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: 1019950
Sex: F
Age: 31
State: AZ

Vax Date: 02/01/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Mango, strawberries and all dairy

Symptom List: Dysphagia, Epiglottitis

Symptoms: Migraine - lasted 48 hours, medication (naproxen - 440mg every 6-8 hours) did not help. Sore Throat-hard to swallow, sharp throat pain, still hurts 48 hours after vaccination. Tongue Pain-started on both sides towards back of tongue, 48 hours later, still hurts, can't eat/talk without being in pain. Right side feels better, left side in a lot of pain. Can't see any type of sore on tongue.

Other Meds: N/A

Current Illness: N/A

ID: 1019951
Sex: F
Age: 43
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Morphine Levaquin Menocyn

Symptom List: Anxiety, Dyspnoea

Symptoms: Felt achy, fatigue, headache onset approx 16 hrs after shot. 48 hrs after injection, injection site is red, warm, itches.

Other Meds: Claritin

Current Illness: None

ID: 1019952
Sex: M
Age: 84
State: AZ

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: 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: Within 12 hours after vaccination, I became hot and sweating with pain all over my body. I went to bed at 7 pm and stayed in bed until noon the next day. The pain and sweats were 90% gone by that time. Total hours in pain+ was about 12 hours.

Other Meds: Ezetimibe

Current Illness: None

ID: 1019953
Sex: F
Age: 27
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: headache, fever, chills, body aches, nausea, lightheadedness, chest pain

Other Meds: Gabapentin - 2 tablets per day Rizatriptin - as needed

Current Illness: None

ID: 1019954
Sex: F
Age: 26
State: CA

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: LA

Lab Data:

Allergies:

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

Symptoms: Dose received 0.3ml

Other Meds:

Current Illness:

ID: 1019956
Sex: F
Age: 50
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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:

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

Symptoms: At 0905 hrs patient complained of feeling as if her BP dropped upon assessment her BP was 200/120, all other VS were WNL, at 0921 hrs her BP was 216/117, S1S2 were regular, breath sounds were clear throughout, no difficulty swallowing, no SOB or difficulty breathing, capillary refill less than 2 seconds, radial pulses equal and strong bilaterally. Patient stated felt fine with no complaints. At 0938 hrs BP was 190/135 all other VS WNL, at 0957 BP 181/120, at 1020 hrs BP 196/95, patient denied any pain and continued to state she felt fine. Advised patient to not continue her working shift and have a family member or friend pick her up from work and rest at home. Patient was picked up by a family friend and advised to follow up with PCP and seek medical attention if begins to feel adverse symptoms. Patient left ambulatory in stable condition with no complaints or symptoms.

Other Meds:

Current Illness:

ID: 1019957
Sex: F
Age: 67
State: IN

Vax Date: 02/08/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Very exhausted and sleepy, headache, fever 101, tummy ache.

Other Meds: Dietary supplements,-vitamins, multipurpose, A, B, and C

Current Illness: none

ID: 1019959
Sex: F
Age: 36
State: OH

Vax Date: 02/08/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: Fever of 101.4, moderate to severe body aches and chills, headache. Lasted approximately 40 hours.

Other Meds: Sertraline 100mg Allegra over the counter 180 mg Omeprazole 40 mg

Current Illness: Sinus infection

ID: 1019960
Sex: F
Age: 56
State: LA

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: Levaquin, sulfa, cipro

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Face and scalp itching, headache, fever, pain to soles of feet, extreme fatigue, body and joint pain. Started approx 3 hours after injection and is continuing on day 3, but symptoms are lessening some. Tylenol and Motrin and rest treatment. Contacted my physician for further advice or treatment needed.

Other Meds: Femhrt, estradiol, vitamin C, fluoxetine, vitamin D3

Current Illness: None

ID: 1019961
Sex: F
Age: 49
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1019962
Sex: F
Age: 43
State: FL

Vax Date: 02/06/2021
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: None

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

Symptoms: Starting with itching on palms and then started to get worsen as days progressed. By Tuesday night the severity increased and started noticing red rashes. Went to ER Wed am and there were swelling noticed in palms and rashes through out the body.

Other Meds: None

Current Illness: None

ID: 1019963
Sex: M
Age: 47
State: NJ

Vax Date: 01/14/2021
Onset Date: 02/09/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Development of Bell's palsy (patient had Bell's palsy approximately 10 years ago)

Other Meds: None

Current Illness: None

Date Died: 02/07/2021

ID: 1019964
Sex: M
Age: 80
State: LA

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:
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: The resident received his COVID-19 Moderna vaccination on 2/6/2021 2:11 pm and expired on 2/7/2021 at 6:04 am. There were no signs or symptoms of vaccination reaction leading up to death.

Other Meds: Ferrous sulfate, Proteinex, Tylenol, Eliquis, Aspirin, Lipitor, Vitamin D3, Cholestyramine, finasteride, flavoxate, lactobacillus, loratadine, magnesium oxide, metoprolol, protonix, miralax, potassium cl, Tamsulosin, acetic acid (for foley)

Current Illness: Peg tube placement Malignant neoplasm of esophagus

ID: 1019965
Sex: F
Age: 49
State: CA

Vax Date: 02/02/2021
Onset Date: 02/09/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: sulfa drugs, erythromycin, Azithromycin

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

Symptoms: 7 days after receiving shot, my arm started to tighten, get sore, swell with slight itching. The next morning, itching increased as well.

Other Meds: multi-vitamin, B-12, Omgega 3, dha, epa, Vitamin D, Digestive Enzymes, iron, Progesterone 50 mg, DHEA 10mg, Testosterone cream 10

Current Illness: None

ID: 1019966
Sex: F
Age: 95
State: MA

Vax Date: 01/21/2021
Onset Date: 02/05/2021
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: acute and progressive onset of confusion, agitation, disorientation - no focal neurologic signs or somatic complaints - difficulty wiht attntion, concentration, focusing on conversation - oriented x 3 but confused why she was where she knew where she was 9 her home), aware of people and names,

Other Meds: Effexor, Synthroid

Current Illness: none

ID: 1019967
Sex: F
Age: 68
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Anaphylaxis from IV contrast dye

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

Symptoms: Felt dizzy but states she was "very emotional" about getting her shot. HX of anaphylaxis from IV contrast. HR 100, O2 98%, BP 175/100. Declined observation and drove home.

Other Meds:

Current Illness:

ID: 1019968
Sex: F
Age: 73
State: TN

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: None

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

Symptoms: A hot flush to my face turning my cheeks red, and I broke out in a cold sweat and my tongue felt a little tingly. These symptoms lasted about 35 minutes and then I was fine. I?ve never been allergic to anything so my question is should I take the second dose, since I know it is much stronger what do you advise?

Other Meds: None

Current Illness: None

ID: 1019970
Sex: F
Age: 33
State: MN

Vax Date: 01/21/2021
Onset Date: 01/29/2021
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: PCN

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 8 days after vaccine, shot site became hard, red, hot, itchy. Red spot was about 5 inches in diameter. Upper arm broke out in raised hives down to the elbow. Symptoms lasted about 24-48 hours.

Other Meds: Multivitamin

Current Illness: n/a

ID: 1019971
Sex: F
Age: 20
State: CA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: No known allergies.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: The vial was punctured at 1551 on 2/8/21. The patient did not receive the vaccine within the 6-hour time frame. She received her dose at 2240 the same day. The patient has not had a reaction since receiving the vaccine.

Other Meds: N/A

Current Illness: None.

ID: 1019972
Sex: F
Age: 21
State: RI

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

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

Symptoms: Nauseous, dizzy, syncopal lasting approx 2-3 seconds.

Other Meds:

Current Illness: Anxiety

ID: 1019973
Sex: F
Age: 55
State: MD

Vax Date: 01/28/2021
Onset Date: 02/05/2021
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: N/A

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

Symptoms: 8 DAYS AFTER THE VACCINATION SWELLING REDNESS SORENESS ITCHING

Other Meds: IBUPROFEN 800 MG TABLET VITAMIN D CALCIUM

Current Illness:

ID: 1019974
Sex: F
Age: 38
State: MI

Vax Date: 12/18/2020
Onset Date: 12/19/2020
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: Unevaluable event

Symptoms: Sore arm after 1st shot. Body aches after 2nd dose that lasted half a day. Second dose was 1/8/2021. Also developed episcleritis a couple of weeks later that wouldn't go away. This was new an unusual for me so I wondered if it might be because of the vaccine. Currently being treated with prednisolone eye drops.

Other Meds:

Current Illness:

ID: 1019975
Sex: M
Age: 68
State: IN

Vax Date: 02/01/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Seafood

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

Symptoms: Rash, severe chest pains, could not breath

Other Meds: None

Current Illness: No e

ID: 1019976
Sex: F
Age: 71
State: CO

Vax Date: 01/06/2021
Onset Date: 01/13/2021
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: sulfa

Symptom List: Injection site pain, Pain

Symptoms: Outbreak of classic flexural exematous dermatitis

Other Meds:

Current Illness:

ID: 1019977
Sex: M
Age: 72
State: IL

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

Date Died: 02/10/2021

ID: 1019979
Sex: M
Age: 72
State: MI

Vax Date: 01/28/2021
Onset Date: 01/29/2021
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: NKA

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

Symptoms: Patient received the Moderna COVID vaccine 1/28/21. He was tested for COVID 19 on 1/29/31. Results were received 1/30/21, at which time he was evaluated and found to be hypoxic with tachycardia. He was sent to the local ER and returned this same day. On 2/2/21, he was evaluated by the provider, who sent him to the emergency room with acute respiratory distress and poor O2 sats

Other Meds: ALBUTEROL HFA (8.5GM) 90 MCG INHA Exp: 05/06/2021 SIG: 90mcg Inhalation every four (4) to six (6) hours as needed x 180 day(s) -- Limited to two (2) canisters every six (6) months Artificial Tears Ophthalmic Solution 1.4 % Exp: 02/23/2021 S

Current Illness: Vitamin Deficiency

ID: 1019980
Sex: F
Age: 59
State: WI

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: Intolerance to Ibuprofen and Tylenol Sulfa, adhesive, Cyclobenzaprine, Methocarbamol Levofloxacin, Sulfamethoxazole-Trimethoprim

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: High pulse rate. Heart rate normally 62-65. 70 at rest today. While making lunch pulse rate 116-130. Slept only 4 hours, feel shaky, and can feel pulse in neck and throat.

Other Meds: Cholecalciferol, Multivitamin, Culturelle

Current Illness:

ID: 1019983
Sex: F
Age: 66
State: AR

Vax Date: 01/06/2021
Onset Date: 01/08/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 48 hrs after vaccination developed severe abd/low back pain. Worked up for diverticulitis but all tests were WNL. 8 days after vaccination she develop blisters on left lower back and abd area and was then dx with shingles and started on acyclovir.

Other Meds: Acebutolol, Synthroid, B12 injections q 2 wks, D3, multi-vits. HCTZ PRN

Current Illness: none

ID: 1019984
Sex: F
Age: 70
State: CA

Vax Date: 02/01/2021
Onset Date: 02/07/2021
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: None

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

Symptoms: Minor, but only started 6 days after vaccine. Itching and redness , slight swelling, appearing to be contained within the muscle of the injection. No pain. Worse at end of the day, night. Tolerable. Ongoing currently, not spreading, not worsening. Reporting for information only.

Other Meds: Vitamin D3

Current Illness: none

ID: 1019985
Sex: F
Age: 73
State: OK

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: IM
Vax Site: RA

Lab Data:

Allergies: Sensitivity to salicylates, allergy to penicillin

Symptom List: Nausea

Symptoms: (first dose) Tenderness at injection site, subsequent joint and muscle pain (first 24 hours), lethargy (second 24 hours); (second dose) tenderness at injection site, much greater pain on right side of body (first 24 hours), nausea, fever, lose of appetite, greater lethargy which included sleeping for 20 hours following the injection, dizziness (second 24 hours). In both cases, symptoms were gone by third day. One dose of 25 mg Tramadol were taken to relieve pain after first injection, two doses of 25 mg Tramadol were taken to relieve pain after second injection.

Other Meds: Montelukast, Hydrochlorothiazide, Alpha Lipoic Acid, Vitamin C, Dupixent

Current Illness: None

ID: 1019986
Sex: F
Age: 75
State: AL

Vax Date: 02/09/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Slight headache; joints aching mild; temperature -100.2

Other Meds: Meloxicam 7.5m;(2x); Centrum Silver - Adult; Nature Bounty -Hair & Nail Supplement

Current Illness: None

ID: 1019987
Sex: M
Age: 33
State: CT

Vax Date: 01/29/2021
Onset Date: 01/30/2021
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: Keflex medication

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

Symptoms: 102 fever for 36 hours, low grade 99-99.5 fever for another 24 hours, massive headache for 72 hours, arm pain for 5 days, tired for the first 24 hours after the 102 fever started.

Other Meds: Ventolin

Current Illness: N/A

ID: 1019988
Sex: F
Age: 19
State: MN

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: IM
Vax Site: RA

Lab Data:

Allergies: NKA per consent and client. Employee of living Center not a patient there.

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

Symptoms: Systemic: Other- Pt stated blurry vision, Full UE numbness and LE numbness, flacid, BP 100/50, cool, clammy, sob, dizziness. Lasted 1 day

Other Meds:

Current Illness:

ID: 1019989
Sex: M
Age: 84
State: OH

Vax Date: 01/21/2021
Onset Date: 01/23/2021
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: GETS ECZEMA + ITCHING DURING SUMMER WHEN OUTSIDE - SEES DERMOTOLOGIST

Symptom List: Tremor

Symptoms: ITCHING, RASH, SWELLING, PAIN ALONG DELTOID TO INSIDE OF ELBOW. STARTED ~2 DAYS AFTER ADMINISTRATION. AS OF 2/10/21- STILL RED "LIKE SUBNURN TURNING TO SUNTAN" NO LONGER SWOLLEN, OCCASIONAL MUSCLE PAIN "IF [HE] BENDS IT THE WRONG WAY"

Other Meds: B12 (SL) 1000MCG, FINASTERIDE 5MG, HCTZ 12.5MG, LEVOTHYROXINE 50MCG, FOLIC ACID 1MG, TAMSULOSIN 0.4MG, LATANOPROST 0.005%

Current Illness: NONE

ID: 1019990
Sex: M
Age: 58
State: CA

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: dose administered 0.3ml

Other Meds:

Current Illness:

ID: 1019991
Sex: F
Age: 71
State: WI

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: Compazine and all phenothiazines, Indomethacin, Oxycodone

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

Symptoms: Within several minutes of injection my vision became very blurry and I was lightheaded. A nurse took my vitals and they were normal, although the BP was on the low side (I believe 95/54). They had me lie back in a recliner and kept checking me. After about 45 minutes my vision cleared and I sat up. About 10 minutes later I walked within the hospital to be sure I was safe to drive, and I was. The doctor on duty did also check me before I left.

Other Meds: Trulicity, Invokana, Metformin, Lisinopril, Pravastatin, Allegra, Multivitamin

Current Illness: Allergies causing sneezing and runny nose

ID: 1019993
Sex: M
Age: 70
State: TN

Vax Date: 02/05/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: No life threating allergies.

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

Symptoms: Had a severe SVT episode of 170 bpm that lasted for 15 hours beginning at 10:00 am on Tuesday, February 9, 2021, and continuing until 1:30 am on the 10th of Feb. 2021. Subsequent muscle aches and general soreness without fever the following day (Feb. 10, 2021). Historical episodes of SVT typically last between 1-3 hours, and I had not had a recent SVT episode prior to vaccination. During the 15 hour SVT episode post vaccination, I experienced much higher than normal blood pressure readings and erratic blood glucose levels which cannot be explained by diet changes, even though I was still taking my prescribed medications on schedule.

Other Meds: Sotalol, Amlodipine Besylate, Levothyroxine, Eliquis, Vitamin D

Current Illness: One month prior, 1hr episode of tachycardia

ID: 1019994
Sex: F
Age: 84
State: AL

Vax Date: 02/08/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Bactrim, Levaquin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: ecchymosis inferior to injection site no hemarthrosis, full ROM, Neuro intact, 1/2 circumferencial,

Other Meds: Alprazolam, Flecainide, Lasix, Lisinopril, Momantine, Methenamine, Prilosec, Coumadin

Current Illness: None

ID: 1019996
Sex: F
Age: 52
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Felt nausea immediately after vaccine on 2/10. This resolved without intervention in a few minutes.

Other Meds:

Current Illness:

ID: 1019997
Sex: M
Age: 30
State: CA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
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: no

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

Symptoms: During afternoon, my left arm felt sore. At 10:00 pm started having body aches. I woke up around 2:00 am and I had a high fever and I was having trouble breathing. My fingertips had turned blue. My oxygen level was about 92%. I took ibuprofen and that brought the fever back down. I had body aches the next day. My cough had gotten worse (that I had at time of vaccination). I went to Urgent Care on January 6, 2021. They did the COVID test that day. I had a sinus infection - antibiotics were prescribed. It took about two weeks for symptoms to resolve.

Other Meds: No

Current Illness: I had a cough and some recurring headaches

ID: 1019998
Sex: M
Age: 55
State: CA

Vax Date: 12/20/2020
Onset Date: 12/20/2020
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: No known allergies

Symptom List: Pain in extremity

Symptoms: Patient received first dose of the Pfizer-BioNTech COVID-19 Vaccine EUA at 17:48 on 12/20/20. At 17:58, patient complained of eye irritation, eyes were red and itchy. No complaint of difficulty breathing, increased heart rate or dizziness. Pharmacist provided diphenhydramine 25mg tab and patient was observed for an additional 15 minutes. Irritation resolved and patient had no complaints at end of the observation period. Discharged to home.

Other Meds: Allopurinol 300mg tab qhs, amlodipine 5mg tab daily, aspirin 81mg chew daily, Salonpas patch daily, vitamin D3 1000 units daily, Claritin 10mg tab daily prn allergies, losartan 100mg tab daily, metoprolol succinate 100mg tab daily, nabiumet

Current Illness: Not available in medical chart

ID: 1019999
Sex: M
Age: 59
State: MO

Vax Date: 12/23/2020
Onset Date: 12/26/2020
Rec V Date: 02/10/2021
Hospital: Y

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

Lab Data:

Allergies: Rocephin, erythromycin, sulfa drugs, Penicillin

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

Symptoms: Tested positive for COVID on December 31, 2020, Symptoms started on December 26, 2020,

Other Meds: Metformin, lisinopril, simvastatin, Lantus, ASA, Claritin D, Vitamin D, Vitamin C, Elderberry Gummies,

Current Illness:

ID: 1020000
Sex: M
Age: 48
State: CA

Vax Date: 02/02/2021
Onset Date: 02/09/2021
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: None

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

Symptoms: I experienced acute arm pain after injection that subsided within 48-72 hours. Last night, on day 8, after five+ days of no pain whatsoever, and through the night to today (day 9) I am again experiencing acute arm pain similar to the worst pain I felt in the days after the injection, both at the injection site and radiating down my arm and into my shoulder. I took Tylenol which has provided some relief, but my range of arm motion is still limited by sharp pain.

Other Meds: Vitamins C, D, B12 Prevacid Turmeric, Lipoic Acid

Current Illness: None

ID: 1020001
Sex: M
Age: 17
State: MN

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

Lab Data:

Allergies:

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

Symptoms: Error: Too Young for Vaccine

Other Meds:

Current Illness:

Date Died: 02/05/2021

ID: 1020002
Sex: M
Age: 74
State: OH

Vax Date: 01/19/2021
Onset Date: 02/05/2021
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: cyclobenzaprine

Symptom List: Vomiting

Symptoms: Given First Moderna covid vacc 1/19/2021. Doing well on multiple contacts from health care providers, then 2/5/2021 was driving, pulled over to the side of the road into a yard, got out of the car and told an observer that he could not breathe, collapsed face down in the snow, EMS called, unable to revive him.

Other Meds: Albuterol, Bumetanide, Metolazone, Candesartan, Carvedilol, Gabapentin, Insulin Pantoprazole, Tamsulosin, Warfarin

Current Illness: CHF

ID: 1020003
Sex: M
Age: 82
State: MD

Vax Date: 01/06/2021
Onset Date: 01/09/2021
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: Horse Serum-Tetanus Shot reaction, Iodine-Contrast, Amoxycillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 2.5 inch X 1 inch red/hard lump

Other Meds: Atorvastatin, Glipizide, Meclizine, Metoprolol, Metformin, Actos, Eliquis, Gabapentin, Glyburide, Lacosamide, Hydralazine

Current Illness: 12/1-12/15 COVID-19 POSITIVE-4 day hospital stay

ID: 1020004
Sex: F
Age: 47
State: WI

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

Lab Data:

Allergies: No

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

Symptoms: Headache, nausea, chills, body aches, sore joints, overall felt horrible

Other Meds: Oral birth control

Current Illness: No

ID: 1020005
Sex: F
Age: 65
State: AZ

Vax Date: 02/06/2021
Onset Date: 02/08/2021
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: Dairy sensitivity.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Shot given 10:19pm on 2/6/21. Noticed rash on 2/8/21 11:55am. Rash was bilateral on face along madibles from TMJ to about 1" from lips and was 2" superior from jaw line towards the eyes. Rash was very red over skin area with multiple darker spots and by 2/7/21 those spots appeared open though no blisters or pustules were seen. Rash had burning sensation which was relieved by Vaseline. Once doctor was seen (PA), Tacrolimus ointment was prescribed BID. Rash no longer burns 2/9/21 pm and it appears to be resolving. Spots are still evident but erythemic area is gone.

Other Meds: Doxycycline hyclate 50mg, qd , Finesteride 2.5mg qd, Clobetasol Propionate foam0.05% to front hairline bid x4 days, rest x3 days, Niacidamide 1,000mg qd, multivitamin qd, Vitamin D3 5,000units qd, Calcium tablet qd.

Current Illness: None

ID: 1020006
Sex: F
Age: 39
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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:

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

Symptoms: Chills, fever shivering, also has headache , body aches which is continuing. Sweating during night, continuing today..

Other Meds:

Current Illness:

ID: 1020007
Sex: F
Age: 50
State: IN

Vax Date: 02/01/2021
Onset Date: 02/10/2021
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: None

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

Symptoms: Aches in neck arms shoulders and nasuea for about 4 hrs then subsided

Other Meds: Blood pressure medicine

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm