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: 1054846
Sex: F
Age: 53
State:

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pfizer COVID-19 vaccination.

Other Meds:

Current Illness:

ID: 1054847
Sex: F
Age: 30
State: KS

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
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: Drug allergies UTD per DOD records

Symptom List: Anxiety, Dyspnoea

Symptoms: excessive fatigue yesterday; today feeling better, though still slightly 'crummy'; no fever since last night - Denies dyspnea, no painful respirations, no loss of taste or smell

Other Meds: zyrtec, flonase, Elderberry/ecchinacea, womens MVI

Current Illness: None

ID: 1054848
Sex: F
Age: 67
State: IL

Vax Date: 02/18/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
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: Sulfa drugs

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

Symptoms: Large patch of raised redness (about 5in X 3 in) at injection site. Itchy rash. Arm hot to touch. Began night of 2nd day after 2nd shot. (Feb 20th) All symptoms decreased gradually over following 4 days. Remaining redness, bumps, and itchiness disappeared by morning of Feb 25th.

Other Meds: Estradiol 0.025% patch, Atrovent .03% Spray, Crestor 10mg. : Tagamet, Claritin, Miralax, Advil : Vitamin D 5000iu, Biotin 2500mcg,, Lutein 6mg, CoQ10 100mg, Coromega Omega3

Current Illness: None

ID: 1054849
Sex: F
Age: 64
State: GA

Vax Date: 01/25/2021
Onset Date: 01/29/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Levaquin, Bananas

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: arm sore as normal following vaccine for 3 days then pain became severe in muscle of upper right arm; pain mild when arm in neutral position and/or at rest but sever stabbing pain when arm is extended outward, upward or reaching backward; pain is sharp stabbing pain, very severe for less than a minute, slowly subsides; also very sore if I lie or lean on that arm; has been ongoing now for over 4 weeks without any relief or change

Other Meds: Propranolol, Omeprazole, Elavil, Vitamins D, E, B12, Tumeric, Fish Oil, Probiotic

Current Illness: Stress fracture 5th metatarsal right foot

ID: 1054850
Sex: F
Age: 39
State: CA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Low grade fever (100.3 max) at 8 pm on 2/23; body aches, chills. Fever was normal in morning and day of 2/24. On 2/24 at 6 pm low grade fever again reaching 100.4 max and temperature was normal in morning 12/25. No medication was used to lower low grade fever. Was unable to return to work due to having low grade fever at night. Contacted doctor's office at the request of my employer. Doctors' office requested me to complete this report.

Other Meds: Hydrochlorothiazide; Amlodipine

Current Illness: None

ID: 1054851
Sex: F
Age: 56
State: FL

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 02/25/2021
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: Informed would like to discuss her reaction to the Covid vaccine. States received the vaccine 12/21 at 10:15 a.m. Approx 1500 - 1600 , the same day the injection site had "normal soreness, like a flu shot". On 12/22 woke up around 7 a.m. and couldn't move the affected arm due to pain. Reports it hurt to move her fingers. Temp was 99.5, maximum. The upper arm was swollen. On 12/23, temp is 97.6. Feels "normal soreness, like a flu shot

Other Meds:

Current Illness:

ID: 1054852
Sex: F
Age: 71
State: MD

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: Patient possibly inadvertently received 1cc of Moderna COVID vaccine instead of 0.5cc. Patient was notified.

Other Meds: unknown

Current Illness: none at the time of vaccination

ID: 1054853
Sex: F
Age: 68
State: IN

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Dust/Mold

Symptom List: Pharyngeal swelling

Symptoms: Patient developed a itchy rash on her face, her mouth and cheeks. Patient was given 25 mg of Diphenhydramine. Rash and itchiness reduced.

Other Meds: Losartin, Pulmacort, HBP, Omeprazole

Current Illness: No

ID: 1054854
Sex: F
Age: 77
State: TX

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient arrived for vaccine and passed screening, received vaccine. When nurse went to enter into Immtrac2 it was recorded the patient received vaccine on 1/28/21 and 2/24/21 of Pfizer then came to us and received dose 1 of Moderna. This was verified with the patient whom seemed confused and stated she only did what her son told her to. Contacted Poison Control and spoke with toxicologist whom stated no intervention required.

Other Meds: unknown

Current Illness: unknown

ID: 1054855
Sex: F
Age: 27
State: AL

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
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: Latex adhesives

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I received the 2nd dose of the Pfizer COVID-19 vaccine around 9:15 am on 2/23/21. Initially, my only symptoms were injection site soreness and minor swelling. Gradually throughout the day, my entire left arm become more and more sore. By 5:00pm, I felt exhausted and dizzy and was having chills. My temperature was 99.8 degrees Fahrenheit. I took a dose of Extra Strength Tylenol, but felt no change. My joints and muscles began to ache around 6:00pm on 2/23/21 and did not stop aching until around 9:00pm on 2/24/21. During the evening of 2/23/21, my dizziness increased and I felt as if I would pass out any time I sat up or stood. My temperature had returned to 98.2 degrees Fahrenheit by 10:00pm on 2/23/21. I then took a dose of Motrin to help with my soreness. On 2/24/21 from morning until 8:30pm, I had no fever or chills, but still felt exhausted and had minor muscle/joint achiness. I took 3 doses of Motrin on 2/24/21 to help with the soreness. Throughout the day, I had some difficulty breathing (felt like a mild asthma attack) and used my emergency inhaler once. At 8:30pm on 2/24/21, my temperature was 100.5 degrees Fahrenheit. I took another dose of Motrin and went to sleep. Around 3:00am on 2/25/21, I woke up drenched in sweat, but feeling better. My temperature was normal then. When I woke up at 7:00am on 2/25/21, I no longer felt achy, dizzy, or tired. I still feel (now at 1:30pm on 2/25/21)as though my asthma is aggravated, but am not having difficulty breathing.

Other Meds: Lexapro 20mg once per day Singulair 10mg once per day Sunflower Lecithin supplement once per day Prenatal vitamin once per day

Current Illness: Sinus cold (mild) about two weeks before vaccination

ID: 1054856
Sex: F
Age: 74
State: MO

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: Patient called and stated that she had a local reaction at injection site that consisted of a orangish rash that spread down her left arm. It was warm to touch. Advised her to contact her doctor of reaction to Moderna.

Other Meds: Unknown, does not fill rx's here.

Current Illness: nka

ID: 1054857
Sex: F
Age: 76
State:

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Percodan

Symptom List: Rash, Urticaria

Symptoms: Same day pt developed burning pain with urination and fever of 101F the same day. Pt came to the hospital, was not determined to have a urinary tract infections. No fevers during time in the hospital.

Other Meds: Tylenol, Coenzyme Q10, Pradaxa, Lexapro, estradiol patches, women's multivitamin, riboflavin

Current Illness:

ID: 1054858
Sex: F
Age: 56
State: IL

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
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: Fever of 102F, body aches, chills

Other Meds:

Current Illness:

Date Died: 01/22/2021

ID: 1054859
Sex: M
Age: 102
State: IN

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 02/25/2021
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: not reported

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

Symptoms: No details - patient died on 1/22/2021

Other Meds: not reported

Current Illness:

ID: 1054860
Sex: F
Age: 36
State: MI

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/25/2021
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: high fever, chills, aches, pains, headache

Other Meds: Meloxicam, lisinopril, nexium, albuterol

Current Illness: non

ID: 1054861
Sex: F
Age: 38
State: GA

Vax Date: 02/17/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
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: Amoxicillin (rash at infancy)

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

Symptoms: Normal ache/pain in my left arm associated with second Moderna vaccination for 36-48hr post vaccine. Around morning on 2/20, I noticed my arm still hurt considerably but pain was more a shooting pain with certain movements, rather than a general sore/ache. Pain progressively got worse over the next several days and movement was quite restricted to avoid pain with movement. Lateral and overhead movements were not possible. The injection was given rather high up on my left shoulder and injection site/surrounding area was very sore for one week, but has diminished. I am currently taking 800mg Ibuprofen 2x/day which seems to help.

Other Meds: tri-sprintec

Current Illness:

ID: 1054863
Sex: F
Age: 23
State: FL

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 02/25/2021
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: I received the COVID-19 vaccine yesterday, Monday December 21, at 0700. Last evening I was up all night with fairly severe symptoms, including a severe migraine unrelieved by pain medication, nausea and vomiting, muscle and joint pain, and a low grade fever. I felt unsafe to return to work today and called out due to my fever.

Other Meds:

Current Illness:

ID: 1054865
Sex: M
Age: 60
State: MD

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
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: RPh administered the vaccine, and the patient passed out 10 minutes afterwards and hit his head. Patient felt very faint even after sat up with feet up. Patient was given orange juice and he drank it all. Paramedics arrived and checked him out. 45 minutes after him passing out, patient felt fine and went back to work. He had gashed his head open on the fall.

Other Meds:

Current Illness:

ID: 1054866
Sex: F
Age: 51
State: NJ

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
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: 4 hours post injection: sore injection site, fatigue 8 hours post: extreme pain at injection site and extreme fatigue 20-36 hours post: extreme pain at injection site , extreme fatigue, low grade fever, nausea, extreme chills, dizziness 36 hours post: cough, clogged sinuses, extreme headache 48 hours post: slight fatigue, slight cough, slight runny nose, moderate pain at injection site

Other Meds: Synthroid

Current Illness: None

ID: 1054867
Sex: F
Age: 67
State: CA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital: Y

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

Lab Data:

Allergies: Macrobid

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

Symptoms: I hade a seizure after second shot

Other Meds: Lexapro, simivistatin, zetia, lipoid c, calcium, baby aspirin, Zinc, psyllium husk

Current Illness: Sub clinical atherosclerotic heart disease Anxiety and depression Migraine Anemia

ID: 1054868
Sex: F
Age: 68
State: OH

Vax Date: 02/01/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
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: Sulfa drugs

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

Symptoms: Headache, extreme fatigue, nausea, shortness of breath, arm soreness. All symptoms started within 3 hours of receiving vaccine. Not sure about duration due to fact that this report has been filed too soon to know outcome

Other Meds: Effexor 150mg Lisinopril 5mg Calcium 600mg Esomeprazole 40mg Ferrous Gluconate x 2 tablets

Current Illness: N/A

ID: 1054869
Sex: M
Age: 36
State:

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin

Symptom List: Unevaluable event

Symptoms: Fever to 101 a/w mild chest tightness. HR 119 and temp 99.9 during remote visit follow up.

Other Meds:

Current Illness:

ID: 1054870
Sex: F
Age: 42
State: IL

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
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 known allergies

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

Symptoms: complaining of mild tightness of chest immediately following vaccination. Pt stated that tightness not uncommon with history of asthma and anxiety. Denied : any itching or allergy related complaints, any respiratory difficulty.

Other Meds: no known

Current Illness: unknown

ID: 1054871
Sex: F
Age: 30
State: CA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Symptoms of Chills, Fatigue, Fever (101.1), Headache, muscle/body aches, nausea lasted until 02/14/2021.

Other Meds:

Current Illness:

ID: 1054872
Sex: F
Age: 79
State: NV

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Albuterol; Day-pro; Trelegy; Cimzia

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, stomach cramps, dizziness, shaking, fatique, joint pain, nausea

Other Meds: Leflunomide; Atenolol; Pantoprazole; Hydroxychloroquine; Amlodipine; Levothyroxine, Gabapentin; oxybutinin;

Current Illness: none

ID: 1054873
Sex: F
Age: 42
State: FL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I received my second covid vaccine on 1/26. On 1/27 I had severe body aches, headache, burning dry eyes, debilitating fatigue, and could barely move my arm. I had these same symptoms on 1/28

Other Meds:

Current Illness:

ID: 1054874
Sex: M
Age: 61
State: KY

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 02/25/2021
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: Nome

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Blood clot large in leg DVT and PE both lungs

Other Meds: Lipitor 10 x Daily Glipzide 5 x Daily Vitiman D x Daily Belsomta 10 Nightly Omeprazole daily Flonase Shot of .75 for diabetes Trulicoty

Current Illness: Diabetes

ID: 1054875
Sex: F
Age: 41
State: VA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: PNC = rash

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: This 41 year old received her second Moderna covid vaccine on 2/5/2021. She had no immediate issues the first 15-30 min post vaccination. During her drive home (about 30 -40 min post vaccination) she noticed her throat felt full and kept trying to clear it. She tried drinking but this did not ease the reaction. She called her MD but was sent to local ER which was closer. She denied any SOB, fever, rash, itching, HA, swelling to throat, tongue or body, and had no dizziness, GI distress or other systemic reactions. She presented to a specific hospital and was treated with epi pen, IV benadryl, solumedrol and pepcid and released on 5 day predinisone taper

Other Meds: synthroid, lisinopril

Current Illness: denied

ID: 1054876
Sex: F
Age: 89
State: CA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Loss of strength/movement below the waist. Admitted to hospital. Physical and occupational therapy administered. Normal strength/movement fully restored.

Other Meds: Atenolol 25mg x2 Lisinopril 40mg x1 Amlodipine Besylate 5mg x1 Calcium 600mg with Vitamin D3 10mcg x1 Super B Complex with Vitamin C OTC x1

Current Illness: Arthritis Hypertension

ID: 1054877
Sex: F
Age: 67
State: NC

Vax Date: 02/12/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: dapagliflozin

Symptom List: Nausea

Symptoms: Patient woke up at 0200 with the room spinning, she felt dizzy, and nauseated. Was able to get into the rest room where she vomited. Patient received meclizine and ondansetron in the ED. Neurology consult requested stroke/TIA work up.

Other Meds: Aspirin, atenolol, canagliflozin, esomeprazole, insulin detemir, losartan/hydrochlorothiazide, simvastatin

Current Illness: None

ID: 1054878
Sex: F
Age: 65
State: NC

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Pain, swelling, warmth and redness around the injection site, over an area approximately 4-5 inches in diameter. Accompanied by discomfort and tightness in arm and shoulder and discomfort up into neck on the left side. Mild paresthesia in lower arm for a short period (< 1 hour). No loss of muscle power. Treated with ibuprofen, 400mg orally three times daily for three days, to date. Ice packs applied to injection site once a day. Neck discomfort resolved after two days. Today (four days after onset) symptoms and signs are lessening but some are still present. Area is still warm but pain and redness have diminished, and swelling and feeling of tightness are almost gone.

Other Meds: Lisinopril, HCTZ, fenofibrate, baby aspirin, AREDS II, Calcium + vitamin D, Imvexxy

Current Illness: None

ID: 1054879
Sex: F
Age: 58
State: CA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Vaccine got on patient's arm during immunization. Pt stated that she is doing okay and had half or more of the dose. Our Clinical Research Team, spoke with Moderna. Per Moderna as long as half or more of the dose was provided into the patient the dose does not need to be readministered.

Other Meds: Asacol

Current Illness: None

ID: 1054880
Sex: F
Age: 37
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: Shrimp

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

Symptoms: Swollen rash on vaccine arm, with itching. 9 days post onset. Extreme fatigue on day 8.

Other Meds: Metformin 1000, levothyroxine 125, multivitamin

Current Illness: Hypothyroidism, pCOS

ID: 1054881
Sex: F
Age: 33
State: FL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/25/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Symptoms began yesterday afternoon. I had a headache, fatigue and mild fever of 99.3-99.7 throughout the evening. As of today, I am still experiencing a fever, most recently 100.6. I also have muscle and joint pain. No chills at this point. I only have mild soreness at the injection site itself but the lymph nodes in my vaccinated arm are swollen.

Other Meds:

Current Illness:

ID: 1054882
Sex: M
Age: 36
State: MI

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
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: General body aches, Chills, Temp 101.3.

Other Meds:

Current Illness:

ID: 1054883
Sex: F
Age: 30
State:

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
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: Moderna COVID-19 Vaccince. Noticeable/severe swelling in arm. No additional treatment required - submitting for data purposes.

Other Meds:

Current Illness:

ID: 1054884
Sex: M
Age: 58
State: FL

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/25/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Sx of confusion/clumsiness began on 1/25. Fever (max 101), chills, fatigue, body aches, and severe sweating occurred 1/26 and resolved 1/27. TM stated he lost 12 lbs from the vaccine

Other Meds:

Current Illness:

ID: 1054885
Sex: F
Age: 60
State: NY

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/25/2021
Hospital: Y

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 soft shell crabs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: As per Dr: 60 year old woman with history of MVA and back pain presents to office today with left arm pain and discomfort that started three weeks ago and has resolved but left her with tingling sensation in her third, fourth, and fifth digits on her left hand, symptoms started three weeks ago, hours after getting her COVID-19 vaccine. About a week and a half ago she began feeling numbness of her right leg going up to her upper abdomen with progressively worsening symptoms that have stabilized in the past several days. She also feels that her walking is off but cannot quite describe how or when it started. Exam notable for left-sided cervical myelopathy and decreased sensation on her right side up to a mid-thoracic sensory level. Of note she has a first cousin on her fathers side with multiple sclerosis and a more distant cousin on her mother's side with multiple sclerosis. Father with Parkinson's disease. I see that COVID-19 biofire came back positive. In light of this, COVID myelopathy is on the differential

Other Meds:

Current Illness:

ID: 1054886
Sex: F
Age: 69
State: FL

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Aspirin, Latex, Codeine

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

Symptoms: Within 20-minutes of vaccination, the patient reported pain in their throat, SOB, tingling in their arms, and chest pressure. EMS evaluated patient on-site. Patient was hypertensive (184/96). 12-lead EKG was NSR, rate of 79 bpm, no ST elevation. FSBG was 137 mg/dL. ETCO2 was 40mmHg with normal square waveform. EMS initiated transport to Hospital Emergency Department. En route, patient became more hypertensive (200/106). In ED, she remained hypertensive and was admitted to inpatient telemetry unit. Patient had 1-night stay to rule out cardiac-related events. Anaphylaxis was ruled out. Discharged with diagnosis of vaccine reaction and chest tightness.

Other Meds: Atorvastatin, Carvedilol, Gabapentin, Insulin, Isosorbide dinitrate, Triamterene

Current Illness: None reported

ID: 1054887
Sex: F
Age: 59
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/25/2021
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: None

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

Symptoms: Received Moderna COVID 19 vaccine on 1/8 and 2/5. Side effects with body ache and fatigue for 2 days after the first dose. Sustained fever, body ache, fatigue, intermittent headache after the second dose. Symptoms have lasted for 3 weeks so far.

Other Meds: None

Current Illness: None

ID: 1054889
Sex: F
Age: 73
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Clindomyacin Chloramphecol

Symptom List: Pain in extremity

Symptoms: COVID arm Swelling Itching Hot to touch 6 inch in size

Other Meds: Ecitalopram Avorstatin Multivitimen Folic acid Colace

Current Illness: None

ID: 1054890
Sex: F
Age: 90
State: SC

Vax Date: 02/04/2021
Onset Date: 02/13/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

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

Symptoms: Pt exam 2/25/2021 found swelling to left hand from wrist to fingers with discomfort in left arm which began 2/13/2021. No erythema noted. No clubbing, cyanosis. Treatment - Patient advised not to get 2nd vaccine.

Other Meds: Levothyroxine sodium, Lisinopril, Pravastatin sodium, Triamcinolone Acetonide, Voltaren

Current Illness: none known

ID: 1054891
Sex: F
Age: 22
State: ID

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: 3 hours after vaccine, extreme fatigue and headache 12 hours after vaccine, cold chills, headache, extreme fatigue, body aches, moderate pain at injection site and surrounding muscle

Other Meds: None

Current Illness: None

ID: 1054892
Sex: F
Age: 48
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient reported feeling flushed during observation period. Pt. gets anxious with shots and has chronic HTN. Pt. was hypertensive. Pt. stated she felt better and was advised to go home and relax, check BP when rested, and check with primary care provider. If needs emergent attention go to nearest ER.

Other Meds:

Current Illness:

ID: 1054893
Sex: F
Age: 88
State: NJ

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: NKA

Symptom List: Vomiting

Symptoms: Fatigue, 100*F, felt hot, Headache, Muscle aches lasting from 11am and continues today at 2:26pm.

Other Meds: Prilosec, Losartan, Centrum Silver, Lexapro 5mg, Cholesterol pill ("when I remember").

Current Illness: N/A

ID: 1054894
Sex: F
Age: 74
State: PA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
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: About 6 hours after getting vaccine, I experienced extreme fatigue and passed out briefly on the bathroom floor. When I came to, I had no recollection of passing out. It was only for a minute or two. I felt better and not as tired. I felt okay the next couple of days.

Other Meds: rosuvastatin 20 mg; 1 day; levothyroxine 75 mcg 1 day

Current Illness: none

ID: 1054895
Sex: F
Age: 77
State:

Vax Date: 02/02/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Difficulty breathing, - Hx of asthma. Evaluated by EMS. O2-99% on room air, HR-68. Client has inhaler in her car and will when discharged.

Other Meds:

Current Illness:

ID: 1054896
Sex: M
Age: 94
State:

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/25/2021
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: Admitted to hospital on 2/24/21 with shortness of breath, lower extremity edema, coagulopathy. Hx of CHF. COVID test negative

Other Meds:

Current Illness:

ID: 1054897
Sex: F
Age: 41
State: FL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Side effects include: Body aches,persistent headache, mild chills, general weakness and fatigue, and extremely sore arm at the injection site and swelling of the lymph node in the 'armpit' of the injection side.

Other Meds:

Current Illness:

ID: 1054898
Sex: F
Age: 75
State: CA

Vax Date: 02/23/2021
Onset Date: 02/01/2021
Rec V Date: 02/25/2021
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: keflix, augmentin, bactrim

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

Symptoms: chills for 2 hours, generalized body aches( really miserable), for 12 hours, slight headache, for 6 hours, intestinal cramping for several hours, fatigue for first day, decreasing the 2nd day.

Other Meds: hydrochlorthiazide 25mgm., lisinopril 40mgm, metoprolol er succinate 25mgm, eliquis 5 mgm

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm