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: 1026973
Sex: M
Age: 56
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Moderna Covid-19 vaccine EUA. Rapid heartbeat, tingling and numbness in extremities, face, tongue, dizziness, swollen lymph node, blood taste in mouth. I?ve been to the ER three times and they can find nothing wrong with me but I am not well.

Other Meds: One a day vitamin Vitamin d3 Hydroxyzine

Current Illness: None

ID: 1026974
Sex: F
Age: 41
State: WA

Vax Date: 02/05/2021
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: No

Symptom List: Anxiety, Dyspnoea

Symptoms: Late adverse reaction, Major swelling and rash, heat and pain. Below injection site.

Other Meds: Propranolol

Current Illness: None

ID: 1026975
Sex: F
Age: 81
State: CA

Vax Date: 01/24/2021
Onset Date: 02/01/2021
Rec V Date: 02/12/2021
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: Ceftin, Lasix, Vasotec, Diovan, Avelox,tape

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

Symptoms: Rash appeared below injection site on 2/1/21. Area red and itchy. Looked like COVID arm rash pictured on internet. Rash gone by 2/10/21.

Other Meds: Aldactone, Amlodipine,Atorvastin, Famotidine, Metroprolol,Tomoxifen, Vitamin D3, Aleve

Current Illness: Osteoarthritis

ID: 1026976
Sex: F
Age: 25
State:

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

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I received the vaccination at 9:30 am. I developed mild-moderate pain in my left arm around 10:30 am. I developed nausea around 10:30 am. I ate normally throughout the day and began feeling faint and severely nauseous at 7:30 pm and vomited immediately after. Vomiting persisted for approx. 5 minutes and was the peak of my adverse event.

Other Meds:

Current Illness:

ID: 1026977
Sex: F
Age: 54
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

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

Symptoms: Vomiting, nausea, fever, headache, fatigue, and body aches.

Other Meds:

Current Illness: None

ID: 1026978
Sex: F
Age: 20
State: MI

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

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

Symptoms: Swelling of arm week after vaccine. Red, swollen lump on left arm. As well as swollen lymph ones under left armpit. The day after vaccine, my arm had the normal inflammation related to the vaccine. It went away after 4 days. A few days after my arm started to become itchy. It has been itchy since. On 2/11, my arm swelled up again and became red around the injection site and hard and warm to touch.

Other Meds: Metoprolol ER 25 mg

Current Illness: None

Date Died: 01/25/2021

ID: 1026980
Sex: M
Age: 80
State: OH

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/12/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient reported to Emergency room on 01/23/2021 with complaint of nausea. According to ER record patient reported he received a COVID 19 vaccine Pfizer the day before. Work up in the ER (CT ABD PELVIS) reveal a clotted of SMA. CT CHEST REVEALED BILATERAL PULMONARY EMBOLUS. THE PATIENT WAS TRANSFERRED TO THE STATE HOSPITAL. HE WAS SCHEDULED FOR EMERGENT VASCULAR SURGERY WHICH WAS CANCELLED AS THE PATIENT DIED SHORTLY AFTER HIS ARRIVAL.

Other Meds: METFORMIN, PIOGLITAZONE, NORTRIPTYLINE, TERAZOSIN, RISPERDONE, VIT D 3, DEPO-TESTOSTERONE, LOSARTAN, FLUTICASONE, NTG SL, CRESTOR, PROSCAR, ZOLOFT, MONTELUKAST, HYDROXYZINE, CARAFATE, OMEPRAZOLE, REGLAN, CENTRUM SILVER.

Current Illness: NONE

ID: 1026981
Sex: F
Age: 77
State: CT

Vax Date: 01/29/2021
Onset Date: 02/01/2021
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, Erythromycin

Symptom List: Pharyngeal swelling

Symptoms: about 80 hours after receiving the shot, I experienced severe diarrhea , starting at about 10 PM. I spend most of the night sitting on the toilet. No vomiting. Some abdominal cramping, and my nose was very runny, altho not stuffy. By morning the diarrhea had stopped, but I felt awful. Did not know if I was mainly dehydrated, exhausted from no sleep, or sick. Ate nothing that day, but drank a lot of fizzy water and herbal tea with a little honey. Following day feeling OK, and by third day, fine. The experience felt like a really bad stomach flu or food poisoning, but I haven't had either of those for over 15 years (and that was from Erythromycin prescribed by my dentist when I didn't realize I am allergic to it).

Other Meds: cod liver oil pills, melatonin

Current Illness: none

ID: 1026982
Sex: F
Age: 72
State: TX

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

Lab Data:

Allergies: Laytex, Penicillin; Cypro; Iodine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient's response to vaccine was VERY similar to her response to the illness. Lack of body strength, stability,(unable to stand by herself, to walk, to follow commands requiring body movement) incontinence, inbility to think clearly, unable to recognize her loved ones, No fever, no vomiting or diarreah, no cough. These symptoms lasted for 24 hours, then went away almost fully and completely. Left arm soreness exists two days after injection.

Other Meds: Naminda 28 mg ; tramadol 100mg; Exelon Patch 13.3mg; Trazadone 100 mg.;Levothyroxin 25mcg ; Sertraline 100mg; Symbicort 160 4.5 MCG ; Ventolin HFA 90 mcg; Tolterodine

Current Illness: Covid (Jan 16-30)

ID: 1026983
Sex: F
Age: 57
State: ND

Vax Date: 02/04/2021
Onset Date: 02/08/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient diagnosed with Bells Palsy on 2/10/2021

Other Meds: White Petrolatum-Mineral Oil (EYE LUBRICANT) OINT Apply 1 application to the affected eye(s) every night at bedtime Right eye polyethyl glycol-propyl glycol (LUBRICANT EYE DROPS) 0.4-0.3 % SOLN Place 1 drop into the right eye Every 2 hours

Current Illness:

ID: 1026984
Sex: F
Age: 72
State: AZ

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: bactrim

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

Symptoms: hives of arms, pruritis arms/trunk/scalp/ears. It resolved for the timebeing w/i 1.5 hours w/ 50 mg oral diphenhydramine and dose of oral famotidine

Other Meds: ascorbic acid, diclofenac topical, hydroxychloroquine, leucovorin, methotrexate, nitrofurantoin

Current Illness: none

ID: 1026985
Sex: F
Age: 64
State: MS

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Morphine, Penicillin

Symptom List: Rash, Urticaria

Symptoms: Arm Pain, Can?t Lift To Dress, Can?t Lift Anything, Shoulder Pops, for 2 weeks

Other Meds: Procardia XL, Armour Thyroid, Aspirin 81 mg, Crestor 5 mg, Ativan (PRN), Vit D. , Vit C , Fish Oil, Multi Vit, Estrace Cream

Current Illness: None

ID: 1026986
Sex: M
Age: 67
State: NJ

Vax Date: 02/09/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Trovan

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

Symptoms: Fever 100 Chills Sleep excessive Nausia

Other Meds: Bystolic

Current Illness: GERD

ID: 1026987
Sex: M
Age: 68
State: CO

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: Swelling, redness, and warmth at injection site. Patient observed in clinic for 35 minutes. Vitals were taken every 15 minutes. Educated patient on the use of ice packs and if symptoms return to call clinic, call with questions concerns, and to call 911 if swelling of face, tongue or airway.

Other Meds: Atorvastatin Calcium, Aspirin 81, Levothyroxine Sodium, Lisinopril, Calcium (OTC), Vitamin D (OTC), Oregano oil, Spironolactone, Vitamin C.

Current Illness: None

ID: 1026988
Sex: F
Age: 37
State: WA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: **15 weeks pregnant. Due date 8/2/21. Second child** I had chills, fever (101), headache, body aches, nausea and diarrhea. My arm was soar, I felt like I got hit by a Mack truck, I couldn't lift my arm. The next two days I still had all symptoms., by Monday I felt ok.

Other Meds: Prenatal Metformin

Current Illness:

ID: 1026989
Sex: F
Age: 65
State: PA

Vax Date: 01/27/2021
Onset Date: 02/11/2021
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: none

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

Symptoms: Two weeks after I received the shot, I got a very large hive around the injection site - about 4 -5 inches in diameter. It hurts, is hot and itchy.

Other Meds: synthroid, Vitamin B, Vitamin D, biotin, magnesium

Current Illness: none

ID: 1026990
Sex: F
Age: 39
State: NJ

Vax Date: 01/29/2021
Onset Date: 02/01/2021
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: Pencillin, sulfa drugs

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

Symptoms: High Fever of 103, aches, rash

Other Meds: Buspirone

Current Illness: None

ID: 1026991
Sex: F
Age: 28
State: MD

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: Amoxicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: During administration of the vaccine in my left arm, the needle came off ("popped off") of the syringe. Doctor and tech said they were using a new shipment of syringes that were bad quality. Because of this, I had another dose of the vaccine in my right arm. It was an honest mistake and was handled appropriately. I am reporting as a means for documentation and scientific study of potential extra-dose effects of the Pfizer-BioNTech COVID19 vaccine.

Other Meds: Vyvanse, Wellbutrin, Lexapro, Liletta IUD, Flagyl, probiotic

Current Illness: None

ID: 1026992
Sex: F
Age: 82
State: FL

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Swelling and redness and blisters at injection site

Other Meds: Carvedilol. Fluoxetine trimethopine praulent Prozac Aspirin fish oil multi vitamin calcium

Current Illness: None

ID: 1026993
Sex: F
Age: 39
State: KY

Vax Date: 02/05/2021
Onset Date: 02/12/2021
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: Chantix

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

Symptoms: 1st vaccine 01/15/2021; 2nd dose 02/05/2021; seen at care center 12/12/2021 for new onset jaw pain and swelling onset 12/12/2021.

Other Meds:

Current Illness:

ID: 1026994
Sex: M
Age: 80
State: MO

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/12/2021
Hospital: Y

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: lidocaine

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

Symptoms: Patient began feeling ill within 24 hours of getting second COVID19 vaccination. Presented to our hospital the evening of 1/28/21 with generalized weakness, fevers, near syncope. Extensive workup revealed likely hemophagocytic lymphohistiocytosis syndrome attributed to reaction to vaccine. Patient treated with blood transfusions, corticosteroid (dexamethasone 20mg) and folic acid 1mg daily. Patient also developed rectus sheath hematoma attributed to vaccine/reaction. Patient continues to remain hospitalized 15 days later. Clinically stable, yet critically ill with no significant / some worsening of laboratory results.

Other Meds: famotidine, metoprolol, pantoprazole, trazodone

Current Illness:

ID: 1026995
Sex: F
Age: 60
State: CA

Vax Date: 02/04/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Herpes Labialis 4 days after second vaccine, fatigue

Other Meds:

Current Illness: N/A

ID: 1026996
Sex: M
Age: 19
State: MA

Vax Date: 02/11/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Red and hot splotches along legs. Started about 27 hours after vaccination

Other Meds: None

Current Illness: None

ID: 1026997
Sex: F
Age: 56
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Latex and walnuts

Symptom List: Injection site pain, Pain

Symptoms: Loose projectile stools about 3-4 hours after injection. This also happened with the first dose which was recently reported because I did not link or to think it was related to the vaccine until the same symptom of upset stomach followed by shooting, watery, stools. The last episode ended over a week. If like before with the first vaccine shot, the diarrhea will occur every evening for about 9 days; however, unable to predict this course/cycle with this second vaccine. I mentioned to my PCP. Meanwhile I just tolerate symptoms with Imodium, hydration, and rest.

Other Meds: Amour Thyroid; wellbutrin, Lexapro, and Metformin

Current Illness: none known

ID: 1026998
Sex: M
Age: 65
State: IN

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/12/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: never symptoms of heart condition with no medication ,age 65, the day after shot, I had severe chest pains left side of chest. went to hospital and had 99% blockage widow maker and another blockage. 6 living siblings, no heart condition in family, neither parent with heart condition prior to mother at age 90. Not sure if its connected to vaccine, I would like to know others had same, hopefully help other people

Other Meds: C D3 zinc , no prescriptions

Current Illness: cancer of prostate 11/2020 stage 1

ID: 1026999
Sex: M
Age: 45
State: MO

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

Lab Data:

Allergies: None

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

Symptoms: Woke up at 3am and it felt like a truck had ran me over. I was hot, had cold chills muscle and joint aches my hair follicles hurt and i had a temperature of 102. It felt like the worst case of the flu in my entire life. It is now 5pm on 2/12/2021 and I'm feeling better still a little dizzy, and still tired.

Other Meds: Odeffsy, Metformin, xanax, ambien, crestor, Vitamin D 50,000 units, Co Q Ten, Benedryl, Tumaric, Vitamin C Vitamin b-12

Current Illness: None

ID: 1027000
Sex: U
Age: 71
State: MN

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient got vaccine and after 15 minutes, stated she felt dizzy, weak, and numbness in her legs. Checked for swelling of tongue and mouth, none noted. Caregiver that was with patient said she last ate "a few hours ago." Patient bought some orange juice and drank half of a cup. Also elevated her legs. Pharmacist offered 50mg of Benadryl at 4:40pm and patient wanted to take. Went to the bathroom accompanied by caregiver and came back. Waited another 10 minutes after returning from bathroom and felt much better. Wanted to get home because of the drive.

Other Meds:

Current Illness:

ID: 1027001
Sex: F
Age: 42
State: CA

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

Lab Data:

Allergies: Erythromycin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Swollen, itchy, and hot.

Other Meds: N/A

Current Illness: N/A

ID: 1027002
Sex: M
Age: 86
State: KY

Vax Date: 02/03/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: PENICILLINS

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

Symptoms: RECEIVED FIRST DOSE OF PFIZER COVID VACCINE ON 02/03/21. REPORTED ER FALLING ON ICE WITH RIGHT HIP PAIN. ALSO HIT HEAD. IS ON BLOOD THINNER. IN ER O2 SAT DROPPED AND WAS PLACED ON 4L OXYGEN. ADMITTED INPATIENT AFTER BEING DIAGNOSED WITH HYPOXIA, CHF, AND PELVIC FRACTURE

Other Meds: ELIQUIS

Current Illness:

ID: 1027003
Sex: F
Age: 51
State: IL

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

Lab Data:

Allergies: No Known Allergies

Symptom List: Nausea

Symptoms: Shortly after receiving vaccine; whole right side of her face went numb. Pt took Benadryl after injection afraid it was an allergic reaction. Pt seen by MD in office; noted with right facial dropping .

Other Meds: buPROPion HCl ER (XL) 300 MG Oral Tablet Extended Daily levothyroxine (Tirosint) 100 MCG capsule Daily acyclovir (ZOVIRAX) 400 MG tablet 5 times per day for 7 days (Started on 2/9/21)

Current Illness: Anxiety Hypothyroidism

ID: 1027004
Sex: F
Age: 73
State: OK

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

Lab Data:

Allergies: Codeine Sulfa Prednisone Statins

Symptom List: Injection site pain

Symptoms: Day 1-Moderna vaccine (Feb 2, 2021) Day 2-pain at injection site, red size of half dollar Day 3-injection site swollen, hot, and itching but no pain Day 4-injection site enlarged doubled in size no pain Day 5-injection site enlarged to 7" long x 3.5" wide, itching painful to touch, skin red and hot (took 100 mg Benedryl, used CeraVe cream Day 6-injection site continues red, hot and intense itching (took 100 mg Benedryl, used CeraVe cream ) Day 7-injection site continues to grow in size, red, hot painful, raised bumps, most intense itching I've ever had (used CeraVe cream) Day 8-left arm (site of injection) is red from near shoulder stretching to within 1" of elbow, wrapping around arm about 6" (used CeraVe cream) Day 9- redness fading, itching and pain subsiding some (used CeraVe cream) Day 10- redness continues to fade, itching getting better - no pain (no treatment) Day 11-no redness, rash remains rough, but little itching no pain (no treatment) Day 12-no itching, redness, pain or signs of rash (no treatment)

Other Meds: Leflunomide (10mg), Vit D3 (5000IU), Estradiol patch( .0375mg) Tylenol XStrength (morning of vaccine) Amlodopine Besylate (10mg), Folic Acid (1mg), Progesterone (100mg) (evening before vaccine)

Current Illness: RA HTN (controlled)

ID: 1027005
Sex: F
Age: 66
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: bee venom (pt reported) ketorolac

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

Symptoms: Pt was administered COVID-19 Pfizer vaccine on 2/12/2021 at approximately 1415. At 1440 pt was observed to be coughing. Pt stated, "It feels like there is something in my throat". POX remained 98% on RA with HR 105-112. Pt observed by nursing staff until 1445 when she was taken to the ED from the vaccination tent. At this time pt exhibited increasing SOB with notable tongue swelling. Pt reports previous anaphylaxis reaction to bee venom.

Other Meds: unknown

Current Illness: unknown

ID: 1027006
Sex: F
Age: 65
State: IL

Vax Date: 01/14/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: Latex sensativity

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

Symptoms: Pain that felt like a muscle spasm initially and progressed from left of spine in upper back to around ribs to under arm and across chest, including numbness and itching , progressed to a few red, non-draining lesions noted on the chest and back along the painful areas. Progression of pain led to an urgent care visit on 2/10/21 at which Shingles was diagnosed and Valtrex, muscle relaxer, and lidocaine gel were ordered for the lesions that were noted.

Other Meds: atorvastatin 20mg PO QHS, Latanaprost 1gtt/eye Q HS

Current Illness: none

ID: 1027007
Sex: F
Age: 75
State: FL

Vax Date: 01/15/2021
Onset Date: 01/17/2021
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:

Symptom List: Tremor

Symptoms: Patient received the vaccination on Friday and by Sunday patient developed tingling of the mouth and slurred speech. EMS brought patient to hospital for a possible TIA. Hospitalist did a CT and MRI. The conclusion was negative for TIA. Not sure of Bell's Palsy diagnosis.

Other Meds: Eliquis and Aspirin 81mg

Current Illness:

ID: 1027008
Sex: F
Age: 67
State: FL

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

Lab Data:

Allergies: Sulfa, codeine and latex,

Symptom List: Erythema, Pruritus

Symptoms: Fever, joint aches, sore arm, tired

Other Meds: Fenofibrate Protonix

Current Illness: None

ID: 1027009
Sex: F
Age: 26
State:

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

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

Symptoms: Headache - intermittent lasting from 2/2/21 - 2/5/21; worst 2nd day, 2/3/21 Body aches - lasting from 2/2/21 at 11:00 p.m. - 2/5/21 (afternoon) Symptoms occurred at home.

Other Meds:

Current Illness:

ID: 1027010
Sex: M
Age: 45
State: SC

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/12/2021
Hospital: Y

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 known allergies

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

Symptoms: Pt received vaccine on 1/22/21. On 1/31/21 he presented to urgent care with fever and morbiliform rash. He tested negative for the flu and was given empiric oseltamivir. He had persistent fever and was given doxycycline and ceftriaxone by urgent care on 2/2. On 2/4 at urgent care he was noted to be hypotensive and referred to ER. He had findings of cardiogenic shock and intra-aortic balloon pump was placed. He was treated for acute heart failure with improvement in symptoms. He was also treated for pneumonia with piperacillin/tazobactam as well as amoxicillin / clavulanic acid. He was discharged with resolved fever, resolved rash, and improvement in EF based on cardiac MRI. Workup for other viral causes of myocarditis was negative.

Other Meds: Zinc, Vitamin C, and Vitamin D3

Current Illness: COVID-19, 12/30/21

ID: 1027011
Sex: F
Age: 79
State: NY

Vax Date: 12/31/2020
Onset Date: 01/01/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Vaccine injection site cellulitis

Other Meds:

Current Illness:

ID: 1027012
Sex: F
Age: 35
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: No Known Allergies

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

Symptoms: She presented with itching and rash a few hours after injection. Relieved by ice and antihistamine oral medication.

Other Meds: Levothyroxine, Xyzal, Metformin

Current Illness: NA

ID: 1027013
Sex: F
Age: 95
State: OH

Vax Date: 01/28/2021
Onset Date: 01/30/2021
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: None

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

Symptoms: A burning/itching rash and blisters started on 1/30/21. It completely covered her backside/buttocks. She was prescribed Acyclovir 800mg on 2/2/21. The rash has subsided however, because of the location of the blisters, they still haven't completely healed.

Other Meds: Glipizide, Pioglitizone, Atenolol, Lisinopril, Citalopram, Calcium w/D, Simvistatin

Current Illness: None

ID: 1027014
Sex: F
Age: 66
State: PA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: unknown

Symptom List: Pain in extremity

Symptoms: patient reports vaccine was given in SQ tissue not deltoid muscle. patient states vaccine was given posterior mid upper arm. Pfizer recommended antibodies be checked. CDC website does not recommend re-vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1027015
Sex: F
Age: 51
State: TX

Vax Date: 02/08/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: NSAIDS

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

Symptoms: A red, hot rash on face, back, and both arms

Other Meds: Spironolactone, Tylenol

Current Illness: no

ID: 1027016
Sex: M
Age: 55
State: MO

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nkda

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

Symptoms: Ct felt dizzy, fell forward out of his chair, was unconscious for approximately 2-3 seconds, was not in respiratory distress, was able to answer questions. Ct was transfer to his back, then to sitting position, c/o nausea, paramedics arrived. B/P was 220/113, Blood sugar was 215.

Other Meds: unknown

Current Illness: none

ID: 1027017
Sex: F
Age: 37
State: NM

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: Sulfa - Rash/Hives, Compazine - Anaphylaxis, Hydrocodone - Rash/Hives, Generic Percocet (Brand Percocet OK) - Rash/Hives, Generic Zonegran - (Brand Zonegran OK) - Rash/Hives, Neosporin (Neomycin) - Tissue Breakdown, Lovenox - Severe bleeding, Ertapenem - Rash, Lasix - Vertigo, and Metronidazole - Causes peripheral neuropathy to spread.

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

Symptoms: Patient started throwing premature ventricular contractions (PVCs).

Other Meds: Allegra Dosage: 180 mg Frequency: At bedtime Reason Taking: Allergies Began On: January 21, 2008 Baclofen Dosage: 20 mg Frequency: Three times a day Reason Taking: Reflex Sympathetic Dystrophy (RSD) now CRPS Began On: September 30, 2007 C

Current Illness:

ID: 1027018
Sex: F
Age: 71
State: NY

Vax Date: 12/31/2020
Onset Date: 01/01/2021
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:

Symptom List: Vomiting

Symptoms: Vaccine injection site red/warm to touch

Other Meds:

Current Illness:

ID: 1027019
Sex: F
Age: 72
State: NY

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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received 2nd dose of Pfizer vaccine felt tingling on tongue. No swelling. Pt took 50mg of own Benadryl. Observed for total 45min. No progression of symptoms.

Other Meds:

Current Illness:

ID: 1027020
Sex: U
Age: 72
State: UT

Vax Date: 02/10/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Lortab

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

Symptoms: Sharp pain to back between shoulder blade and waist on right side, pain initially took breath away and made it difficult to breathe. Pain most intense between 0000-0800. Took Tylenol at 0800 and then an anti-inflammatory at 1130. Client reports pain is improving now and is not currently experiencing shortness of breath. Recommended client follow-up and be seen by physician, recommended to be seen urgently for any shortness of breath/difficulty breathing.

Other Meds: Levothyroxine, simvastatin, Gabapentin

Current Illness:

ID: 1027021
Sex: F
Age: 31
State: HI

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Around noon after getting vaccine, I was getting dizzy spells and a headache. My arm was tender. I went to bed around 7 pm and I woke up around 10 pm. I was dripping in sweat and shivering. My back was sore. It felt like my back was on fire. It felt hot and sore. My arm was still sore. I didn't go to work. I got my kids ready and around 8:00 am I threw up. And throughout the day, until around 3 pm, I was sweating, no fever, I had a headache and I was extremely tired. I wanted to sleep all day. My arm was still sore. After around 3 pm, I felt fine. Pregnancy history - my third pregnancy. I have two children already. Date of Delivery: August 27, 2021. With each pregnancy, I get a little more nauseous and a little more sore.

Other Meds: Prenatal vitamins

Current Illness: Just a sore arm and diarrhea and vomiting the day after the first dose of the vaccine (COVID 19) - one day only.

ID: 1027022
Sex: F
Age: 70
State: WA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: sulfa

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

Symptoms: lightheadedness immediately after injection, 6:30pm 02/02/21 periods of dizziness 02/04/21 til present severe vertigo on laying down 02/06/21 - no repeat since site of injection still red 10 days later, but not still sore. Soreness dissipated by the 2nd or 3rd day dizziness and vertigo could possible be a result of a physical activity, but because of the lightheadedness at the time of the vaccine, I thought I should report as possible vaccine adverse event.

Other Meds: Levothyroxine "AlgaeCal" calcium complex supplement "Strontium Boost" Strontium supplement Vit D, Vit C, curcumin

Current Illness: none

ID: 1027023
Sex: M
Age: 55
State: WA

Vax Date: 01/19/2021
Onset Date: 01/25/2021
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: Aspirin Bactrim Ciprofloxacin Mefloquine Nitrofurantoin oxaprozin quinidine quinine sertraline sulfa drugs

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

Symptoms: Patient complained of burning sensation and achiness from left deltoid up to left side of neck and behind left ear. Patient complained of left ear clogged, numbness, swelling, with swelling and tingling of lips. Patient took ibuprofen. Went UC and ED, was prescribed prednisolone.

Other Meds: fluoxetine omeprazole fexofenadine fluticasone nasal

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm