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: 1026918
Sex: M
Age: 67
State: NC

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: Cephalosporins, sulfa, tomatoes, silk

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chills, distended stomach, nausea, abdominal pain, fever 101.5.

Other Meds: Altace (Ramipril) 10mg x2 a day Allegra 60mg Probiotic pearl Multivitamin Vitamin C 500mg x4 Metamucil capsules x5 Vitamin D 1000mg x2 a day Vitamin E 400mg Fish oil 1050mg CoQ10 100mg x2 twice a da

Current Illness:

ID: 1026919
Sex: F
Age: 27
State: CA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: Patient denies

Symptom List: Anxiety, Dyspnoea

Symptoms: 02/12/2021 at 1031- Patient received 1st dose of Moderna COVID 19 vaccine. At 1047 patient began to experience mild sob. Doctor and Registered Nurse to patient to assess patient. Patient alert, oriented, and awake. GCS=15. Clear speech with full sentences. Pt denied any itchiness in throat or body, n/v/d, or any other complaints. Benadryl 25mg PO given at 1050 by RN. Patient tolerated well. Vitals are as follows bp=140/87 hr=73 pulse ox=98% rr=22. At 1100 patient self administered personal INH. Patient report to feel ?better? at 1110. Patient discharged with discharge instructions by Doctor. Patient with no signs of distress upon discharge at 1115.

Other Meds: None. Patient denies.

Current Illness: Patient denies

ID: 1026921
Sex: F
Age: 78
State: AR

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital: Y

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: Aspirin, Cephalexin, Sulfa Drugs

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

Symptoms: HISTORY OF PRESENT ILLNESS: Pleasant 78-year-old female with history of lung cancer with remote partial pneumonectomy, some element of COPD and chronic respiratory failure on home oxygen therapy. She presents with worsening shortness of breath, which started rather abruptly the day prior to presentation. On arrival to the ED she was mildly tachypneic and slightly tachycardic and appeared to be in mild respiratory distress. Her O2 had been titrated to 4 L/m nasal cannula in order to sustain SaO2 values in the 90% or above range. Patient also noted to have pallor. No hematemesis, melena, hematochezia, abdominal pain, fever, cough or known exposure to COVID. Patient reports having received her first COVID vaccination just over one 1 week ago. A hypochromic microcytic anemia, progressive, was noted with a hemoglobin of 7.4 g/dL. Patient reported that she was up-to-date on EGD and colonoscopy within the past year without findings of acute pathology or bleeding. A CTA of the chest was conducted with findings of bilateral pulmonary emboli. She denies lower extremity swelling, pain or tenderness. Patient placed in observation in order to provide palliative blood replacement therapy and commence with anticoagulation for venous thromboembolism. DISCHARGE SUMMARY/OBSERVATION COURSE: Uneventful observation course for this pleasant 78-year-old female who presented with somewhat sudden worsening of her chronic shortness of breath and was found to have CTA evidence of bilateral pulmonary emboli. This in the setting of a progressive iron deficiency anemia without evidence of active clinical gastrointestinal bleeding. The patient received 2 units of packed red blood cells in a palliative fashion for her presenting hemoglobin of 7.4 g/dL. Posttransfusion hemoglobin was 10.1 g/dL. Concurrently, she was placed on weight-based low molecular weight heparin for full anticoagulation. I examined the patient on the morning of February 12 and found her to be nondistressed. Her SaO2 value was 96% on 4 L/m nasal cannula O2. Recall that her baseline flow rate historically had been 2 L/m his cannula. Etiology of the patient's thromboembolism uncertain. She had no clinical findings of unilateral or bilateral lower extremity swelling or tenderness. Patient noted to be a survivor of both breast and lung cancers but without known evidence of active persistent malignancy. Of interest, she had received a COVID-19 vaccine just over one week prior to presentation. I contacted pharmacy in this regard and encouraged him to report possible adverse event via VAERS. I recommended a course of rivaroxaban and provided a prescription with a VTE dosing schedule. Patient was advised to followup with Dr in 10 days. M.D., Hospital Medicine MD Feb 12, 2021 08:40

Other Meds: Famotidine 20mg tab - 1 tab PO BID; Hydrocodone/APAP 5-325mg - 1 tab PO Q6H PRN Pain

Current Illness:

ID: 1026922
Sex: F
Age: 48
State: MD

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Sulpha and clindamycn antibiotics

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 2/7/21 2:00pm - Mild Headache, fatigue and mild muscle aches 11:30pm - Fever and chills, along with above symptoms 2/8/21 (Midnight - Midnight ) High Fever (101 with Motrin on board) Chills Headache Fatigue Nausea Muscle Aches 2/9/21 (Midnight - Midnight) Headache Mild Fever Fatigue 2/10/21 (Midnight - Midnight) Headache Fatigue 2/11/21 Headache 2/12/21 Headache

Other Meds: Motrin, Vitamin D (50,000 1xwk), Vitamin C, Skelaxin 800mg (1xday), melatonin

Current Illness: None

ID: 1026923
Sex: M
Age: 78
State: SD

Vax Date: 02/09/2021
Onset Date: 02/10/1921
Rec V Date: 02/12/2021
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

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

Symptoms: Upset stomach, no appetite, chills, headache, disorientated. Temp went as high as 104.6, given Tylenol and put cold rags on extremities, Pulse oximeter read as low as 85and varied to 90. Applied CPAP and pulse Oximeter began to register 91 Pulse was as high as 103 and blood pressure was 152/92. This occurred over a time from 4:30 P.M. to approximately 6:40 when temp dropped to 102.8, and 7:45 temp was 101.8, Pulse oximeter was 86-89. By 9:05 pm Pulse oximeter went to 90 and rose to 92 and then 93 in the next couple hours. Patient had aching all over and felt disorientated the next day.

Other Meds: Oxycodone, levothyroxine, Oxcarbazepin, Allopurinol, Calcium,Sertraline ,potassium Chloride, Ropinirole Amitiza, Lisinopril, Furosimide, Docusate Sodium

Current Illness: Bursitis in left hip.

ID: 1026924
Sex: F
Age: 57
State: WA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: None, to my knowledge.

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

Symptoms: Due to the snow, I took the bus to the HD, instead of riding bicycle. Due to the snow, however, buses were reduced, only running hourly; I walked home using my walking sticks instead of waiting for the next bus. Later in the evening, I developed an extremely severe right shin splint (anterior tibialis irritation). My left leg is always painful, even with my brace that treats me like an amputee. Dr at the Clinic has told me that he's amazed I'm still able to walk, even with my custom brace. Beginning about 11 PM on 2/11/2021, my legs were so painful that I could not stand and walk, even wearing my brace. Crawling was painful too, but I crawled anyhow. I also scooted on my butt and grabbed furniture to get around. Getting into bed took a very long time, quite likely several hours, due to my severely impaired mobility. My bed is low, several inches above the ground; I had to knowingly fall into bed to get there. Once in bed, I was still in lots of pain.

Other Meds: Fluoxetine HCL, Trazodone HCL, multivitamin, calcium, magnesium

Current Illness: None, to my knowledge.

ID: 1026925
Sex: F
Age: 45
State: RI

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: Cipro, Sulfa, Erythromycin, Anesthesia

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Employee c/o tingling in both hands Benadryl 25mg given at 1646. V/s 122/80 99% 91 p. Tingling subsided at 1700. Ending v/s o2 99% P:73.

Other Meds: Multi vitamins

Current Illness:

ID: 1026926
Sex: F
Age: 46
State: MS

Vax Date: 01/18/2021
Onset Date: 02/09/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Bell's Palsy may or may not be related to vaccine. Developed about 21 days after initial vaccine dose. Emergency room doctor prescribed a course of steroid (Valtrex 1gm - 1 tablet 2/day for 7 days)

Other Meds: Janumet XR Tab 50-1000mg, Farxiga 10mg, Amlodepine Besylate 5mg, Lisinopril 10mg, Omeprezole 20mg, Centrum multivitamin, Fluticansone Propionate Nasal Spray 50mcg, Ibuprofen 200mg as needed, Phenylephrine HCL 10mg as needed

Current Illness: Rhinitis

ID: 1026927
Sex: F
Age: 75
State: AZ

Vax Date: 01/26/2021
Onset Date: 01/30/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Beginning 4 days after shot and running for 8 days, had significant abdominal aches, pains in hip, pelvic areas as well as mid-spine to limbo-sacral areas. Temperature range 96.2 to 100.8, night sweats. At times had hard time getting around, e.g. standing straight, bending, getting into bed, moving around in bed. Pain moved around - intense in one area and then 6 hours later, intense in another area. Pain range 2 - 7 on scale of 0-10. Sleep interrupted for 8 nights sometimes for long stretches. Normally active, flexible, healthy, mentally alert, more like a 50 year old. Weight appropriate for height. Eat well and pay attention to staying healthy. Don't like taking medication, so only took one tylenol when temp got to 100.8.

Other Meds: Calcium, Magnesium, Cranberry, Vitamin D, occasional baby aspirin

Current Illness: none

ID: 1026928
Sex: M
Age: 71
State: OH

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: Sulpha and cortisone PO

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Client has a history of some allergic reactions to medications. (Did not indicate this on form) Rc'd vaccine in a drive thru clinic and with in minutes delt flushed in his eyes and cheddls. He proceeded to Recovery area and was seen by Dr. No SOB or respiratory distress but had overt facial flushing and mild swelling. Client given 50 mg of PO Benadryl and observed x 30 minutes w/o improvement and worsening flushing. Transported by EMS to local hospital.,RN per Dr written vaers form and incident report form.

Other Meds: Lisinopril, Atenolol, Claritin

Current Illness: None

ID: 1026929
Sex: F
Age: 69
State:

Vax Date: 01/23/2021
Onset Date: 02/08/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: biaxin and sulfa

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

Symptoms: Pt. developed an itchy diffuse rash to torso, face and genital region but was also started on antibiotics following vaccine administration.

Other Meds: calcium carbonate, estradiol vaginal cream, famotidine, losartan, memantine, metronidazole topical cream, multivitamin, pravastatin, probiotic, Prolia injection Amoxicillin 875 mg- potassium clavulanate 125 mg and neomycin-polymyxin-hydroc

Current Illness:

ID: 1026930
Sex: M
Age: 77
State: AR

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
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: Morning after, left leg was partially paralized, for about 20 minutes. Left elbow was same way except didn't last but about 5 minutes. Under front of nose there was a weird sensation that lasted until the second day. Felt like something was messing with nose but nothing was there that could be seen. Now this is day 8 and there is swelling abouve my left ankle probably about 2 inches up. The leg and elbow and nose seem to be ok. I don't think I want to take vaccine #2 because of these effects that happened.

Other Meds: triamterene-hydrochlorothiazide 37.5-25mg tablet meloxicam 15mg. tablet lysine 500 mg capsule multivitamin tablet omega-3 fatty acids 1000mg tab

Current Illness: none

ID: 1026931
Sex: M
Age: 67
State: FL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/12/2021
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 drug allergies

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

Symptoms: Severe fatigue and weakness, hypotension with blood pressure 78/58, presented to Hospital emergency room where they originally wanted to blame it on his Parkinson's disease but decided it probably was an adverse vaccine reaction(gee, I wonder if they reported this). Patient was so weak she could not even get out of bed and bear weight on his legs. No fever or chills. No cough. Labs were normal including COVID-19. Felt normal the following day.

Other Meds: I'll just stop right now and say for the record that this is why most physicians probably do not fill these out, this is not a user-friendly website and very time consuming. Carbidopa levodopa, loperamide, pravastatin, trazodone, 81 mg as

Current Illness: No acute illnesses around this time

ID: 1026932
Sex: M
Age: 77
State: UT

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: benedryl, Sulfonomides

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

Symptoms: sepsis UTI, ESBL bacteremia

Other Meds: pregabalin, hyzaar, Flomax, lantus

Current Illness: none

ID: 1026933
Sex: M
Age: 66
State: CA

Vax Date: 01/28/2021
Onset Date: 02/09/2021
Rec V Date: 02/12/2021
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: 02/09/2021 my upper left arm was slightly itchy with a red circle in same area, approximately 3" in diameter 02/10/2021 my upper left arm had a slightly red circle same size 02/11/2021 very faint red circle 02/12/2021 arm shows no signs of red rash.

Other Meds: Multi-vitamin, Vitamin D3, Vitamin C

Current Illness: None

ID: 1026934
Sex: F
Age: 59
State: TX

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: Codeine: Hives

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

Symptoms: Sudden onset of chest tightness with shortness of breath 20 minutes after receiving the vaccine. Symptoms last for 10 minutes

Other Meds: Symbicort inhaler Dexelant B12 injection

Current Illness:

ID: 1026935
Sex: F
Age: 58
State: RI

Vax Date: 01/26/2021
Onset Date: 01/01/2021
Rec V Date: 02/12/2021
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: Clindamycin

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

Symptoms: I have history of drug reaction to Clindamycin (true allergy) and to Levofloxacin (rash, may not have been true allergy). After the second dose I had itchy rash all over my body, sparing face, hands and feet, Resembles the drug rashes in appearance, distribution and itchiness. It hasn't gotten much better. It does seem to be bad in my upper left arm, and not on the upper right arm. Antihistamines and triamcinolone ointment havent really settled it down.

Other Meds: Synthroid, Fluoxetine, Bupropion

Current Illness: N/A

ID: 1026936
Sex: F
Age: 70
State: MN

Vax Date: 02/04/2021
Onset Date: 02/08/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: EPINEPHRINE, EGGS, PEANUTS, DAIRY, FRAGRANCE, MINERAL OIL (RASH), JEWELERY (OTHER THAN GOLD).

Symptom List: Ear pain, Hypoaesthesia

Symptoms: IT WAS ITCHING AT NIGHT MONDAY (2/8/21). REMINDED PATIENT OF PHLEBITIS/CELLULITIS. WENT TO DR OFFICE AND NURSE LOOKED AT IT. NURSE SAID IT WAS RAISED AND WARM. HURT WHEN PRESSED ON. NURSE RECOMMENDED ICE AND BENADRYL ORAL AND TOPICAL. 2 BENADRYL EVERY 4 HOURS FOR A DAY. 2/10/21 IT WAS CLEAR; ONLY BRUISE REMAINDED.

Other Meds: CLARITIN OR CLARITIN-D AS NEEDED. OCUVITE, VITAMIN D 2000, CALCIUM, PLEXUS PROBIOTIC TWICE DAILY.

Current Illness:

ID: 1026937
Sex: F
Age: 58
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: Rash breakout on my neck, around the collar that traveled to my chest and under around my breasts to my armpits -

Other Meds: Atorvastatin 40mg daily Montelukast 10mg daily Spironolactone 25mg daily Aspirin 81mg daily Allegra 180mg daily Pro-air HFA_Albuterol Sulfate - prior to exercise daily Multi Vitamins Vit D3 5000 daily Vitamin C 1000 IU daily Calcium Magnes

Current Illness:

ID: 1026939
Sex: M
Age: 77
State: IN

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

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

Lab Data:

Allergies: codine, lobster, sulfa drugs

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

Symptoms: moderate pain at injection site rt arm. lots of body/ joint pain. chills. headache. no fever . lasting 24 hrs

Other Meds:

Current Illness:

ID: 1026941
Sex: F
Age: 67
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: IV Contrast, Lisinopril

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

Symptoms: Employee c/o lips prickly and throat scratchy at 1352. Benadryl 25 mg administered. V/s b/p: 123/85 P:100 o2:97. At 1430 employee complained that the symptoms had not subsided. Benadryl 25 mg administered. At 1450 employee stated she felt much better and she left observation area.

Other Meds:

Current Illness:

ID: 1026942
Sex: M
Age: 32
State:

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: Dizziness Fever

Other Meds:

Current Illness:

ID: 1026943
Sex: F
Age: 43
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Fever of 102 degrees, arm pain, swelling in arm, back pain, muscle pain, headache

Other Meds: Acetaminophen 200mn

Current Illness: No

ID: 1026944
Sex: F
Age: 75
State: AL

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 02/12/2021
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: redness at injection site. It is very hot and red and swelling states it is now pink and has cooled down some.

Other Meds: insulin and DM pill, gabapentin, losartin, atenalol, vit E, B12, B3,

Current Illness: no

ID: 1026945
Sex: F
Age: 58
State: NC

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

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

Lab Data:

Allergies: Unknown and none reported

Symptom List: Injection site pain, Menorrhagia

Symptoms: PT FELT HOT AND FLUSH, HIGH ANXIETY, RASH AT INJECTION SITE, BLOOD PRESSURE WAS ELEVATED

Other Meds: 600mg ibuprofen within 2 hours prior to vaccination for headache. Diphenhydramine 50mg to treat allergic reaction within 30 minutes of reporting reaction.

Current Illness: None reported

ID: 1026946
Sex: F
Age: 77
State: KY

Vax Date: 02/03/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: PENICILLIN

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

Symptoms: RECEIVED COVID VACCINE 1ST DOSE ON 02/03/21. REPORTED TO ICC ON 2/12/21 FOR HEADACHE, NO TASTE, FATIGUE, AND CONGESTION. REPORTED COVID EXPOSURE 1 WEEK PRIOR. HAD POSITIVE COVID PCR 02/12/21. RECIEVED BAM INFUSION ON 02/12/21.

Other Meds:

Current Illness:

ID: 1026947
Sex: M
Age: 37
State: MD

Vax Date: 01/10/2021
Onset Date: 01/29/2021
Rec V Date: 02/12/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Double vision - 1/29/21 to present. Noticed double vision when was about to drive to work (7:30am 1/29/21). Double vision currently being monitored by neuro-ophthalmologist. Cause of double vision not yet known. Currently still have double vision. Severe headaches - 1/20/21 to 1/24/21 Vomiting - 1/20/21 Woke up in middle of night (3:00am 1/20/21) with severe headache. Started vomiting few hours later. Vomiting continued throughout the day. Went to clinic later that night and was given IV for dehydration. Vomiting stopped, but headaches continued for about 3-4 days.

Other Meds: N/A

Current Illness: N/A

ID: 1026948
Sex: M
Age: 21
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: fever, fatigue, headache, heavy breath

Other Meds: None

Current Illness: None

ID: 1026949
Sex: M
Age: 72
State: CA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: Symtoms: Body Aches, Low Grade fever, generalized weakness. Treatment: Tylenol

Other Meds:

Current Illness:

ID: 1026950
Sex: F
Age: 71
State: MN

Vax Date: 01/30/2021
Onset Date: 02/03/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Macrodantin

Symptom List: Nausea

Symptoms: Starting on February 3 starting experiencing dizziness, nausea, headache, shakes like I had a bad stomach due. The symptoms waxed and waned and have continued to this date. Background history I have a Covid test on November 4th and received a confirmation by telephone that it was positive on November 9th. After 14 day quarantine I felt fine and proceeded with my life. The symptoms now appear to me to be related to the vaccine. Was this the result of having Covid or getting the vaccine within the 90 days of having supposed immunity or a result of the vaccine. It does make me question getting the second injection

Other Meds: Celexa, Crestor, Astelin, Estrace, turmeric, CoQ10, calcium, zinc, magnesium, Vitamin D

Current Illness: None

ID: 1026951
Sex: M
Age: 73
State: IN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Penicillin,

Symptom List: Injection site pain

Symptoms: Headache, back ache, chest pain, hurt all over, chills, felt like the first day I had Covid 19

Other Meds: Vitamin D3 Aspirin 81 mg Lisinopril, Atenolol, Atorvastatin, Venlafaxine-HCL-ER, Clonazepam, Tamsulosin

Current Illness: None

ID: 1026952
Sex: M
Age: 46
State: KY

Vax Date: 01/30/2021
Onset Date: 02/07/2021
Rec V Date: 02/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: 1st dose COVID vaccine 1/30/21; developed shortness of breath 2/7/21; worsening symptoms SOA, falls, chest pain; seen in ED on 2/12/21; Admitted to Hospital for severe sepsis, acute respirator failure.

Other Meds:

Current Illness:

ID: 1026953
Sex: F
Age: 33
State: NY

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 02/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: 2 days, fever, chills, tiredness

Other Meds: Birth control- syeda Bupropion Lexi pro

Current Illness:

ID: 1026954
Sex: F
Age: 40
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: Codeine, Quinoa

Symptom List: Tremor

Symptoms: Fever, pain in joints, stabbing pains abdominally, canker sores in the mouth

Other Meds: None

Current Illness: NA

ID: 1026955
Sex: F
Age: 55
State: TX

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: NKDA

Symptom List: Erythema, Pruritus

Symptoms: Swelling and bruising to the face. Pain only in shoulders. Neg SOB

Other Meds: Advair 250mg/50 1 puff BID Singular 10mg po QD Hydroxychloroquine 300mg PO QD

Current Illness: None

ID: 1026956
Sex: F
Age: 57
State: TX

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Swelling, pain, knot in lymph node in underarm of shot arm

Other Meds: Amlodipine Besylate, Atorvastatin, Escitalopram, Calcium, Vitamin D, Fish Oil, Multivitamin supplement

Current Illness: None

ID: 1026957
Sex: M
Age: 67
State: PA

Vax Date: 02/08/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient describes having a large pimple on his behind that started sometime last night

Other Meds:

Current Illness:

ID: 1026958
Sex: M
Age: 66
State: IN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: extremely sore muscles and joints-chills

Other Meds: symbicort inhaler-----tamsulosin

Current Illness: none

ID: 1026959
Sex: F
Age: 49
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
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: Penicillin

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

Symptoms: The late afternoon/evening on the day of the shot, my right side of my face, head, and neck felt sore. The next morning when I woke up, my right jaw joint was extremely inflamed and so much so that I could not bite down and my teeth did not touch or fit together. The pain was so bad and I had such limited movement of that area that I couldn't even move my tongue out to lick my lips. Then on Sunday, the pain was even worse and I could still not touch any teeth together and my bite was so off that my lower teeth did protrude out beyond my upper teeth. I went to the doctor the next day (Monday) in which he gave me a prescription for Meloxicam to reduce the inflammation. I had taken ibuprofen the days prior with no effect at all. Meloxicam did not work that much better but did reduce the inflammation a little bit. It was not until Thursday of that week (6 days after vaccine) that the inflammation was reduced enough to actually chew. MY front teeth touched together first and then the other teeth over the next couple of days.

Other Meds: None

Current Illness: none

ID: 1026960
Sex: F
Age: 44
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
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: throbbing pain at injection site for 3 days

Other Meds:

Current Illness:

ID: 1026961
Sex: M
Age: 61
State: IA

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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: Pain in extremity

Symptoms: Pts was red and hot around the area of injection. pt also reports that it is painful.

Other Meds:

Current Illness:

ID: 1026962
Sex: F
Age: 75
State: CO

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

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

Lab Data:

Allergies: Sulphate, Nickel, Acetaminophen

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

Symptoms: Ok for about 12 hours after inoculation, Feb.10, then chills, fever, severe body aches and fatigue. Symptoms continued well into the following day, Feb. 11. Chills and fever subsided, late evening, while body aches remained. Treated with fluids, and two doses of Ibuprofen, 600 mg. 11::00 am and 8pm on the 11th. Slept solidly that night and awoke feeling refreshed, free of all symptoms.

Other Meds: Daily multiple vitamins, Fish Oil, Flaxseed Oil,Calcium, Benadryl

Current Illness: None

ID: 1026963
Sex: F
Age: 31
State: MN

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
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: Vomiting occurred approximately 12 hours post vaccine and lasted approximately 10 hours. Several rounds of vomiting, chills, restless legs.

Other Meds: escitalopram, spironolactone, multivitamin, calcium/D vitamin

Current Illness: Positive COVID diagnosis within the month prior to vaccine

ID: 1026964
Sex: M
Age: 76
State: AZ

Vax Date: 01/20/2021
Onset Date: 01/24/2021
Rec V Date: 02/12/2021
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: NKDA

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

Symptoms: Patient received Moderna COVID vaccine on 1/20/2021. Shortly after (with in 1 week) patient experienced addominal pain, diarrhea, loss of appetite, and chills.

Other Meds: Prilosec 20mg on tablet once a day. Spiriva with HandiHaler 18mcg Inhalation.

Current Illness: None

ID: 1026965
Sex: M
Age: 92
State: PA

Vax Date: 01/24/2021
Onset Date: 01/26/2021
Rec V Date: 02/12/2021
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 known allergies

Symptom List: Vomiting

Symptoms: received second Pfizer COVID dose on 1/24 to left deltoid. On 1/26 began with pain in bilateral arms and hands. On 2/1 had limited range of motion. Receiving Tylenol PRN for pain. On 2/7 new order for ibuprofen 600mg Q8hr. PRN. On 2/10 rating pain 10/10 sent to ER for eval and treat. Labs work CT negative, dose of morphine and returned to facility same evening. On 2/12 rated pain right 5/10 and left 8/10, continue to monitor and follow up with physician

Other Meds: no new meds given

Current Illness:

ID: 1026966
Sex: F
Age: 73
State: PA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
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: Microbid

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Chest pain radiating to arm pits, shortness of breath, fast heart rate, fainting, loss of vision

Other Meds: Synthroid, Crestor, Vitamin D, Vitamin B, Calcium, Tylenol, eye drops, Prolia, Vagifem

Current Illness: Detached retina--surgerically repaired 2/9/2021

ID: 1026967
Sex: F
Age: 28
State:

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/12/2021
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: Penicillin

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

Symptoms: Sore arm, terrible headache, neck pain, muscle soreness, chills, stomach ache, slight cough - started about 18 hours after shot and lasted around 12-24 hours

Other Meds: Oral contraceptive

Current Illness: NA

ID: 1026968
Sex: F
Age: 56
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/12/2021
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: latex; walnuts

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After the first vaccine on 14JAN2021, Upset stomach followed by loose projectile stools 3-4 days in a row in the late afternoon and early evening hours between 4 and 7pm. Initially thought it was due to food poisoning but spouse who also had his shot (same day) and we eat same foods, he did not have these symptoms. Finally called PCP on 20JAN2021, as the diarrhea was not subsiding; but it did finally subside a day later and back to normal stools by 22JAN2021. 12FEB2021 the second Moderna vaccine given around 1150AM; same loose projectile stools came with upset stomach around 4PM; will fill out another form. Informed PCP.

Other Meds: Amour thyroid; wellbutrin; lexapro; metformin

Current Illness: none known

ID: 1026969
Sex: F
Age: 26
State: MN

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
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 allergies

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

Symptoms: 7 days status post first dose of Moderna vaccine experiencing itchy rash located axillary, back, abdomen, chest, and bilateral upper and lower extremities.

Other Meds: Birth control

Current Illness: None

ID: 1026970
Sex: M
Age: 73
State: TX

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/12/2021
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: Peanuts - reaction is NOT typical; about a day after eating peanuts I have stomach cramps for about 1.5 days; then I get a non-itchy rash from the waist up that looks like a sunburn and a low-grade fever (~99F) that lasts for about 1.5 days. Then I feel fine again.

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

Symptoms: About an hours after injection, felt tingling in lower jaw. About an hour later tongue was about double size. Took an antihystamine

Other Meds: Metoprolol ER, Hydrochlorothiazide, Omeprazole, Levothyroxine, Atorvastatin, Multivitamin, Culturelle

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm