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: 1023818
Sex: M
Age: 63
State: CT

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: NKDA

Symptom List: Dysphagia, Epiglottitis

Symptoms: H/A - moderate to good relief with acetaminophen 750 mg , 2 doses over 24 hours; intermittent chills, generalized achiness - some relief with acetaminophen, some fatigue

Other Meds: none

Current Illness: none

ID: 1023819
Sex: F
Age: 48
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever 100.8, chills, body aches, exhaustion, pain in left arm gradually spreading over entire left side of the body, numbness/tingling of left lower lip

Other Meds:

Current Illness:

ID: 1023820
Sex: F
Age: 82
State: FL

Vax Date: 02/02/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
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: Date and time of vaccination: (list both if they received both shots): 1/5/21 1st, 2/2/21 second Facility name where the vaccine was given. dizziness 3 days after the 2nd shot, resolving .

Other Meds:

Current Illness:

ID: 1023821
Sex: M
Age: 23
State: ME

Vax Date: 01/29/2021
Onset Date: 02/07/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Dust, Animal Fur, Some Wood/Grass

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Red bumpy circle around injection site

Other Meds: Albuterol Inhaler(Taken as needed), Clobetasol ointment

Current Illness:

ID: 1023822
Sex: F
Age: 30
State: NJ

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/11/2021
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: Rapid heart rate above 100 beats per minute when normal is around 70. Hard to take a deep breath due to chest tightness. Started a few hours after vaccine and continued for over a week (still occurring today)

Other Meds: Wellbutrin XL 300 mg

Current Illness:

ID: 1023823
Sex: F
Age: 50
State: MD

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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: Not feeling good, stayed home from work on following day on 2/11/2021

Other Meds:

Current Illness:

ID: 1023825
Sex: M
Age: 36
State: IN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: sertraline

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: joint pain, fatigue, headache

Other Meds: diclofenac, nugenix, tylenol, omeprizole

Current Illness: none

ID: 1023826
Sex: F
Age: 0
State: GA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Augmentin, Aspirin, Latex, banana, Codiene, Lidocaine

Symptom List: Pharyngeal swelling

Symptoms: Dizziness, elevated blood pressure and heart rate. 20 mins after injection

Other Meds: Valtrex 500mg Prilosec 20mg Vit D3 25mcg

Current Illness: Shingles 2 weeks ago

ID: 1023827
Sex: F
Age: 59
State: NH

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: tramodol penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: vomiting dizziness severe headache

Other Meds: lisinoprol amitripptylyn atenonol omepprezole

Current Illness: high bp

ID: 1023828
Sex: F
Age: 65
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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, fatigue, headache, nausea

Other Meds:

Current Illness:

ID: 1023829
Sex: F
Age: 42
State: NC

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

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

Symptoms: Numbness and tingly in right arm 5 min post vaccination

Other Meds: Latuda, Mulit-vitamin, Naproxen, Benztropine, Famotidine, Gabapentin, Iron, Citalopram

Current Illness: n/a

ID: 1023830
Sex: F
Age: 36
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: At 15 minutes post vaccination right leg felt "heavy" followed by tingling of right side of face and tongue. Mostly, but not completely resolved at 24 hours post vaccination.

Other Meds:

Current Illness:

ID: 1023831
Sex: F
Age: 26
State: WI

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

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

Symptoms: Client reported that she chest pain, pain on her "breast bone." Also reports her right arm is swollen, experiencing lymph node tenderness or pressure in right armpit. Called and made a doctor's appointment for today.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1023832
Sex: F
Age: 78
State: PA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
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: NKDA and no known food allergies, MD listed COVID-19 vaccine as an allergy after the reaction

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

Symptoms: Bilateral upper arms reddened, swollen and pain resident also presented with a temperature. No treatment rendered for the localized reaction however antipyretic medication given and resolution of temperature achieved. Primary care physician ordered allergy to the COVID-19 vaccine.

Other Meds: Vitamin D3 and Calcium tablet

Current Illness: Rhabdomyolysis

ID: 1023833
Sex: M
Age: 51
State:

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pfizer E18982 Vaccine adverse reaction. Hives over 90% of body, severe itching, short term chills, joint pain and teeth chattering. No fever or breathing issues. Vaccine on 1.30.21, doctor visit on 1.31.21eceived IM dexamethasone shot. Symptoms (hives/itching) not resolved. Went to PCP steroid changed to Prednisone twice a day x 5 days. My Allergy doctor advised nothing different however has advised not to get regular allergy shots this week until symptoms subside. The reaction did not occur after injection during the Employee Vaccination visit, it occurred later that evening.

Other Meds:

Current Illness:

ID: 1023834
Sex: F
Age: 76
State: CT

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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: Aspertame, sugar substitutes, codeine

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

Symptoms: Emergency Medical Technician was on-site during clinic performing medical observation of vaccine recipients. Patient complained of feeling light-headed and general uneasiness. BP taken by EMT was 170/90 and pulse 72. Patient was aware and able to walk on her own. Patient walked to her vehicle, assisted by EMT, but she returned to the building because she still wasn't feeling well. EMT contacted emergency services for transport of the patient to Hospital ED.

Other Meds: none

Current Illness: no

ID: 1023835
Sex: M
Age: 85
State: FL

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/11/2021
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: Date and time of vaccination: (list both if they received both shots): 1/5/21, 2/2/21 Facility name where the vaccine was given: Dizziness occurred 6 days after the 2nd vaccine

Other Meds:

Current Illness:

ID: 1023836
Sex: F
Age: 58
State: OH

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Developed fever of 102.5, with chills and muscle aches. Lasted about 36 hours

Other Meds: Buproprion, Synthroid, Wixela, Diltiazem, Eliquis, antihistamine nasal spray, Enterogam, low dose erythromycin Various vitamins and herbals: Mindease, Zyflamend, Calcium, Vitamin D, Osteobiflex, Selenium, Ocuvite, Fish oil, EMIQ, Acetyl L C

Current Illness: Had a cardiac ablation for atrial fibrillation on Jan 19.

ID: 1023837
Sex: F
Age: 45
State: OH

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: temperature of 100.7, chills, headache on the first night. temperature of 101.1, sweating, and headache on the second night.

Other Meds: tylenol, ginger root, tumeric curcumin, vit D, buspar, magnesium

Current Illness: none

ID: 1023838
Sex: F
Age: 53
State: MS

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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: 1/14/21- severe injection site muscle pain and feeling tired 1/15/21- very fatigued with low grade fever 1/16/21- fever to 100.4 with loss of taste and smell 1/17/21- no fever but still tired 1/18/21- taste and smell returned

Other Meds:

Current Illness:

Date Died: 02/11/2021

ID: 1023840
Sex: M
Age: 62
State: IL

Vax Date: 02/04/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
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: NKDA, NKA

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

Symptoms: Pt was administered Moderna Covid-19 Vaccine on 2/4/2021. Pt exhbited no symptoms of an adverse reaction of any sort. Pt was ambulating alert and attentive. Pt was observed for the alloted 15 mins by pharmacist and case worker who had escorted pt to vaccination clinic. It was reported that Either on sunday 2/7/2021 or monday 2/8/2021 pt had passed away. Circumstances revolving patient death is still unknown.

Other Meds: Ziprasidone, divalproex, haloperidol, allopurinol, Lisinopril, atorvastatin, aspirin, carvedilol

Current Illness: Hypertension, Morbid Obesity, DMII, Neuropathy, Cardiomyopathy, Hyperurecemia, Glaucoma, Polyp, Foliculitis, Bi-Polar disorder.

ID: 1023841
Sex: F
Age: 25
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Fever, chills, nausea, diarrhea, vomiting lasting for over 12 hours.

Other Meds: Fluoxetine 20 mg

Current Illness: N/A

ID: 1023842
Sex: F
Age: 24
State: MA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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:

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

Symptoms: Connection between syringe and needle was not tight, contents of syringe leaked down patient's arm. Neither patient nor vaccinator believe that the patient got any vaccine administered.

Other Meds:

Current Illness:

ID: 1023843
Sex: M
Age: 74
State: IN

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/11/2021
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: Contrast

Symptom List: Injection site pain, Pain

Symptoms: shortness of breath, elevated anxiety

Other Meds: None

Current Illness: None

ID: 1023844
Sex: F
Age: 45
State: NY

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
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: " Prior taking the vaccine I had a cold, but nothing serious. After taking the vaccine, I had a slight headache throughout the weekend. Starting Monday, I had chills weakness, muscle cramps and shortness of breath. Now, all the symptoms have resolved"

Other Meds:

Current Illness:

ID: 1023845
Sex: M
Age: 53
State: NM

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/11/2021
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: no

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

Symptoms: pt stated that the night after the vax the left side of his face started drooping, he had severe headache behind left ear and some slurred speech. The next day his symptoms got worse so he took Benadryl since he thought he was having an allergic reaction but he continued to get worse. The third day his speech was getting worse, his face continued to swell and droop and he still had severe headache on the left side. Pt ended up going to the ER where they did a CT, EKG, Chest X-Ray, blood work, gave him IV fluids and steroids. The ER Dr. consulted a Neurologist which told him he had the symptoms of Bell Palsy so they did the stroke protocol but ended up telling him his symptoms were from taking the Covid Vaccine. He was told to finish his medicine that they prescribed which is steroid and antibiotic and if he did not get any better to come back for FU.

Other Meds: Metformin, Lisinopril,

Current Illness: no

ID: 1023846
Sex: F
Age: 33
State: RI

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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: Augmented Diflucan

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt came over c/o lighthearted, feeling warm, no sod no cp. Pt was transferred onto our stretcher base live vs obtain. Pt was given water. After 5 min pt state's all side effects have passed. 169/92 99hr spo2 99% 18 reps

Other Meds: Prozac

Current Illness: None

ID: 1023847
Sex: F
Age: 58
State: WA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Sulfa meds

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chills lump/soreness in armpit of the arm for the vaccine extreme lower back pain....3 days

Other Meds: HBP med

Current Illness: none

ID: 1023848
Sex: F
Age: 84
State: IA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/11/2021
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: Patient's arm became red and itchy at injection site. Patient's caregiver thinks it was given to close to inside of arm and not in deltoid so it would have been more of a SQ injection vs an IM in deltoid.

Other Meds:

Current Illness:

ID: 1023849
Sex: F
Age: 35
State: MD

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Dilaudid, Aspirin, Demerol

Symptom List: Nausea

Symptoms: Patient complained of itching, slurred speech and migraine

Other Meds: Moderna Covid vaccine

Current Illness: hx of migraine

ID: 1023850
Sex: F
Age: 31
State: TN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: About 8hrs prior to the injection I began to have a pain in my arm, nauseous, and a headache. I also had slight diarrhea. As of now (2/11/2021 @ 2:54p) i am still experiencing a headache

Other Meds:

Current Illness:

ID: 1023851
Sex: F
Age: 93
State: MN

Vax Date: 02/03/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Rash first starting to present mildly on 1/8/21 after receiving the first vaccination on 1/6/21. However after the vaccination on 2/3/21, the rash spread and became more severe. On 2/10 the nurse manager stated the following: The rash is located on bilateral arms, back, chest, upper bilateral thighs, and groin area. The areas present as little bumps that are raised and have been scratched open. Resident is saying they are extremely itchy and causing her much distress. Resident went to the ER on 2/10/21 and received a steroid, antihistamine, and diflucan and they also prescribed Doxycycline and Triamcinolone cream.

Other Meds: Fluoxetine, Lipitor, Carvedilol, Furosemide, Vanicream, Carbamazepine, Remeron, Demeclocycline, Magnesium, Lactobacillus, Sucralfate, Pantoprazole, and Lamotrigine.

Current Illness: None present

ID: 1023852
Sex: F
Age: 65
State: FL

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
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: Cipro

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

Symptoms: Within 15-minutes of vaccination, the patient reported that she was short of breath and having difficulty breathing. EMS evaluated the patient on-site. The patient is currently prescribed albuterol for a history of breathing issues. EMS placed patient on 8lpm oxygen and administered 2.5mg inhalation albuterol treatment. Patient refused transport.

Other Meds: Albuterol

Current Illness:

ID: 1023853
Sex: F
Age: 77
State: FL

Vax Date: 01/20/2021
Onset Date: 02/03/2021
Rec V Date: 02/11/2021
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: tetracycline,macrodantin, pollen, dust mold,peanuts

Symptom List: Tremor

Symptoms: I developed a rash under my left arm on Feb.1,2021. By Feb. 3, it had spread to under my right arm, my trunk, back and inner thigh area. The rash exhibited a classic pine tree pattern with an initial herald patch under the left arm. The rash is consistent with a diagnosis of Pityriasis Rosea. Over the last 5 days, the rash has begun to fade on the trunk and back and the herald patch has disappeared during the laast 24 hours. A low level if itching has been treated with 25 mg. of Benadryl taken at bedtime.

Other Meds: neurontin,naprosyn,mybetriq,citracal,centrum silver,vitamin C,

Current Illness: none

ID: 1023854
Sex: M
Age: 68
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
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: Erythema, Pruritus

Symptoms: 1, Left arm sore 4 plus hours following the injection sore to touch for 48 hours. 2. Dizziness / double vision - 48 hours after receiving the injection - lasting 24hours.

Other Meds: None

Current Illness: None

ID: 1023855
Sex: F
Age: 63
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 02/11/2021
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: Erythomyacin, Keflex

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

Symptoms: Very sore arm Tightness in high chest, near collarbone only on right side Felt like I needed to cough but couldn?t. No true shortness of breath.

Other Meds: Welbutrin, levothyroxine,benicar,creator, jardiance

Current Illness: None

ID: 1023856
Sex: F
Age: 73
State: PA

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/11/2021
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: avalox penicillin prezantine neproxan byaxine coedine arythomycin benadryl adhesive tape

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

Symptoms: About 3:30 in the morning I woke up and I was really cold. I started having chills. when I checked my temperature it was in the 99s (the highest my temperature 101.9. When I checked my heart rate in the morning and it was in the 90s, and that's higher than normal for first thing in the morning. My heart rate went high and I had achy muscles. I sat around all day, but I didn't feel that bad in the morning, I took an extra strength Tylenol and I didn't have much have an appetite. My heart rate stayed in the 90s-130, so I called my cardiologist and he recommended I alternate Tylenol and ibuprofen and drink lots of fluids. By dinner that night I had no appetite, and then I had nausea and dry heaves, so I took 25 mg of promethazine at about 8 and the dry heaves got better within an hour. I got the COVID tongue. I had a white coating on my tongue and I couldn't get it off and a weird metallic taste in my mouth, I had a mild headache. The next day I felt much better. I called my PCP and they didn't think it was necessary for me to come in for a cardiogram because I was feeling better.

Other Meds: levothryoxine 12.5 mcg flumodedine 20 mg zyrtec 10 mg biotin 1000 mcg vitamin d3 1000 IU areds multivitamin 2x daily losartin 25 mg zocor 10 mg lorzepam .5 mg (as needed)

Current Illness: No

ID: 1023857
Sex: F
Age: 63
State: CO

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
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: Carrot - mild Pistachio- mild

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: generalized mild rash with mild-moderate puritis

Other Meds: Allegra Montelukast Flonase Pepcid medroxyprogesterone Zyrtec

Current Illness: none

ID: 1023858
Sex: F
Age: 69
State:

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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:

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

Symptoms: Dizziness, tachpnea

Other Meds: synthroid, anti depressant

Current Illness:

ID: 1023859
Sex: F
Age: 25
State: KS

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Developed rash at injection site with itching, erythema and warmth as well as inflammation. Rash lasted about a day. Some other generalized hives over the course of the day. Took benadryl, rash resolved on its own after 24 hours

Other Meds: Verapamil 120 mg/d

Current Illness: None

ID: 1023860
Sex: F
Age: 36
State: IL

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Hydrocortisone - itchy, get a rash Tetracycline - have an epi-pen because I get a rash on my stomach 2 weeks into taking and anaphylaxis. Pine nuts - itchy, swollen throat and lips

Symptom List: Pain in extremity

Symptoms: My arm was sore, kind of heavy on 2/10/2021 in the evening. My arm was still sore the next morning (2/11/2021). It hurt to lift above my head. I happened to look in the mirror and I had a red mark where I received the vaccine. It is about an inch in diameter with the center not red. It does not feel warm to the touch and I don't have a fever.

Other Meds: Prescriptions - Metformin, phentermine, azithromycin Over the Counter - Zyrtec

Current Illness: None

ID: 1023861
Sex: F
Age: 28
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/11/2021
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: 2nd dose of COVID-19 vaccination the morning of 2/1/2021 . She had an adverse reaction including sensation of swollen tongue and tachycardia while being monitored during the 15-minute waiting period following the injection. She was given 25 mg Benadryl and advised to go home from work. She was advised to call 911 if symptoms worsened or she experienced any difficulty breathing.

Other Meds:

Current Illness:

ID: 1023862
Sex: F
Age: 41
State: MD

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
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: patient received dose 2 of the moderna vaccine and waited the required 15 mins, in which no symptoms appeared. As she went to leave, she felt as if her throat was closing up. She received one dose of 50mg IM Benadryl, followed by a second dose administered 15 mins later. Symptoms resolved and she left after 45 mins of observation

Other Meds: none

Current Illness: none

ID: 1023863
Sex: F
Age: 77
State: VA

Vax Date: 09/25/2020
Onset Date: 09/26/2020
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient has called to inform us (4 months after immunization) that she is having pain and reduced mobility in her shoulder, beginning shortly after being immunized.

Other Meds:

Current Illness:

ID: 1023864
Sex: F
Age: 33
State: CA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
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: no

Symptom List: Vomiting

Symptoms: Currently 33 weeks pregnant. Following morning after shot I woke up with severe chills. I was experienced severe weakness and I was really tired and I could not get up all day. I did not have a fever but i felt hot. The next day I was better.

Other Meds: Synthroid 175 mcg, Buproprion SR 50mg TID, & pretnatal vitamins including Folate, Vitamin D, and Co-Q10

Current Illness: no

ID: 1023865
Sex: F
Age: 49
State: AZ

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/11/2021
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: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Nausea, Vomiting (for four hours), diarrhea (for 3-4hours). Felt tired for 24hrs. 100% better by next morning 6am

Other Meds: Synjardy XR, Gabapentin

Current Illness: n/a

ID: 1023866
Sex: F
Age: 28
State: NC

Vax Date: 01/15/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Miscarriage at 6 weeks 1 day. Vaginal bleeding and decline in HCG hormone. Pregnancy not viable.

Other Meds: Prenatal vitamin

Current Illness: None

ID: 1023867
Sex: F
Age: 26
State: TX

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 02/11/2021
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: Amoxicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After the first vaccine, I had a severe migraine for over 48 hours. I had to contact my neurologist for rescue medication. After the second dose, I had chills, sweats, body aches, migraines, nausea, and dizziness for 24 hours.

Other Meds: Maxalt Migraine medication

Current Illness: None

ID: 1023868
Sex: F
Age: 39
State: WA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/11/2021
Hospital:

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

Lab Data:

Allergies: Zoloft Percocet pill

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

Symptoms: After 9 minutes my tongue start to swell and tingle .. within a hour my mouth and lips started tingling. My moth and lips felt as if they were swollen

Other Meds: Singulair Monteluast Trasidone Annuity inhaler Albuterol as needed estradiol Vitamin D Vitamin D3 Zinc

Current Illness: None

ID: 1023869
Sex: F
Age: 38
State: MN

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/11/2021
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: seasonal allergies

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

Symptoms: Thursday started extreme fatigue, headache, muscle aches. On Sunday started rash on chest, arms and legs with itching in face and throat. Went to urgent care on Monday and received steroid cream for rash. Rash went away by Thursday, but came back on Saturday, then have had a light redness on and off since the following Sunday. Still had the fatigue, headache, muscles aches, but started the shortness of breath, chest pain with dry cough, nausea. Saw NP on Thursday and got prednisone for cough and shortness of breath. Felt better on Thursday but got worse over the weekend with increased shortness of breath, chest pain with cough and spotty vision. Saw NP on Monday and was sent to ER to rule out life threatening illnesses. Finished the prednisone on Monday.

Other Meds: Trikendi XR, Omperazole, albuterol inhaler (prn), IUD, promethazine (prn), calcium supplement, emergen-c

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm