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: 1011054
Sex: F
Age: 41
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Itchy painful hot rash approx 2 in in diameter at injection site from that evening through today, still not resolved 3 days later. Muscle aches moderate and constant from 6 hours post injection through approx 33 hours post injection. Joint pain hips and knees same duration as muscles pain.

Other Meds: None

Current Illness: None

ID: 1011055
Sex: F
Age: 62
State: TX

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
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: NSIDs, thimerasol

Symptom List: Anxiety, Dyspnoea

Symptoms: A day after the vaccine, a large baseball size knot appeared at vaccine site, later that evening it grew to softball size, hot, and very painful. When I got the first dose, was not as drastic as this second dose. After the first does, it lasted around 10 days.

Other Meds: Lasarton, flecinine, Zyrtec, levothyroxin, levothyrine, gabapentin, methacarbomal, vitamin D, hctz, CBD capsule, singular, biotin.

Current Illness: None

ID: 1011056
Sex: M
Age: 39
State: NH

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Moderate flue-like symptoms (malaise, anergia, headaches, myalgia, chills, skin hypersensitivity) throughout the day following the second dose of the Moderna vaccine.

Other Meds: none

Current Illness: none

ID: 1011057
Sex: F
Age: 48
State: MT

Vax Date: 01/01/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: PCN,Latex, coconut, walnuts, pecans

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Itching and swelling at injection site 9 days after receiving the shot. Rash on right check as well. Was very sore for 2 days after getting injection as well.

Other Meds: B12, vitamin D

Current Illness:

ID: 1011058
Sex: F
Age: 91
State: TX

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
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: 4 days after injection, I experienced chills, slight fever (99.1), drop in oxygen level (96), aches all over, intestinal distress, extreme fatigue, lasted over 12 hours. Temperature and oxygen level back to normal, but am still shaky this morning, so I'm returning to bed.

Other Meds: Multi vitamin; calcium

Current Illness: none

ID: 1011059
Sex: U
Age: 17
State:

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
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: No adverse effects. Pt was vaccinated 3 days prior to turning 18 years of age, which is the recommended age for administration.

Other Meds:

Current Illness:

ID: 1011060
Sex: M
Age: 81
State: GA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
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: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Brain fog, agitation

Other Meds: Fluticasone, Albuterol, zoloft, memantine, aricept, lipitor, Tylenol

Current Illness: Dementia, Depression, Thrombocytosis

ID: 1011061
Sex: M
Age: 19
State: WV

Vax Date: 01/14/2021
Onset Date: 01/19/2021
Rec V Date: 02/08/2021
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: Pharyngeal swelling

Symptoms: Bumps kind of like bug bites, that later make the skin dry and leathery. some are itchy and some just appear over night. the pop up locations are random.

Other Meds: none

Current Illness: none

ID: 1011062
Sex: F
Age: 59
State: FL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: ACE Inhibitors, kiwi, latex sensitivity

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever, chills, severe headache, severe back pain, body aches, weakness

Other Meds: losartan, vitamin D, Ester C, Multivitamin Complex, Omega Fish Oils, Vitamin B Complex

Current Illness: migraine

ID: 1011063
Sex: F
Age: 47
State:

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Injection site has become red, raised, warm and itches. Still tender and about the circumference of a half dollar. No medical treatment. Iced area on Saturday evening to help minimize itching.

Other Meds:

Current Illness:

ID: 1011064
Sex: F
Age: 39
State: PA

Vax Date: 01/30/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: IV dye, shellfish, tramadol, latex, cephalosporin, penicillin, sulfa.

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

Symptoms: I have pictures. Swollen red arm, size of plum, getting bigger, showed up a week after the shot, hot, hard, itchy and just generally feel miserable.

Other Meds: Lexapro 20mg. vitamin D 2000

Current Illness: None

ID: 1011065
Sex: F
Age: 43
State: NC

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 02/08/2021
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: PCN

Symptom List: Rash, Urticaria

Symptoms: Vaccine 1-unusual headache x 4 days-rizitriptan-relieved . Vaccinine 2- same unusual headache x 2 days plus. neck muscle pain , limited range of motion, heat compress and stretching-still not resolved

Other Meds: Prozac

Current Illness:

ID: 1011066
Sex: F
Age: 41
State: IN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: sore arm at injections site, chills, headache, body aches, nausea, flu like symptoms, sore throat, fatigue.

Other Meds: Multivitamin, probiotic, Elderberry, Collagen, Prozac

Current Illness: none

ID: 1011067
Sex: F
Age: 32
State: IN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
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: Biaxon

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

Symptoms: Received shot at 5:20 PM and by the next day at 11:30 AM I had body aches, fever, body chills, headache, nausea. Then the following day, I was experiencing extreme fatigue and had a full-body rash from my head to my legs.

Other Meds: Adderall 15 MG 3 times a day

Current Illness: None

ID: 1011068
Sex: M
Age: 73
State: FL

Vax Date: 01/18/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
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: Pfizer-BioNTech COVID-19 Vaccine EUA Bell's Palsy Face paralysis

Other Meds: 80 mg asprin; 40 mg simvastatin; 160/12/5mg valsartan/hydrochlorothiazide 1000mg turmeric;saw palmetto;centrum silver; 1000mg vit c; 2 capsules daily calcitrate/mag/zinc with vit d

Current Illness: sore throat

ID: 1011069
Sex: F
Age: 53
State: MI

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: None

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

Symptoms: After 2nd dose of Moderna vaccine I had restlessness. Unable to sleep from 1:00 a.m. - 6:30 a.m.

Other Meds: Lisinopril 20 Mg, Amlodipine 5Mg

Current Illness: None

ID: 1011070
Sex: M
Age: 42
State: IN

Vax Date: 12/21/2020
Onset Date: 12/24/2020
Rec V Date: 02/08/2021
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: Codeine

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

Symptoms: Left fourth cranial nerve palsy and double vision.

Other Meds: Atorvastatin CoQ10 Omega-3 oral capsule

Current Illness: None

ID: 1011071
Sex: F
Age: 61
State: NJ

Vax Date: 01/27/2021
Onset Date: 02/01/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: large raised red, warm, sore area with increasing size of area as time went on. I saw an article about "Covid Arm" and that is what it looked like. I have pictures if needed.

Other Meds: Toprol XL, Tirosent, Cytomel, Losartan, Metformin, Trulicity, Atorvastin, Welchol

Current Illness: n/a

ID: 1011072
Sex: F
Age: 46
State: MI

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: Morphine,

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: When driving home , I felt like my right side of my neck was swelling but it wasn?t and then it felt like my right side of my throat was sweet and then my asthma kicked in , I used my inhaler and I few hours all my symptoms went away.

Other Meds: Valsartan, singular, norvasc, Zyrtec, qvar, proair

Current Illness: None

ID: 1011073
Sex: M
Age: 57
State: IN

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: Codeine, penicillin, morphine,

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

Symptoms: Awoke feeling ill at 2:30, restless sleep got out of bed at 4:30 am, temperature of 99.6- 101.5 for 16 hours at rest, Awoke next am feeling tired, with no obvious symptoms or adverse events.

Other Meds: Bupropion 100 mg, Felodipine ER 24 HR 5 mg, Atorvastatin 40 mg

Current Illness:

ID: 1011074
Sex: F
Age: 67
State: PA

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
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: Itching and a red area around the injection site. Swelling and hardness in a 2-3 inch circumference around the injection site. It was painful to the touch. The symptoms lasted for four days (Thurs-Sunday) with the swelled area decreasing in size each day. The itching subsided around day 2. I did not take any medications during this time as I did not want to interfere with the vaccine's efficacy.

Other Meds: lisinopril, levothyroxine, women's silver daily vitamin, D3, B12, Colace

Current Illness: None

ID: 1011075
Sex: F
Age: 66
State: MA

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: Bee stings

Symptom List: Unevaluable event

Symptoms: The patient consented to receive the vaccine at the facility on 1/31/21. She admitted to the facility on 1/29/21. She failed to inform us that she had already received her first vaccine at her rest home on 1/28/21. Consequently she received 2 doses of the Pfizer Covid-19 vaccine within 4 days. She had no adverse effects from either vaccine.

Other Meds:

Current Illness:

ID: 1011076
Sex: F
Age: 73
State: ME

Vax Date: 01/30/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: nnone

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

Symptoms: warm and redness, small amount of swelling, itchy at inject site

Other Meds: Lasortin 25 mg

Current Illness: none

ID: 1011077
Sex: F
Age: 45
State: MI

Vax Date: 01/21/2021
Onset Date: 01/28/2021
Rec V Date: 02/08/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Developed a large red, itchy rash, one week following injection. The skin around the injection site was red for about another week. During that time, the rash was itchy and red. At times a bit hard as well.

Other Meds: 10 mg Rosuvastatin, 10 mg Loratadine, 25 mcg Vit D3, 5 mg Melatonin

Current Illness: None known

ID: 1011078
Sex: F
Age: 34
State: NC

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: Alpha Gal Allergy

Symptom List: Injection site pain, Menorrhagia

Symptoms: Skin reaction with big red rash and swelling around vaccine site that burn and itches that still continues on arm. Accelerated heartbeat of over 120 bpm while sitting still, started day after the vaccine. Body aches, fever of 101 that have resolved after 2nd day. Fatigue, headache, pain on under arm of vaccine site ongoing.

Other Meds:

Current Illness: n/a

ID: 1011079
Sex: F
Age: 18
State: IA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/08/2021
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: NKDA

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

Symptoms: The patient was diagnosed with Mononucleosis on 2/1/2021. Symptoms started on 1/20/2021, 1 day after her second COVID vaccination dose. Liver enzymes were also elevated

Other Meds: Loestrin 1.5/30 one tablet daily

Current Illness: None

ID: 1011080
Sex: M
Age: 27
State: GA

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
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: Soreness in arm, fast heart rate, dizziness, feeling weak, urinated self, sweats, warm to the touch

Other Meds: None

Current Illness: None

ID: 1011081
Sex: F
Age: 69
State:

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Skin rash in ejection area. Area about two inches red itching and hot to the touch. No soreness or pain.

Other Meds:

Current Illness:

ID: 1011082
Sex: F
Age: 36
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/08/2021
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 12 hours after the injection she developed throat tightening and hallucinations about 3 hours prior. Patient watched her oxygen stats from home with a home pulse ox machine. Patient did not take any medications. Patient had symptoms for about 12 hours once they started.

Other Meds:

Current Illness:

ID: 1011083
Sex: F
Age: 53
State: IN

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: sulpha drugs, gluten intolerance

Symptom List: Nausea

Symptoms: fever, chills, nausea, body aches, extreme fatigue

Other Meds: welbutrin, lexapro, Miralax, all daily

Current Illness: none

ID: 1011084
Sex: F
Age: 39
State: PA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: iodine, iodine contrast, amoxicillin, clarithomycin

Symptom List: Injection site pain

Symptoms: Patient is a 39 y.o. female presenting to ED with itchy tongue and throat which occurred 1 hour after second dose of COVID-19 patient received vaccination this morning. Patient states symptoms started an hour and a half after vaccine administration. Patient denies rash or swelling. Patient received 50 mg of Benadryl for presentation. Patient will be discharged and instructed to follow up with primary care doctor in 1-2 days and return to the ED if symptoms worsen. Symptoms believed to be from allergic reaction, nausea. Pt received atarax, pepcid, zofran, decadron.. Patient will be discharged with atarax, epipen. Pt has no oral swelling on repeat exam.. Patient understands and agrees with plan.

Other Meds: Albuteral, Fioricet, Cymbalta, antivert, mobic, singular, phenergan, topamax, tramadol

Current Illness: none

ID: 1011085
Sex: F
Age: 77
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1011086
Sex: M
Age: 71
State: NY

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
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:

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

Symptoms: Three inch firm red swelling around injection site and mild itching.

Other Meds:

Current Illness:

ID: 1011087
Sex: M
Age: 78
State: GA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
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: Anxiety, Anger, Agitation, Pacing

Other Meds: Synthroid, glucosamine, Insulin Glargine, glucosamine chondroitin, ASA, Trintellex, Prednisone, Remiron, Valium,

Current Illness: DM Type 2, Alzheimer's

ID: 1011088
Sex: F
Age: 26
State: NC

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: Raspberry, Pet hair, smoke

Symptom List: Erythema, Pruritus

Symptoms: In left area near the injection site was sore. By the next day my arm had trouble with movement and could not lift my arm above my head. On the third day little to no pain near the injection site and full movement in my arm.

Other Meds: Advir, Flonase, Adderall XR, Adderall IR, Zyrtec, Larin (Birth control)

Current Illness: None

ID: 1011089
Sex: F
Age: 46
State: NY

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: None

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

Symptoms: High fever, nausea, headache and vomiting 2 and 1/2 days

Other Meds: Levothyroxine and relizen

Current Illness:

ID: 1011090
Sex: F
Age: 25
State: KS

Vax Date: 01/29/2021
Onset Date: 02/08/2021
Rec V Date: 02/08/2021
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: N/A

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

Symptoms: I have a small rash around the vaccination site on my arm. About 3 inches long and 1 inch wide.

Other Meds: N/A

Current Illness: N/A

ID: 1011091
Sex: M
Age: 11
State: NY

Vax Date: 08/29/2019
Onset Date:
Rec V Date: 02/08/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: muscle aches in extremeties

Other Meds:

Current Illness:

ID: 1011092
Sex: F
Age: 61
State: WA

Vax Date: 01/27/2021
Onset Date: 01/30/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: Red, Hard area around injection site.

Other Meds:

Current Illness:

ID: 1011093
Sex: F
Age: 56
State: NY

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: no

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

Symptoms: lightheaded ,dizzy feeling of passing out . sweating drop in blood pressure 90 over 40. Was given an IV with fluids plus benadryl and a steriod. was taken to the ER for observation. was given an EKG and it was normal. the outcome was presyncope.

Other Meds: no

Current Illness: no

ID: 1011094
Sex: F
Age: 31
State: WI

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: No known allergies.

Symptom List: Pain in extremity

Symptoms: Itchy mouth, headache for 48 hours, low energy/generally felt unwell.

Other Meds: Tri-nessa, Valacylcovir

Current Illness: Ten days after my first dose I got symptoms for genital herpes type 1 for the first time.

ID: 1011095
Sex: F
Age: 75
State: NM

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Chills, joint aches, excessive fluid under arm where shot was administered, swelling and redness at shot site

Other Meds:

Current Illness:

ID: 1011096
Sex: F
Age: 42
State: OH

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
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: blue liquid gels

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

Symptoms: Felt fine during the waiting period after receiving the vaccine. As I was walking through the parking lot started feeling very light headed. Went home and rested, took Tyenol but the dizziness never went away. When I laid down in bed it felt like the room was spinning. Woke up today and still feel dizzy and light headed. The only other side affect is a really dry mouth and throat.

Other Meds: atenoloL 25 MG tablet, ergocalciferol 1,250 mcg (50,000 unit) capsule, losartan 50 MG tablet, metFORMIN 500 MG 24 hr, cholestyramine 4 gram packet, allopurinoL 300 MG tablet, hydroCHLOROthiazide 25 MG tablet, Lactobacillus acidophilus (PRO

Current Illness: none

ID: 1011097
Sex: F
Age: 71
State: FL

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: Percodan Bee Stings Adhesive bandages

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

Symptoms: Rapid Heart Rate, elevate BP

Other Meds: Atorvastin 20 mg Amlodipine 2.5 mg Multivitamins, Calcium gummies Omega 3 gummies

Current Illness: Cellulitis upper arm near first injection site 7 days after shot Urticaria upper arm near first injection site 10 days after shot Laparoscopic surgery of abdomen 22 days before second dose

ID: 1011098
Sex: F
Age: 26
State: FL

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
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: Codiene, imitrex, keflex

Symptom List: Vomiting

Symptoms: After I got the shot within 15-20 minutes I was coughing, and my heart rate was 147 and my blood pressure was 138/110 I felt light headed and my ears felt like they got clogged went back to see a nurse practitoner and they said to take a few deep breaths and that my throat did look irritated but that I should be fine because it was after 20 minutes and she said when I am driving home if it gets worse call 911. My throat started to hurt really bad and I felt like I could not breathe I looked in my mouth and my tonsils were swelling and I had to give myself an epi pen so I could breathe. Went home called my doctor and told him what happen I was very flushed, headache, sore throat cough, and I started to warm up several hours later to 100.9. He told me to take steroids I was given when I had COVID and told me if I start to have other symptoms to go to the emergency room. He also said since I recently had gotten COVID I was not suppose to get the second vaccine yet.

Other Meds: Metformin HCL ER,

Current Illness: I had tested positive for COVID on January 11th, 2021 and negative on January 26th, 2021

ID: 1011100
Sex: M
Age: 67
State: FL

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
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: Headache beginning several hours after injection and lasting for one day. Day after injection I get a stomach ache that continues into the third day which is when Im writing this. Some nausia and hot flashes. Tired and feel sick on the 8th. Shot was on the sixth

Other Meds: Pantoprazole Carvidalol Bueprenorphine

Current Illness: None

ID: 1011101
Sex: M
Age: 66
State: NC

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/08/2021
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: Shell fish,

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

Symptoms: I have chronic Lyme disease, with extreme symptoms of photosensitivity and photophobia. 12 years ago, I had a series of intravenous antibiotics for 9 months. That halted the progression of the symptoms. However, with the first injection of the Pfizer vaccine, I had an immediate and increasing photosensitivity/photophobia. For example, my computer monitor was at 6% brightness. I reset to 3% brightness, which is still too bright. My concern is that the second injection due on February 12th may further increase the symptoms. My Lyme doctor believes that the light sensitivity is perhaps coming from the thalamus. Additionally, the injection seemed to increase my INR.

Other Meds: Antibiotics, anti-fungal, anti-microbial, zinc, vitamins C and D, Neurotin, Coumadin

Current Illness: None

ID: 1011102
Sex: F
Age: 46
State:

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: low fever (101F), body aches, head ache, sore left arm where shot was administered

Other Meds: none

Current Illness: none

ID: 1011103
Sex: F
Age: 47
State: MN

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: Sulfa medications Environmental allergies

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

Symptoms: Initial symptoms were sore throat and nausea the evening of the vaccination (Wednesday, 2/3/21). Those continued the following day and as the day progressed I also was experiencing a headache, mild achiness, left side of my neck was sore/tender, and then that evening chills and a fever of 101.3. On Friday, 2/5/21 I woke up with a very sore and swollen right axilla and still had a headache, but the fever resolved over night. All symptoms, except right axillary swelling/soreness was resolved by the afternoon on 2/6/21. Currently, on 2/8/21, I still have mild tenderness/soreness in right axilla.

Other Meds: Progesterone only birth control pill Vit D3 25mcg daily Trazodone 50mg at HS for sleep

Current Illness: None

ID: 1011104
Sex: F
Age: 68
State: NJ

Vax Date: 01/25/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Left arm round red area with raised bumps

Other Meds: Zoloft multivitamin B12 calcium citrate focus Rosuvastatin Xanax prn Tylenol prn

Current Illness: No

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm