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: 1029396
Sex: F
Age: 53
State: MD

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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: Ibuprofen, shellfish

Symptom List: Dysphagia, Epiglottitis

Symptoms: Received second dose of vaccine at 1730 on 2/12/2021. He started with hives on 2/14/2021 and reported to Urgent Care for evaluation.

Other Meds: None

Current Illness: None

ID: 1029397
Sex: F
Age: 65
State: PA

Vax Date: 01/28/2021
Onset Date: 02/05/2021
Rec V Date: 02/14/2021
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: on about the 8th day after my vaccine, my arm around the injection site became itchy with redness in a large circular area

Other Meds: synthroid Vitamins: D, B complex, C, biotin, Supplements: magnesium, green tea, calcium, turmeric, petadolex butterbur root Sumatriptan for migraines

Current Illness: none

ID: 1029398
Sex: F
Age: 70
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: painful skin ongoing 4th day mild body ache ongoing 4th day fatigue ongoing 4th day headache intermittent intermittent cough only treatment fluids and rest regular diet

Other Meds: metformin simvastatin effexor metroprolol losartin

Current Illness: none

ID: 1029399
Sex: F
Age: 75
State: AL

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Codeine, streptomycin, hand sanitizer

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Moderna COVID-19Vaccine EUA Vaccinated shoulder, arm, armpit, neck and part of shoulder became very swollen. A severe rash developed with an itching and burning sensation. It developed within 24 hours of vaccination and resolved 72 -84 hours later

Other Meds: Prednisone;Actemra; potassium ; talmusartan, vitamin D, zyrtec

Current Illness: GCA

ID: 1029400
Sex: F
Age: 59
State: CA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Patient received the Pfizer-BioNTech COVID-19 Vaccine EUA at 1130 with symptom onset at 1135. Pt reported numbness in arm and shoulder of injected site (left), which progressed to the tip of her tongue and lips with a tingling sensation. Benadryl 25mg PO administered at 1155. Symptoms resolved after further observation.

Other Meds: Unknown

Current Illness: Unknown

ID: 1029401
Sex: F
Age: 65
State: FL

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Rash itching and redness at injection site. Benedryl not helping

Other Meds: None

Current Illness: None

ID: 1029402
Sex: F
Age: 25
State: WI

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Bactrim

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Vaginal infection - currently seeking medical care, 2/12 had general low grade fever/malaise and noticed infection on 2/13; unsure if related or not

Other Meds: Kurvelo oral contraception, methylcellulose, miralax, probiotic, women's multivitamin, nasacort

Current Illness: None

ID: 1029403
Sex: F
Age: 35
State: NM

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 02/14/2021
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, Sulfa Antibiotics

Symptom List: Pharyngeal swelling

Symptoms: The evening following administration of the second COVID-19 vaccine, I experienced pain in my left armpit and noticed a large amount of swelling in the lymph node area. Unaware this could be related to the vaccine, I made an appointment with urgent care. The pain was mostly gone the next day and was only experienced when pressure was placed in the area of swelling. I was seen the following day (1/13/21) and it was noted that the swelling was not attributed to an infection and I was sent to the breast imaging center to rule out a breast cancer diagnosis. At this visit it was ruled not to be cancer and was potentially attributed to the vaccine. I still have the englared armpit/lymph area, but no pain.

Other Meds: Metformin, Probiotic, Cetirizine, Vitamin D3

Current Illness: None

ID: 1029404
Sex: M
Age: 66
State: CA

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: 24 hours after vaccine, neuropathy in both feet and toes has improved.

Other Meds: Synthyroid, Cialis, Garlic

Current Illness: Neuropathy in feet which began with severe viral throat infection in 1/25/2020 before testing for Covid19 was available.

ID: 1029405
Sex: F
Age: 24
State: NE

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/14/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I got the vaccine at about 9:30 am. I started to have a headache that didn't totally go away with ibuprofen at 2:00 pm. At 6:00pm I started to get a fever with aches and chills. The aches felt worse than normal flu aches and pains. The aches and fever were on and off for the next day and a half. They didn't fully stop till almost 48hrs after administration. The highest my fever ever got was the second night at 101.9 degrees (F) axillary.

Other Meds: Birth Control- Mono-Linyah

Current Illness: None

ID: 1029406
Sex: F
Age: 71
State: IN

Vax Date: 02/06/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: Initially had only soreness and a little fatigue. One week later on 2/13 the area on my arm where I was injected started itching badly. When I scratched it the whole are turned red and large lump about 3 inches long and an inch wide developed. It became painful and hot. Today, 2/14, I still have the lump, redness, and heat covering a spot about 3 inches wide and 5 inches long. This could be a normal reaction, but it seems odd that it would start after a week when the initial soreness had been gone for several days.

Other Meds: Levothyroxine

Current Illness: None

ID: 1029407
Sex: F
Age: 35
State: PA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Severe anaphylactic shellfish allergy, Severe anaphylactic bee venom allergy, multiple food and environmental allergies (non-anaphylactic)

Symptom List: Rash, Urticaria

Symptoms: I received my vaccine, sat in a chair facing the clock and noted it said 5:00pm. Within a minute I notice tingling and slight numbness of my soft palate. I found this odd, but didn't notice any swelling or difficulty breathing. At 5:02 I texted my husband to make sure my Epipen was in the glove compartment in case I needed it later after leaving the vaccination clinic. Over the next few minutes the numbness increased and started to spread to my oropharynx area. I noticed my heart beating faster and wondered if my body was subconsciously anxious about the numb feeling even though I didn't feel worried because I was breathing fine. Very suddenly my heart started to pound very hard, my entire laryngopharynx went numb and I felt like a deck of cards was sitting in the back of my throat. I looked at the clock, it was 5:07. I started to feel dizzy and weak, my heart felt like it was about to explode, my hands were suddenly cold, clammy and shaking, I started to get sharp stomach pains similar to other anaphylactic events, but still no effects on my breathing. I looked at the clock, 5:09, I knew I had to tell someone before I couldn't get up to walk. As I started to talk to a staff member I felt very disoriented and suddenly went from feeling like I was going to faint to very hypertensive with pain shooting into my left arm. The staff quickly tooth my BP and HR, I noted my BP was 166/100 (I am normally 114/72) and the doctor stated I was too tachycardic and needed to go to the ER. At the ER I received Benadryl, Pepcid and an IV, but never needed any epinephrine. The medications resolved numbness and stomach pain. I left with the feeling of a tight turtleneck around my throat and it continues to come and go. Every 6-8 hours I have had to take Benadry and a steroid to keep the intense itching numb feeling in my soft palate away. I still have tightness around my neck that returns every 6-8 hours, but still no airway or edema issue. I felt like I had anaphylaxis without the edema.

Other Meds: Daily OTC Vitamin

Current Illness: Hypersensitive allergies ever since 1st vaccine, getting intense itching at night requiring Benadryl randomly and chronic migraine

ID: 1029409
Sex: F
Age: 30
State: NV

Vax Date: 02/06/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Macrobid

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

Symptoms: Tender, flat, red rash around injection site about 6cm long and 3 cm wide. Warm to the touch. Developed 7 days after first dose.

Other Meds: NuvaRing (generic)

Current Illness:

ID: 1029410
Sex: F
Age: 66
State: CO

Vax Date: 02/04/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Red, swollen, itchy, 'hot' at injection site.

Other Meds: Valsartan for HBP

Current Illness: none

ID: 1029411
Sex: F
Age: 36
State: FL

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
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: Sulfa antibiotics

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

Symptoms: Severe, debilitating muscle pain over whole body beginning AM 2/11/21-AM 2/12/21. Moderate-severe muscle pain of back continued through 2/12 and became mild 2/13 AM until resolution felt 2/14. Fever ~101 F Afternoon 2/11-Early morning 2/12. Extreme thirst for only cold fluids afternoon 2/11-mid-morning 2/12. Severe fatigue 2/11 AM to 2/13 AM with dreams unable to awake from.

Other Meds: Effexor XR, ativan, blisovi 24fe, emgality,adderall,vyvanse,baclofen,trazodone,seroquel

Current Illness: N/A

Date Died: 02/09/2021

ID: 1029412
Sex: M
Age: 69
State: NY

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 02/14/2021
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: Death

Other Meds: NA

Current Illness: None

ID: 1029413
Sex: F
Age: 55
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/14/2021
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: Levofloxacin and sulfa antibiotics (reaction and severity not listed in chart)

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

Symptoms: Patient received the Moderna COVID-19 Vaccine at 0825, with onset of symptoms at 0828. Patient reported numbness at the tip of the tongue, lower lip, and slight nausea. Patient given Benadryl 25mg PO at 0830 and kept for additional observation time. At 0903 numbness went away and patient was able to leave the vaccine clinic.

Other Meds: Unknown

Current Illness: Unknown

ID: 1029414
Sex: F
Age: 73
State: WA

Vax Date: 01/23/2021
Onset Date: 01/30/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Oxycodone intolerance Seasonal allergies

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Red, itchy, swollen patch directly under the injection site, one week after injection. The reaction lasted for 3 days.

Other Meds: Zyrtec 10 mg

Current Illness:

ID: 1029415
Sex: F
Age: 74
State: CA

Vax Date: 01/30/2021
Onset Date: 02/08/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin, Lipitor tree nuts cats, dogs

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: For the first day or two after the shot, I had a slight fever and a slight headache. My arm was a little swollen. These symptoms cleared up but approx. 9 days after vaccination, a large red blotch appeared at the injection site on my upper left arm. At first, I thought it was an insect bite but there were no obvious indications of a bite. A few days later, after the red area got bigger and more itchy, I contacted my internist, and he told me to put betamethazone cream on that spot. Over the next 5 days, it got larger and larger--up to about 3x5 inches--but the redness faded. Today (about 6 days after it sppeared) the blotch is less red. When I looked up "red blotch after vaccine" on the internet, I found several postings entitled "covid arm." The descriptions and photos matched my symptoms and I now assume this is what I had.

Other Meds: Zofran 8 mg Atarax 25 mg aspirin 81 mg Allegra 180 mg Simvastatin 20 mg multivitamin

Current Illness:

ID: 1029416
Sex: F
Age: 70
State: CA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: low grade to moderate continual headache tynenol

Other Meds: amlodipine astorvastatin furosemide potassium chloride alendronate sodium estrace fish oil multivitamin women b-12

Current Illness: none

ID: 1029417
Sex: M
Age: 70
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Allopurinol,

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

Symptoms: Lethargy, body aches

Other Meds: Cell Cept, Prednisone, Metoprolol, Nexium, biotin, vitamin c, Losartan, Nexium, Calcium, culturelle, vitamin E, Lexapro, Gabapentin, multivitamin, Preservision

Current Illness:

ID: 1029418
Sex: F
Age: 28
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Large red welt at injection site. 2 hrs post inj, 2/12, tissue around inj site started to become very firm - expected. 2/13 AM, woke up with a big red welt at inj site, hot to the touch, 1.5in x 2.5in. 2/14, 4in x 3in. It is hard, hot and feels a bit like cellulitis forming. Very sore and tender to touch. Seems to be spreading.

Other Meds: Lexapro Buspirone Welbutrin Advil Tylenol

Current Illness: None

ID: 1029419
Sex: F
Age: 29
State: VA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 02/14/2021
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: Augmentin

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

Symptoms: Shortness of breath, fatigue, body ache to left lower limb, fever 99.6F. Lasted approximately 8.5 hours.

Other Meds: Zoloft, Omega-3, NatureMade Prenatal, Vitamin B12, Vitamin D

Current Illness: N/A

ID: 1029420
Sex: F
Age: 65
State: NY

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Developed Bells Palsy as possible side effect 4 days later.

Other Meds: Daily vitamins - No prescription meds.

Current Illness: None

ID: 1029421
Sex: F
Age: 59
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Had my shot at 7:05pm on 2/12/21. Woke the next morning with a sore arm at the shot site, slight lump and warm. Around 5:30pm after getting home from work i felt tired, went to lay down , immediatly fell asleep. Woke 2 hours later with shooting pains to both my knees. I have severe arthritis and with every heart beat I felt pain. I also had fever. Around 10pm I took 1 aleve and checked my temp 100.1. The last t time I had checked my temp and that was at midnight it was 99.7. The pain was still there but started to subside. I woke today 2/14/21 and the fever is gone, still feel achy in the knees. I can deal with that.

Other Meds: 2 Aleve 220 mg at 9am

Current Illness: None

ID: 1029422
Sex: F
Age: 23
State: IL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: NO KNOWN DRUG ALLERGIES

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

Symptoms: This should of been administered into the deltoid muscle, however this was administered into the triceps muscle. The patient complained of pain, soreness, redness, swelling at the injection site beyond normal. It seemed that it was possible that capillaries may have been broken during administration that caused this.

Other Meds: I DO NOT HAVE ANY RECORDS OF THS BESIDES NITROFURANTOIN MONO/MAC 100MG BUT THIS COURSE SHOULD OF BEEN COMPLETED 3 DAYS BEFORE VACCINATION.

Current Illness: UTI

ID: 1029423
Sex: F
Age: 34
State: PA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Morphine-arrhythmia Demerol: full body red rash

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Body aches, nausea, vomiting, and fevers. Also severe left arm pain with associated weakness and radiating pain down my arm to 4th/5th fingers

Other Meds: Advair Singular Birth control GNC active woman vitapack Vitamin c Vitamin d Vitamin b Magnesium

Current Illness: Gastroenteritis

ID: 1029424
Sex: F
Age: 34
State: NY

Vax Date: 01/21/2021
Onset Date: 01/26/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Strawberries

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Moderna COVID-19 Vaccine EUA Morbilliform rash appeared within one week, spread and itch increased in second and third week, still present four weeks from injection - patient was first prescribed antibiotic cream that had no effect, then prescribed steroid when rash was identified as morbilliform.

Other Meds: Vitamin B Vitamin C Women's Daily Probiotic

Current Illness: HPV

ID: 1029425
Sex: F
Age: 56
State: OR

Vax Date: 01/30/2021
Onset Date: 02/05/2021
Rec V Date: 02/14/2021
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: Sulfa drugs

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

Symptoms: Developed rash at injection site about a week after vaccination then turned red and warm. Very mild itching. Fades for a bit but is then comes back, no itching just a pale redness and rashiness. Still there today. About 4 inches long and 3 inches wide.

Other Meds: 50mg metropolol

Current Illness:

ID: 1029426
Sex: F
Age: 82
State: TX

Vax Date: 02/01/2021
Onset Date: 02/04/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Left shoulder injury. Unable to reach behind back with left arm. Started approximately 2/4/21. Still have pain & hard to reach behind back on 2/14/21. Noticed small dime-sized red spot on left shoulder on 2/11/21. On 2/14/21 red spot had grown to approximately 3 1/2? long & 2 1/2? wide. Is warm to the touch, but doesn?t seem to be swollen & not painful. Intermittent problem finishing a sentence without taking an additional breath. Started about 2/5/21. Not sure if heart murmur is related.

Other Meds:

Current Illness:

ID: 1029427
Sex: M
Age: 19
State: IL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: very tired, hard to stay awake

Other Meds: antihistamines, daily vitamin & fiber supplement

Current Illness: none

ID: 1029428
Sex: M
Age: 40
State: VA

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Ampicillin

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

Symptoms: Chronic Headache for 3.5 weeks. No history of headaches. Three subsequent doctors visits to assess.

Other Meds: Benedryl

Current Illness: None

ID: 1029429
Sex: F
Age: 45
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: Sulfa Naproxen NSAIDS Codeine

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

Symptoms: Temperature 103 degrees F. since 7pm on 2/12/21. Vomited three times on 2/13/21. Uncontrollable chills. Lightheaded.

Other Meds: Skipped prescriptions at the time of vaccination.

Current Illness: No illnesses

ID: 1029430
Sex: M
Age: 85
State: AR

Vax Date: 01/02/2021
Onset Date: 02/05/2021
Rec V Date: 02/14/2021
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: penicillin

Symptom List: Tremor

Symptoms: Shingles reactivated 2/6/2021, as of 2/11/2021 on course of acyclovir 800 mg tablets

Other Meds: Morning: Metformin 500 mg, Women's multivitamin, fish oil 1000 mg, Vitamin D3 25 mcg, Calcium 600 mg, CoQ10 100 mg, Zinc 50 mg, Vitamin C 500 mg: Evening: Rosuvastatin 5 mg, aspirin 81 mg, fish oil 1000 mg

Current Illness: None

ID: 1029431
Sex: M
Age: 69
State: WA

Vax Date: 01/27/2021
Onset Date: 01/31/2021
Rec V Date: 02/14/2021
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: IVP dye Erythromiacin Chlorhexidine

Symptom List: Erythema, Pruritus

Symptoms: 4 days after the injection I had some raised red bumps on my right are in the ante-cub ital area. These went away in 2 days and did not itch. Over the following couple of weeks I started to have intermittent red bumps with flakey surfaces and intense itching on both arms . At this time I have several of these over both arms and my back with intense itching that I'm using hydrocortisone cream to treat. I am scheduled for the second shot on Tuesday Feb 16. Today, Feb 14, these spots are increasing in number and itching. I am going to contact my PCP to day to try to be seen tomorrow before the scheduled second dose.

Other Meds: Acyclovir 800 mg Amlodipine 5 mg Atovaquone 150 mg Finisteride 5 mg Pantoprazole 40 mg Xarelto 20 mg Tamsulosin 0.4 mg Thalidomide 50 mg Vitamin D 3

Current Illness: None

ID: 1029432
Sex: F
Age: 33
State: FL

Vax Date: 02/07/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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: Itchy rash on the arm I received the vaccine; warm to the touch but not painful.

Other Meds: Zyrtec

Current Illness: None

ID: 1029433
Sex: M
Age: 74
State: SC

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/14/2021
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: Note: Shot was administered at Clinic . not Dr. office. Beginning on the evening of 1/29/21 I began experiencing Chills, a slight fever of 100.3 and extreme fatigue. These conditions continued for a period of 3 days. At that point I also began to experience shortness of breath and my O2 level dropped to 78%. I began using a nebulizer, spirometer, flutter valve and exercises at that point and over the next several days. Please note that I am a COPD patient and had completed a 16 day course of Prednisone on 1/25/21. On approximately 2/6/21 my breathing and O2 levels began to return towards normal, although even today I'm still not quite back to what's normal for me. I am continuing to use the nebulizer, spirometer and flutter value in preparation for shot #2 scheduled for 2/18/21.

Other Meds:

Current Illness:

ID: 1029434
Sex: F
Age: 62
State: IL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: red patch at injection site 2.5" x 3.5", slightly hardened

Other Meds: ClaritinD12, Florastor, Calcium + Vitamin D, multivitamin

Current Illness: none

ID: 1029435
Sex: F
Age: 72
State: MD

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: Shellfish, Iodine, Tramadol. sulfa. Levaquin. Anti fungal rx

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

Symptoms: Triggered Migraine headache within 30 min. Within 6 hrs large red circle on upper arm. Within 11 hrs very large bullous areas appear and continue to grow over the following 12 hours Currently the several large blisters have joined into one very large one that is 2" long by 2" wide by 1/2 " high I would like to submit photos. Please let me know how I can do this.

Other Meds: Synthroid 75 mcg Lamotrigine 150 mg

Current Illness: None

ID: 1029436
Sex: F
Age: 57
State: NC

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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 known

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

Symptoms: Fever, swollen lymph glands, sore throat, fatigue, nausea, vomiting

Other Meds: Adderall 30mg taken daily, 1 Centrum Silver multi-vitamin

Current Illness: None

ID: 1029437
Sex: M
Age: 75
State: FL

Vax Date: 02/01/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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: Pain in extremity

Symptoms: No sleep at night, temp to 101F

Other Meds: Metformin, Diltiazem, Pioglitazone, Farxiga , Lisinopril, Repaglinide, Atorvastatin, Fenofibrate. Tresiba.

Current Illness: None

ID: 1029438
Sex: M
Age: 36
State: MA

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

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Fever body aches fatigue

Other Meds: Celexa 10mg

Current Illness:

ID: 1029439
Sex: F
Age: 62
State: PA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: 4 1/2 hours after the vaccine my arm got red, hot and felt a little swollen, the band aid placed got really tight. I got the chills and started shaking, I developed a fever of 102, chills and fever broke in 36 hours. I developed a cough, congestion and wheeze, had aches and pains all over, rolled around in bed for 36 hours. The fever broke by 7am on Sunday morning the aches and pains especially lower back still continue. I took Acetaminophen 1000mg twice during my 36 hours .Severe symptoms appear to be over.

Other Meds: none

Current Illness: none

ID: 1029440
Sex: F
Age: 77
State: TX

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Chills, vomiting, diarrhea, sweats, tremors, dizzy, headache, unsteady gait, fever 101. Symptoms lasted for 24 hours and then I was feeling bad and in bed for 3 days. I took Tylenol for symptoms. I called my doctor and was advised to take Tylenol.

Other Meds: Sotolol, Fosamax,Methylprednisol, Potassium, Forosemide, Estradiol, Omega 3,

Current Illness:

ID: 1029441
Sex: F
Age: 66
State: CA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/14/2021
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: I woke up at 2:30am the morning after receiving the first dose of the Moderna vaccine. My temperature was 107.2. I took 2 Extra-Strength Tylenol which lowered my fever to around 105 where it remained most of the day on 1/28/21. The next day, 1/29/21 my fever was in the 103-104 range. I took one dose of 2 Advil that day. The night of the 29th it went down to 102-103. The third day, 1/30/21 my fever broke.

Other Meds: Crestor

Current Illness: Had COVID 19 diagnosis 12/24/20.

ID: 1029442
Sex: F
Age: 47
State: PA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/14/2021
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: There was no adverse event. This patient was given Pfizer vaccine #1 on 1/15/21. Pfizer lot # EL3249. She was then given a Moderna COVID vaccine for her second dose on 2/08/21. There are several safeguards in place to ensure the same brand of vaccine is given for first and second doses. The hospital is looking into this vaccination error to ensure this does not happen again. The patient did not have her vaccination card with her for her second dose.

Other Meds:

Current Illness:

ID: 1029443
Sex: F
Age: 22
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Pain and soreness in arm through afternoon on 2/12 after getting vaccine. I started to get a small lump on my arm. That evening I had bad chills through the night and next morning. I took tylenol and got a low fever on 2/13. Lump was red and grew all day. Had low fever all day, increased to 101.6 in afternoon despite the Tylenol. Fatigue, headaches, and body aches. 2/14 I felt better in the morning. Headaches and fatigue still. Large red lump/swelling on arm (around 3 inches wide) at site of vaccination, arm still sore and painful to touch.

Other Meds: None

Current Illness: None

ID: 1029444
Sex: F
Age: 80
State: NC

Vax Date: 02/01/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fly like symptoms, fatigue, chills, fluid cough more than usual, left side pain under navel

Other Meds: Too many to list

Current Illness:

ID: 1029446
Sex: F
Age: 68
State: KY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: sulfur, epinephrine

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

Symptoms: Within 45 minutes I had rapid heart palpitations and felt nauseas.

Other Meds: sertraline,estradial,lisinopryl,atenolol. vitamin, ebrta B, extra C

Current Illness: none

ID: 1029447
Sex: F
Age: 71
State: NY

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 02/14/2021
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: Ceftin

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

Symptoms: Terrible stomach spasms and cramping. Nausea, vomiting, and fever.

Other Meds: Gabapentin

Current Illness: UTI

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm