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: 1046433
Sex: M
Age: 75
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046434
Sex: F
Age: 51
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: My period stopped in December 2019, I got covid19 vaccine on 2/19/2021 in the morning and I got my period at night. Not sure it is side effect of vaccine or not.

Other Meds: Levotyroxine

Current Illness: None

ID: 1046435
Sex: F
Age: 64
State: TX

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/22/2021
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: UNK

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

Symptoms: site pain headache, nausea, vomiting

Other Meds: UNK

Current Illness: UNK

ID: 1046436
Sex: F
Age: 42
State: PA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: Avonex, bee sting, NSAID's, Penicillin, Sulfa drugs

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: gradual onset of mild itching sensation in bilateral ear canals and posterior pharynx along with a tingling tongue sensation after administration of vaccine. No signs of urticaria or respiratory distress (or wheezing). Patient had no other known allergy triggers today, but did have post-nasal drip PTA. Chose to self-administer 0.3mg of epi at 1530 via her own epi-pen which she always carries with her. Post-administration all symptoms resolved, signed a release and left independently

Other Meds: Advair, Epi Pen, Flomax, Iron Sulfate, Lamictal, Minipress, Seroquel

Current Illness: post-nasal drip at time of vaccination

ID: 1046437
Sex: M
Age: 63
State: NE

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: same symptoms I had with covid approx 11/4/20: extreme fatigue, night sweats, muscle aches

Other Meds: Vit D, 81 mg ASA, losartan, actos, januvia, multivit, atorvastatin, escitalopram, metoprolol, celebrex, loratadine, finasteride, androgel

Current Illness: none

ID: 1046438
Sex: F
Age: 31
State: IL

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: none

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

Symptoms: Starting 12 hours after injection fatigue, overall body aches and headache. Starting 12 hours after injection red hot painful welt over the arm. Increased to 3inches by 4 inches after 48 hours. At 48 hours began to itch.

Other Meds: levothyroxine, norethindrone

Current Illness: none

ID: 1046439
Sex: M
Age: 88
State: NJ

Vax Date: 02/11/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Began to ITCH all over, especially on his head-top and in and around ears. Also, a rash, flat mostly but a few pimply spots on his torso. Torso has this blotchy rash all over from neck to stomach and all over his back. Dr. prescribed a cortisone cream to be applied 2x/day. 2nd Dr prescribed a benedryl cream to slather over his torso. Severe itching and tingling comes and goes.

Other Meds: BREO, TAMSOLUSIN, CRESTOR, 81MG ASPIRIN, NAMENDA, TYLENOL, GINKO BILOBA, GLUCOSAMINE

Current Illness:

ID: 1046440
Sex: F
Age: 43
State:

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/22/2021
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: Dizziness at time of injection

Other Meds:

Current Illness:

ID: 1046441
Sex: M
Age: 67
State: SC

Vax Date: 02/03/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: SUMMARY Two weeks after first vaccine: uncontrollable shaking throughout body, followed by chills, then entire body ache and fever. The first 12 hours were the worst, but after 36 hours all symptoms were gone. DETAIL The Feb 3, 2021 First vaccine - Phizer Feb 18, 2021 5:00 pm suddenly came down with shaking throughout my body and then chills. 6:00 pm shaking subsided 7:00 pm entire body aches from head to feet Later in evening - fever throughout body Feb 19, 2021 feeling better, but still muscle and joint pain throughout body. Some slight fever. No appetite, but can smell chicken broth. February 20, 2021 feeling better but tired 10:00 am COVID test at pharmacy. Noon ate peanut butter and crackers 2:00 pm sat outside for 30 minutes 6:30 pm ate full Mexican dinner February 21, 2021 feeling good with a good appetite. NO SYMPTOMS. 9:30 am breakfast 1:00 pm sat outside for 30 minutes 1:30 pm lunch REFLECTION: During entire time, no difficulty breathing or coughing. And the other symptoms came and went in 36 hours. The symptoms I did have are the same as a bad reaction to the 2nd vaccine. (my muscle aches are not a reaction to the vaccine). Yet, my reaction was not immediate, rather it was 2 weeks and 1 day after my first vaccine. Therefore, do I have COVID, or a bad reaction to my first vaccine? WAITING for COVID test results. Second vaccination is scheduled for upcoming Friday, February 26.

Other Meds: Pentoxofylline ER 400 Mg Tab - 1 tablet two times a day by mouth Baby aspirin Zinc B12 Multivitamin DHL Licorice Bacopa

Current Illness: None

ID: 1046442
Sex: F
Age: 54
State: CA

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Sulfas

Symptom List: Diarrhoea, Nasal congestion

Symptoms: fever, severe body pain, severe headache, dizziness, nausea, night sweats, fatigue lasting for 28 hours

Other Meds: progesterone, estradiol, Singulair, hydroxyzine

Current Illness: none

ID: 1046443
Sex: M
Age: 32
State:

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
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: chills, headache

Other Meds:

Current Illness:

ID: 1046444
Sex: F
Age: 76
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046445
Sex: F
Age: 58
State: CA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/22/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Aches nausea tired headache diarrhea vomiting

Other Meds:

Current Illness:

ID: 1046446
Sex: F
Age: 55
State: UT

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
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 medications old anti seizure medications - dilantin; tegretol; phenobarbital anything outside ie grass, trees, etc

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

Symptoms: 1/12/21 first vaccine dose. Delayed reaction. Similar to a weak reaction to allergy shot. no issues 2/16/21 second vaccine dose. 7am: vaccine administered. Could feel in muscle 8-9am: could feel swelling deep in muscle. No visible swelling at shot site. 9-12noon: could feel vaccine swelling / pain radiate down the arm to the elbow and below 3:00 - 4:30 pm start feeling neck and buttock pain 6:00 pm - neck and buttock pain becomes more pronounced. 8:00 pm - ibuprofen taken 200 mg 4 tablets 2/17/21 4:45 am pain spread throught body 5:30 am pronounced muscle, joint pain 5:45 am ibuprofen taken 200 mg 4 tablets sleep 11:00 am continued deep muscle and joint pain 11:00 am naproxen liquid gel 220 mg 3 capsules sleep 5:00 pm some reduction in pain 8:00-9:00 pm Full On Body Rash 8:00 pm ibuprofen 200 mg 3 tablets sleep 2/18/21 5:00 am still have full on body rash. pain reduced 7:00 am arrive to work. Fatigue. 4:00 pm leave work. Nausea. 5:00 pm Home. Nausea. vomiting. Take Nauzene 2/19/21 Itchiness begins. Benadryl Taken. Body Rash fading 2/20/21 symptoms begin to subside 2/21/21 itchiness resumes. Very Annoying. Change of clothes finds pustules all over abdomen and back. broken pustules likely from scratching

Other Meds: bi-weekly allergy shots lexapro proponal citirizine montekulast famitidine benadryl fish oil digestive enzyme zinc biotin vitamin k

Current Illness: January - February: sinus infection January - possible severe gastroenteritis

Date Died: 02/18/2021

ID: 1046447
Sex: F
Age: 38
State: NM

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/22/2021
Hospital: Y

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

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

Symptoms: 2/12/2021 Vaccine 2/13/2021 Weakness, oral ulcers 2/17/2021 Brought to ER for loss of consciousness, altered mental status, rectal bleeding; work up showed sepsis, UTI, anemia, pneumonia, pleural effusion, pancytopenia, hypotension; persistent hypotension and respiratory failure 2/18/2021 Passed away at 5:54AM

Other Meds: Vitamin D3 2000 U daily, Calcium carbonate 500 mg daily, Cyanocobalamin/folic acid/pyridoxine 200mcg-500 mcg-5mg daily, Vitamin B12 1000 mcg daily, Echinacea 450 mg twice daily, St. John's Wort 300 mg daily, Fish oil 1000mg daily, Vitamin

Current Illness: 1/17/2021 Fell while drunk, right distal humerus fracture, right facial bruising

ID: 1046448
Sex: F
Age: 74
State: NY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
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: Allergies to Evergreens

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

Symptoms: 02/12/2021- 9 PM -Left arm felt great pain at injection site, Midnight- great pain again, chills, fever, no balance-dizziness, walking into walls, dresser. 02/13/2021-Exhausted, sleeping all day, cold-wrapped in blankets, headaches 02/14/2021- finally sitting up, starting to move around 02/15/2021- starting to recover to normalcy

Other Meds: Amlodipine Besylate, Atorvastatin, Montelukast, Q-Var Inhaler, Meclizine-( as necessary) CVS Women's Daily Multivitamin ,Glucosamine Chondroitin w/MSM, Biotin

Current Illness: None

ID: 1046449
Sex: F
Age: 48
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/22/2021
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: Vicodin

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

Symptoms: I started feelin strong COVID Symptoms like when I was sick, head and neck pain, chills, joint and body pain, weakness, body heaviness lasted for 2 days. A week after, I had minimal physical exercise with my upper body and had a very strong pain on my right thigh, like muscle pain but stronger with some burning sensation just in the upper part then it turn into a rheumatism like pain with no strength, next day the left thigh same thing, by Friday the pain in my thighs was less but went up to my hips and was a kind of pain and numbness and still difficulty to walk, by Saturday I got better, pain and legs weakness almost gone. I have exercised years, and I know what is a muscle pain when returning to work out. I don't even use my legs and this pain way different and stronger. I had covid on December, started with symptom's on 12/15/2020

Other Meds: n/a

Current Illness: none

ID: 1046450
Sex: F
Age: 61
State:

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: chills, temp 100.7, body aches, headache

Other Meds:

Current Illness:

ID: 1046451
Sex: F
Age: 44
State: MA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/22/2021
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: Nausea, dizziness, headache, fever of 102, chills, fatique

Other Meds: vitamin D

Current Illness: none

ID: 1046452
Sex: M
Age: 77
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046453
Sex: F
Age: 38
State: MI

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/22/2021
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:

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

Symptoms: Patient had respiratory distress unknown cause . Onsite EMS was called vitals BP 111/74 100% O2 room air HR 78 BG 97 Patient refused evaluation/care went home against medical advice.

Other Meds:

Current Illness:

ID: 1046454
Sex: M
Age: 73
State: IN

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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

Symptom List: Unevaluable event

Symptoms: Fever of 101, uncontrolled shaking, headache,

Other Meds: Advair, Atorvastatin, calcium, B12, Omeprazole, Aspirin (162mg), Fish oil, Probiotic, Areds 2 with multi vitamin

Current Illness: none

ID: 1046455
Sex: F
Age: 23
State: MT

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
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:

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

Symptoms: Fever & Body aches

Other Meds:

Current Illness:

ID: 1046456
Sex: F
Age: 85
State: MD

Vax Date: 02/22/2021
Onset Date:
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Moderna COVID-19 Vaccine: Pt received 2nd dose 22 days after 1st Moderna dose (1/29/21). Pt not registered at time of 2nd dose and computer system was not working. Pt spouse also received 2nd dose but his was 26 days from 1st Moderna dose (1/25/21)

Other Meds:

Current Illness:

ID: 1046457
Sex: F
Age: 43
State: OH

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: KNA

Symptom List: Injection site pain, Menorrhagia

Symptoms: On 2/20/21 when I woke up I went to use the restroom. When I wiped I noticed that I was spotting on the tissue. This happened a second time and then it was finished. I felt really tired and not myself. Then later that night my arm began to hurt so bad that I could not lift it. I began to rub the area that was hurting and noticed that I now had a nice size lump there . I took a Tylenol 500mg and a hot shower. When I woke up the next morning my arm was still hurting but not as bad. When I went to use the bathroom I had began to start spotting again. This continued throughout the day and now I am bleeding as if I was having my period. I am super tired. It is to the point that i cant function at work.

Other Meds: Tylenol, Jamaican sea moss.

Current Illness: None

ID: 1046458
Sex: F
Age: 70
State: CO

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: nickle in jewlery

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

Symptoms: 27 hours after injection I began to feel a migraine, chills, incredibly tired and my temperature went up to 100.8. My chest was tight and achy and my oxygen levels stayed at about 88. I slept about 10 hours and woke up feeling fine. My chest is sore and achy but better than yesterday.

Other Meds: Symbicort, Incruise Ellipta, Rosuvastatin, Levothyroxine, Paroxetine, Flonase

Current Illness: none

ID: 1046459
Sex: F
Age: 56
State:

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt received injection, first dose. of Pfizer vaccine at 10:27am. Pt was taken to observation station in mall area of hospital for 15 minute observation, by another nurse.. At approx. 10:32, when observing nurse questioned pt about any headache, nausea, vomiting or other reactions, , pt c/o headache, then dizziness, nausea and ultimately started attempting to vomit, having "dry heaves" only. This nurse calls Code RRT to location of event.. Pt was taken to ER via stretcher.

Other Meds:

Current Illness:

ID: 1046460
Sex: M
Age: 79
State: OH

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/22/2021
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 states since he got the first dose of Pfizer vaccine on 2/3 and the second on 2/17. He has gained almost 20 pounds since taking the first shot. Patient states he has gained right around 20 pounds since getting the first shot of the Pfizer vaccine. States he had some shortness of breath right after receiving the first dose of vaccine, but that has cleared. Felt achy and stiff and sore after the second injection. Follow up with patient on 2/20/21 F/U with caller - He was advised at ER that he had excessive fluid retention; no other issues were identified. He was advised to increase his furosemide dose from 20mg twice daily to 40mg twice daily for 5 days. He continues to feel tired and weak, with slight shortness of breath. Confirmed with caller that his 2 vaccinations were separated by only 14 days.

Other Meds: Furosemide 20mg BID lisinopril 40mg QA , Xarelto 20mg QD metformin 250mg QD Sotalol 80mg BID Simvastatin 40mg QD Ibuprofen 200mg 4 times daily since second shot

Current Illness:

ID: 1046461
Sex: F
Age: 54
State:

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
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: Penicillin, latex

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

Symptoms: 1100 patient sitting in recovery. states she feels "funky". Declined w/c and stated she really needed to use the restroom. Patient ambulated without difficulty, gait steady and nurse accompanied to restroom. Patient describes a strange tingling type of sensation in left arm and face that has progressed all over head. Pt. voided and ambulated accompanied to private observation area. 1105 BP 149/93; HR 97; O2 sat 99% on room air. EMT in attendance. 1108 Patient moved to outside and mask removed due to feelings of anxiety over the "strange sensations" Encouraged to deep breath. Offered patient ambulance transport. Patient declined. 1116 Patient BP 128/81; HR 94; O2 97%. Husband with patient, patient signed declination of ambulance transport, left with husband to personal vehicle. gait steady.

Other Meds: Valsartan, ASA 81 mg, vitamins

Current Illness: none

ID: 1046462
Sex: F
Age: 80
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046463
Sex: F
Age: 59
State: CA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: Injection site pain

Symptoms: chills body aches fever last for 24 hours

Other Meds:

Current Illness:

ID: 1046464
Sex: M
Age: 89
State: NE

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa (sulfonamide antibiotics)

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

Symptoms: Patient stated he felt "funny in the head" on 02/19/2021 at 4:00 pm. His wife stated that the patient had seemed confused. Gave patient 2L of fluids and discontinued trazodone. Patient returned to baseline and was discharged after 24 hours.

Other Meds: acetaminophen, alprazolam,amlodipine, aspirin, atorvastatin, escitalopram, levothyroxine, losartan, meclizine, meloxicam, pantoprazole, tamsulosin, vitamin D3

Current Illness:

ID: 1046465
Sex: F
Age: 72
State: VA

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
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 (was told as a child), seasonal allergies hay fever, sinus congestion ongoing

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

Symptoms: Racing heart 40 minutes after vaccination Large redness and itching where the vaccine was done on left arm 2.5 days after vaccination

Other Meds: nasonax nose spray daily, claritin daily, lipitor 2x week, metoprol tar 25 mg

Current Illness: none

ID: 1046466
Sex: F
Age: 64
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
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:

Symptom List: Tremor

Symptoms: Chills, body aches for 10 hours

Other Meds:

Current Illness:

ID: 1046467
Sex: F
Age: 71
State:

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 02/22/2021
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: Pt reports that she got severe vertigo starting 1d after vaccination which last for 1w then spontaneously resolved. Pt reported this when she presented for 2nd dose and she requested that I write a VAERs report.

Other Meds:

Current Illness:

ID: 1046468
Sex: F
Age: 67
State: FL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/22/2021
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: Full body aches Insomnia Headache Difficulty concentrating Temp low

Other Meds: Fluoxetine. 60 mg Alprazalom. .5 mg at bedtime Bupropion XL 300mg Omeprazole. 40 mg Trelegy Elipta 100/62.6/25 Pro air HFA. As needed Lutein. 20 mg

Current Illness: Anxiety/Depression

ID: 1046469
Sex: M
Age: 72
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046470
Sex: M
Age: 39
State: WA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Staff member reported being sick and in bed for 3 days. Staff member also noted 'sporadic nose bleeds'.

Other Meds:

Current Illness:

ID: 1046471
Sex: F
Age: 83
State: NJ

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/22/2021
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: Not disclosing

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

Symptoms: With the second dose I experienced itching and what it feels like a swollen mass on my left arm. I could push it and it would move around my arm. Like a little ball. It was hot to the touch. I also developed cellulitis on my left arm but not at the injection site, lower (medium anterior lateral part of my left arm). I decided to go to the ER to get it checked and they told me it was cellulitis. They prescribed me Augmentin and it did the trick, 48 hrs after starting the Augmentin it was much better and now it is all gone. The little moveable lump in my arm is much smaller but I can still feel it if I press it.

Other Meds: Not disclosing

Current Illness: Not disclosing

ID: 1046472
Sex: F
Age: 59
State: MT

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
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: Headache, Body ache, Nausea, & Fever

Other Meds:

Current Illness:

ID: 1046473
Sex: M
Age: 61
State: MN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: FLUPHENAZINE, NICKEL

Symptom List: Pain in extremity

Symptoms: 2/20/21-61 year old male with decreased level of consciousness and hypoxia. I received a call from nursing staff indicating that patient was having low oxygen saturations this AM and required oxygen. He needed only 1.5-2L by NC but was mouth breathing so mask was used and 4L due to mask. This brought his saturations back up. He has been quite drowsy since receiving his second COVID vaccine on 2/17/21 and has not been eating and drinking much. Today he is not responding to nursing staff in a coherent fashion. I met with him in his room along, RN. He did not wake to my voice or touch. On examination he is sleeping and using accessory muscles to breath, especially his abdomen. NC/AT, face symmetric. Lungs are clear to auscultation bilaterally anteriorly with no wheeze heard. No pretibial edema. 61 year old male with decreased level of consciousness. I will send patient to the ER due to his decreased level of consciousness and difficulty with breathing causing accessory muscle use despite normal respiratory rate of 17 but with hypoxia. I do believe his fever of 103 this AM was due to the COVID vaccine. I am concerned that he could be having a COPD exacerbation on top COVID vaccine symptoms and his bladder cancer is dragging him down along with dehydration from poor intake the past few days. I did call and speak with the ER provider and the EMS crew. They reported seeing a lot of this with the second COVID vaccine. 2/21/21-I received a call from nursing staff indicating that patient had worsening hypoxia with need for 8L of oxygen by mask. He was very restless and not making a lot of sense. He had receive Tylenol PR for a fever of 103 that was now only down to 101 and not budging. He was in the ER yesterday and diagnosed with possible Right middle lobe pneumonia on CT. He is already taking Levaquin. Due to his Oxygen need I did call to see about possible direct admission as he had a full work up the day before. The hospitalist was concerned that he might need BiPAP and so I did call and speak with the ER provider and she agreed that due to his new oxygen requirements he should be sent to the ER there and likely would need ICU. She was advised of the work up from yesterday so as not to repeat what wasn't needed. He was sent by ambulance due to his inability to sit up well. I received a call later that night from the intensivist in the ICU indicating that patient was reacting to the COVID vaccine most likely. He felt that there really was not much in the way of a pneumonia diagnosis as that has really not shown up on their imaging and all labs are normal including white count, CMP and blood gases. He is still requiring oxygen and is able to answer in sentences but is very drowsy and may be a bit confused. He has a minimal UTI and they will keep him given his low level of consciousness and hypoxia.

Other Meds: ASPIRIN, 81 MG TABLET, ENTERIC COATED, ORAL, 81 MG EVERY NIGHT AT BEDTIME , Preventative Medicine ATORVASTATIN, 10 MG TABLET, ORAL, 10 MG EVERY NIGHT AT BEDTIME , Hyperlipidemia BISACODYL, 5 MG TABLET, ENTERIC COATED, ORAL, 5 MG TWO TIMES A

Current Illness: Urinary Tract Infection

ID: 1046474
Sex: F
Age: 76
State: MO

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

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

Lab Data:

Allergies: no known allergies

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

Symptoms: Patient said the day of the vaccination she developed a red patch about 1/2 inch in diameter that was red and swollen and a little tender. Patient reported that it was periodically itchy and she has been scratching it. She stated that yesterday (day 9 after vaccination) that she noticed the size of the redness had increased. She said it was still periodically itchy and only slightly tender to the touch. She said she felt otherwise fine no systemic effects reported. Patient had not taken anything. Recommended benadryl and icing the area. Treatment outcome unknown at this time.

Other Meds: unknown

Current Illness: unknown

ID: 1046475
Sex: F
Age: 46
State:

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/22/2021
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:

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

Symptoms: Low grade temp, body aches, chills

Other Meds:

Current Illness:

ID: 1046476
Sex: F
Age: 68
State: OH

Vax Date: 02/12/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
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: Allergic to Celebrex

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

Symptoms: I had no symptoms for the first 48 hours. On days 3-6 I was fatigued but not enough to effect daily living activities. Day 6 ( Feb 18, 2021) I started to have a lot of muscular aches and the injection site started to get red and swollen. I had fever and chills from the 18th through the 20th as well as a swollen arm and a lot of redness in the arm and minor itching. The red area on my arm was a patch about 4 inches wide and 6 inches long. The swelling was confined to the injection site and was raised up in a circle about 2 inches in diameter. My fever during this time was at 99 degrees. Today is Feb 22 and most of my symptoms are gone, just minor redness and itching at injection site. I was just surprised that my symptoms didn?t show up until about 6 days after the vaccination.. Everything I have read suggested they could appear within 48 hours of the injection.

Other Meds: L-THYROXINE 50mcg 1 x day LISINOPRIL. HCTZ/20-25 mg. 1x day ATORVASTATIN 10mg 1x day CEQUA 0.09% solution for dry eye 2 x day COSOPT Pf 2%-0.5% solution for dry eye 2x day Vitamin D 1000 IU per day Baby Aspirin 81mg per day Multi vitamin 1

Current Illness: None

ID: 1046477
Sex: M
Age: 87
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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:

Symptom List: Vomiting

Symptoms: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046478
Sex: F
Age: 72
State: NH

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
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: Bee stings

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received vaccine at 10:23 am and parked and instructed to wait 30 min due to prior reaction to bee stings. At 10:47am patient reported feeling a flushed and reddened face, "blurry eyes", and lightheadedness. Assessment VS as follows BP 150/70 HR 70 - SR skin- warm and dry SpOx-99 % This reaction was not like a typical bee string reaction. She denies restricted airway and throat tightness. Talking in a normal rate and rhythm. Advised patient that we will call EMS for transport to a higher level of care, however patient refused. This patient was instructed to remain onsite for further observation and she agreed. She was accompanied by her spouse who was the driver. She reported that she will return home and take benadryl or the epi-pen if condition worsens. She will contact her doctor and report her experience today. Patient felt recovered and decided to leave after 30 additional minutes.

Other Meds: meds for hypertension Has an epi-pen and Benadryl at home for bee stings.

Current Illness: none

ID: 1046479
Sex: F
Age: 72
State: CA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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, Pcn, food allergies

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

Symptoms: Pt states that approx 4 hours after the injection she had her glands in her neck start swelling and her throat became very itchy. She took 2 benadryl and it started to get better after about 20 minutes.

Other Meds:

Current Illness:

ID: 1046480
Sex: F
Age: 80
State: NY

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
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: IV dye

Symptom List: Injection site swelling, Limb discomfort

Symptoms: itching of the skin in the neck area. Lightheaded. Ambulated with staff to the medical area. Given water and Benadryl 50 mg po. Rested lying down for 15 minutes, felt much better and declined to receive further medical care. Husband with her and driving her home.

Other Meds: Methimazole

Current Illness: none

ID: 1046481
Sex: F
Age: 29
State: FL

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Fatigue, cold sweat/chills, slight headache, muscle/joint pain, skin painful to the touch (typically occurs to me right before getting a fever or becoming sick)

Other Meds: None

Current Illness: UTI

ID: 1046482
Sex: F
Age: 20
State: MT

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
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:

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

Symptoms: Body aches, Chills, Headache, Injection site pain

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm