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: 1053223
Sex: F
Age: 57
State: PA

Vax Date: 02/10/2021
Onset Date: 02/19/2021
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: Tetracycline, Talwin, Wellbutrin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Developed Covid Arm. Red itchy circle at injection site approx 2 inches in diameter with firm lump underneath. The date I first noticed it is approximate. It?s almost gone and it?s been approx 4 days. Did not need any treatment.

Other Meds: Keytruda, Carvedilol, Valsartan, Levothyroxine, Atorvastatin, Myrbetriq, Paroxetine, Multi-vitamin

Current Illness:

ID: 1053224
Sex: M
Age: 66
State: MN

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:

Symptom List: Anxiety, Dyspnoea

Symptoms: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1053225
Sex: M
Age: 96
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Recently my grandfather presented at clinic for a flu shot, and received a COVID vaccine in error. He had received his first (Pfizer) vaccine dose 9 days prior. This incident is being reported because we are concerned about (i) mixed series (1st dose Pfizer on 2/9; 2nd dose Moderna on 2/18), (ii) Interval error (10 days between 2 series), and (iii) immunity concerns (Moderna 28; Pfizer 21 days). He reports feeling fine, and we are closely monitoring him during this time.

Other Meds:

Current Illness:

ID: 1053226
Sex: M
Age: 74
State: MN

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered. The patient has not reported any adverse effects at this time.

Other Meds:

Current Illness:

ID: 1053227
Sex: F
Age: 86
State: TN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: LA

Lab Data:

Allergies: penicillins tramadol

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

Symptoms: 2.12-fever, flu-like symptoms, confusion and disorientation 2.15 - resident presented with extreme confusion and weakness in arms and legs. unable to do usual daily activities. unable to self-transfer. Taken to ER and diagnosed with UTI. 2.18 - resident complained of headache and being unable to sleep previous night. VS: temp 101.8; BP:135/63; P:93; R:20; SP02:79-80%; HOB elevated. Resident send to ER via ambulance. Diagnosed with pneumonia. hospitalized for 5 days.

Other Meds: amlodipine lantus letrozole levothyroxine cetirizine escitalopram pantoprazole tresiba melatonin donepezil cerovite metamucil vitamin D3 janumet carvedilol irbesartan tobramycin diclofenac gabatenin humalog lorazepam polyethelene glycol

Current Illness: n/a

ID: 1053228
Sex: M
Age: 75
State: MN

Vax Date: 02/23/2021
Onset Date: 02/24/2021
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: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1053229
Sex: F
Age: 54
State: UT

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: In March 2019 had large welts after shingles vaccine. In 2020 had throat swelling after shingles vaccine. Her MD was notified.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Sore, raspy throat, felt like it was closing. Lump in throat. Lightheaded and increased HR. Nurse administered 12.5 mg/5ml Benadryl and monitored pt until symptoms lessened. Instructed to go to ER if symptoms returned or pt. has difficulty breathing.

Other Meds: Took Losartan and Jenadueto in morning prior to vaccine.

Current Illness:

ID: 1053230
Sex: F
Age: 49
State: CA

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: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Pt reported tongue numbness and mild swelling. Observed mild tongue swelling. BP noted to go high up to 186/90, and came back down to 145/92 over the course of about 30-40 minutes. Otherwise vitals normal, tongue swelling improved, symptoms improved. No meds given. Pt remained calm and spoke with clear speech the entire time.

Other Meds:

Current Illness: COVID positive 1/2021

ID: 1053231
Sex: F
Age: 70
State: MN

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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1053232
Sex: F
Age: 34
State: OH

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

Lab Data:

Allergies: Eggs, peanuts, tree nuts, and some animals (reaction is throat swelling)

Symptom List: Diarrhoea, Nasal congestion

Symptoms: No symptoms with first dose, but 10-15 minutes after receiving her second dose of Pfizer vaccine, her throat began to swell and she felt dizzy. EMS came to take her vitals and gave her oral Benadryl. The patient felt much better after 15 minutes. She said it was a similar reaction to when she is exposed to eggs or nuts.

Other Meds: N/A

Current Illness: None

ID: 1053233
Sex: M
Age: 94
State: SC

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

Lab Data:

Allergies: PCN nexium

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

Symptoms: tonic clonic seizure hospitalized for observation

Other Meds: q HS afluzocin prn TUMS slow iron

Current Illness: n/a

ID: 1053234
Sex: F
Age: 40
State: CA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: I noticed about 2:15 (15 minutes after injection)my elbow (funny bone) was very sensitive. Then the pain went up my arm, over my left shoulder blade, up the left side of my neck, and up into the left side of my chest. It has lasted and seemed to be more intense more than 24 hours after. 1:00pm the next day, I got extremely light headed and dizzy, sat down and it went away after a couple of minutes. Called my Primary Dr. and was told to report it. I will be seeing a Dr tomorrow the 25th. The pain, I thought was maybe a hit nerve from the injection, its kind of like an electronical zap

Other Meds:

Current Illness: Liver Disease with Cirrhosis

ID: 1053235
Sex: F
Age: 65
State: MN

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:

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

Symptoms: Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered. The patient has not reported any adverse effects at this time.

Other Meds:

Current Illness:

ID: 1053237
Sex: F
Age: 73
State: CA

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

Lab Data:

Allergies: none

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

Symptoms: chils, fever extreme body aches for about 30 hours. Injection site and surrounding area was swollen and started itching. Has been itching since 2/9/2021 . Yesterday 2/23/2021 I developed a rash in that area and it itches.

Other Meds: None

Current Illness: Cirrhosis of the liver stage IV

ID: 1053238
Sex: F
Age: 81
State: OR

Vax Date: 02/14/2021
Onset Date: 02/15/2021
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: Trazadone Sulfites

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

Symptoms: Hives /Urticaria on lower back and up between shoulder blades. Extremely itchy. Came on about 1 day after the vaccination and has not improved in 9 days. Very concerned about whether or not to get the second dose! Please contact me with any advice on this.

Other Meds:

Current Illness:

ID: 1053239
Sex: M
Age: 63
State: TX

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

Lab Data:

Allergies: Bee sting

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

Symptoms: I had a nasty reaction to 2nd dose of Moderna 8-12 hours after. Began with body aches and chills so severe it was hard to breath. No fever. When I got under covers and warmed up so chills subsided and breathing returned to normal it felt like I was being squashed in a Panini press. Every cell in my body felt like it was vibrating in pain. I had to get up ever hour or so to urinate. I would be back in sever chill mode before i made it to the bathroom and it took about 5 minutes back in bed for chills to stop and breathing back to normal. I was also nauseous the whole time but did not vomit Then. The room temperature was 72F. This continued for 12-14 hrs. I then tried to drink cranberry juice and eat 3 bites of a banana which I immediately regurgitated. The rest of the day I was drained of energy. No sleep 48hrs. 3 days

Other Meds: Atorvastatin, Nexium, Finasteride, Fluticasone Propionate spray, Losartin/HCTZ, Certraline, Amlodopine, Budesonide w/saline nasal rinse Aspirin, Zyrtec,Centrum silver,Glucosamine/Chondrointin,Preservision,Pre/pro-biotics, fish oil,Vit C,Dox

Current Illness:

ID: 1053241
Sex: F
Age: 36
State: MA

Vax Date: 02/23/2021
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: Apples and cherries

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

Symptoms: Rash on neck and chest, itchy.

Other Meds: Advil

Current Illness: NA

ID: 1053242
Sex: F
Age: 74
State: WA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: When vaccination was being conducted, the entire dose of 0.5 cc ran down his arm. After consulting with agency doctor, he ordered that a full dose be administered.

Other Meds: NA

Current Illness: NA. Client passed screening questions

ID: 1053243
Sex: F
Age: 22
State: OH

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: nortriptyline, kiwi

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient felt dizzy, nauseas, and lightheaded like she might pass out. EMS came to take a look at her. Her blood pressure was elevated and her heart beat was rapid. This was not typical for her after vaccines. She felt this way around 5 minutes after receiving her second vaccine.

Other Meds: hydroxyzine, nuvaring

Current Illness: Had COVID in November (over one month prior) ; was hospitalized for 5 days (Cardiac SVT)

ID: 1053244
Sex: F
Age: 74
State: CA

Vax Date: 02/24/2021
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:

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

Symptoms: Ringing in my ears and feeling flushed. Not serious, but friends insisted I report it. I didn?t go to the Doctor or feel I required any care.

Other Meds: Armour thyroid , Welbrutin, DHEA, D3

Current Illness:

ID: 1053245
Sex: F
Age: 44
State:

Vax Date: 02/23/2021
Onset Date: 02/24/2021
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: Severe seasonal allergies to ragweed, grass, pollen, mold and dust mites

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

Symptoms: Fever of 101 starting at 6:30 am, chills, tired achy and very large itchy hot red arm at sited

Other Meds:

Current Illness:

ID: 1053246
Sex: F
Age: 75
State: CA

Vax Date: 01/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Lactose intolerant, Polymox, Sulfa, Amoxcillin

Symptom List: Unevaluable event

Symptoms: Numbness and tingling in tips of left hand starting after first dose.

Other Meds: Edarbi, Plavix, Lipitor, Tradjenta, Lantus, Pepcid, Protonix, Aspirin, Allegra, Calcium, Vitamin D, Glucosamine, Magnesium

Current Illness:

ID: 1053247
Sex: F
Age: 44
State: VA

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: n/a

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

Symptoms: About 15 minutes after receiving the second dose of the Moderna COVID-19 vaccination my face started tingling and my tongue started to swell and feel numb. My tongue sensation subsided in about 30 minutes. It took about two hours for the tingling in my face to subside. I took Benadryl and all symptoms went away.

Other Meds: metoprolol 12.5 mg, valtrex 500 mg, vitamin D3, vitamin C, multivitamin, alrex eye drops

Current Illness: n/a

ID: 1053248
Sex: F
Age: 50
State: MT

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient presented to immunization clinic for asplenia vaccinations on 2/22/21. Pt rcvd PPSV23 via SubQ to Left arm. On 2/23/21 pt reported having chills, body aches, and shivers. Reported redness and some swelling to LUA where PPSV23 was administered. Pt's temp increased to 101.3 in the middle of the night. Pt reported going to local hospital for evaluation on 2/24/21. Pt is currently (2/24/21) admitted to local hospital and seeking treatment for cellulitis of L arm. Pt is being treated with ABX and antipyretics.

Other Meds:

Current Illness: Status Post Splenectomy 01/2021.

ID: 1053249
Sex: F
Age: 47
State: NC

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: SYR
Vax Site: LA

Lab Data:

Allergies: N/a

Symptom List: Injection site pain, Menorrhagia

Symptoms: Fever 102, tiredness, weakness, headache, shaking, sore throat, congestion, bloody mucas

Other Meds: Hctz, gabapentin, advil, mvi

Current Illness: N/a

ID: 1053250
Sex: F
Age: 34
State: UT

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: none

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

Symptoms: Small hives on forearms 10 min post vaccine. Pt observed. 50 min. post vaccine slight increase in hives. 25mg Benadryl given PO. VS stable , Pt released.

Other Meds: none

Current Illness: none

ID: 1053251
Sex: F
Age: 84
State: LA

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fever, loss of appetite, mental confusion, weakness

Other Meds: Metformin Ibuprofen

Current Illness: Pre-diabetic

ID: 1053252
Sex: F
Age: 40
State: WA

Vax Date: 02/03/2021
Onset Date: 02/17/2021
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: Sulfa

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Development of shingles on scalp.

Other Meds: Cetirizine 10mg daily, levothyroxine 0.125mg daily, elderberry sambucus 1250mg daily

Current Illness: None

ID: 1053253
Sex: F
Age: 70
State: GA

Vax Date: 02/22/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin, aspirin, sulfur drugs, and G6PD Factor

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

Symptoms: Around 5:30 PM, I had to stop putting up groceries, get into lounging clothes, and put a box fan on me while lying down. I experience shortness of breath, rapid heartbeat, dizziness, and weakness. My left upper quadrant is sore from the Moderna vaccine. It appears to be spreading circular to the size of a quarter to about the size of a fifty-cent piece. I had gone to sleep. I contacted the veteran 24 hour nurse, my best friend, and my brother to tell them my health status. I had eaten dinner, taken a Tylenol, and went back to sleep before brushing my teeth.

Other Meds: None

Current Illness: None

ID: 1053255
Sex: F
Age: 68
State: OH

Vax Date: 02/13/2021
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: RA

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: The injection site was hot, itchy, a lump and red.

Other Meds: Simvastatin 20 mg once/day, aspirin 81 mg once/day, CoQ-10 once/day, vitamin D 1000 IU once/day, multi vitamin once/day, fish oil 1000 mg once/day

Current Illness: None

ID: 1053256
Sex: F
Age: 51
State: DC

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

Lab Data:

Allergies: Food- nuts, pancake

Symptom List: Injection site pain

Symptoms: Swelling on injection site, itchiness

Other Meds: Multi vitamins

Current Illness: None

ID: 1053257
Sex: M
Age: 79
State: OH

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: "Pfizer-BioNTech COVID-19 Vaccine EUA" Exagerrated numness on the left side of my face from ear to mouth

Other Meds: omeprazole 40 mg losartain potassium 50mg

Current Illness: none

ID: 1053258
Sex: F
Age: 74
State: WA

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: RA

Lab Data:

Allergies: Sulfa drugs, Lorazepam

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

Symptoms: Patient had reaction to COVID-19 vaccine. Patient was monitored after COVID-19 vaccine as recommended per agency guidelines. The following reaction signs/symptoms were observed: difficulty swallowing, nausea and other : felt "woozy," felt like tongue and throat were swollen. Patient in passenger seat of car with her husband in driver's seat. Symptoms started about 5 minutes after vaccination. Pt reports that she is on BP meds for the last few months, took her BP meds today, lately BP ~120/80. She did eat lunch before coming. Called EMS due to feeling of tongue, throat swelling. EMS arrived, assessed pt, released her to home with her husband.

Other Meds:

Current Illness:

ID: 1053259
Sex: F
Age: 42
State: IL

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

Lab Data:

Allergies: Coconut Blueberries Relpax

Symptom List: Tremor

Symptoms: Moderate Asthmatic cough for about 5 hours. I used my Albuterol inhaler 2 puffs bid. Headache started same day of vaccine. Tylenol was taken 1000 mg every 6 hours. Switched over to Advil 800 mg every 6 hours. I still have a headache now. Nausea and Diarrhea started 02/24/21 @630am. Went to the restroom 5 times within a 4 hour period. Chills started around 10 am 02/24/21. Extremely tired. Fatigue and weak.

Other Meds:

Current Illness:

ID: 1053260
Sex: F
Age: 88
State: FL

Vax Date: 02/07/2021
Onset Date: 02/09/2021
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: diarrhea for 2 weeks. Tested for infection. There was none.

Other Meds: Synthroid fosamax diuretic potassium mybetric centrum. vitamin D3

Current Illness:

ID: 1053261
Sex: F
Age: 37
State: CA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: Ginger, aloe Vera, additives and preservatives, soy,

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

Symptoms: Rashes on my left side of body and face for a day and then was gone

Other Meds: Vitamin D, B12, B complex, Zoloft, vitamin C, zinc,

Current Illness: N/A

ID: 1053262
Sex: F
Age: 58
State: CA

Vax Date: 02/15/2021
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: LA

Lab Data:

Allergies: None

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

Symptoms: Large, red, warm itchy rash around injection site

Other Meds: Levothyroxine

Current Illness: None

ID: 1053263
Sex: F
Age: 50
State: VA

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

Lab Data:

Allergies: Ciprofloxacin, Bactrim (sulfamethoxazole and trimethoprim), and permethrin cream.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Side effects emerged approximately 12 hours after vaccinated. 1) temp that fluctuates from regular to 101F. 20 hrs after vaccination, T100.7F, then persisted up and down for about a week. 2) Musculoskeletal pain to Left side of body: Mainly left upper body. -- 17 hrs after, woke up with severe pain to Lt shoulder and clavicle (thought it was broken somewhere.) The injected site was sore but mild. The Musculoskeletal pain still continues, and the pain comes in various sites, various forms, and in various level. It can be at Left shoulder, scapula, armpit, rib, lumber, hip, knee, and foot. Once in a while, Left ear pain. Mostly Lt shoulder, scapula, armpit, rib lately (today is 0224/2021.) Level changes depends on how it hurts; severe-moderate/shooting and needle pain, moderate/radiating pain, moderate-mild/dull pain, mild/annoying persistent uncomfortable pain. 3) neck and jaw joint stiffness only on left side. Current. 4) Extreme fatigue and brain fog--Extreme fatigue started on the next day and persisted for 3 days, then it became randomly daily. No warning signs given, suddenly feels extremely tired. This fatigue often comes with intermittent confusion. When severe, unable to move while laying. Today is 3rd week from vaccinated and unresolved completely.

Other Meds: Ibuprofen 800mg taken one hour prior to vaccination.

Current Illness: n/a

ID: 1053264
Sex: F
Age: 72
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Tetracycline

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

Symptoms: Restricted breathing, light-headed, difficulty drawing a deep breath, minor chest pain and feeling weight on chest when inhaling. Increase in mucus production with difficulty clearing plugs.

Other Meds: Twice Daily Nebulizer Levoalbuterol, Nebulizer Glutathione(mucolxtic), zertec nightly

Current Illness: Severe Bronchiectasis, Asthma

ID: 1053265
Sex: F
Age: 45
State: CA

Vax Date: 01/18/2021
Onset Date: 01/23/2021
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: Carrots, sulfa, propylene glycol

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

Symptoms: Pain along lower spine, bilateral Achilles? tendon and bilateral heels. Decrease mobility.

Other Meds: Levothyroxine

Current Illness: None

ID: 1053266
Sex: F
Age: 72
State: IN

Vax Date: 01/29/2021
Onset Date: 02/04/2021
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: Septra, Ceclor, Levaquin, Biaxin

Symptom List: Pain in extremity

Symptoms: On Feb. 4, in the evening, the area about 3 inches below the injection site started to itch and was slightly reddened in an area about 3 inches across and 2 inches up and down. These symptoms continued about 8 days. I did not seek medical attention, but did treat the itching with Cortizone 10 cream a couple of times per day for about 4 or 5 of the 8 days.

Other Meds: Premarin .3mg, Lisinopril 7.5mg, Vitamin D, Citracal, Stool Softener, Diltiazem

Current Illness: Received the flu vaccine on Dec. 29, 2020

ID: 1053267
Sex: M
Age: 77
State: CO

Vax Date: 12/30/2020
Onset Date: 12/31/2020
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: Shellfish

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

Symptoms: Significant soreness at the injection site that persists now 2 months after the vaccination and does not seem to be going away.

Other Meds: Latanoprost; Tardjenta; Jardiance; Vitamin D3; Metformin; Lisinopril; Amlodipine Beslate; Synthroid; Allopurinol; Atorvastatin; Low does aspirin Omega 3; cinnamon, multi-vitamins

Current Illness: None

ID: 1053268
Sex: F
Age: 41
State: GA

Vax Date: 02/17/2021
Onset Date: 02/24/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Redness and itchy around shot site (left arm) 7 days after vaccine. I believe it?s called ?Covid arm?

Other Meds: Birth control pill

Current Illness: No

ID: 1053269
Sex: F
Age: 44
State: VA

Vax Date: 01/07/2021
Onset Date: 01/19/2021
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: No

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

Symptoms: 10 days after the injection I developed a high fever and chills and aches. The fever became low grade and continued for 10 days. I was then diagnosed with reactivated Epstein bar virus. So it was an active virus but I had also previously been exposed to EBV

Other Meds: Escitalopram

Current Illness: No

ID: 1053270
Sex: F
Age: 38
State: UT

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: NKMA

Symptom List: Vomiting

Symptoms: Pt presented with itching and heaviness in chest 15 min after vaccine administered. Pulse regular. Denies chest pain. 10cc liquid Benadryl given PO, 25 min later itching gone and chest heaviness decreased, 15 min later feeling much better with no itching and chest heaviness gone, VS stable. Released 15 min later at 7pm to father and instructed to notify dr. Pt called nurse hotline the next day (1/29/21) experiencing 102.5 fever, achy, hard time breathing, HA and chills, appt with MD in3 days. Given emergency protocol.

Other Meds: none

Current Illness: none

ID: 1053271
Sex: M
Age: 57
State: NJ

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Next morning woke up with 103 temperature, chills, muscle aches, slight dizziness. No headache or nausea

Other Meds: Multivitamin

Current Illness:

ID: 1053272
Sex: F
Age: 77
State: CA

Vax Date: 02/09/2021
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: Lactose

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

Symptoms: COVID arm Chronic headaches

Other Meds:

Current Illness: None

ID: 1053273
Sex: F
Age: 45
State: TX

Vax Date: 02/09/2021
Onset Date: 02/16/2021
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: shellfish, cats, phenergan

Symptom List: Injection site swelling, Limb discomfort

Symptoms: One week after vaccine a red, swollen, painful, itchy patch appeared at injection site. It has lasted over a week so far.

Other Meds: N/A

Current Illness: N/A

ID: 1053274
Sex: F
Age: 34
State: AK

Vax Date: 02/12/2021
Onset Date: 02/21/2021
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: none

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

Symptoms: thrombocytopenia, ITP

Other Meds: daily MV

Current Illness: none

ID: 1053275
Sex: M
Age: 77
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Bactrim

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

Symptoms: Moderna COVID-19 Vaccine EUA Fatigue, muscle pain, joint pain, chills, fever (100.4)

Other Meds: Metformin 500 mg, Losartan/Hctz 100/25 mg, Tylenol 500 mg, Equate Allergy Relief 20 mg

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm