Date: 02/21/2021
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: Bromfed Codeine Lisenopril

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

Symptoms: No treatment: took Tylenol slept 10 hours Stomach pain Headache Serious Fatigue

Other Meds: Topiramate Amlodipine Flouxitine Tizanidine Symbicort Meloxicam

Current Illness: COVID 19 in January

ID: 1044356
Sex: M
Age: 83
State: CA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: spinach,,turkey

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

Symptoms: moderna covid-19 vaccine EUA loss of balance,,,,dizzy required sitting down to keep from falling

Other Meds: midodrine hcl 5mg,,,carbidopa levo 25-100,,,,saw palmetto 450mg,,,fish oil,,,D3 25mcg,,,multivitiam vit,,,

Current Illness:

ID: 1044357
Sex: M
Age: 88
State: CT

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/21/2021
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: Zithromax asparagus

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

Symptoms: My Brother has been vomiting since 2/16/21 He is in Hospital since2/20/21 He is on IVs and antiemetic medicine but still vomiting

Other Meds: metoprolol, Tamsulosin hcl , amlodipine taken off losartan on 2/17/21

Current Illness: has pacemaker lung cancer kidney disease

ID: 1044358
Sex: M
Age: 54
State: CA

Vax Date: 12/22/2020
Onset Date: 12/25/2020
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: cefdinir

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 12/28/20 I woke up with a fever, chills, body ache. I went and got tested for Covid19. 12/29/20, I was informed I tested positive. 3 weeks of rest, over the counter medicine- nightquil, cold ez, Mucinex. Prescription inhaler.

Other Meds: complara, Zyrtec, doxocin, oxybutynin, famciclovir, finasteride, Lipitor, multi vitamins.

Current Illness: none

ID: 1044359
Sex: U
Age: 78
State: FL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
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: I was diagnosed with shingles. Nerve and muscle pain on right side of neck and rash on upper back, below the neck pain area. Was taking steroids and muscle relaxant. Had persisted for about 3 weeks before Covid vaccine 2/18/2021. At time of vaccine I thought I was essentially over the shingles because pain and rash essentially gone. That late afternoon and night after the vaccine and all the next day I was in excruciating pain in the same location as my shingles. I attribute it to the Covid vaccine reinflaming the nerves that were inflicted with the shingles virus. I have not had Shingrix. I am currently taking an antiviral, Gabapentin, Methocarbomol, Tramadol, Ibuprofen, Acetaminophen, all for the neck pain.

Other Meds: Eliquis, Sertraline, Atorvastatin, Niacin, Gabapentin,Tramadol

Current Illness: Shingles

ID: 1044360
Sex: F
Age: 34
State: PA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/21/2021
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, Vancomycin, Cephalosporins, Morphine

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Fevers of 101.2 degrees F, on and off starting from 10 hours after receiving vaccine lasting for 100 hours. Body aches, muscle weakness, severe muscle and joint pain in lumbar spine, SI joint and hips. Making it extremely difficult to move. Headaches. Loss of appetite. Swollen tonsils and lymph nodes- neck and inguinal. Swollen left arm around injecting site. Stiffness and pain in shoulder joint- unable to lift arm more than 40%. Extreme fatigue starting 5 hours after injection lasting 96 hours. Felt like a severe case of influenza.

Other Meds: None

Current Illness: None

ID: 1044361
Sex: F
Age: 72
State: NV

Vax Date: 02/03/2021
Onset Date: 02/13/2021
Rec V Date: 02/21/2021
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: Amitriptyline, Amlodipine, Compazine, Compazine, Metoprolol Phenergan Verapamil, Vicodin Zofran Sulfa

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

Symptoms: Headache, injection site pain and some facial swelling initially Followed by a 6 by 3 inch itching rash on February 13th which I still have along with swollen glands. .

Other Meds: Levoxyl, Pantopraxole, Latanoprost, Telemisartin, Vitamin D

Current Illness:

ID: 1044362
Sex: F
Age: 60
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/21/2021
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: Swelling, redness, soreness at injection site lasted five days. swelling was hard lump the size of a golf ball. no other symptoms.

Other Meds: advair, albuterol

Current Illness: none

ID: 1044363
Sex: F
Age: 43
State: NY

Vax Date: 02/11/2021
Onset Date: 02/21/2021
Rec V Date: 02/21/2021
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, leviquin, Zithromax , sulfa drugs, alka-seltzer, mold, ragweed

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

Symptoms: After shot sore arm, dry mouth, fatigue, muscle pain 10 days later large red rash near injection site.

Other Meds: Prevacid, levocetirizine, benedryl, multivitamin, vit D

Current Illness:

ID: 1044364
Sex: F
Age: 51
State: NV

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/21/2021
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: allergic to medical tape, my skin turns red from the take and last a three or 4 days

Symptom List: Injection site pain, Pain

Symptoms: 5 days after shot, lt arm started to itch, I noticed it was red, it spread and hot to the touch, Went to urgent care Thursday, Feb.18, 2021, the doctor gave me Benadryl and Famotiodine, and outlined the redness and told me to go to urgent care if it gets worse, it got worse, I went to urgent care, he gave me steroid to put on for the itch. It is itchy and is still spreading. I will call the doctor tomorrow and see what I should do next.

Other Meds: na

Current Illness: na

ID: 1044365
Sex: F
Age: 65
State: NC

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, fever, chills, fatigue, nausea, vomitting, body aches

Other Meds: Effexor, buproprion

Current Illness: May have had COVID-19 2/4/21-2/7/21 but tested negative on 2/12/21.

ID: 1044366
Sex: F
Age: 28
State: KY

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Injection site pain, arm soreness, bruising under injection site. Starting at midnight 2/20/201 I started to have a reaction. I had fatigue, headache, muscle pain, joint pain, chills, and nausea. These worsened as the day went on and did not subside till 2/21/21 10am.

Other Meds: Birth control (Sprintec) Acne Medication ( Spironolactone)

Current Illness: None

ID: 1044367
Sex: F
Age: 73
State: CO

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/21/2021
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: penecillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Sore left arm, as expected, but then awoke every 3 hrs during then night following the injection with strong pain in the wrist/hand affected by the carpal tunnel, had to go get a cold pack from the freezer, then could sleep another 3 hrs before the pain woke me up again. (Recommend that carpal tunnel pts get the shot in the opposite arm!) Improved during the day, a little pain the next night, pain recurred the 3rd night and had to get a cold pack again, then OK.

Other Meds: Atenolol, rosuvastatin, glucosamine + chondroitin, calcium, multivitamin, additional Bs & C, CoQ-10, Turmeric, fish oil

Current Illness: carpal tunnel, left wrist

ID: 1044368
Sex: F
Age: 67
State: FL

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: swelling and redness of arm to elbow Pain at injection sight headache fatigue nausea

Other Meds: Prevastatin Multi-vitamin Magnesium Gabapentin Zinc

Current Illness:

ID: 1044369
Sex: F
Age: 32
State: TN

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/21/2021
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: Large red splotch on my skin at the injection site, four inches wide and three inches tall, warm to the touch, very tender, and itchy. It also feels swollen or tense. It hurts. It appeared the day after my vaccine and is still there, with the same amount of visibility and pain, at this point (8 days after the vaccine).

Other Meds: 125mg spironolactone, 150mg Wellbutrin, 20mg celexa

Current Illness: None

ID: 1044370
Sex: F
Age: 26
State: KY

Vax Date: 02/11/2021
Onset Date: 02/21/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: RECEIVED 1ST DOSE OF PFIZER COVID-19 VACCINE ON 02/11/21. ON 02/18/21 WENT FOR BURNING WITH URINATION AND DIAGNOSED WITH ACUTE UTI. ON 2/19/21 CALL REQUESTING CHANGE IN ANTIBIOTIC FOR UTI. LATER ON MESSAGE SENT ABOUT URINE CULTURE SUGGESTING NOT A TRUE UTI. ON 02/21/21 WENT ER COMPLAINING OF DYSURIA, RT FLANK & BACK PAIN. DIAGNOSED WITH LOWER ABDOMINAL AND CVA PAIN AND INSTRUCTED TO FOLLOW UP WITH UROLOGY.

Other Meds:

Current Illness:

ID: 1044371
Sex: M
Age: 49
State: CA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/21/2021
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: Pt reports feeling light headed, instructed patient to lay down with feet elevated r/t vasovagel response to Covid Vaccine. Pt reports this happening each time he receives a injection.

Other Meds: n/a

Current Illness:

ID: 1044372
Sex: F
Age: 35
State: PA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: -MODERATE MUSCLE PAIN SHOULDER TO ELBOW ON INJECTION ARM STARTING IMMEDIATELY AND LASTING ~12 HOURS -MODERATE LOWER EXTREMITY MUSCLE PAIN STARTING ~ 11 HOURS POST-INJECTION LASTING 12 HOURS -SEVERE HEADACHE STARTING ~22 HOURS POST-INJECTION LASTING SEVERAL HOURS

Other Meds: ZYRTEC FLONASE PRENATAL

Current Illness: NONE

ID: 1044373
Sex: F
Age: 74
State: TX

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/21/2021
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:

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

Symptoms: Bad headache for several days, one night of high temperature, itching at injection site, hair loss, and tinnitus or ringing in my ears.

Other Meds:

Current Illness:

ID: 1044374
Sex: F
Age: 69
State: IL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
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 Soaps with fragrances Erythromycin HCTC Gluten Statins

Symptom List: Tremor

Symptoms: Client states she has problems with allergies that causes hives. Client received shot. Took her seat for observation. Her face began to get splotchy and red. Hands turned red. Itching started on neck, abdomen,legs and face. Although she complained about itching, only area with any visible signs was face and redness of hands.Benadryl was offered, but client refused. Client was observed for 1 1/2hr. Client stated she was not feeling any worse. Was very calm about situation and stated this happens to her all the time. Client left vaccine clinic, but stated she would not be alone.Upon interview 2/19/2021 she stated itching and splotches on face lasted about 4hr.

Other Meds: On a blood pressure med.

Current Illness: None

ID: 1044375
Sex: F
Age: 78
State: CA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: chills, nausea, headache, some site pain, some muscle pain, fever, tiredness

Other Meds: xanax omeprazole tylenole pm propanole trospium vitamon d3

Current Illness:

ID: 1044376
Sex: F
Age: 60
State: VA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/21/2021
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: unavailable

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

Symptoms: I interviewed the vaccinator and Paramedic that were involved in the incident. The vaccinator stated the "hub of the needle was not secured to the syringe" and all of the vaccine ran down the recipient's arm. The Paramedic confirmed the vaccinator and recipient version of what occurred. According to the paramedic, the recipient was not vaccinated.

Other Meds: unavailable

Current Illness: unavailable

ID: 1044377
Sex: F
Age: 69
State: CO

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: "Moderna COVID -19 Vaccine EUA" I got the vaccine on 2-11-21. I had no reaction. Eight days later (morning of 2-19-2021) my upper left arm felt itchy. I was rubbing the area. I thought it might be a bug bite. When I looked I couldn't see evidence of bug bite but there was a large (2" wide by 2 1/2 " long) red, hot, itchy place on my arm in the area I received the vaccine. I called and left messages on on 2/19 & 2/20. No call back. Called my Dr. Office & spoke with on-call Dr. I would like to know if this delayed reaction is normal?? Please send me information.

Other Meds: none

Current Illness: none

ID: 1044378
Sex: F
Age: 26
State:

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/21/2021
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: ALLERGIC TO KIWI

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: WOKE UP FEELING FINE, AS TIME WENT ON, BODY ACHES IN JOINTS BEGAN TO HAPPEN

Other Meds: MOTRIN

Current Illness:

ID: 1044379
Sex: F
Age: 59
State: PR

Vax Date: 02/18/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: None

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

Symptoms: Fever, headache, joints aches, and chills day after vaccination. 2 days after - red rash on the left arm area the shot was given. It feels warm in that area only. Pain under left armpit.

Other Meds: Levothyroxine 50 mg Vitamin C, B12 Multi vitamin

Current Illness: None

ID: 1044380
Sex: F
Age: 68
State: CA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Lisinopril

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

Symptoms: Flu-like head and body aches, muscle and joint pain, painful injection site

Other Meds:

Current Illness:

ID: 1044381
Sex: F
Age: 57
State: CA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Medications: Morphine Tequin Food: Most grains mushrooms cheeses containing bleus (molds)

Symptom List: Pain in extremity

Symptoms: Began bleeding from rectum approximately eight hours after the injection, without related pain, but some discomfort. Bleeding occurs with or without a bowel movement. The first bleeding began without a BM. The bleeding lasted for approximately 10 days. The healthcare providers at the clinic have not provided any type of care at this point. They have decided without any kind of physical assessment (no temp check, pulse ck, BP ck, etc) that it is unrelated and probably hemorrhoid's even though I have never had hemorrhoids in my life. I reported history of polyps removed and of Colon cancer in father, grandfather and aunt. GF and aunt both died from colon cancer and dad from other cancer. Providers said to use hemorrhoid cream. and ordered tests. They concluded it's not related to shots without even touching me.

Other Meds: At bedtime: Lunesta Nexium Topiramate Lyrica Montelukast Pristiq Each morning: Daily vitamin: Vyvanse 30 mg Each afternoon: Adderall 10 mg

Current Illness: unk

ID: 1044383
Sex: F
Age: 78
State: MI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Penicilin

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

Symptoms: Chills, headache,,, fever 101..7, swelling at site of shot,, itching, I slept, took advil,, and ate chicken soup.

Other Meds: Liisinopril Atorvastatin Escitalopram Wellbutrin Furosemide Potassium Multi-vitamin Vitamin D-3 Baby aspirin Vitamin B12

Current Illness: none

ID: 1044384
Sex: F
Age: 38
State: MD

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: skin allergy to nickel

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

Symptoms: Covid arm. Swelling and pain at injection sight along with itchiness.

Other Meds: None

Current Illness: none

ID: 1044385
Sex: F
Age: 36
State: CA

Vax Date: 01/23/2021
Onset Date: 02/01/2021
Rec V Date: 02/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: amoxicillin

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

Symptoms: severe abdominal pain, went to ER, diagnosed with Gastritis. Pain improved with prilosec, maalox , tums and IV fluids. No h/o gastritis in the past.

Other Meds: Viviscal hair vitamins, iron supplements, Vitamin D supplements

Current Illness:

ID: 1044386
Sex: F
Age: 23
State: OR

Vax Date: 02/19/2021
Onset Date: 02/21/2021
Rec V Date: 02/21/2021
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: No

Symptom List: Vomiting

Symptoms: Dose 2- red area where the injection was. Hot to touch. Slightly itchy and raised

Other Meds: Zoloft Portia

Current Illness: No

ID: 1044388
Sex: F
Age: 73
State: FL

Vax Date: 01/22/2021
Onset Date: 01/31/2021
Rec V Date: 02/21/2021
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: No

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Had nosebleed one week after first dose. Had second nose bleed four days after the second COVID vaccine. Then had a third nose bleed six days after the second COVID vaccine. The third nose bleed was so bad that patient had to run to the hospital.

Other Meds: Vitamin D3 and Prevastatin

Current Illness: No

ID: 1044389
Sex: F
Age: 36
State: PA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/21/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Red rash on arm for a week. Head aches, body aches. Arm pits lymph nodes swollen, extreme exhaustion

Other Meds: None

Current Illness: None

ID: 1044390
Sex: F
Age: 68
State: IL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Client was in observation area. Began to complain of itching of face and back of neck. Red splotches appeared on face. Client then began to complain of itching on abdomen. Client was offered Benadryl. Client took 50mg of Benadryl PO. Client continued to complain of itching . Client taken to private area with nurse. No splotches or rashes noted on arms or abdomen or back. Only on face, but client continued to complain of extreme itching. Client verbalized that when she got up to go to the bathroom with nurse that she did not feel well. Upon return to observation area, client c/o feeling extremely hot. Began to have nausea and heartburn. Was belching. This vaccine clinic although done by Health Department was held in the local hospital. Client was taken to ER for further observation and assessment. Client was called 2/19/2021 for update on condition. States she received no other meds in the ER. Was just observed. Itching and red splotches lasted about 2 more hours. Denies any further problems on 2/19/21. Client called her physician and he advised her not to receive the second dose.

Other Meds: Unk

Current Illness: None

ID: 1044391
Sex: M
Age: 57
State: MO

Vax Date: 02/01/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
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: headache, shoulder soreness, loss of taste and smell. still experiencing 3 day later.

Other Meds: Reason for shot: Base of Tongue cancer survivor. Last chemo (2 - cysplatin treatments) and radiation (21 treatments) ended 08/2018. Been clear of all signs using scans with contrast every 3 months for 2 yrs, blood analysis, and ongoin

Current Illness: none

ID: 1044392
Sex: F
Age: 65
State: TX

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: N/a

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

Symptoms: Palpitation-pt verbalized heart beating fast. 11:32 BP 165/71 HR 70 96% saturation 11:40 BP 165/78 HR 72 97% saturation pt has instructed to follow up with PCP with me elvated BP verbalized understanding pt verbalized subsiding of the symptoms pt was driven home by family member in no distress.

Other Meds: N/a

Current Illness: N/a

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm