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: 1019897
Sex: F
Age: 61
State:

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 02/10/2021
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: Reports intermittent fluttering sensation in right ear and constant ringing in left ear that started 2 days after receiving second dose of vaccine. Referred to PCP for further evaluation.

Other Meds:

Current Illness:

ID: 1019898
Sex: F
Age: 23
State: NY

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/10/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: After the first and second dose the following events happened: Headaches, Chills, Fever, Fatigue and Arm pain was experienced.

Other Meds: None

Current Illness: None

ID: 1019899
Sex: F
Age: 35
State: MN

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: Systemic: Other- lightheaded, dizzy, tingling of roof of mouth, chest tightness, tongue felt swollen-Severe

Other Meds:

Current Illness:

ID: 1019901
Sex: F
Age: 23
State: PA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Pineapple

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Chills, dizziness, and migraine.

Other Meds: Ibuprofen and Sumatriptan. Received Toradol injection

Current Illness:

ID: 1019902
Sex: F
Age: 92
State: DC

Vax Date: 01/25/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Resident was noted with generalized rash throughout her lower and upper extremities, trunk, back area. left harm at injection site was grayish red.

Other Meds:

Current Illness:

ID: 1019903
Sex: F
Age: 70
State: GA

Vax Date: 01/30/2021
Onset Date: 02/01/2021
Rec V Date: 02/10/2021
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: Mupirocin, Tessalon Perles, Codeine and Keflex

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

Symptoms: Flu like symptoms, sneezing, runny nose, stomach pain and achy all over. Low grade fever one day.

Other Meds: Albuterol Inhaler, Atorvastatin, Amlodipine, Losartan, Levothyroxine, Hydralazine, Vitamin C, Vitamin E, Zyrtec, Tylenol, Advil.

Current Illness:

ID: 1019904
Sex: F
Age: 72
State: CO

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
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: anesthetics (ester type, parabens)

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: shortly after vaccination patient reported dizziness, diplopia, headache, and difficulty with answering questions. Denies chest and abdominal pain and shortness of breath. Patient transported to the emergency department where initial vital signs within normal ranges except blood pressure 170/119 mmHg. Physical and neurlogical exam noted above symptoms with cranial nerves, sensation, and extremty strength intact/normal. Patient's symptoms rapidly resolved without intervention. Repeat vital signs within normal ranges except blood pressure 134/91 mmHg. Determined patient experienced a vasovagal episode. Patient discharged to home stable.

Other Meds: apixaban, benazepril, cholecalciferol, hydrochlorothiazide, multivitamin, omeprazole, pravastatin, tramadol

Current Illness: none reported

ID: 1019905
Sex: M
Age: 64
State: ND

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: strawberries, seasonal allergies

Symptom List: Pharyngeal swelling

Symptoms: Started sneezing with watery itchy eyes 4 days after injection. On day 4 woke up with hives on back that has spread to right arm. Rash is small and not raised, but is quite itchy.

Other Meds: Atenolol, Losartan, escitalopram, loratadine, fluticasone propionate

Current Illness: none

ID: 1019906
Sex: F
Age: 39
State: IA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Pain, swelling, and redness of the right arm. Fatigue, muscle pain, joint pain, chills, nausea, and weakness. The pain started yesterday afternoon, The swelling got pretty bad in the evening and also that arm is really warm to the touch. The rest of the symptoms I noticed as soon as I woke up this morning.

Other Meds: Famotidine, Atorvastatin, Vitamin D supplement

Current Illness: None

ID: 1019907
Sex: F
Age: 57
State: CA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
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: Chills. fever, body aches, head ache, diarrhea, runny nose, sneezing and red and sore arm.

Other Meds:

Current Illness:

ID: 1019908
Sex: F
Age: 45
State: IN

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever > 100 (24hrs) Body aches/chills (24hrs)

Other Meds:

Current Illness:

ID: 1019909
Sex: F
Age: 47
State: PA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: The patient was administered the Moderna vaccine into the left arm at 9:46am. The patient was monitored for 15 minutes post-vaccination without adverse side effects. When exiting the building the patient reported feeling poor. She reported palpitations and sudden chest heaviness. She was able to sit and converse without difficulty. The Doctor onsite evaluated the patient: She denied shortness of breath or pleuritic pain. She noted mild nausea. Examination revealed no circumoral cyanosis or mottling. She was awake, alert and conversant without use of accessory muscles. She was diaphoretic and slightly pale. Breath sounds were normal without wheezing or stridor. She was tachycardic (156/min, with BP 156/90. O2 sat 99%. 9-1-1 was called. At the time of transport, the patient noted feeling slightly better, with heart rate 110/min. Pallor and diaphoresis slightly improved. Report was called to the Emergency the patient was transported to.

Other Meds:

Current Illness:

ID: 1019910
Sex: F
Age: 40
State: CA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Epinephrine allergic reaction - palpitation

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

Symptoms: Systemic: Other- palpitation-Mild

Other Meds:

Current Illness:

Date Died: 02/09/2021

ID: 1019911
Sex: M
Age: 77
State: WI

Vax Date: 01/25/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital: Y

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: Review of patient's allergies indicates: Allergies Allergen Reactions ? Other [Uncoded Nonscreenable Allergen] Rash Neoprene

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

Symptoms: Client was administered the vaccine while symptomatic (01/25/21) although client did not know he was symptomatic for COVID-19. He had been exposed to a family member who had tested positive and should have been in quarantine but wasn't either because it was not felt he was considered a close contact by his family opinion or his family member never notified public health of this close contact...?. Clinet had presented to the ED following day after vaccination for shortness of breath and fatigue and an antigen test showed he was positive for COVID-19. He was sent home that same day 01/26/21. He was back in ED on 01/28/21 for worsening symptoms and admitted to hospital and later placed on ventilator. He passed away on 02/09/2021 (date of death was per his wife).

Other Meds:

Current Illness: Tested positive for COVID-19 on 01/26/2021 (Antigen positive) - presented to ED due to shortness of breath and fatigue

ID: 1019912
Sex: F
Age: 64
State: IA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/10/2021
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: The outside of my left started to tingle and went all the way down unto my hand and fingers, the outside of my palm from my little finger and up to about 2" above my wrist. After a couple of days only my hand felt and fingers were still numb. That lasted about a week and then the last week until the day that I got my 2nd injection (Feb. 5) only my little finger felt like that. I have that sensation in my hand again but it is very weak and it comes and goes. I have migraines and sometimes I have that feeling in my arm and hand.

Other Meds:

Current Illness: none

ID: 1019913
Sex: F
Age: 67
State: TN

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: Chest discomfort with high heart rate and shortness of breath, dizzy upon standing. In ER HR was 156 with atrial fibrillation with RVR. BP 146/89. 2/7/21 1546 - Patient complaining of left side peripheral field deficit, CT showed subacute right occipital lobe infarct

Other Meds: Lostartan 25mg PO Daily Lovastatin 20mg PO Bedtime Lortab 5-325mg PO BIDPRN Celecoxib 200mg PO Daily

Current Illness:

ID: 1019914
Sex: F
Age: 23
State: WA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: Fever, chills, upset stomach I'm feeling better a few hours later but not recovered.

Other Meds:

Current Illness:

ID: 1019915
Sex: M
Age: 66
State: NY

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Low platelet count on my blood-test taken the next day as part of a routine physical. This has never been a problem for me before.

Other Meds: Lansoprazole, 30 mg. 1/day: Atorvastatin 40 mg. 1/day; Fluticascone Propionate Nasal, 50 mg. prn: apririn, 81 mg. 1/day; CoQ-10 100 mg. 1/day; Melatonin 10 mg. 1/day; Vitamin D3 25 mcg 1/day.

Current Illness: none

ID: 1019916
Sex: F
Age: 61
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Missed 1 day of work due to fever, body aches, chills, headache, and sore arm.

Other Meds:

Current Illness:

ID: 1019917
Sex: U
Age:
State: FL

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/10/2021
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: phone call from a 71 YR OLD FEMALE who is calling to report on her ADVERSE REACTION to MODERNA VACCINE that she received on 1/25/2021. Caller reports that on 1/26/2021 pt began having shortness of breath, which progressed to n/v, headache, muscle weakness, and fever. Caller reports fever is no longer present but pt still has shortness of breath. Advised with severity and duration of sx would refer to HCF for further eval. Caller reports she will not be going to HCF today but is amenable to callback. Advised SNT35 and that PIC is available prn. PVH

Other Meds:

Current Illness:

ID: 1019918
Sex: F
Age: 28
State:

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
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: Clindamycin, erythromycin, NSAIDs

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

Symptoms: Rash and itchiness local area

Other Meds: None

Current Illness: None

ID: 1019919
Sex: F
Age: 82
State: AZ

Vax Date: 01/08/2021
Onset Date: 02/03/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Bactrim

Symptom List: Unevaluable event

Symptoms: Had positive covid-19 test on 02/03/2021 via Rapid Abbott BinaxNOW Ag card. Patient denied any symptoms.

Other Meds:

Current Illness:

ID: 1019920
Sex: F
Age: 51
State: CA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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 allergy

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

Symptoms: Systemic: Other- High blood pressure (198/123) pulse (106bpm), palpitation -Medium

Other Meds:

Current Illness:

ID: 1019921
Sex: M
Age: 28
State: CT

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
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: unknown

Symptom List: Injection site pain, Pain

Symptoms: Patient arrived to clinic to receive a flu vaccine for the 2020-2021 season. Upon arrival to clinic, patient completed flu questionnaire. Patient was then vaccinated with Moderna Covid-19 vaccine by error. Upon realization of incorrect vaccine being administered, staff then vaccinated with correct vaccine (afluria) in opposite arm. Upon speaking with the patient the next day, he reported feeling chills, fever, fatigue continuing throughout the day. States did have a headache on 2/9/2021 that then subsided. Was taking tylenol and theraflu for side effects

Other Meds: unknown

Current Illness: unknown

ID: 1019922
Sex: F
Age: 86
State: MO

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
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: Around noon she got really hot, sick to stomach, fainty, hard to talk and a headache. Call the ambulance and refused transport to the hospital. Lasted approximately 24 hours.

Other Meds: omeprazole, furosemide, pravastatin, lisinopril, metoprolol, amlodipine, claritin

Current Illness: kidney infection around 1/25

ID: 1019923
Sex: F
Age: 67
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 02/10/2021
Hospital: Y

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: Pt was hospitalized with COVID-19 Pneumonia. Admitted on the 25th of January and treated with Remdesivir. Discharged to home on February 1st.

Other Meds:

Current Illness:

ID: 1019924
Sex: M
Age: 45
State: TX

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 1. Moderate Pain Site of the Injection (started 12 hours after injection) lasted (4 days) 2. Painful Lymph-nodes : Location Right cervical , Right side supra clavicular and infra clavicular , lasted for 1 week 3. Light headed lasted 2 days 4.nauseas lasted 3 days 5 diarrhea mild lasted 2 days 6. Chills , lasted for 3 days 7 weakness , lasted 10+ days

Other Meds: n/A

Current Illness: no

ID: 1019925
Sex: F
Age: 48
State: KS

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Gluten, Sulfa based medications, Tramadol, Amoxicillon Clavical, Docyclocyclin, latex

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: A few hours after the vaccine I developed a fever, dizziness, chills, severe headache and had night sweats. It was if my whole body was swollen and just to move had me in tears because my body was so sore. The arm pain was there but not as bad as from the first vaccine. I developed SOB and have had to start using my asthma pump which I hadnt had to use in over 3 years. I have been off work since 1/3 from the AE experienced to both vaccinations and to date I am still experiencing breathing issues. I have been developing intermitten fevers off and on throughout this whole time. An the fatigue has been awful. I havent been able to stay awake long and as of yesterday was the first day I have been able to stay awake for an extended period of time.

Other Meds: Vit C,D,B and Zinc, Acetaminophen

Current Illness: AE from the 1st vaccination

ID: 1019926
Sex: F
Age: 66
State: CA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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: Wrong dose- patient received 0.3ml

Other Meds:

Current Illness:

ID: 1019927
Sex: F
Age: 47
State: CA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: no known allergy

Symptom List: Nausea

Symptoms: Systemic: Fainting-Medium, Systemic: Other- High BP

Other Meds:

Current Illness:

ID: 1019928
Sex: F
Age: 30
State: CA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital: Y

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

Lab Data:

Allergies: None-very healthy

Symptom List: Injection site pain

Symptoms: Very healthy person, got the shot then that night got sudden hot sweats, chills, body ache pains everywhere, could not sleep, head ache, legs sweating

Other Meds: None

Current Illness: NONE

ID: 1019929
Sex: F
Age: 46
State: CA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Ten minutes after receiving the vaccine, patient reported to MD in Observation area that she was experiencing a headache, tongue and right arm numbness. After MD assessed patient (and patient relayed this was the same reaction she had with the first vaccine), MD kept her in the observation area for 30 minutes as the symptoms subsided. Patient was released when all symptoms were gone.

Other Meds: IBUPROFEN 800MG SLEEP RIGHT OTC CENTRUM MVI OTC

Current Illness: unknown

ID: 1019930
Sex: F
Age: 31
State: CA

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
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: Peaches

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

Symptoms: Around 3:45 pm the day of the injection I had strange sporadic head pains followed by waves of nausea. The head pains and nausea never lasted more than 5 minutes. The next day I was extremely fatigued. Slept a lot. The waves of head pains and nausea were more frequent throughout the day after and lasted more like 15 minutes. The following day the fatigue was gone. Had random waves of dizziness and nausea that lasted about 3 minutes and then would pass.

Other Meds: Yaz

Current Illness: none

ID: 1019931
Sex: F
Age: 35
State: OH

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/10/2021
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: Reporter documented "Patient was accidently given Dtap instead of Tdap on 1/12/21". Additional documentation from reporter "A couple months ago or so, we did not have Tdap and the long green box of Dtap appeared on our top shelf in the fridge. It is a different brand, I looked at the ingredients were the same , so I had thought it said Dtap was because it was a different company. I didn't realize that one was the initial vaccine and the other was the booster. Someone did recently write on there for 6 weeks to 6 years. It was still on our shelf in the fridge until I moved it to the bottom shelf the day I discovered the mistake. I notified the midwife as this was her patient. She tried to contact patient. I also notified my supervisor. I did share with fellow employees that there is a difference in Tdap and Dtap and to always make sure you have Tdap when giving in clinic".

Other Meds: Prenatal

Current Illness:

ID: 1019933
Sex: F
Age: 53
State: PA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/10/2021
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: erythromycin

Symptom List: Erythema, Pruritus

Symptoms: fainted approximately 12 hours after vaccinated and injured my nose.

Other Meds: amlodipine lisinopril pravastatin duloxetine cosentyx pantoprazole tresiba victoza

Current Illness: None

ID: 1019934
Sex: F
Age: 67
State: CA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
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: KNA

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

Symptoms: 09:35A Pt c/o of wrist discomfort pinching like pain and swelling, pt stated sensation subsided and replaced w/ itching, which slowly resolved. pt was stable and ten d/c. Initial vitalt: bp 124/90, hr 74 rr 18 O2 98% temp 97.2. d/c vitals: temp 97.2 hr 76 O2 98% rr 18 bp 126/90. Pt stable at d/c, educated and advised to seek medical medical attention if worsening s/s. 10:12A.

Other Meds: losartan, baby aspirin, omeprazole, and amlodipine.

Current Illness: HTN, hyperlipidemia, GERD

ID: 1019935
Sex: F
Age: 56
State: NY

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
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: Penicillin, morphine, percocet, tamoxofen, exemestane, sulfa drugs

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

Symptoms: Swollen tongue, tingling tongue and lips, Tightness in throat, lightheadedness, weakness and heaviness in both legs.

Other Meds: Diclofenac sod 75 mg

Current Illness: None

ID: 1019936
Sex: F
Age: 65
State: MT

Vax Date: 01/06/2021
Onset Date: 01/15/2021
Rec V Date: 02/10/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: I had pain in my upper left thigh. It was localized and didn't radiate.

Other Meds: I take medication for HBP, Cholesterol and a fluid pill.

Current Illness: No

ID: 1019937
Sex: F
Age: 88
State: WA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: No known allergies

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

Symptoms: Systemic: Chills-Severe, Systemic: Fainting-Severe, Systemic: Other- High heart rate, 121 BPM, high anxiety, body shaking chills, passed out for about 30 seconds, was able to speak and breath normally

Other Meds:

Current Illness:

ID: 1019938
Sex: M
Age: 70
State: CO

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pt was given first dose of Moderna vaccine while inpatient today (02/09). I sent the after visit summary and discharge summary to his nursing home. Was then notified by nursing home liaison that the pt had already received both doses of the Pfizer vaccine at the nursing home (second dose on 02/03).

Other Meds:

Current Illness:

ID: 1019939
Sex: F
Age: 76
State: OH

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: Cardizem allergy

Symptom List: Pain in extremity

Symptoms: Patient stated that 1 week later, she had a red itchy rash about 3x4" diameter around injection site.

Other Meds: Not known

Current Illness: Not known

ID: 1019940
Sex: F
Age: 17
State:

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 02/10/2021
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: Pt was signed up for an appt for her first dose. Multiple calls were made to administration regarding her appt including Lt Col (Dr.) Direction had been provided earlier that week that clinical concerns could be channeled to Lt Col (Dr.) for determination of tx. It was discussed that she was 17, and active EMT and had a parent present at time of vaccine. It was discussed that we were not supposed to be vaccinating minors but she had a appt and met 1A criteria. Approval was given to vaccinate pt. Upon the pts second dose, administration was again contacted and it was determined pt should not be given the second dose. This writer spoke both with pt and mother.

Other Meds:

Current Illness:

ID: 1019941
Sex: F
Age: 67
State:

Vax Date: 12/18/2020
Onset Date: 12/24/2020
Rec V Date: 02/10/2021
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: Imitrex

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

Symptoms: About 5-7 days after vaccination patient started having symptoms she reported as right sided facial numbness also had pain and headache. Patient did also report localized reaction of redness and hives around injection site along with fever 0- the time frame on this. Patient did report to the emergency department and had a workup but no definitive diagnosis was identified. On 2/10/21: Patient reports for the most part this has significantly improved and continues to although still some residual numbness

Other Meds: Tyelonol with codeine, Xanax, Tegretol, Vitamin D, Aimovig, Lexapro, Estrace cream, Flovent HFA, ketoconazole shampoo, Xarelto

Current Illness:

ID: 1019942
Sex: M
Age: 69
State: LA

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA or other allergies

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

Symptoms: SOB, coughing , BNP and BUN elevated. Covid REGN-Cov2 antibodies

Other Meds: amiodarone, aspirin, insulin

Current Illness: no acute

ID: 1019943
Sex: F
Age: 79
State: WA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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: aspirin, Dilaudid, morphine

Symptom List: Vomiting

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1019944
Sex: M
Age: 84
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
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: PCN

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient tested positive for Covid-19 on 02/08/2021. Patient denies any symptoms.

Other Meds:

Current Illness:

ID: 1019946
Sex: M
Age: 81
State: FL

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/10/2021
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:

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

Symptoms: Wife calling, sitting with her husband an 81 yo m currently in the Neuro ICU. He went Pharmacy Monday morning 11:30 AM for a covid shot. No immediate issues, no symptoms that day. 8 PM that night she noted facial asymmetry and slurred speech, called 911. He's still in hospital, improving mentation today, more aware to person than before. Had surgery to remove the clot. She doesn't currently have all the information on her person (ex, unsure exact meds, CDC card at home. She isn't certain it's related but wants to report this, just in case. Reviewed with Dr., no reports of this type of ADR, most likely issues unrelated, but Relayed to patient also that it's great that she had the presence of mind to report this, because this is how we can best assess vaccine safety. PCC will Check back in a week for patient status, missing report information. Slurred speech, facial asymmetry/other neuro, confusion, blood clot, - still ongoing but improving

Other Meds: blood pressure meds, doxycycline for infection prevention, allopurinol for gout, heart doctor has him on ASA.

Current Illness:

ID: 1019947
Sex: F
Age: 80
State: AR

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
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: no

Symptom List: Injection site swelling, Limb discomfort

Symptoms: extreme diahrea weakness anto diahrea med dicyclomine still have diaerhea

Other Meds: losartan neflundipine leflunomide escitalopram premirin shot twice a month don't know name for rheumatism

Current Illness: gastroparesis, rheumatoid arthritis

ID: 1019948
Sex: M
Age: 54
State: MD

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Felt dizzy immediately after vaccine

Other Meds: STATIN

Current Illness:

ID: 1019949
Sex: F
Age: 37
State: CA

Vax Date: 01/13/2021
Onset Date: 01/21/2021
Rec V Date: 02/10/2021
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: Penicillin and Sulfa drugs. atopic dermatitis of unknown origin happened many times throughout lifetime

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

Symptoms: 2-inch diameter red, painful rash/ raised circle centered around vaccine injection site. Treatment: 1 benadryl 25mg HCl at first sign, repeat 1 more, 6 hours later. Rash was resolved 80% by next day, 90% for following 2 days, and 100% by day 4. To note had localized pain in armpit and left chest for 3 days PRIOR to onset of rash, had resolved by morning of Jan 21 (day rash showed up in afternoon).

Other Meds: Zyrtec, Vitamins A, D, E, C and zinc.

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm