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: 1052497
Sex: F
Age: 42
State: MI

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

Lab Data:

Allergies: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever, child, muscle aches, slight nausea and headache

Other Meds: Multi vitamins and fish oil

Current Illness: No

ID: 1052498
Sex: F
Age: 50
State: CA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sensitivities: Corn; Eggs; Dairy; Gluten; Legumes Allergy: Ergot Alkaloids ex. Methergine, Ergomar, Ergostat, DHE-45

Symptom List: Anxiety, Dyspnoea

Symptoms: Swelling, Redness & Pain at injection site. Size of approximately a $1 coin; Pain throughout Left side of body, particularly neck, shoulder, **shoulder blade through back

Other Meds: Levothyroxin; Lamictal; Propranolol; Naltrexone; Seroquel; Zolpidem; Trintellix; Mucinex D; Advil or Tylenol

Current Illness:

ID: 1052499
Sex: F
Age: 32
State: PA

Vax Date: 01/27/2021
Onset Date: 02/04/2021
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: On Day 8 following vaccination, pt reports developing a red circle around the injection site. Denies itching or pain. Lasted approximately 5 hours then went away. Patient denies treatment or medication.

Other Meds:

Current Illness:

ID: 1052500
Sex: F
Age: 68
State: CA

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: macro ditin, bismuth subsalicylate

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Swelling in throat, tongue, face and then eyes. fast heart rate. rash on face and dizziness and weakness Give prednisone and benydrl in IV and took 1 50mg prednisone at home. Weakness for 3 days and swelling has gone down

Other Meds: Alve only

Current Illness: none

ID: 1052501
Sex: F
Age: 43
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: Bactrim, ciprofloxacin

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

Symptoms: 43 yo female received second dose of Moderna COVID-19 vaccine on 1/27 @1239. Approximately 10 minutes after administration, patient began experiencing lip tingling and sensation of itchiness in throat. Patient given cetirizine and famotidine without relief. Patient continued to report lip and tongue tingling/burning, dry cough, and sense of anxiety. Upon examination by physician, no tongue swelling, stridor, or wheezing observed. Mild erythema noted on chest, not neck. Diphenhydramine 25mg oral solution was administered and close monitoring continued including serial tongue examination and throat/lung auscultation. BP 138/82, HR 84. Approximately 5 minutes after the dose of diphenhydramine, noted a new sense of altered speech and shortness of breath. Tongue noted to be mildly edematous, increased as compared to prior exams, with clear view of oropharynx, still with no stridor or wheezes. Epinephrine pen 0.3 mg was administered to left thigh. EMS was called at this time as well, and 2L supplemental oxygen was administered. Noted improvement in symptoms after the epinephrine and tongue appearance returned to normal within about two minutes, speech normal. Continued to report feeling anxious. BP 143/80, HR 116 after epinephrine. EMS arrived and handoff given. Dexamethasone 8 mg, diphenhydramine 25 mg and lorazepam 0.5 mg given in the ED. Patient eventually asymptomatic after 4 hours and discharged with EpiPen prescription @2051 that same day. Patient reported having urticarial and rash after her first vaccine. She has never had an anaphylactic reaction before, but did develop mucosal blisters with Bactrim and ciprofloxacin.

Other Meds:

Current Illness:

ID: 1052502
Sex: F
Age: 71
State: NY

Vax Date: 02/21/2021
Onset Date: 02/22/2021
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: When the patient returned for her second dose she reported that she had pain and a marked decrease in mobility in that arm and shoulder for about 2 weeks. She stated it is much better but still sore to the touch. She left the original band-aid in place from that vaccination and indeed, a worn band-aid was in place. The injection site was very high in the left shoulder, near the boney prominence.

Other Meds:

Current Illness:

ID: 1052503
Sex: F
Age: 52
State: VA

Vax Date: 02/09/2021
Onset Date: 02/12/2021
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: Pyrexia, White blood cell count decreased

Symptoms: shingles Right side of chest/pain from right back through right breast

Other Meds: Norvasc , Vit d

Current Illness: dizziness/Pots syndrome

ID: 1052504
Sex: F
Age: 50
State: AL

Vax Date: 02/12/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Delayed rash. Not itchy. Red around injection site.

Other Meds: I got the Moderna vaccine and now I have a non itchy red rash around injection site. I Googled it and it appears to be "Covid arm".

Current Illness:

ID: 1052505
Sex: M
Age: 60
State: CA

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: Eliquis , Plaquanil

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Upset stomach, headache, severe entire body aches short of breath, diarrhea, chest pressure, chills, fever and body weakness. Talk to Dr. and she recommended to drink plenty of fluids, take Tylenol , and rest.

Other Meds:

Current Illness:

ID: 1052506
Sex: F
Age: 76
State: PA

Vax Date: 02/13/2021
Onset Date: 02/24/2021
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: Bee stings Ct scan dye

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Left arm Pain at injection site Redness Swelling

Other Meds: High blood pressure Cholesterol

Current Illness: None

ID: 1052507
Sex: F
Age: 69
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: antibiotics

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

Symptoms: syringe failed and part of the dose leaked down her arm

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1052508
Sex: F
Age: 66
State: MA

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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Numbness/Tingling on left side of face under eye and lips (primary) Started after injection, stopped and started up again 2/23/2021 Numbness/Tingling on left arm ER Visit 2/23/21 : Covid tested (negative), Blood Work, EKG, Neurology Visit GOOD

Other Meds:

Current Illness:

ID: 1052509
Sex: F
Age: 81
State: CA

Vax Date: 02/13/2021
Onset Date: 02/14/2021
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: Penicillin

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

Symptoms: Rash on chest area, headache and muscle aches Lasted 2 days. Rash still on chest

Other Meds: Entresto

Current Illness: N/a

ID: 1052510
Sex: M
Age: 69
State: FL

Vax Date: 02/06/2021
Onset Date:
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: Lisinopril - swelling

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

Symptoms: 1-16-21 @ approx 1pm 2-6-21 @ approx 1:30pm Pfizer LOT # EL8982 Pfizer LOT # EL9262 pain to arms, throbbing to injection area, pain to neck started has been for a few weeks. unknown onset

Other Meds: amlodipine 10mg Daily rosuvastatin 5mg Daily hydrochlorothiazide 25mg Daily ASA 81mg Daily multi vitamin vit C 1000mg Daily D3 2000 IU Daily fish oil 1200mg w/omega 3 360mg Daily

Current Illness:

ID: 1052511
Sex: F
Age: 68
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: sulfa

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

Symptoms: she felt unsteady, off balance when walking x 24 hours

Other Meds: amitriptyline 75 mg tabs, TAKE 1 TABLET DAILY AT BEDTIME atorvastatin 10 mg PO qday 03/20/2020 - Present 10 mg PO qday celecoxib 100 mg PO bid as needed for pain clonazepam 0.5 mg tabs, 1 tab PO bid Estrace vaginal 0.01% (0.1 mg/gram) crea

Current Illness: none

ID: 1052512
Sex: F
Age: 74
State: TX

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

Lab Data:

Allergies: Demerol, Adhesive tape

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

Symptoms: Extreme red rash at injection site. Area approximately 4 1/2 inch long, 2 inches wide occurred on the 22nd. Rash became feverish and swollen. Because of previous reaction to injection 1 and doctor's recommendation, I began taking Benadryl on the 21st. I'm continuing to take Benadryl every day and using an ice pack occasionally. Reported rash on 1st injection on January 27.

Other Meds: Atorvastatin, Paroxetine, Propranolol, Fosamax, Prilosec, Fish Oil, Naproxen

Current Illness: None

ID: 1052513
Sex: M
Age: 23
State: NM

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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:

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

Symptoms: Patient reported itching all over a few minutes after receiving vaccine. Patient said he felt fine other than that. I advised patient to take Benadryl.

Other Meds:

Current Illness:

ID: 1052514
Sex: F
Age: 43
State: OH

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Became lightheaded/faint and had facial flushing. Unable to stand up for fear of syncope.

Other Meds:

Current Illness:

ID: 1052515
Sex: M
Age: 68
State: NY

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Much like my experience of COVID in 3/2020 and after my first shot of vaccine in 1/2021: extreme chills, extreme achiness, extreme weakness & fatigue, extreme dry mouth, extreme chapped lips. Duration of side effects after first shot was 4 days; duration after second shot was 48 hours, with lingering fatigue & dry mouth until at least a week after the shot. Symptoms, though severe, resolved themselves in the time frames described above.

Other Meds: RS meds, vitamins & supplements 12.4.2020 Rx: Amlodipine Besylate Tabs 10 mg?1 tablet/day (substitute for Nifedipine ER (CC) 90 mg) Metoprolol Succ (Toprol) ER?100 mg?1 tablet/day Losartan?100 mg?1 tablet/day Atorvastatin?40 mg?1 tablet/

Current Illness: None

ID: 1052516
Sex: M
Age: 68
State: SC

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

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

Symptoms: In under two minutes fainted. Believed to be Vasovagal syncope although patient has never fainted in the past and even with getting other vaccines.

Other Meds: The night before I took: Paroxetine 10 mg , Meloxicam 15 MG , 1 Benedryl , Vitamin C, D, Zinc and Quercitin. The morning of my vaccine I took: LisinopriL 10 mg , Omega 3, Curcumin and a joint supplement. Also took Sudafed PE 10 mg and/o

Current Illness: Having a stuffy nose for about two weeks

ID: 1052517
Sex: M
Age: 84
State: TN

Vax Date: 01/30/2021
Onset Date: 02/01/2021
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: NKA

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

Symptoms: A FEW DAYS AFTER GOT 2nD COVID VACCINE STARTED TO HAVE RASH ON OPPOSITE ARM/SHOULDER THAT HE GOT VACCINE IN. SINCE THEN IT HAS SPREAD TO BOTH SHOULDERS AND TO NECK. SEEN PCP AND WAS PRESCRIBED SOME OINTMENT AND HAS BEEN TAKING BENEDRYL

Other Meds: COREG, LASIX, ALLOPURINOL, TAMULOSIN, POTASSIUM

Current Illness: NONE

ID: 1052518
Sex: F
Age: 32
State: GA

Vax Date: 12/29/2020
Onset Date: 01/05/2021
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: Unevaluable event

Symptoms: sudden constant eruption of cystic acne on chin, back, and chest; not alleviated by any OTC medications. Menstrual cycles, post-vaccine, pain/longevity/heaviness incredibly increased.

Other Meds: NA

Current Illness: NA

ID: 1052519
Sex: F
Age: 40
State: FL

Vax Date: 02/23/2021
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: nka

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

Symptoms: Client complained of itchy throat. seen and assessed by EMS. Vitals are as follows: B/P 107/72, HR-109, O2-99. Client denies any other symptoms and verbalized decrease is sensation. Client cleared by EMS to go home. Client advised to seek MD if symptoms worsen.

Other Meds: none

Current Illness: none

ID: 1052520
Sex: F
Age: 58
State: MI

Vax Date: 12/29/2020
Onset Date: 01/04/2021
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: Seasonal Allergies(dust, mold)

Symptom List: Injection site pain, Pain

Symptoms: I exp on welts on face/throat which lasted 3 days. I had continued itchiness around jawline for weeks. Shortly after that exp itchiness under left arm and I also exp short periods of dizziness repeatedly for first month of vaccine. As of today not exp dizziness.

Other Meds: Hydrochlorizide, Potassium,Multi Vit with minerals

Current Illness: No

ID: 1052521
Sex: M
Age: 20
State: FL

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

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

Lab Data:

Allergies: Chocolate, Dust, Peanuts

Symptom List: Injection site pain, Menorrhagia

Symptoms: 20 year old with cerebral palsy, chronic bronchitis, G-tube dependent received COVID 19 vaccine approximately 1030 on 2/18. Within 5 minutes c/o headache and had audible wheezing. He was treated with Benadryl in the vaccine clinic. He was taken to ER noted to be in resp distress. He received IM epinephrine and symptoms quickly improved. Less than an hour later was again noted to be wheezing and in respiratory distress. He was treated with second IM epinephrine, albuterol, steroids, and antihistamines. Admitted into PICU overnight and remained asymptomatic. Patient received the pneumococcal and influenza vaccines 3 days prior. Has never had any similar reactions in the past. Patient was discharged on 2/19.21.

Other Meds: montelukast; lactulose

Current Illness: None

ID: 1052522
Sex: M
Age:
State: NC

Vax Date:
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: SYR
Vax Site: LA

Lab Data:

Allergies: penicilon

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

Symptoms: Bad chills, slight fever that night for about 1 hour and moderate chills next morning for 15/20 minutes.

Other Meds: carvidol,spiron./hctz

Current Illness: none

ID: 1052523
Sex: M
Age: 26
State: NM

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt recived his second Moderna vaccine 2/15/21, and on 2/16, staff at pt's group home noted pt was unable to walk although pt previously ambulatory (could go on long hikes prior to acute illness). Pt was grabbing his legs and rubbing them, and initially staff thought it was pain that would resolve. However, on 2/22, lower extremity edema was noted, and pt without improving symptoms, so he was brought to the hospital for evaluation and treatment. GBS suspected, IVIG initiated.

Other Meds: Aripiprazole 15 mg daily, clonidine 0.1 mg QHS, diazepam 10 mg BID, divalproex 1000 mg PO BID, fluphenazine 10 mg AHS

Current Illness: None other than chronic conditions

ID: 1052524
Sex: F
Age: 53
State: KY

Vax Date: 01/11/2021
Onset Date: 01/12/2021
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: unknown

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 11 January 2021 ~6pm: Patient developed a rash underneath her right arm, neck, trunk that was itchy/burning/painful. January 12, 2021: Rash spread more under right arm, top arm, belly and back. January 21, 2021: Patient had been taking benadryl since January 12th, but rash was still present and spreading. Patient came in to see Prev Med Doctor on 21 January.

Other Meds: unknown

Current Illness: unknown

ID: 1052525
Sex: F
Age: 33
State: CT

Vax Date: 02/15/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: About 8 hours after shot was administered, a severe, painful headache began. A temperature of over 102 with convulsing chills, hot and cold sweats, and fatigue and body aches. The fever did not drop below 100 for 2 days after the shot. The body aches lasted over 24 hours. Was not able to get out of bed for nearly 48 hours after symptoms began. I developed a dry cough that last for a week after all other symptoms subsided. The headaches came and went but never as severe as the first night. Usually just a dull throb. The pain in the injection site was far less than with the first shot but still sore for a few days post shot.

Other Meds:

Current Illness:

ID: 1052526
Sex: M
Age: 33
State: IA

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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Headaches, bodyaches. ringing in the back of the ear, fever, nausea, .. Took Tylenol to help with the headaches and fever. All those adverse affects disappeared about 16 hours after they appeared.

Other Meds:

Current Illness:

ID: 1052527
Sex: F
Age: 72
State: VA

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sulfa

Symptom List: Injection site pain

Symptoms: the evening after 8 days of receiving my vaccine, my left arm around the shot site began to get sore and became swollen to about the circumference of a soft ball. A rash appear in the area. I did feel fatigue all day. This is the next day. The rash is gone but the area is still sore, red, hard, and swollen. I have no fever. I feel no fatigue. I had no side effects at the time of the shot except for a sore arm for a couple of days and I also felt cold the first day. I just want to report this side effect that hit me last night. I plan on icing and taking Advil.

Other Meds: valtrax, hydrochlorothiazide, atorvastatin, flax oil, vitamin D, probiotic, Vit B12

Current Illness: no

ID: 1052528
Sex: F
Age: 37
State: MA

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

Lab Data:

Allergies: Egg

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

Symptoms: Hives, swelling, growing redness and hard lump began on 2/22/2021?8 days after shot

Other Meds: Celexa Labetalol

Current Illness: No

ID: 1052529
Sex: F
Age: 91
State: WI

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: Azithromycin

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

Symptoms: Dizziness/vertigo, nausea, vomiting, chills started at about 7:30 am on 2/20/2021. This was the day after I received the vaccine. Nausea and vomiting subsided around noon. Chills were ongoing through out the day. On and off vertigo episodes continued through 2/23/2021. All symptoms subsided by 2/23/2021. Also had a very sore left arm.

Other Meds: Eliquis 5 mg ; Aspirin 81 mg; Atorvastatin 10 mg; diltiazem 120 mg; benadryl 25 mg; colace 100 mg; lasix 20mg; melatonin 25mg; prilosec 40 mg;

Current Illness: None

ID: 1052530
Sex: M
Age: 64
State: PA

Vax Date: 02/19/2021
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: NKDA

Symptom List: Tremor

Symptoms: Approximately 23 hours after vaccination, erythematous rash on face, trunk/back & arms, not noted on lower extremities. Mild tingling. No other symptoms at all. Rash subsided spontaneously in 2-3 hours. The question is: Should 2nd vaccine dose be given and if so should it be given in a facility better equipped? PCP has not responded to this question.

Other Meds: Irbesartan

Current Illness: None

ID: 1052531
Sex: F
Age: 65
State: AR

Vax Date: 02/11/2021
Onset Date: 02/19/2021
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: Nka

Symptom List: Erythema, Pruritus

Symptoms: On day 8 I awoke with an extremely itchy bump at the shot site. By the end of the day there were two bumps. On day 9 there was a 4? itchy red circle. It was warm to the touch but no pain. Just itchy.

Other Meds: Generic Zyrtec

Current Illness: None

ID: 1052532
Sex: F
Age: 41
State: FL

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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:

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

Symptoms: asked me to reach out to you in regards to a COVID Vaccine Reaction I had yesterday. I received my first shot on Tuesday around noon and yesterday I experienced shortness of breath, headache and muscle pain. I ended up in the ER. The ER doctor advised for me to stay home for a few days to make sure everything calms down.

Other Meds:

Current Illness:

ID: 1052533
Sex: F
Age: 75
State: FL

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

Lab Data:

Allergies: amoxicillin, lidocaine

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

Symptoms: 2/19 woke up with pain in right arm, swelling at site, hot to touch, reddish discoloration, stinging, itchy, and noted right above the swollen are three red areas size of tip of my pinky. (these redish spots same on my first vaccination). A few hours after I took my temp and was 99.1. I double checked and 99.1. I took one Motrin for fever and couple hours no fever. Today 2/24= Lump swelling decreased and warm to touch. I have been applying Hydrocortisone Cream 1% for mild itching.

Other Meds: all rx was taken few hours after receiving vaccination #2 and were Amlodopine, baby aspirin, & Atorvastatin

Current Illness: none

ID: 1052534
Sex: F
Age: 57
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NSAIDS

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: within 24 hours extreme fatigue then shortness of breath, palpitations chest tightness at 48hours started having itching in throat and lump in neck/throat. Family doctor prescribed a steroid injection celestone 12mg once followed by a prednisone taper of 40mg, 30mg, 20mg, 10mg over then following 4 days and benadryl for itching

Other Meds: unknown

Current Illness:

ID: 1052535
Sex: F
Age:
State: TN

Vax Date: 02/01/2021
Onset Date: 02/03/2021
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: Cipro, sulfa drugs

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

Symptoms: Next morning there was a red dome size spot on injection site that gre to baseball size that lasted 17 days. Along with redness I had itchiness and swelling at the same spot and it was hot to the touch.bonbthe 14 the day I used ice for two days and took over the counter benadryl for two days. It didn't seem to help so I stopped taking the benadryl and using ice on the 14th day and around day 17 it went a way leaving a shadow of a spot of where the redness once was

Other Meds: Carvedilol, avorstatin, prilosec, percocet, vitamin d3 ,

Current Illness: None other than my copd and my back problemd

ID: 1052536
Sex: F
Age: 50
State: FL

Vax Date: 02/03/2021
Onset Date: 02/13/2021
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: Swelling, Readness, warm to touch, shortness of breath

Other Meds:

Current Illness:

ID: 1052537
Sex: F
Age: 47
State: AZ

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: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Pain in extremity

Symptoms: Heart rate spiked after vaccine. Received shot at 4:30pm. At 4:45 was cleared to leave and left the vaccine facility. At 4:56, the heart rate monitor on my watch alerted me to an abnormally high heart rate of 153. It went up to 155 before gradually returning to my normal heart rate of around 55. The spike and return to normal happened over the course of about 10 minutes. No shortness of breath or other symptoms to report.

Other Meds: none

Current Illness: none

ID: 1052538
Sex: F
Age: 83
State: WA

Vax Date: 02/19/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: codine

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

Symptoms: Red skin, hot to the touch, itches Started the day after, and continues to today five days. Slowly getting better.

Other Meds: losartan, levothyroxine

Current Illness:

ID: 1052539
Sex: F
Age: 26
State: MN

Vax Date: 01/11/2021
Onset Date: 02/04/2021
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: Very sore left arm/shoulder, unable to lift up over head for a week after. Now, over a month later it is still sore and stiff especially moving a certain way, sleeping on it, and in the morning.

Other Meds: none

Current Illness: none

ID: 1052540
Sex: F
Age: 36
State: NH

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 02/24/2021
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: n/a

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

Symptoms: 1/6 vaccination 1/7 typical immune system response; recovered in 12 hours. 1/8 Woke up and my left hand was weak, numb and tingling in glove distribution. The right hand started to have problems as evening came. The right hand resolved within 12 hours. The left hand symptoms persisted for 6 weeks. *unable to work for 6 weeks. **Still having symptoms in middle finger, pointer finger; left hand. 1/8 I went to urgent care; referred to ED. They did put me in the clinical observation unit, discharged the next day. I went to PCM 2 days later. Dr. didn't know what to think of symptoms. Had me try some steroids. Hospital referred me to neurology; He had me do another MRI (1st in the ER). EMG. He didn't find anything unusual except some nerve damage; carpal tunnel *Symptoms are still persisting. It has gotten better but the 2 fingers are still an issue.

Other Meds: Zoloft

Current Illness: n/a

ID: 1052541
Sex: M
Age: 68
State: WA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/A

Symptom List: Vomiting

Symptoms: Within an hour of receiving 2nd dose started experiencing headaches and dizziness. In addition to the headaches and severe dizziness I started having significant bouts with diarrhea, malaise, loss of appetite and have not slept well. Within a couple days I noticed pronounced tremors in my right hand and I started losing weight from 180 pounds to 157, around 23 pound loss. I contacted my physician and was alerted to make this report and have an appointment on March 1.

Other Meds: Spiriva Respimat 2.5mcg; Proair HFA albuterolsulfate; Symbicort 160/4.5; vitamin D 25 mcg and Metamucil fiber supplement

Current Illness: None

ID: 1052542
Sex: F
Age: 44
State: NY

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 2/22 body aches, fever, rigors, fatigue 2/23 R axillary lymphadenopathy, pain in axilla, shoulder and arm, fever, fatigue, myalgias 2/24 low grade fever, otherwise same as 2/23

Other Meds: Zoloft Multi vitamin Elderberry

Current Illness:

ID: 1052543
Sex: F
Age: 78
State: GA

Vax Date: 02/01/2021
Onset Date: 02/19/2021
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: Crabmeat, Zoysyn Piperacillin, Flagyl, Augmentin

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

Symptoms: After Dose #2 Muscle swelled and red mark just below vaccination site same day. Next day fatigue, chills, sweats, diarrhea, low grade fever, burping Next day pain above stomach below breast bone, nauseau, vomiting, indigestion, burping. Next day arm still swollen, red spot much larger, itchy, hot.

Other Meds: Fish Oil, Livalo, Synthroid, Lisinipril, Pentasa, Caltrate plus D, Multi Vitamin, Vitamin C, Hair Skin Nails w/ Biotin

Current Illness: None

ID: 1052544
Sex: M
Age: 79
State: WV

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: This was an administration error. All documentation provided to us shows that the patient received 3 doses of the Moderna Vaccine. 1st on 12/20/20, 2nd on 1/20/21, and 3rd on 2/23/21. Patient/LTCF has not reported any adverse side effects

Other Meds: Unknown

Current Illness: Unknown

ID: 1052545
Sex: F
Age: 83
State: OR

Vax Date: 02/16/2021
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: RA

Lab Data:

Allergies: none

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

Symptoms: inject site was sore 2-3 days then became itchy and red 3-6 days now itchy red swollen warm with small infection site 6-8 days

Other Meds:

Current Illness: none

ID: 1052546
Sex: F
Age: 73
State: MO

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: Pfizer COVID 19 vaccine given 01/22/21. Patient reports severe arm pain the following day. She presented to ED and was seen by a provider who believes she may have bursitis or tendonitis secondary to the vaccine. I followed up with her 02/16/21 and she is still experiencing severe pain and unable to use that arm. She has an appointment scheduled with an orthopedic specialist 02/18/21 for further evaluation.

Other Meds: Unknown

Current Illness: Unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm