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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1046584
Sex: F
Age: 42
State: OH

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

Lab Data:

Allergies: Shellfish

Symptom List: Dysphagia, Epiglottitis

Symptoms: Symptoms began 10 minutes after vaccine administration as tingling in the tongue and progressed to swelling of the toungue

Other Meds: Daily multivitamin

Current Illness: None

ID: 1046585
Sex: F
Age: 65
State: NY

Vax Date: 01/29/2021
Onset Date: 02/05/2021
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: allergic to sulfa drugs

Symptom List: Anxiety, Dyspnoea

Symptoms: ?Moderna COVID?19 Vaccine EUA? About a week after my first dose (only immediate side effect, about 12 hours after shot, was stiff left arm/shoulder for about 3 days), I had the WORST genital herpes attack that I've had in literally 40 years, with extremely swollen labia, excessively "weeping" sores, intense itching and pain. The shot was the only variable in my routine health and healthcare to which I can attribute this; the herpes attack finally began to heal, but then repeated itself, not as bad as the first one. During this time I have been taking Valcyclovir and Acyclovir cream, prescribed by OB/GYN. A few days into the initial herpes attack, my hands and face swelled and broke out in a case of (probably) dermatitis (which I've had once or twice in the last 2 years), covering my arms, legs, hands, somewhat belly and back, with itchy hives which are still healing. Was prescribed by dermatologist Hydroxyzine HCL 10 MG 3x/day + Triamcinolone Acetonide lotion USP 0.025% topical ointment, which are helping to relieve itching.

Other Meds: insulin: Levemir, Fiasp Synthroid

Current Illness: none

ID: 1046586
Sex: M
Age: 71
State: IA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: Pseudfederin, Statins

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

Symptoms: Aprox 24 hrs after vaccine I had extreme pain in my left upper jaw tooth rear tooth, I mean extreme like the tooth was dying , then headachy on the left side of my head, and then extreme tiredness! The tooth pain has reduced to a mild pain but still hard to eat, the extreme tiredness has lessened a little buy today the 21st it is still there!

Other Meds: Pradaxa, Sotolol, Amilodepine, Vit D3, Zinc, Fish Oil, Gemfibrozil, Red Yeast Rice, Curcumin

Current Illness:

ID: 1046587
Sex: F
Age: 45
State: CA

Vax Date: 02/18/2021
Onset Date: 02/20/2021
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: NONE

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: PATIENT CALLED PHARMACY ON 02/22/21 STATING SHE RECEIVED SECOND DOSE OF MODERNA VACCINE ON 02/18/2021 AND HAD TYPICAL SYMPTOMS OF CHILLS, HEADACHE, AND FEELING TIRED DAY OF VACCINE. HOWEVER, ON 02/20/21 SHE NOTICED A RASH ON DIFFERENT PARTS OF HER BODY ALONG WITH HIVES.

Other Meds: SYNTHROID PROZAC ZYRTEC VITAMIN D

Current Illness: NONE

ID: 1046588
Sex: F
Age: 71
State: OH

Vax Date: 02/07/2021
Onset Date: 02/09/2021
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:

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

Symptoms: Presented to ER with subsequent admission two days after receiving second dose of COVID 19 vaccine with Lactic Acidosis/Sepsis. She was hospitalized for 4 days

Other Meds:

Current Illness:

ID: 1046589
Sex: F
Age: 62
State: CO

Vax Date: 02/13/2021
Onset Date: 02/22/2021
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: Pen vk Dilaudid, Morphine (All opioids)

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

Symptoms: Three inch Red warm circle over injection site

Other Meds: Statins

Current Illness: None

ID: 1046590
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

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

Other Meds:

Current Illness:

ID: 1046591
Sex: F
Age: 31
State: MA

Vax Date: 02/12/2021
Onset Date: 02/14/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: At 24 hrs, warm, red, itchy spot appeared on arm. Disappeared into a bruise at 1 week post injection. Reappeared at the same size as a red, warm, itchy spot on arm with a hard bump on the middle.

Other Meds: Metformin, birth control, Multivitamin, vitamin e, vitamin c

Current Illness: None

ID: 1046592
Sex: F
Age: 94
State:

Vax Date: 02/18/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Per patient's daughter, the patient told her that she "passed out" while she was on the toilet the day following vaccination. States she felt weak. Per daughter the patient is doing fine now.

Other Meds:

Current Illness:

ID: 1046593
Sex: F
Age: 81
State: MI

Vax Date: 02/06/2021
Onset Date: 02/08/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Macular papillary rash on thighs, buttocks, and trunk. She took a dose of benadryl, and I advised she take Claritin and zyrtec.

Other Meds: custor 10 mg daily baby aspirin 81 mg daily

Current Illness: No

ID: 1046594
Sex: M
Age: 37
State: AR

Vax Date: 01/02/2021
Onset Date: 01/05/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: No

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

Symptoms: Other than brusing and a sore muscle, on 01/05/2021 at 3AM, I noticed my stomach felt bloated after drinking soda. It got worse through out the day. At 5:30PM, I took medicine for gas. By 6:30PM, the pain was worse so I went to UC and after a check up, I was sent to the ED for a CT scan and they found an inflamed appendix. I had surgery to have it removed. After surgery, I developed asthmatic pneumonia which led to a 7 day hospitalization.

Other Meds: No

Current Illness: I have asthma that has been under control for the past 20 years.

ID: 1046596
Sex: M
Age: 91
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: 1046597
Sex: F
Age: 36
State: OR

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

Lab Data:

Allergies: amoxicillin

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

Symptoms: muscle pain, fatigue, seizures

Other Meds: none

Current Illness: none

ID: 1046598
Sex: F
Age: 29
State: MA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Nausea, fever, chills, aches and pains, fatigue, headache, neck ache, ear pain, swollen lymph nodes, sore arm. These symptoms lasted about 2 days total.

Other Meds:

Current Illness:

ID: 1046599
Sex: F
Age: 90
State: MA

Vax Date: 01/11/2021
Onset Date: 01/28/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Patient received the first dose of Moderna COVID vaccine on 1/11/2021. It was documented in her immunization record. She was admitted to a nursing facility on 1/13/2021 for short term rehab. Her vaccination records were sent with her when she was admitted to the nursing facility. She then received a dose of the Pfizer COVID vaccine on 1/28/2021.

Other Meds: ? Oxycodone HCl 5 MG Tablet Take 1 tab (5mg) every morning and 1/2 tab (2.5mg) every night. Isolated MOTs. 42 Tablet 0 ? DULoxetine HCl 20 MG Capsule Delayed Release Sprinkle Take 40 mg by mouth one time a day 60 Capsule 1 ? Lidocaine

Current Illness: none

ID: 1046600
Sex: F
Age: 90
State: MD

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: Patient was admitted and treated for severe PE and DVT, as well as hypoxia and paroxysmal SVT. Pt was discharged to inpatient rehab when stable

Other Meds: Amlodipine-benazepril, celecoxib, furosemide, levothyroxine, metoprolol succinate, tramadol, trazodone

Current Illness:

ID: 1046601
Sex: F
Age: 37
State: MT

Vax Date: 02/16/2021
Onset Date: 02/17/2021
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:

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

Symptoms: Rash & Hot and cold flashes

Other Meds:

Current Illness:

ID: 1046602
Sex: F
Age: 59
State: FL

Vax Date: 02/12/2021
Onset Date: 02/22/2021
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: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: A large red area on my arm. Sore in general and to touch. Just started today - one week and two days after the shot was given.

Other Meds: Levothyroxine, Vitamin D, Potassium-magnesium, Glucosamine, Omega 3 fish oil, Collagen-C, Calcium, Zinc, Multi-Vitamin,Zicam

Current Illness: none

ID: 1046603
Sex: F
Age: 75
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

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

Other Meds:

Current Illness:

ID: 1046604
Sex: F
Age: 69
State: CA

Vax Date: 02/05/2021
Onset Date: 02/07/2021
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: ceclor, sulfa drugs

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

Symptoms: sore arm, fatigue, rash,

Other Meds: Synthroid, align probiotic, systane eye drops, zolpidem 5mg

Current Illness: n/a

ID: 1046606
Sex: F
Age: 32
State: IL

Vax Date: 02/12/2021
Onset Date: 02/20/2021
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: Cipro, Bactrim, Phenergan

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

Symptoms: itchy, round rash around injection site. firmness and mild tenderness noted at site as well

Other Meds: Requip, Gabapentin, Omeprazole, Zyrtec, Magnesium, Vitamin D3, and Mirena

Current Illness:

ID: 1046607
Sex: F
Age: 22
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Abdominal pain, pale, hypotensive, tachycardic. Received epi pen and transport to ER

Other Meds:

Current Illness:

ID: 1046608
Sex: F
Age: 77
State: AZ

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: none known

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

Symptoms: fever: 102.8, chills, muscles aches, "fuzzy" head, took 2 advil, fever broke after few hours, aches remained for 42 hours, repeated advil twice during that time. much better now (vaccination was working)

Other Meds: metropalol, atorvastatin, meloxicam, allegra, dulera, dymista, albutorol, singular,

Current Illness: none

ID: 1046610
Sex: M
Age: 80
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Fever (up to 102 F); headache; mental confusion; lack of responsive speech or delay in responding to questions. Symptoms began around 11:30 a.m. on Feb. 21. Administered one Tylenol at 2:30 p.m. on Feb. 21. By 6 p.m. on Feb. 21, the fever and headache abated. But confusion and lack of speech continues to Feb. 22 (10:30 a.m.) as I prepare this report.

Other Meds: 1) Levetiracetam; 2) Topiramate; 3) Eliquis; 4) Carbidopora/Levodopa; 5) Donepezil; 6)Tamsulosin; 7) Mirtazapine; 8) Vitamin D-3; 9) Vitamin B-12; 10) Adult Vitamin

Current Illness: None

ID: 1046611
Sex: M
Age: 78
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

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

Other Meds:

Current Illness:

ID: 1046612
Sex: F
Age: 71
State: VA

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

Lab Data:

Allergies:

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

Symptoms: hard lump under skin at injection site; very tender to touch; still sore at site after 7 days.

Other Meds:

Current Illness:

Date Died: 02/22/2021

ID: 1046613
Sex: F
Age: 70
State:

Vax Date: 01/28/2021
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: patient passed away within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1046614
Sex: F
Age: 36
State:

Vax Date: 01/19/2021
Onset Date: 01/28/2021
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: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Developed Covid-arm: raised, warm to the touch, red area at site of injection on the morning of 01/18/2021 . Later that evening broke out in hives from my hips to my ankles. Spoke with my allergist who said it was most likely an inflammatory response from the vaccine and to treat with Benadryl. Took Benadryl and hives were gone by the next morning.

Other Meds: Synthroid, Spironolactone

Current Illness: asthma

ID: 1046615
Sex: F
Age:
State: ID

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: None

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

Symptoms: Client waved nurse over to observation area and stated, " I feel a little strange". I asked her to describe how she was feeling and she was thirsty and feeling a bit anxious. She stated she lived alone and her daughter was out of town. I asked her if I could take a few vitals. She agreed to having them taken behind the curtain area. VS: BP 134/72, P 66, R 16,Temp: 97.1. SPO2 99%Client stated that she normally has pretty low BP so this was elevated for her. I offered her a bottle of water and she accepted. We talked about her daughter and people we know in common. This helped calm her and her next vitals were 126/56, P 73, R 16 SPO2 98% . Client stated that she was feeling better. By 10:55 am she was moved back to group waiting area and waited a few more minutes. She did not accept the offer of a phone call for someone to come pick her up. Cleint stated that she felt like she could drive herself home as she did not live far away. Client last Vitals 10:57 am : BP 115/67 P; 67, R 14, SPO2 99%. Client walked out of facility at 11:01 am .

Other Meds:

Current Illness: NA

ID: 1046617
Sex: F
Age: 71
State: MI

Vax Date: 01/28/2021
Onset Date: 02/05/2021
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: amoxicillan

Symptom List: Nausea

Symptoms: COVID - arm (rash)

Other Meds: levothyroxin vitamin D multivitamin tab.

Current Illness:

ID: 1046618
Sex: F
Age: 87
State: TX

Vax Date: 01/16/2021
Onset Date: 01/18/2021
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: Penicillin, Vinegar, Cheyanne pepper, Prednisone

Symptom List: Injection site pain

Symptoms: About 2 days after receiving the vaccine, she bitter taste in her mouth. She still has it as of today. It is kind of metallic taste. She also has blurry vision and swelling in her eyes. It felt like she had discomfort behind her eyes. It was causing difficultly reading. This lasted about 2 weeks. It is not as blurry but her vision is not what it is was prior to receiving the vaccine. She went to Eye Center, they told her they didn't know what it was from. They gave her some eye drops and gave her antibiotic/steroid cream. She has a follow up appointment 2/26/2021.

Other Meds: Flexeril 10 MG daily, Lexapro 10 MG twice a day, Aspirin 81 MG daily, Claritin 10 MG twice a day, Multi-vitamin gummy (2 gummies daily), Vitamin C gummy (2 gummies every day), Prilosec 40 MG daily

Current Illness:

ID: 1046619
Sex: F
Age: 64
State:

Vax Date: 01/16/2021
Onset Date: 01/16/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Medication leaked out injection site causing suboptimal dose. Dose was repeated later for a total of 3 injections

Other Meds:

Current Illness:

ID: 1046620
Sex: F
Age: 55
State: AZ

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: Eggs Morphine Sulpha Erithermicyn

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

Symptoms: Big hive at shot site with 3 smaller hives in area. Area is very hot and extremely itchy. It's been this way since 2am on Friday 2/19/21. I take Benadryl at night and cortizone and ice on it during the day. As of Monday, 2/22/21 it is still the same.

Other Meds: Lialda Progesterian Atervastatin Linsinapril tramadol Multi Vitamin D3 vitamin Magnesium Turmeric

Current Illness: I had insert of hormone pellets 1 day prior to vaccination . 2 weeks prior to vaccination I had 2 steriods shots into L4-L5, and L5-S1

ID: 1046621
Sex: F
Age: 82
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

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

Other Meds:

Current Illness:

ID: 1046622
Sex: F
Age: 75
State: NJ

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

Lab Data:

Allergies: antibiotics, grass, dogs

Symptom List: Erythema, Pruritus

Symptoms: pt stated that she was very tired that day and next day. On 1/23/2021 pt stated she developed a enlarged lymph node under her left arm. Pts doctor sent her for mammo and sonogram test for the swollon lymph nodes. Pts doctor let her know that these symptoms were directly related to taking the Covid Vax. Pt states that the swelling is not completely gone but it is smaller and getting better.

Other Meds: no

Current Illness: no

ID: 1046623
Sex: F
Age: 78
State: NY

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: Xidra and Zithromax

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

Symptoms: Shortly after I received the vaccine, and stood up, I felt a bit light-headed so I continued to walk around the store for a few minutes. Later in the afternoon, my right arm where I had the vaccine was very painful, reducing the ability to raise my arm, which continued through the following day. On Day 3, it was still a bit sore, but improving. On Day 4, I was totally fine.

Other Meds: Armour Thyroid 60 mg. , Norvasc 2.5mg, Crestor 5 mg, Bayer Aspirim 81 mg Magnesium 125 mg, Calcium 800 mg, , Vitamin D, 1000 mg Biotin 1,000 mg, Vitamin C 500 mg, Tumeric 500 mg

Current Illness: No

ID: 1046624
Sex: F
Age: 50
State: MA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
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: Penicillin Benzoyl peroxide Apples Eggs

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

Symptoms: dizziness, headache, ear pain, popping sensation ears, feeling hot and cold, chills, diaphoresis, night sweats, severe fatigue, sinus congestion, runny nose, post nasal drip, sore arm

Other Meds: tenofovir 300mg by mouth daily Vitamin d 50,000IU 3x/ week Calcium 500mg 3x/ week

Current Illness: None

ID: 1046625
Sex: F
Age: 48
State: AZ

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

Lab Data:

Allergies: none that aware of

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Friday injection site hurt almost immediately (first dose didn't feel anything until 6 hours after shot)... started to ice arm an hour after appointment and continued to ice throughout the day Friday. Saturday morning the injection side was significantly swollen (bump and felt like a knot) and continues to be swollen and ache as of Monday a.m. Have a red circular patch around injection site which also occurred after first shot and lasted 10 days. Saturday woke up with bad headache... took tylenol and slept.. headache gone by late afternoon. Sunday morning woke up covered in a rash that was from my neck to below my belly button on front side, entire back area (including neck) and both sides of torso. Took 2 doses of Benadryl on Sunday. Rash has faded (not as red) and took another dose of Benadryl Monday morning.

Other Meds: birth control pills

Current Illness: none

ID: 1046627
Sex: F
Age: 69
State: CA

Vax Date: 02/12/2021
Onset Date: 02/20/2021
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: None known

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

Symptoms: Red, itchy spot at injection site appeared about 8 days after injection. No treatment.

Other Meds: Atorvastatin, daily multivitamin

Current Illness: None

ID: 1046628
Sex: F
Age: 86
State: CA

Vax Date: 02/11/2021
Onset Date: 02/13/2021
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: daughter stated patient was found on the floor at her facility and was transported to the hospital where she was diagnosed with a CVA. Unknown if this event was related to her COVID vaccine.

Other Meds:

Current Illness:

ID: 1046630
Sex: F
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

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

Other Meds:

Current Illness:

ID: 1046631
Sex: F
Age: 42
State: PA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: Clarithromycin, Corticosteroids, Escitalopram, Topiramate Bupropion

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

Symptoms: Moderna vaccine as given as indicated above but recorded in chart as Pfizer-BionTech COVID-19 vaccine, resulting in second dose being given as Pfizer-BionTech vaccine rather than Moderna

Other Meds:

Current Illness: NOne

ID: 1046632
Sex: F
Age: 1
State: IL

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

Lab Data:

Allergies: None

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

Symptoms: Starting day of vaccine she had swelling of her L leg with difficulty bending the leg at the thigh and limping. She also had pain with crying. The leg swelling and difficulty walking lasted 2 days. She had low grade fever for 12 hours of 100.3

Other Meds: sulfamethoxazole 200mg- trimethoprim 40mg/5ml- 1.ml daily prophylaxis for hydronephrosis

Current Illness: None

ID: 1046633
Sex: F
Age: 53
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Tachycardia, palpitations, SOB, anxiety before, during and after injection. She did go to ER, symptoms resolved quickly.

Other Meds:

Current Illness:

ID: 1046634
Sex: F
Age: 62
State: CA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: Motrin

Symptom List: Vomiting

Symptoms: Headache, bodyaches & pain or soreness at the injection site.

Other Meds: Tramadol-50 mgs. - for knee pain. Vit. D with Calcium

Current Illness: None

ID: 1046635
Sex: F
Age: 66
State: SC

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: Thimerosal

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: After receiving the Moderna COVID 19 vaccine the pt. (while walking around in the store with her husband) began to feel dizzy and weak. She came back to the pharmacy area and she was seated and had her blood pressure checked. It was high (194/84) but she reported that she does have high blood pressure and takes her med at night. She was given a bottle of water, monitored and her blood pressure was checked twice again over the next 20 minutes. It read lower each time she was checked and when it read 156/84 she said she felt fine and was ready to leave with her husband. She also said she was diabetic and had eaten a small breakfast compared to normally. She will be contacted today to make sure she is still feeling ok.

Other Meds: Pt. did not indicate exact meds she was on but she said she takes blood pressure medication and oral medication for diabetes.

Current Illness:

ID: 1046636
Sex: F
Age: 22
State: NH

Vax Date: 02/12/2021
Onset Date: 02/13/2021
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: Gluten

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

Symptoms: 12 hours after my second Moderna shot, had severe chest pain and shortness of breath. Admitted to emergency room later in the week for myocarditis as a result of the vaccine.

Other Meds: Lamictal- 100 MG Trileptal- 300 mg AM 600 PM Prozac- 10 MG Birth control contraceptive

Current Illness: None

ID: 1046637
Sex: M
Age: 68
State: OH

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Felt dizzy, blurry vision, passed out, pale. Short of breath and vomited. RPh gave epinephrine which worked right away. Squad came and took to ED where he was observed for 4 hours. They did a chest xray, troponin, EKG, Lab work. Everything normal. Name of physician or treating hospital: ED- MD. Pharmacist advised not to get the 2nd dose. ED MD advised to get a 2nd dose. His MD told him to get the 2nd dose in a medical setting where he can be monitored.

Other Meds: Lisinopril, Carvedilol, simvastatin, asa 81mg, fish oil

Current Illness:

ID: 1046638
Sex: M
Age: 79
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

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

Other Meds:

Current Illness:

ID: 1046639
Sex: F
Age: 64
State: MD

Vax Date: 02/14/2021
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: RA

Lab Data:

Allergies: Cows Milk, cortisone,adhesive, floroquinolins ie Cipro

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

Symptoms: 2? Oval red rash around injection site. Very itchy

Other Meds: Metoprolol.25 Multiple vitamins

Current Illness: N a

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm