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: 1051972
Sex: F
Age: 40
State: NJ

Vax Date: 02/14/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Left arm is swollen, irritated and there is a large red spot several inches in diameter. This happened about a week after initial dose. Have had this irritation for about 2 days.

Other Meds: None

Current Illness:

ID: 1051973
Sex: F
Age: 32
State: AR

Vax Date: 01/27/2021
Onset Date: 02/03/2021
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: amoxicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: rash (large red welt) at the injection sight 7 days after vaccination

Other Meds: NA

Current Illness: NA

ID: 1051974
Sex: F
Age: 68
State: CA

Vax Date: 02/01/2021
Onset Date: 02/22/2021
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: None

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

Symptoms: Swollen itching red soreness welts at injection on arm

Other Meds: None

Current Illness: None

Date Died: 02/23/2021

ID: 1051975
Sex: F
Age: 86
State:

Vax Date: 01/19/2021
Onset Date: 02/23/2021
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: 1051976
Sex: F
Age: 84
State: NC

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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:

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

Symptoms: Patient was light headed she was given the option to be seen at hospital and she refused. She was given water and crackers and watched until she felt better. Family friend drover her home.

Other Meds:

Current Illness:

ID: 1051977
Sex: F
Age: 41
State: OH

Vax Date: 01/05/2021
Onset Date: 01/09/2021
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: PCN

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

Symptoms: Armpit tenderness and swelling. It was the arm I got the injection in. It lasted at least 2 weeks. I took ibuprofen to help the tenderness.

Other Meds: Flonase, Buspar

Current Illness: N/A

ID: 1051978
Sex: M
Age: 62
State: OR

Vax Date: 02/21/2021
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: chills and headache

Other Meds: Levothyroxine; multivitamin

Current Illness:

ID: 1051979
Sex: F
Age: 44
State: OH

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Levaquin Sulfa (bactrum) Progesterone (promethium) Doxicycline

Symptom List: Pharyngeal swelling

Symptoms: Enlarged painful lymph nodes on right side neck and body under arm. Hot arm, diarrhea, extreme fatigue, headache. My neck and underarm are still achy and enlarged. My body is still sore and I have not been able to continue with my daily activities. I have not felt like this since I had mono as a 19 year old. I have 5 children and have gone through natural childbirth 3 times. I?ve received all my vaccinations faithfully and have never in my life reacted this way. I am not getting the second dose until I have blood work done to see how my high my antibody levels are. I respect and am grateful for your work However I need to see data on my body?s reaction to even consider getting another dose.

Other Meds: Magnesium citrate 420 mg Vitamin d 1000 x 2 Vitamin c 180 mg x 2 Multi vitamin women?s multi 40+ complete omega probiotic once day ultra 90 billion Sertraline 75

Current Illness: None feeling really good.

ID: 1051980
Sex: F
Age: 64
State: NY

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: Compazine (dystonic reaction)

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 5 hrs post- Left eye flashing lights to lateral area throughout night, leading to "floaters" in early AM, leading to linear "blur" along field of vision. Primary eye exam suggested PVD. Follow up w. retinal specialist 1 wk later confirmed. 22 hr post- sudden onset chills, fever. Symptoms abated after 3-4 hr, after Motrin 800mg

Other Meds: Crestor, CoQ10, Melatonin prn

Current Illness: no

ID: 1051982
Sex: F
Age: 81
State: PA

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

Lab Data:

Allergies: penicillin, amlodipine, Cartisin, Sipro

Symptom List: Diarrhoea, Nasal congestion

Symptoms: on the 11th I woke up around 4 or 5 am both legs were locked below my knees through the feet and it was very painful. i rubbed theraworx relief and finally 20 to 30 mins later it quit.

Other Meds: blood pressure meds and a lot of Supplements

Current Illness:

ID: 1051983
Sex: M
Age: 77
State: CT

Vax Date: 01/20/2021
Onset Date: 01/20/2021
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: Moderna COVID-19 Vaccine EUA. Several hours later develop sweats, feeling hot and cold, felt like a fever but temperature was normal, severe muscle and joint pains, unable to sleep, very tired next two days. Most symptoms have resolved although joint pains persist.

Other Meds: Cozaar ASA 81 mg Finasteride Crestor

Current Illness: None

ID: 1051984
Sex: F
Age: 75
State: KS

Vax Date: 02/18/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: Antidepressant ? name.

Symptom List: Rash, Urticaria

Symptoms: Got the vaccine, and on 2/22/21 she woke up at 2-3:00 AM with violent vomiting, two episodes. Her arm was sore, still having nausea. She feels like she is going to throw up still, 2/24/21. She has not taken anything for the symptoms.

Other Meds: Gabapentin, Lorazepam, Seroquel, Atorvastatin, Amlodipine, Sertraline, Hyvee multivitamin.

Current Illness: None.

ID: 1051985
Sex: F
Age: 42
State: TX

Vax Date: 02/15/2021
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: na

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

Symptoms: 10 days post vaccine developed a red, circular itchy rash around the vaccine site. the spot is slightly warm to the touch. this follows arm soreness in the several days right after the vaccine. no other adverse effects.

Other Meds: np thyroid, low dose naltrexone, progesterone

Current Illness: na

ID: 1051986
Sex: M
Age: 25
State: FL

Vax Date: 02/03/2021
Onset Date: 02/04/2021
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: No

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

Symptoms: I had fever, chills, body ache headache, fatigue and diarrhea lasting 4 days.

Other Meds: No

Current Illness: Sinus infection few days after Dose 1

ID: 1051987
Sex: F
Age: 66
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: 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: AFTER RECEIVING THE VACCINE TODAY, SHE COMPLAINED OF A HEADACHE AND CHEST PAIN. ON SITE EMS RESPONDED. VITALS ARE BELOW. SHE DID NOT TAKE ANY OF HER MEDICATIONS TODAY. SHE RECOVERED AND RELEASED TO HOME

Other Meds: AMLODIPINE, METOPROLOL AND VITAMINS

Current Illness:

ID: 1051988
Sex: F
Age: 60
State: NJ

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

Lab Data:

Allergies: ibuprofen, clindamycin, diphenhydramine, fluticasone, levalbuterol, naprosyn, nitrofurantoin, sulfa

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

Symptoms: left arm numbness, flushing sensation and numbness in both legs

Other Meds: spiriva handihaler ketotifen opth

Current Illness:

ID: 1051989
Sex: M
Age: 74
State: UT

Vax Date: 02/13/2021
Onset Date: 02/20/2021
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: None

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

Symptoms: Occasional light dizziness, especially in the morning. Today, dizziness and weakness has been with me at least 50% of the time. Seems to be getting worse.

Other Meds: No prescriptions. Supplements: Daily: Multi-vitamin; fish oil; A-Reds Every other day: Zyrtec 10mg (for itchy skin rash that I've had for a year.

Current Illness: None

ID: 1051990
Sex: M
Age: 79
State: AL

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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: Headache, fever, chills, body aches

Other Meds: statin

Current Illness: no

ID: 1051991
Sex: M
Age: 81
State: MA

Vax Date: 02/09/2021
Onset Date: 02/18/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Light red rash at injection site noticed about one week after shot. Still there two weeks after shot. About two and on half inches in diameter.

Other Meds:

Current Illness:

ID: 1051992
Sex: F
Age: 72
State: MN

Vax Date: 02/20/2021
Onset Date: 02/21/2021
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: No

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

Symptoms: My arm was sore that night and it's still very sore today. Because of my leukemia I have enlarged lymph nodes and the lymph nodes under my arm has been very, very sore. I've had fevers, chills and fatigue. My stomach has been upset since the vaccine and my appetite has been decreased.

Other Meds: diltyazime 180 mg daily atenelol 25 mg daily losartin 100 mg daily levothryoxine .1 mg daily cyclovere 200 mg daily

Current Illness: No

Date Died: 02/14/2021

ID: 1051993
Sex: F
Age: 95
State: NY

Vax Date: 02/05/2021
Onset Date: 02/14/2021
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:

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

Symptoms: Notified on 2/24/2021 that patient passed away on 2/14/2021. Other cause of death - non-covid -19 related

Other Meds:

Current Illness:

ID: 1051994
Sex: F
Age: 60
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergy status to penicillin, Allergy status to other drugs,

Symptom List: Unevaluable event

Symptoms: Patient experienced an allergic reaction . Onsite EMS was called vitals BP 176/104 99% O2 room air HR 95. Patient Treated, Transported by the EMS to the hospital.

Other Meds: Diurex Water Caps Pill

Current Illness:

ID: 1051995
Sex: F
Age: 72
State: NY

Vax Date: 02/15/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sulfa drugs. At least my dermatologist THINKS I had an allergic reaction to that. No other known allergies

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

Symptoms: I had only light soreness within a day of the shot. However, starting about 7 days in, I developed fatigue. Then about day 9, give or take a day, I noticed a large red swelling at the injection site. It doesn't hurt unless you press on it, but I did not have it within the first week and thought I had no side effects.

Other Meds: synthroid, vitamin D, claritin D at night, guggul/red yeast rice, omega 3 fish oil

Current Illness: None

ID: 1051996
Sex: F
Age: 69
State: IN

Vax Date: 02/11/2021
Onset Date: 02/20/2021
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: codeine hydrocodone prednisone Vicodin

Symptom List: Injection site pain, Pain

Symptoms: Had a headache several days after vaccines. Also developed a rash on left arm 9 days after receiving the vaccine. It is warm to touch, very tender and very sore arm

Other Meds: atorvastatin calcium fluticasone propionate metoprolol tartrate multivitamin omega 3-dha-epa-fish oil Probiotic Tylenol Vitamin D3

Current Illness: None

ID: 1051997
Sex: F
Age:
State: IN

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Extreme virtigo, difficulty in walking/ numbness in legs

Other Meds: Lisinopril 15 mg daily and multi vitamin daily

Current Illness: None

ID: 1051998
Sex: F
Age: 77
State: NC

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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: IV CONTRAST DYE

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

Symptoms: PATIENT BEGAN TO FEEL HOT AND SWEATY POST VACCINE

Other Meds:

Current Illness:

ID: 1051999
Sex: F
Age: 70
State: MI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: No

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Sore arm....48 hours

Other Meds: Simvastatin

Current Illness: Covid

ID: 1052000
Sex: F
Age: 70
State: FL

Vax Date: 02/18/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin Latex

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe hives

Other Meds: Multi vitamin

Current Illness: None

ID: 1052001
Sex: F
Age: 77
State: CA

Vax Date: 02/18/2021
Onset Date: 02/19/1921
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: alcohol (drinking), coconut, almond, papaya, pineapple, penicillin,

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

Symptoms: 2/19/21 12:30 AM- slight headache, followed by chills and body ache-especially lower bac. Last until about 4 PM 2/19/21 2/19/21 2:00 AM - discomfort chest/heart- Thought maybe I should mention it to doc if continued. Lasted 20 min. max. 2/19/21 12:30 AM-lower abdominal discomfort, bowel movement did not relieve discomfort - intermittent for several days until 2/23/21. Did not interfere with activities. Since symptoms were mild, I "toughed" it out. No medication

Other Meds: irregular use of Vit. D, Osteoprime, EPA-DHA 7820, Psyllium Husk

Current Illness: none

ID: 1052002
Sex: F
Age: 67
State: FL

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

Symptom List: Nausea

Symptoms: Fever , muscle aches, fatigue for 9 days after second shot

Other Meds: Lamictal

Current Illness:

ID: 1052003
Sex: F
Age: 61
State: WY

Vax Date: 02/08/2021
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: Injection site pain

Symptoms: Per patient, she received her vaccine on 02/08/21 and approximately 24 hours later on 02/09/21, she started hallucinating. Patient denied any other symptoms or events. Patient stated that the hallucinations last about 4-6 hours and then went away. She has not had any other symptoms or hallucinations following this.

Other Meds: Albuterol Inhaler, Albuterol Solution for inhalation, Albuterol/Ipratropium Solution for inhalation, Bupropion, Calcium carbonate, Carboxymethylcellulose oph drops, Cetirizine, Cholecalciferol, Cyclobenzaprine, Docusate, Famotidine, Fish oi

Current Illness: Trouble breathing due to chronic obstructive pulmonary disease (COPD)

ID: 1052004
Sex: F
Age: 64
State: TX

Vax Date: 02/03/2021
Onset Date: 02/03/2021
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: codeine

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

Symptoms: 8 inch area on arm -- red, hot, and hard -- lasted for 9 days

Other Meds: Synthroid tablet

Current Illness:

ID: 1052005
Sex: U
Age: 43
State: OK

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: RA

Lab Data:

Allergies: unknown

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

Symptoms: 11:37: felt rapid HR, c/o blurred vision & headache; 11:41: felt like might pass out, was assisted to floor; 11:43: HR: 85 BP: 135/90 O2: 100%, c/o blurred double vision, headache, & chest pain, & tongue swelling; 11:44 Benadryl 25 mg PO given; still c/o tongue swelling HR: 83; O2 applied at 25L via NC; 11:46: Rapid response team called; 11:48 18g IV started in LAC, Epinephrine 0.3 mg admin IV; 11:53: Slurred speech observed, c/o feeling tired; 11:56: BP: 155/100 HR:85 O2: 100% on O2 of 25L; 11:59: c/o chest pain, stated "tongue not as swollen"; 12:03: Pt alert & orientedx4 BP: 150/100 HR: 85 O2: 100% on 25L; 12:05: Pt on air mattress then transferred to stretcher; c/o Chest pain and dizziness; transferred to ED

Other Meds: lisinopril

Current Illness: unknown

ID: 1052006
Sex: F
Age: 36
State: IA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: No

Symptom List: Tremor

Symptoms: Swollen and painful armpit on the side of infection. Started about 11 hours after infection. Also that the night after injection had shivers and body aches. Next day no shivers but still had body aches. Treating with ibuprofen.

Other Meds: Hair, skin, and nail vitamin

Current Illness: No

ID: 1052007
Sex: F
Age: 38
State: TX

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient experienced lip swelling, facial redness & swelling with tingling. Patient transported to ER for further treatment.

Other Meds:

Current Illness:

ID: 1052008
Sex: M
Age: 83
State: TX

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/24/2021
Hospital: Y

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: daratumumab, amlodipine, honey

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

Symptoms: Fever of 101, chills and profound weakness. Patient was unable to ambulate. Patient was admitted due to these symptoms

Other Meds: Apixaban, benzonatate, calcium carbonate-vitamin D3, donepezil, gabapentin, lysine, metoprolol succinate, mirabegron, mirtazapine, morphine, multivitamin, ondansetron, pantoprazole, pomalidomide, prochloperazine, tramadol, valacyclovir

Current Illness: C. difficile, possibly pneumonia

ID: 1052009
Sex: F
Age: 25
State: MA

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

Lab Data:

Allergies: Gluten Amoxicillin Augmentin

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

Symptoms: Vision was off for about an hour. Felt like my eyes weren?t focusing properly, but did not impact my overall vision.

Other Meds: Prozac Lunesta Multi vitamin Probiotic

Current Illness: None

ID: 1052010
Sex: F
Age: 65
State: AZ

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

Lab Data:

Allergies: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: on the 23rd of Feb in the afternoon I noticed that my arm started to hurt and I had a dull ache in my armpit. My husband remarked that the site where I got the shot was warm and tight. It was painful. the right side of my neck is stiff feeling as well.

Other Meds: atorvastatin Clonazepam Melatonin Vitamin D Fyflamend Ibuprofen occasionally marijuana candy for pain

Current Illness: Sinus issues

ID: 1052011
Sex: F
Age: 28
State: IA

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: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Moderna COVID-19 Vaccine EUA Joint aches, hot flashes, headache, mild dizziness, difficulty concentrating

Other Meds: Amphetamine 10mg Fluoxetine 20mg nexplanon implant

Current Illness: none

ID: 1052012
Sex: F
Age: 71
State: NM

Vax Date: 12/30/2020
Onset Date: 01/01/2021
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:

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

Symptoms: Initially on Friday onset of diarrhea, followed by fever to 101 if I remember correctly maybe slightly above that, cough, debilitating fatique and bone aches and chills and headaches lasting until almost 5 January. Second shot administered 01-18/2021 Pfizer Lot #EL3249 - again, significant fever, terrible chills and bone aches lasting approx 4-5 days.

Other Meds: Metroprolol Mo,ntelukast 81 aspirin Flovent

Current Illness:

ID: 1052013
Sex: F
Age: 71
State: NC

Vax Date: 02/22/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: swollen lymph node in neck on left side, same side as lymph nodes surgically removed

Other Meds:

Current Illness:

Date Died: 02/15/2021

ID: 1052014
Sex: F
Age: 91
State: TX

Vax Date: 02/06/2021
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: None

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

Symptoms: Extreme difficulty breathing upon exertion, collapsed shortly after walking started, loss of conciousness, and death

Other Meds: Digoxin, Levothyroxine, Atorvastatin, Pregabalin, Sertraline, Monteleucast, Tylenol, Aspirin 81 mg,, Vitamin D3, Vitamin C, probiotic, Benadryl

Current Illness: COPD exascerbation' UTI flare-up

ID: 1052015
Sex: F
Age: 33
State: OH

Vax Date: 12/29/2020
Onset Date: 01/08/2021
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: none

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

Symptoms: 10 days after the first does of the moderna vaccine the injection site developed a hive - red, swollen, painful, slightly itchy. Notified work and my PCP via message with picture. PCP instructed me to use antihistamine such as zyrtec or claritin due to it seeming to be allergic reaction. I took benadryl that night and used hydrocortisone cream on the site. Symptoms were improved the next morning, and resolved by day 3.

Other Meds: Propranolol 80 mg QD Flecainide 50 mg BID Balcoltra Vitamin D 2000 IU QD Xyzal QD Flonase QD

Current Illness: none

ID: 1052016
Sex: F
Age: 56
State: TX

Vax Date: 02/15/2021
Onset Date: 02/23/2021
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: Pollen, dogs, cats, dust

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

Symptoms: swelling, redness, itching at injection site beginning 8 days after injection

Other Meds: Allegra, Lexapro, Nexium

Current Illness: none

ID: 1052017
Sex: M
Age: 64
State: MT

Vax Date: 02/12/2021
Onset Date: 02/16/2021
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:

Symptom List: Vomiting

Symptoms: Chills & Upset Stomach

Other Meds:

Current Illness:

ID: 1052018
Sex: F
Age: 82
State: NC

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: BODY FLUSHING, CHEST PAIN PATIENT EVAULATED BY EMS FOR 40 MIN VITALS STABLE AND SYMPTOMS RESOLVED

Other Meds:

Current Illness: DM, HTN

ID: 1052019
Sex: F
Age: 58
State: OH

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: Penicillin, Cipro, Pseudaphed

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

Symptoms: Tinnitus began approximately a day later but not sure on the exact date. Still present. Believe it is in both ears, although difficult to tell.

Other Meds: generic Synthroid and Crestor, 50,000 vitamin E, Daily: multivitamin, vitamin C, Calcium, Krill Oil

Current Illness: approaching pre-diabetic status

ID: 1052020
Sex: M
Age: 71
State: NY

Vax Date: 01/27/2021
Onset Date: 02/16/2021
Rec V Date: 02/24/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Acute Myocardial Infarction on 2/16/2021 Patient had a CABG performed on 2/17/2021 Patient is post-surgery - remains hospitalized

Other Meds:

Current Illness:

ID: 1052021
Sex: F
Age: 35
State: IA

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: Fish and all seafood

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

Symptoms: Anaphylactic Shock. 10 minutes after injection - vomiting, shortness of breath, throat swelling, chest pain. Self-administered EpiPen and went to the ER, given multiple doses of epinephrine, solumedrol, Benadryl, Pepcid. was monitored overnight and sent prednisone and Pepcid.

Other Meds:

Current Illness:

ID: 1052022
Sex: M
Age: 55
State: TX

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

Lab Data:

Allergies:

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

Symptoms: Patient experienced a rash that started on chest & spread out, but only lasted about 2 minutes.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm