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: 1027755
Sex: F
Age: 65
State: IL

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: Shell fish (iodine), bee stings

Symptom List: Dysphagia, Epiglottitis

Symptoms: After 1st vaccine I developed a very sore arm w a lump under my skin the size of a tennis ball. This was a Thursday by Monday it subsided. By the end of the 1st week, the site of the vaccine is very red about 2 inches in diameter and the lump is back w tenderness returning.

Other Meds: None

Current Illness: No

ID: 1027756
Sex: F
Age: 60
State: AZ

Vax Date: 01/28/2021
Onset Date: 01/31/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Mild soreness on 1st & 2nd day.

Other Meds: None

Current Illness: None sore on vaccine minimum

Date Died: 01/28/2021

ID: 1027757
Sex: F
Age: 77
State: PA

Vax Date: 01/25/2021
Onset Date: 01/28/2021
Rec V Date: 02/13/2021
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: Death

Other Meds:

Current Illness:

ID: 1027758
Sex: F
Age: 42
State: TX

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

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

Lab Data:

Allergies: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Red arm rash at vaccine site started this morning day 11 post vaccine

Other Meds: Bupropion xl

Current Illness: No

ID: 1027759
Sex: F
Age: 29
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/13/2021
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: Right after vaccine had rough patch of skin 2 inches below vx site- may be reaction to glove. 26 hours after vx experienced extreme lethargy, chills, temp rise to 99.3, mild congestion/cough that continued until 2/13/2021. Was out of breath/lightheaded if holding anything over 10lbs. Sleeping or spending 12-24 hrs in bed at a time.

Other Meds: 120mg Duloxetine sid 5mg Methylphenidate prn

Current Illness:

ID: 1027760
Sex: F
Age: 59
State:

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/13/2021
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: Starting around 9 am the following day, Feb 9th, I began to have body aches with chills and a headache. This lasted until 8:30 pm. I still had a headache the next day, Feb 10 but once I took Ibupropfen the headache went away.

Other Meds: Lexapro, vitamin D, Crestor

Current Illness: None

ID: 1027761
Sex: M
Age:
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Sore arm fever chills

Other Meds:

Current Illness:

ID: 1027762
Sex: F
Age: 41
State: CO

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

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

Lab Data:

Allergies: Anaphylaxis to bananas Allergic to morphine Environmental allergies

Symptom List: Pharyngeal swelling

Symptoms: 7 minutes after vaccine, I felt my heart pounding heavily and checked my iwatch. It indicated that my Heart rate went from 88 to 141 in the past 5 minutes while sitting. I then felt flushing throughout my body. I had the sensation of tingling on my face and lips and told the present employees that I felt weird. They retrieved the doc, who then took my pulse ox - registered at 96/97. Then they took my blood pressure and it was 180/100 (I typically have low blood pressure 98/60). I started to feel disequalibrium and nauseous and the doc to be back to a room. She administered a dose of IM EPI and IM benedryl and called EMS. My symptoms persisted and the doc told the EMS workers I had urticaria on my face during her case presentation. I was transported to the ED, where I was monitored. My symtoms had reduced following epi and benedryl but returned when I was in the ED. The doctor administered pepcid and solu-medrol and zofran. They also conducted and EKG- reportedly normal. These medications helped control my symptoms and my BP had returned to normal (120/70) following meds. discharged on a tapering dose of steriod and zofran prn.

Other Meds: Cetirizine QHS Woman's daily vitamin

Current Illness: None

ID: 1027763
Sex: F
Age: 77
State: AZ

Vax Date: 02/02/2021
Onset Date: 02/09/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Sensitivity to morphine, percocet, amoxycillin, tree nuts

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderna COVID-19 Vaccine EUA. One week after vaccination (Feb 9), area around site became red and itchy. By next day area was swollen, tender, very itchy and still red. Sept. 11 symptoms were easing. Saturday , Feb 13 itching & soreness are back.

Other Meds: One a day vitamins, low dose aspirin, align prebiotic, oxybutynin

Current Illness: none

ID: 1027764
Sex: F
Age: 47
State: OR

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/13/2021
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: Pyridium

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Splitting headache, for about 12 hours .. I did take 200 mg ibruprofen Injection site was swollen, painful warm to touch for about 2 days after injection. Arm swelling resolved until 2/8/21. Severe itching at the injection site, readiness, heat and pain returned and is ongoing at time of reporting. A second headache developed 2/8/21 and resolved within 24 hours.

Other Meds: Vitamin D 1000IU daily

Current Illness: None

ID: 1027765
Sex: M
Age: 37
State: NY

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Allergic to most tree nuts

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

Symptoms: Day 1: 103F temperature, chills, headache, exhaustion Days 2-4: normal temperature, fatigue, headaches, difficulty sleeping

Other Meds: None, but took Tylenol the day after to address fever and headache

Current Illness: None

ID: 1027766
Sex: F
Age: 56
State: CO

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: Sulfer hot springs gives me a little rash.

Symptom List: Rash, Urticaria

Symptoms: Rash on arm at injection site. Achy chills very sleepy for 24 hours. Still have red rash but feel great now.

Other Meds: .05 my estrogen progesterone

Current Illness: No

ID: 1027767
Sex: F
Age: 76
State: TX

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Patient stated she felt a little "woozy" for a few seconds but stated the feeling had subsided by the time of staff arrival. Patient stated she only had a headache. Patient advised to call PCP, 911, or go to the nearest emergency room if she has any further symptoms.

Other Meds:

Current Illness:

ID: 1027768
Sex: M
Age: 82
State: FL

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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

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

Symptoms: Diarrhea, vomiting, low fever, indigestion, pain in abdomen

Other Meds: Tamsulosin 0.4 mg - 1 a day, Metoprolol Tartrate 25mg - 2 a day, Lisinopril 10mg - 1 a day, Pravastatin 20mg - 1 a day, Invokamet XR 50mg/500mg - 1 a day, Centrum Silver - 1a day, Ibuprofen as needed

Current Illness: None

ID: 1027769
Sex: F
Age: 49
State: CA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: Chills, muscle aches, headache, nausea, vomiting, fatigue, arm soreness

Other Meds:

Current Illness:

ID: 1027770
Sex: F
Age: 30
State: MA

Vax Date: 01/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Bell's palsy - of R face

Other Meds: Nuva Ring

Current Illness: None

ID: 1027771
Sex: F
Age: 26
State: PA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
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: NKA

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

Symptoms: Around 11 pm on 2/12/2021 patient had sever body aches that required Motrin OTC , I woke at 5 am on 2/13/2021 and had sever body aches and chills, I went to the bathroom and woke up on the floor and had passed out.

Other Meds: Motrin 800 mg by mouth at 11:00 pm on 02/12/2021.

Current Illness: N/A

ID: 1027772
Sex: F
Age: 38
State: IN

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Sulfa-; lexapro

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Nausea immediately after injection for about 60 minutes; facial flushing and 99.7 degrees Fahrenheit temperature upon waking up the following two mornings for ~45 minutes. Fatigue and not feeling well for 36 hours after injection. Sever arm soreness the following day after injection.

Other Meds: None

Current Illness: None

ID: 1027773
Sex: F
Age: 27
State: PA

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

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

Lab Data:

Allergies: None known

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I became suddenly very dizzy, passed out, and woke up on the floor. I don?t remember falling. When I woke up I had bladder incontinence, was very dizzy, and became nauseous. I threw up over night from dizziness. Today I am still dizzy.

Other Meds: Birth control- nuvaring (was removed morning of vaccine, prior to vaccine administration)

Current Illness: None

ID: 1027774
Sex: M
Age: 67
State: NJ

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

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

Lab Data:

Allergies: Penicillin

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

Symptoms: fever, chills, body aches

Other Meds: Losartan, Propulsid, Pepcid, Ventolin, Symbicort

Current Illness:

ID: 1027775
Sex: F
Age: 78
State: IL

Vax Date: 02/04/2021
Onset Date: 02/08/2021
Rec V Date: 02/13/2021
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: None

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

Symptoms: About 3 days after the vaccination her her arm turned Black and Blue in a small area. After about 2 more days the bruise got larger. Then on February 12th she came to me about 4:00 pm and showed me that around the black and blue area was a 1 in area of very red itching area. I took her to the Express Care near us. the nurse checked her arm and gave her 1 tablet of Benadryl and gave her prescription for more.

Other Meds: Lisinopril

Current Illness: None

ID: 1027776
Sex: F
Age: 71
State: IN

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: Experienced depressed thinking, including suicidal thoughts in the very early hours of 2/11/21. Throughout the daytime (2/11/21), I experienced general malaise and lacked motivation to do anything. However, slept well the night of 2/11 through 2/12 and felt fine from 2/12 onward.

Other Meds: none

Current Illness: none

ID: 1027777
Sex: M
Age: 27
State: MA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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 known.

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

Symptoms: Had no symptoms prior to injection. After injection, quickly developed moderate pain at injection site that eventually became severe. Over the rest of the day, developed a severe headache, severe muscle aches (not just at injection site), severe fatigue, fever of 100.6F, moderate joint aches (not just in arm, but all over body - neck is worst), and general weakness (I almost fell walking to the bathroom and I'm in decently good shape). Toward the evening, I started struggling with thermal homeostasis - I was simultaneously sweating and shivering. The combination of these was severe enough that I had extreme difficulty sleeping last night and woke up at least once an hour, getting <6 hours of sleep after lying in bed for almost 12 hours. Right now (23h post vaccination), the pain at the injection site has gotten significantly less bad, but I still have a splitting headache, fever of 100.3F, moderate fatigue/weakness, and mild muscle/joint pains across my whole body. I'm unsure how much the headache this morning is from sleep deprivation. At no point did I lose sense of smell or taste, have a sore throat, cough, runny nose/nasal congestion, or shortness of breath.

Other Meds: 54mg Concerta (methylphenidate extended release) once daily in the morning (~8am)

Current Illness: N/A

ID: 1027779
Sex: F
Age: 50
State: NY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: n/a

Symptom List: Injection site pain, Pain

Symptoms: 5:05PM Pt. began complaining that she had tingling in her lips approximately 5 minutes after receiving vaccine. Patient became very flushed, and admitted to being anxious. Diphenhydramine administered by Doctor at 5:05PM - 25 mg IM. BP 132/88, Pulse Ox 98/99, pulse regular 103. 5:13PM Pt. complained of numbness in lower lip and chin 5:18PM 25 mg Diphenhydramine given IM by Doctor. BP 130/90, pulse ox 99, pulse 86 BPM 5:40PM Pt. c/o feeling nauseated, given crackers and water. 5:50PM Pt. ambulated to restroom (greater than 100 feet) unassisted. Left clinic stable with a friend to drive her home.

Other Meds: Albuteral Inhaler

Current Illness: Had donated blood two days earlier and had an allergic reaction to the anti-coagulant

ID: 1027780
Sex: M
Age: 34
State: OH

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

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Passed out in his chair and hit the floor. Possible seizure for 5 seconds. He was the conscious over the next hour but would get light headed and need to lay down.

Other Meds:

Current Illness:

ID: 1027781
Sex: F
Age: 25
State: PA

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/13/2021
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: Pollen Dust mites

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

Symptoms: Soreness in both arms and redness and bump forming at injection site. Severe Fatigue lasted 24 hours.

Other Meds: Trileptal Effexor Levothyroxin Folic Acid Azelastine Nasal Spray Iron supplements Vitamin D supplements

Current Illness: N/A

ID: 1027782
Sex: F
Age: 65
State: ID

Vax Date: 02/01/2021
Onset Date: 02/09/2021
Rec V Date: 02/13/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Day 2 injection site hot and red . Muscle pain in upper left side of back. Lasted two days. Nothing more until day 9. Injection site became red, hot, itchy on day 9. Went away day 11. Returned with achy, red, sore, hot injection site on day 13. Benadryl and hydrocortisone applied topically didn?t help.

Other Meds: Armor Thyroid, meteformin, lipitor, astragulus, red rice yeast, Coq10, elderberry

Current Illness: Cold

ID: 1027783
Sex: F
Age: 44
State: SD

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Bactrim Augmentin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Macular rash (blanchable) on chest and trunk

Other Meds: Synthroid Trazodone

Current Illness: None

ID: 1027785
Sex: F
Age: 43
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/13/2021
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: NKDA

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

Symptoms: 2/5 0200 woke with significant joint pain in elbows/hips/knees and slight headache, this lasted on an off throughout the day 2/5 1300 fever/chill/fatigue, significant headache 6/10, arm pain at injection site - could not lift arm over head, fever/chills abated within 3-4 hours, all other symptoms lasted throughout the night, wheezing 2/6 - symptoms worsened, migraine headache 8/10, muscle pain, joint pain in knees/hips/hands, became "foggy" and clumsy - bumping into things, cutting my hands 3x with knives while attempting to fix food, then decreased appetite, very fatigued, fever/chills that last a few hours through the night, wheezing 2/7 - migraine headache 7/10, join pain ongoing, still foggy and clumsy - confused at times, very fatigued, muscle pain gone, still trying to lay down, no appetite, wheezing is gone 2/8 - called off work, still foggy (but no longer clumsy), headache 6/10, joint pain stopped mid-afternoon, still tired most of the day (likely my body trying to recover), appetite returned 2/9 - able to return to work and feeling almost back to normal

Other Meds: Cosentyx, nabutamone (Relafen), birth control (Yaz), Synthroid, migraine meds (Topamax, Wellbutrin, Skelaxin), Flonase/singulair/steriod nasal spray/Zyrtec, lisinopril/HCTZ, epi-pen, albuterol inhaler, Vit B complex, omega 3, flaxseed oil,

Current Illness: N/A

ID: 1027786
Sex: F
Age: 66
State: IN

Vax Date: 02/03/2021
Onset Date: 02/10/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, ampicillin

Symptom List: Nausea

Symptoms: Hives which then turned into a red, oval itchy patch approximately 4 inches around

Other Meds: Lisinopril, 81 mg aspirin, fish oil, D3, calcium, joint supplement, Ceylon cinnamon, biotin

Current Illness: None

ID: 1027787
Sex: M
Age: 66
State: CA

Vax Date: 01/23/2021
Onset Date: 02/03/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Injection site pain

Symptoms: left arm mobility -could not lift Armand movement limited for 3 days-then got 95% better but then about 1 week later same issue with left arm-limited lifting ability and movement-after 3-4 days called my doctor who told me to take Tylenol, has helped and I am about 96% normal s of ti date 2/15- **question --is it recommended for my second shot 2/22 to be given in left arm?

Other Meds: n/a

Current Illness: n/a

ID: 1027788
Sex: M
Age: 32
State: NH

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Sore arm, body aches, migraine, stiff lower back, chills, tiredness, smell/taste affected.

Other Meds: None

Current Illness: None

ID: 1027789
Sex: F
Age: 75
State: CA

Vax Date: 01/25/2021
Onset Date: 02/04/2021
Rec V Date: 02/13/2021
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: Dust mites,oral penicillin

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

Symptoms: Arm a bit sore after vaccination, but 7 days after shot, upper half of left arm developed a pink rash, that turned red. Arm was sensitive and itchy. It felt like a big mosquito bite. Injection site was red and tender. Still have pale pink rash on upper left arm and injection site is still red and tender. No other adverse affect. Did take picture of arm.

Other Meds: Unisom Acyclovor

Current Illness: NONE

ID: 1027790
Sex: F
Age: 64
State: RI

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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 - Cucumbers - Canteloupe - Pears

Symptom List: Tremor

Symptoms: - 7 days after receiving 1st dose of Moderna COVID19 vaccine - Pain and itching at injection site - Large area of redness/swelling on arm - "COVID Arm"

Other Meds: - Cold-EEZ - Miralax - Tyleonol (post injection)

Current Illness: - Irritable bowel syndrome

ID: 1027791
Sex: M
Age: 61
State: MN

Vax Date: 01/14/2021
Onset Date: 02/03/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Tender two nights after vaccine admin that self resolved. 21 days after, the arm started throbbing and having deltoid spasms. Pain radiated from elbow to skull up To ears. Spasm would come and go. Tingling in forearm also reported. Lasted three or four days and then went away the day before the second shot.

Other Meds:

Current Illness: NKA

ID: 1027792
Sex: F
Age: 78
State: IN

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: Pennicillin

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

Symptoms: Had no reaction during my 30 minute wait after the injection. That evening at 9:15 started feeling really tired and was chilled feeling which made me shake. Was nauseated all night long. I had dry heaves three times. Had a headache all night. These symptoms subsided later in the morning and by noon I was feeling fine except for being tired from the night's experiences. I feel fine now.

Other Meds: Atorvastatin(lipitor) Sertraline(zoloft) Apirin 81mg Osteo Biflex Multi-vit+minerals Calcium Citrate +D3 Fish oil

Current Illness: None

ID: 1027793
Sex: F
Age: 83
State: IN

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: all cillans, penn, amp, etc/ vancomycin all myacins bee, wasp, stings

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

Symptoms: swollen . sore arm, elevated temp, 2 degrees above normal, weak, ache all over, feet burnt and itched (not normal) today, 13th, temp is down, arm is better, still sore , weak, but not the ache all over as bad, feet not burning, now today diarrhea, but at 11;30 getting better, eyes have been more sensitive and blurry than normal and still are.

Other Meds: Synthroid 75, lorazepam .0.5, 81 mg asprain , vitamin E, D3, potassium, zinc, Glucosamine chondrin , Q10-300, cinnamon, fish oil, salmon oil, flax seed oil.

Current Illness: none

ID: 1027794
Sex: F
Age: 66
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Around noon became very tired. Then chills started & a slight fever. Between 9 -10 pm same day it all went away. Felt myself again.

Other Meds: N/A

Current Illness: NO

ID: 1027795
Sex: F
Age: 48
State: MN

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/13/2021
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 , latex

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

Symptoms: Extremely rash that has spread all over body and is very itchy. Still very extreme. Was referred to an allergist to do testing on Tuesday february 16th. Nothing is relieving symptoms.

Other Meds: None

Current Illness: None

ID: 1027796
Sex: M
Age: 53
State: VA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/13/2021
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: PCN, Synvisc, cpehalosporins, Sulfa

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

Symptoms: elevated BP, headache

Other Meds: none

Current Illness: no

ID: 1027797
Sex: F
Age: 89
State: PA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List: Pain in extremity

Symptoms: starting about 4pm the day of vaccination the patient reports extreme abdominal distress, nausea and vomiting, and dry heaves which lasted about 12 hours and subsided around 4am 2/9/2021. Patient tells me she "didn't care if I lived or died" during that period. As of 2/11/2021, she called the Pharmacy wishing to report her experience. She told me she feels better now, just some residual "crampiness" from the dry heaves

Other Meds: Eliquis 5mg once daily, Diltiazem CD 240mg once daily, HCTZ 12.5mg once daily

Current Illness: none reported

ID: 1027798
Sex: F
Age: 78
State: OH

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: penicillin, steroids, prednisone, cefdinir, spironolactone, codeine, percocet [oxycodone-acetaminophen], and bisoprolol.

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

Symptoms: Shortness of breath two days after vaccination.

Other Meds: atorvastatin, nifedipine, clonidine, vitamin a, vitimin b, vitimin c, vitimin d, potassium, and calcium.

Current Illness:

ID: 1027799
Sex: F
Age: 58
State: NY

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 02/13/2021
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: Amoxicillin Z-Pak oral contraceptives

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

Symptoms: Jan. 4, 2021 First day of vaccine administration , slight soreness at injection site in the evening. Jan. 5, 2021 4:00 PM Arm pit soreness, both arms. Injection site ok. Jan. 6, 2021 4:00 AM Injection site soreness, strong aching in neck, shoulders, and across upper back .Continued armpit soreness, both arms. Felt neck and throat and discovered swollen lymph nodes. Also swollen lymph nodes behind ears. Jan, 11, 2021 ( one week post vaccination) 4:00 AM Injection site swollen, hard, red, hot, and painful. Lymph nodes all still swollen and tender (sometimes painful). CNP (in charge of infection control at my hospital), observed injection site and checked daily to be sure cellulitis was not developing where an antibiotic would be indicated. Jan, 14, 2021 Injection site redness is dissipating and inflammation is decreasing. Running out of time.... Feb. 13,2021 Still swollen and painful lymph nodes.

Other Meds: New Chapter Calcium supplement

Current Illness: None

ID: 1027800
Sex: F
Age: 66
State: FL

Vax Date: 01/22/2021
Onset Date: 02/04/2021
Rec V Date: 02/13/2021
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: Mold

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

Symptoms: Had normal reaction within 24 hours of vaccine and 2 weeks later developed "COVID Arm" which caused me to visit the Emergency room and then Urgent Care. Severe symptoms lasted3-4 days

Other Meds: Zyrtch, Vit C, Vit D, Vit B-12

Current Illness: Neuropathy, Vertigo

ID: 1027801
Sex: M
Age: 79
State: MS

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/13/2021
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: None

Symptom List: Vomiting

Symptoms: Nausea first day Next morning chills and fever 103.4 Incoherent Couldn?t function, like pull self out of chair Nausea Wet chair Inflammation in lungs after being checked at hospital

Other Meds: Vit. B-1, Vit. B3, Folic Acid, zinc, rosuvastatin, ezetimibe, Celebrex, warfarin, amlodopine, allopurinal, amiodorone, and omeprazole.

Current Illness: None

ID: 1027802
Sex: F
Age: 59
State: IL

Vax Date: 02/01/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Slight headache but very sore injection sight with mod amount of swelling

Other Meds: None

Current Illness: None

ID: 1027803
Sex: F
Age: 26
State: OH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Arm swelling and stiffness. I have a raised red splotch below the injection site. It's about 2 inches in diameter.

Other Meds: Zoloft, birth control and flonase

Current Illness:

ID: 1027804
Sex: M
Age: 53
State: MI

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/13/2021
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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: First adverse reaction was 01/23/2021 Fever of 103.0 Farenheit. Took tylenol 1000mg orally Second adverse reactio was on 1/24/2021 All over body hives. Treated with Benadryl 50mg orally multiple doses. Third adverse reaction 1/25/2021 numbness and tingling in left arm. Continues and is getting worse.

Other Meds: Synthroid 75mcg daily

Current Illness: none

ID: 1027805
Sex: F
Age: 72
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/13/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: flu like symptoms the day following the second vaccine. fatigue, muscles soreness, general bad feeling two days at current time, getting better

Other Meds: levothyroxine

Current Illness: none

ID: 1027806
Sex: F
Age: 68
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/13/2021
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: Codeine Penicillin Iodiene contrast Shellfish Prednisone

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

Symptoms: Severe headache, fever of 102, chills, joint pains and weakness for 36 hours

Other Meds: Norvasc Protonix Vit D Probiotics

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm