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: 1051920
Sex: M
Age: 78
State: FL

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/24/2021
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: Chlorine

Symptom List: Dysphagia, Epiglottitis

Symptoms: He got the vaccine, 2 days later patient stated that he had a full body red, itching rash. He went to the ER where they prescribed Famotadine, hydroxyzine and Prednisone for next 5 days. When the allergy clinic saw the patient on 2/16/21, the rash was already gone. He has subsequently recovered completely. He informed the allergy clinic that he tried to see his PCP but they referred him to the ER.

Other Meds: Desmopressin acetate spray, rosuvastatin, Uroxatral, magnesium, multivitamin, saw palmetto.

Current Illness: None.

ID: 1051921
Sex: F
Age: 62
State: AZ

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/24/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Covid 19 Vaccine screening questionnaire reviewed , administered Covid vaccine; patient developed coughing spells, non productive after 2-3 minutes after the vaccine administration, she states she felt like fainting. Lung sound checked - no wheezing. Pulse Oximetry checked 96%. Observed for 30 mins in the field. Intermittent coughing still noted. Pulse oximetry remained 96%, no shortness of breath or difficulty breathing. After 3 0 mins, patient continue to cough , states she feels tickles in her throat that makes her cough and she has a headache. Patient given Benadryl 25 mg p.o. and monitored for 30 mins. Patient felt better after 25 mins of observation and minimal coughing , pulse oximetry @ 96-98% denies SOB or difficulty breathing . Patient sent home with husband and advised to rest at home and call 911 if she develops SOB or difficulty breathing. Followed up call over the phone at 5: 00 PM , patient states she fell asleep when she went home and no cough , no SOB or difficulty breathing.

Other Meds:

Current Illness:

ID: 1051922
Sex: F
Age: 32
State: UT

Vax Date: 02/20/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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:

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

Symptoms: Had nausea, fever, chills, headache and body aches following vaccine. Symptoms resolved. On 2/23, 3 days post vaccine, she developed abdominal cramping and diarrhea.

Other Meds:

Current Illness:

Date Died: 02/21/2021

ID: 1051923
Sex: F
Age: 97
State:

Vax Date: 01/31/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient passed away within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1051924
Sex: F
Age: 75
State: DE

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
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 reported

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

Symptoms: Patient received her second dose of Moderna Covid-19 vaccine on 02/22/2021 around 1430 PM, waited for 15 minutes post vaccination and started feeling dizzy upon standing up. RN and interdisciplinary team came in immediately, assessed patient and obtained HR 74, RR 16, BP sitting 164/72 and BP standing 164/ 76. Patient's daughter stated that "this is her baseline and normal for her to feel dizzy upon sanding up". RN recommended that patient go to ER for proper check up. Patient declines ER visit and stated, "please don't call Ambulance because am not going there, I will be fine". After about 10 minutes, patient states she feels better and ready to go home. RN and team escorted patient to car. Patient's vital signs stays the same the whole time.

Other Meds: Lasix, Amlodipine, Hydrochlorothiazide

Current Illness: HF, HTN

ID: 1051925
Sex: F
Age: 32
State: AR

Vax Date: 01/27/2021
Onset Date: 02/05/2021
Rec V Date: 02/24/2021
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:

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

Symptoms: Rash

Other Meds:

Current Illness:

ID: 1051926
Sex: F
Age: 36
State: VT

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
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: hours after receiving 2nd dose fever, chills ,HA, arthralgia, myalgia fatigue diarrhea continued thru 2/24/21

Other Meds:

Current Illness:

ID: 1051927
Sex: F
Age: 76
State: MI

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Patient experienced pain headache or migraine after vaccination . Onsite EMS was called vitals BP 158/94 99% O2 room air HR 64. Patient Refused Evaluation/Care released against medical adive.

Other Meds: Lisinopril

Current Illness:

ID: 1051928
Sex: F
Age: 45
State: PA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: shellfish, mold

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 3:30 am 2/19- Extreme body ache, headache; 8:00 am couldn't stand up, fever, chills, elevated blood pressure & heart rate, dizziness, complete fatigue and meltdowns and very high blood glucose . This lasted till 2/20 until around 5:30 pm

Other Meds: Novolog Insulin, Tresiba, Dimethyl Fumarate,, Levothyroxine, Sertraline, VitaminD-3, Magnesium

Current Illness: none

ID: 1051929
Sex: M
Age: 35
State: CA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/24/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 101 fever, aches, chills, headache. Followed the next day diarrhea the following day.

Other Meds:

Current Illness:

ID: 1051930
Sex: M
Age: 60
State: WI

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Chills, joint pain and slight pain in bones. went to bed at 10 PM with chills, at midnight severe sweating. 5 AM woke with pains in joints and bones. Took three Tylenol extra strength. Woke at 8 AM, took two more Tylenol. Currently at 10:30 AM feel OK, a little tired from lack of sleep. most symptoms gone.

Other Meds: Centrex Vitamins, Trulicity, glimepiride, Vasepa, metformin, pentazole,

Current Illness: None

ID: 1051931
Sex: F
Age: 78
State: MI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/24/2021
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: Sulfa and bacitracin zinc ointment

Symptom List: Rash, Urticaria

Symptoms: After vaccine I was fine went home and took a nap, when I woke up at 2pm I was a little dizzy. By 7pm I was dizzy and nauseated, and it got worse, I got chills and shook and shook and shook, I had a fever and the next day I tried to get out of bed, and I fell to the floor and couldn?t stand up, I had no energy or appetite. I had covid in August 2020 and the wasn?t made aware of the possible side effects if you had covid. They didn?t ask if I had covid in the past and the pharmacist told me later that people who has had covid has reported having bad side effects. I had gone a couple weeks ago to see if I had the covid antibodies and I was positive for antibodies and the injection works against the antibiotics. This part of the procedure was overlooked. I have no one else to help me and going through this alone, it would have been better to have been made aware of this ahead of time.

Other Meds: no, I stopped taking meds the day before

Current Illness: no

ID: 1051932
Sex: F
Age: 25
State:

Vax Date: 12/28/2020
Onset Date: 01/28/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: -low grade fever -chills -muscle aches -nausea Symptoms began approximately 12 hours after second dose of vaccine. Symptoms resolved approximately 36 hours later. Treated with tylenol and ibuprofen.

Other Meds: Estyralla Zoloft

Current Illness: None.

ID: 1051933
Sex: F
Age: 49
State: PA

Vax Date: 02/17/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
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: nuts, anaphylaxis (pt has Epi pen)

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

Symptoms: redness warmth & soreness to injection site

Other Meds: biotin, buproprion HCTZ lorazepam ambien, omepazole

Current Illness: n/a

ID: 1051934
Sex: F
Age: 40
State: TX

Vax Date: 02/08/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
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: On Wednesday, Feb 17, I experienced an earache in my left ear and an eye twitch in the left eye, which continued to Thursday , Feb 18. On Feb 18, also experienced extreme fatigue and a jabbing, throbbing pain behind my left ear that came and went all day. I also noticed when I brushed my teeth that I had a hard time swishing water in my mouth, especially on the left side. On Friday morning, I woke up and noticed my left eyelid was drooping and my smile was lopsided. As I have a history of hemiplegic migraine, I assumed I was experiencing a migraine, although this was not the usual course of these migraines, and I had not had one of these types of migraines in many years. The left side of my head, behind my ear, and wrapping from my neck to my temple continued to hurt (but not as painful as a normal migraine). Thinking I was in a chronic migraine state, I took 40 mg of Prednisone, as I have done before to 'cut through' the migraine. When the facial weakness did not resolve by the next day, I suspected this was not migraine and instead suspected Bell's Palsy and consulted my physician. Looking back in time, I also realized that I had experienced some adverse tingling/taste sensations on part of my tongue as far back as February 8, that felt similar to burning your tongue from drinking too hot liquids that I realized later could have also been part of the Bell's Palsy.

Other Meds: propranolol (60 mg); topiramate (50 mg)

Current Illness: none

ID: 1051935
Sex: M
Age: 83
State: KY

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: Patietnt fell 12 hours post shot and then had a seizure.

Other Meds: anti-seizure and anti-hypertensive medications

Current Illness:

ID: 1051936
Sex: F
Age: 34
State: OK

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/24/2021
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: Penicillins

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

Symptoms: Flu symptoms (1 day), left side weakness/numbness/pins and needles (comes and goes), headache (comes and goes)

Other Meds:

Current Illness:

ID: 1051937
Sex: F
Age: 72
State: CT

Vax Date: 02/17/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Ear pain, Hypoaesthesia

Symptoms: pt states that the next day after her vax she had weakness, chills, fatigue and she still has these symptoms. Pt states that the injection site hurt for just a few days. Pt contacted her PCP regarding her symptoms and was told not worry about them at this time but has an appt next week for an annual check up and will FU w/ her about this at that time.

Other Meds: Lipitor, levothyroxine, Multivitamin

Current Illness: no

ID: 1051938
Sex: F
Age: 40
State: WA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient had witnessed seizure like activity for 30 seconds. Patient transported to ER on Gurney with RN All extremities contracted with grunting Airway maintained After activity was alert pale diaphoretic

Other Meds: unknown

Current Illness: unknown

ID: 1051939
Sex: F
Age: 81
State: MD

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Lisinopril, tetracyclines, PCN, shellfish (muscles only can eat other shellfish)

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

Symptoms: fever, chills body aches, shortness of breath, urinary frequency, factigue, headache, body aches, water does not taste good.

Other Meds: tylenol, norvasc, multivitamin, amlodipine, lipitor, calcium and Vit D3, pradaxa, colace, estrace, synthroid, losartan, metoprolol, trazadone

Current Illness: none. had mammogram two weeks prior to the second vaccine. first vaccine 1/26/2021. had mammogram 2/9/2021.

ID: 1051940
Sex: F
Age: 76
State: MA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/24/2021
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: Bactrim Morphine

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

Symptoms: Reported that experienced the onset of dizziness, "full feeling in head" at 30 minute discharge time- stated that these symptoms had started @ 2 minutes after Covid-19 vaccine was administered but was not reported until discharge ( did have multiple check-ins in waiting area) "hoping it would go away" no SOB, no urticaria, no facial swelling

Other Meds: Unknown

Current Illness: Unknown/none reported

ID: 1051941
Sex: M
Age: 71
State: MI

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: ampicillin

Symptom List: Unevaluable event

Symptoms: After receiving the vaccine he felt his breathing was abnormal. He has not taken any of his medications this morning. HIS VITALS ARE BELOW. HE WAS ALL SET TO LEAVE TO GO HOME AND THEN HE STARRED INTO SPACE FOR A SECOND, HIS ENTIRE BODY SHOOK, AND IT SHOOK THE VEHICLE HE WAS IN. IT TOOK A SECOND FOR HIM TO COME OUT OF IT AND HE SAID IT WAS ANXIETY AND IT HAD HAPPENED ABOUT A YEAR AGO. WE EXPLAINED OUR CONCERN IF HE HAD BEEN ON THE ROAD WHEN THAT EPISODE OCCURED. HE AGREED TO GO TO THE EMERGENCY ROOM FOR FURTHER EVAL.

Other Meds: metformin, januvia, AMONG OTHERS

Current Illness:

Date Died: 02/22/2021

ID: 1051942
Sex: M
Age: 84
State: NY

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 02/24/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Intolerance to Morphine, Propoxyphene, Statins, Bisphosphonates, Tramadol, Methadone, and Meperidine

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

Symptoms: Hepatorenal syndrome- Death

Other Meds: Casodex, Sinemet CR, Plavix, Namenda, Midodrine, Protonix, Crestor, Zoloft, Trazadone,

Current Illness: Acute Hepatitis,

ID: 1051943
Sex: F
Age: 71
State: WI

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
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: approx. 15 minutes after vaccination client reported heart palpitations and feeling light headed. Client was assessed by EMS and found to have elevated blood pressure and pulse. 1st vital signs: BP-180/100, P-130, R-18 2nd vital signs: Bp-160/90, P-118, R-18 After 30 minutes of observation client continued to report feeling light headed. Client chose to go to urgent care to be assessed by a physician. Client transported to urgent care by her husband.

Other Meds:

Current Illness:

ID: 1051944
Sex: F
Age: 74
State: AL

Vax Date: 02/11/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
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: 10 DAYS AFTER INJECTION ARM BELOW INJECTION SITE STARTED TO ITCH AND WAS BRIGHT RED. APPLIED LOTION AND ITCH STOPPED BUT REDNESS CONTINUES. NO PAIN BUT TENDERNESS.

Other Meds: 10 MG LISINOPRIL

Current Illness: NONE

ID: 1051946
Sex: F
Age: 76
State: MI

Vax Date: 02/17/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
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: fast heartbeat, first experienced 2or 3days after injection, during early morning hours, 2 nights then the next night no fast heartbeat, the fourth night again the fast heartbeat two times during the same night. I originally thought it was possibly what I had eaten, or maybe my medication. After reading side effects of vaccine I decided to report this thinking it could possibly be the vaccine.

Other Meds: aspirin 81mg, spironlactone, famotidine,atorvastatin, losartan, carvedilol

Current Illness: congestive heart failure high blood pressure

ID: 1051947
Sex: F
Age: 66
State: WA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
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: unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: tongue swelling, angioedema, denies SOB RR even, unlabored, no hives or rashes Taken to ER by wheelchair

Other Meds: unknown

Current Illness: unknown

ID: 1051948
Sex: F
Age: 69
State: SC

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
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 Vertigo. States she gets Vertigo on occasion

Other Meds: none

Current Illness: none

ID: 1051949
Sex: F
Age: 74
State: OH

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/24/2021
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: Cefuroxime

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

Symptoms: About 10 minutes after receiving the Maderna vaccine my head started hurting which I reported to the doctor on site. She talked to me and said I was ok to go. My headache pain persisted all day and into the next. For the pain I took Tylenol and Advil. The pain has not let-up since the day of my vaccination. In addition to the head pain, I started sneezing and had terrible eye irritation with burning and watering. These side effects are still persisting. The worst, however, is the severe head pain which only settles down when I sleep. I am sleeping only 3-4 hours at night now. I wake up for a bathroom break at 3-4 A M and can't go back to sleep. My head pain starts after I get up every morning about 1/2 hour to an hour. My doctor recommended taking Extra Strength Tylenol and Advil alternating them and an antihistamine. Functioning day to day and making decisions has been very difficult. But, the pain is the worst!!!

Other Meds: Vit. C pantoprazole Vit. D lisinopril Vit. B-12 nortriptyline (for fibromyalgia) Zinc Calcium

Current Illness: No illnesses

ID: 1051950
Sex: F
Age: 80
State: NC

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital: Y

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

Lab Data:

Allergies: Aggrenox - anaphylaxis Lisinopril - cough

Symptom List: Nausea

Symptoms: Angioedema, onset began 8 hrs after vaccination. Did not have adequate response to steroids & antihistamines; required nasotracheal intubation, now with our team in the ICU. Unclear if secondary to vaccine or other cause.

Other Meds: Amlodipine, aspirin, B12, Lasix, hydralazine, Isordil, synthroid, cozaar, antivert, simvastatin, sodium bicarbonate tab, warfarin

Current Illness: Reports of a fall, decreased oral intake & nausea a few days prior to vaccination.

ID: 1051951
Sex: F
Age: 59
State: TX

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Yes, sulpha based antibiotics, and I also had the same reaction at my arm, (swelling and rash plus itchiness) with tetanus shot

Symptom List: Injection site pain

Symptoms: Rash and redness at arm injection site, itching and a small amount of swelling

Other Meds: Flecanide Valsartan Diltiazem Carvedilol Baby Aspirin

Current Illness: No

ID: 1051952
Sex: F
Age: 51
State: CO

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: The arm is swollen and sore. My body hurt. Painful, chills, fever (101). I was nauseous and very tired. My arm and shoulder have been swollen for two weeks.

Other Meds: No

Current Illness: No

ID: 1051953
Sex: F
Age: 88
State: IA

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin

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

Symptoms: skin around injection site with a 3 inch dm. was red, very itchy on 2/17 on 2/24 the area is less red but no decrease in size and there is a 6inch long, 3 inch wide red area extending down her arm to just above her elbow

Other Meds: Viactiv=Calcium 650mg, Vit D 12.5 mg/ Vit K 40 mg one a day

Current Illness: none

ID: 1051954
Sex: F
Age: 59
State: GA

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
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: PCN

Symptom List: Tremor

Symptoms: JUST THE PAIN STATED BEFORE

Other Meds: GLYZIBDE 5 MG. METROPOL 25MG, NONERAMAPRIL 1.25MG

Current Illness: NONE

ID: 1051955
Sex: M
Age: 48
State: PA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/24/2021
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: denied

Symptom List: Erythema, Pruritus

Symptoms: PT reports vaccine on a Tuesday morning at 930, at 6PM> 9 hours after injection L ear fullness/pain/pressure. Wednesday, L eye watery and pain behind L ear. Thursday dribbled when drinking water when working overnight shift. upon awakening Friday afternoon, speech was "off" noted L side of face drooped and unable to close L eye. went to Urgent care and referred to ED for suspected stroke due to High BP> member stopped HTN meds 8/2020. Seen at Holy Redeemer Hospital ED and dx Bell's palsy. now on steroids, eye ointment and metoprolol.

Other Meds: denied

Current Illness:

ID: 1051957
Sex: M
Age: 64
State: MI

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
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: HE FELT DIZZY AFTER RECEIVING THE VACCINE. HE BROUGHT HIS OWN BLOOD PRESSURE MACHINE. ON SITE EMS RESPONDED VITALS BELOW. HE HAD CRACKERS AND WATER. HE FELT BETTER AND WAS RELEASED TO HOME

Other Meds: HIGH BLOOD PRESSURE MEDICATION

Current Illness: TUMOR ON ADRENDAL GLAND

ID: 1051958
Sex: F
Age: 62
State: PA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Allergic to cat dander, cedar.

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

Symptoms: Sore arm

Other Meds: Atenolol/Chlorthalidone Nexium Vital Proteins Collagen Peptides Ezetimibe Omega + CoQ10 Multi Vitamin Zyflamend Apple Cider Vinegar Gumies

Current Illness: None

ID: 1051959
Sex: F
Age: 40
State: FL

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
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: Allergies to injected or ingested alcohol

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Hardening , itching and radiating heat at injection site. Pain when trying to use arm, especially when lifting it 90 degrees of higher. This has been ongoing for three days, with very minimal improvement each day.

Other Meds: none taken at time of vaccine

Current Illness: none

ID: 1051960
Sex: F
Age: 65
State: OH

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/24/2021
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: Prednisone

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

Symptoms: Shaking from being cold. Chills, left ear pain, nausea, very tired and rundown fir 3 days afterwards. Couldn?t eat for / days afterwards. Bad dry cough still persists now 2 weeks later. Took Tylenol nothing helps the dry cough

Other Meds: Lisinopril. And Amlodipine

Current Illness: None

ID: 1051961
Sex: F
Age: 77
State: MA

Vax Date: 02/02/2021
Onset Date: 02/07/2021
Rec V Date: 02/24/2021
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: doxycycline, sudafed

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

Symptoms: About 5 days after vaccination injection site was very red, itchy and skin was hot..Went to primary care Doctor a few days later and was diagnosed as having an infection. was placed on an antibiotic for 7 days. Rash improved greatly and hotness of skin dissipated. I still have some redness and a measles like rash today (24 Feb21). I am concerned about getting 2 nd shot on 2 March 21.

Other Meds: Vitamin D3, Calcium

Current Illness: None None

ID: 1051962
Sex: M
Age: 67
State: GA

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: N\A

Symptom List: Pain in extremity

Symptoms: Awakened at 5:45 a.m. had body aches, chills, nasal congestion, lethargy/exhaustion

Other Meds: Atorvastatin, Levothyroxine, Lisinopril, Alphrazolam, Tamsulosin, Fish Oil, B Complex

Current Illness: N/A

ID: 1051963
Sex: F
Age: 67
State: CA

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Arm soreness. Muscle aches. Fatigue. Cognitive fog Backache. Lasting 5 days. Cognitive fog and backache still there after 8 days, improving but not totally gone. Muscle aches still present but improving.

Other Meds: Protonix. Pepcid. Lisinopril. Crestor. Vit D

Current Illness: Cushings in remission. Gastric ulcer

ID: 1051964
Sex: F
Age: 53
State: MI

Vax Date: 02/02/2021
Onset Date: 02/10/2021
Rec V Date: 02/24/2021
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, Sulpha, Cortisone Cream

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

Symptoms: "COVID Arm": Soreness at the injection site and surrounding area with a large itchy and red and white inflamed circle with three circles and bullseye. It lasted for about 4 days. I used Benadryl and ice packs to relieve itchiness and redness; and ibuprofen for inflammation and soreness. I noticed today that it finally feels "normal." There is still a large red circle but it's faded, similar to a long-lasting bruise; but red not yellow.

Other Meds: Ibuprofen, Multi-Vitamin, Vitamin E, Vitamin C, Magnesium

Current Illness: none

ID: 1051965
Sex: M
Age: 74
State: AL

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/24/2021
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: Sulfur

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

Symptoms: Received shot 2/6/2021. On 2/7 two red areas - 1 near injection site the other a little lower. Sensitive to touch, a little swollen. Cleared up 2/14. Red spot near injection reappeared on 2/15 but not as severe. By 2/17 most of red was gone but still noticeable. As of 2/24 still a little visible but not sensitive. SHOULD I GET SECOND DOSE ON 3/6

Other Meds: Omeprazole 20MG - Prolia Injection Twice a year- Calcium 600MG - Vitamin D3 400IU- Multi Vitamin- Fiber supplement- Maganese 8MG

Current Illness: Original reaction cleared up Sunday 2/14 but reaction came back on Monday 2/15 in a milder form. Still developed red spots but not as intense. Appears to be clearing up as of today 2/24. Should I get second shot on 3/6/2121?????

ID: 1051966
Sex: F
Age: 47
State: MI

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 02/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Latex

Symptom List: Vomiting

Symptoms: Noted above

Other Meds: Vitamin E, Biotin, Crestor, Tumeric, Excedrin, Amphetamine

Current Illness: Fatigue, face and ears were flush for hours, nausea, headache for 2 weeks, sore arm where injection was done, heaviness in both legs after injection, but went away later that night, felt brain fog, slightly off for 3 days.

ID: 1051967
Sex: F
Age: 69
State: OH

Vax Date: 02/16/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Sulfa, Quinolones, cephalosporins, Erythromycin base

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Hot, itchy, red, swollen, hard 7 days after injection.

Other Meds: Avapro 225mg daily, nexium 20mg daily, Zoloft 25 mg daily

Current Illness: None

ID: 1051968
Sex: M
Age: 40
State: CA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/24/2021
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: very sore arm, could not lift it, fatigue hit almost 24 hours exactly after injection, rash the following day over chest and neck

Other Meds: breo hctz valsartan

Current Illness: none

ID: 1051969
Sex: F
Age: 68
State: CA

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
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: facial flushing, dizziness, itchy throat, SOB, cough

Other Meds:

Current Illness:

ID: 1051970
Sex: F
Age: 65
State: OK

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Statins

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

Symptoms: I was sick like when you get the flu for two straight weeks. I had absolutely no energy or will to do anything. Couldn't get out of bed and it felt like my skin was crawling all the time. I have never been so sick in my life. I am NOT getting second shot because NO doctor will help me understand what happened to me. But, you need to know!

Other Meds: None

Current Illness: rheumatoid arthritis

ID: 1051971
Sex: F
Age: 78
State: FL

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Had vaccine on Feb 19. On 22nd my arm became sore and itchy and developed a red rash. Up until then my arm had not been itchy, only slightly sore. The area is very warm and itching became worse on the 23. On the 24 the redness is worse and the level of itching has not changed. The red rash is about 3 inches long and from 1? to 2? wide.

Other Meds: Atorvastatin, lexapro, tramadol, lisinipril, calcium,vit.D3, vit.B12, osteobiflex, magnesium, cq10, over 50 vitamin pill, tylenol

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm