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: 1029448
Sex: F
Age: 49
State: OH

Vax Date: 12/22/2020
Onset Date: 01/04/2021
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: acetaminophen, advocare, albuterol, aspirin, adhesive tape, Augmentin, Bactrim, bee sting, zipro, CT Scan dye, Demerol, diaconate, diclofenac, Entex, flexural, ibuprofen, enteral, lamictal, latex, Mestinon, mobic, MRI dye, Mucinex, naproxen, Neurontin, oxycodone, paxel, peanuts robitussen, theroquil, shellfish, sulfa, tophorol, trazadone, Zoloft

Symptom List: Dysphagia, Epiglottitis

Symptoms: 12/22 Vaccination Unknown dates; around the holidays 1.5.2021 - missed 2 weeks of work. I started the propranolol. I ended up with extreme HA, vomiting, syncope, Stomach pain, couldn't keep anything down. Lasted for 2 weeks. *2nd shot - same symptoms

Other Meds: prednisone, keppra, lexapro, propranolol

Current Illness: n/a

ID: 1029450
Sex: M
Age: 81
State: MI

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: total loss of strength. could not crawl on the floor, only roll at about 10:30pm on day of vaccination via ambulance to Hosp. ER

Other Meds: BABY ASPIRIN LEVOTHROXINE .075MG SIMVASTATIN 20MG CITALOPRAM 20MG

Current Illness: no

ID: 1029451
Sex: F
Age: 69
State: GA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: Codine, Penicillin, Sulfur, Dairy, Wheat, MSG, Mold, Pollen

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

Symptoms: Severe muscle pain, severe weakness, slight shortness of breath. Was unable to sleep because of severe muscle pain. I passed out when I went to the bathroom at 3:53 am from the pain I came to on the floor at approximately 3:57 and had hit my head just below my eyebrow on the sink counter. I was bleeding from a wound and sustained a black eye.

Other Meds: Liothyronine SOD 5 MCG Tab, Levothyronine 25 MCG Tab - one half dose, DHEA

Current Illness: None

ID: 1029452
Sex: F
Age: 45
State: VA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Malaise in the evening and woke up with chills, the next day had malaise and achy and significant soreness of arm three days following

Other Meds: none

Current Illness: no

ID: 1029454
Sex: M
Age: 70
State:

Vax Date: 01/16/2021
Onset Date: 01/16/2021
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: Raw carrots

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

Symptoms: Mild lower abdominal discomfort. May or may not have been associated with shot. Lasted about a day, then went away. Pain at injection site started later, that day, gone in a day or so. No treatment

Other Meds:

Current Illness:

ID: 1029455
Sex: F
Age: 57
State: CA

Vax Date: 02/12/2021
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: Amoxicillin Sulpha based drugs Coreg

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

Symptoms: Immediately upon receiving the injection I felt a tingle in my throat which grew into a lump resulting in a coughing attack where I could not catch my breath or stop coughing. It lasted for about 10 minutes but then subsided however the discomfort or feeling of something in my throat lingered for a couple of hours

Other Meds: Metformin Atorvostatin Lisinopril Sertraline Topamax Full Aspirin

Current Illness: None

ID: 1029456
Sex: F
Age: 29
State: IL

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Soreness at injection site, fever (101.2), headache, chills

Other Meds: None

Current Illness: COVID 19 positive test 21 days prior to vaccination.

ID: 1029457
Sex: F
Age: 49
State: OH

Vax Date: 01/22/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: acetaminophen, advocare, albuterol, aspirin, adhesive tape, Augmentin, Bactrim, bee sting, zipro, CT Scan dye, Demerol, diaconate, diclofenac, Entex, flexural, ibuprofen, enteral, lamictal, latex, Mestinon, mobic, MRI dye, Mucinex, naproxen, Neurontin, oxycodone, paxel, peanuts robitussen, theroquil, shellfish, sulfa, tophorol, trazadone, Zoloft

Symptom List: Pharyngeal swelling

Symptoms: 1/22 Vaccination chills, extreme fatigue, extreme HA. Slept all day and night. Didn't feel better all weekend. 1/29 went to dr. office. Pre-scheduled due to reaction from 1st vaccine.

Other Meds: prednisone, Keppra, Lexapro, Tylenol, propranolol

Current Illness: asthmatic, chronic kidney disease, hypertension, autonomic dysreflexia , seizure disorder, chronic migraines

ID: 1029458
Sex: F
Age: 80
State: MA

Vax Date: 02/06/2021
Onset Date: 02/12/2021
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, sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: My left upper arm the site of the injection started to be itchy on Friday Feb. 12, 2021, six days after the shot. It has a rash of about an inch and a half radius. I put some cortisone on it and took a quarter of a Benadryl tablet today Sunday Feb 14, 2021 because the itch becoming more irritating. The itch did decline .

Other Meds: Diltiazem, HZTZ, pravastatin, fluoxetine, metoprolol, baby aspirin

Current Illness: None

ID: 1029459
Sex: F
Age: 57
State: NC

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: On 2/6/2021 in the morning I had numbness & tingling on my left hand. My arm was very sore & it was painful. I also had fever 99.2. My arm numbness and tingling is still going on that hasn't resolved and I've been seeing a doctor for it.

Other Meds: Azythromycin 250 mg every morning Metoprlo 75mg twice a day Lisinopril 20mg Loprzlie 20mg nlortirptyline 45mg tizanidie 2mg flonsie 50 Inhaler Montelukast 10mg musinex 600mg Fish Oil 1200mg Vitamin D Multi Vitamin Benzonatate 200mg

Current Illness:

ID: 1029460
Sex: F
Age: 79
State: MA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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: aspirin bupvicaine azithromycin clindamycin codiene epinephrine fentanyl levoquin lidocaine metformin morphone penicillin

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

Symptoms: Patient started to experience chest tightness and then hypertension

Other Meds: atenolol atorvastatin diazepam keppra levothyroxine lisinopril omeprazole multivitamin prednisone

Current Illness: none

ID: 1029461
Sex: F
Age: 78
State: VA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: low grade fever, fatigue, headache, muscle aches, chills, pain at injection site these symptoms started around 9:00am 24 hours after injection of second dose.

Other Meds: glipizide 2.5mg aspirin [ low dose] 81mg lisinopril 10 mg atorvastatin 10 mg Jardiance 25 mg one-half tablet

Current Illness: Type 2 Diabetes

ID: 1029462
Sex: F
Age: 39
State: IA

Vax Date: 02/03/2021
Onset Date: 02/09/2021
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:

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

Symptoms: Large rash on Legs and lower abdomen

Other Meds:

Current Illness:

ID: 1029464
Sex: M
Age: 66
State: CO

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

Lab Data:

Allergies: Compazine

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

Symptoms: Chills beginning at 4:30 am., Fever/temp at 7 am 101.4. > 500 mg of Acetaminophen given. Fever at 10 am 100.4, Fever at 1:45 pm 101.7 > 500 mg Acetaminophen given. Called Hospital and told to call if climbs to 102.

Other Meds: Vitamin D

Current Illness: Surgery for Prostate Cancer on January 12, 2021

ID: 1029465
Sex: F
Age: 71
State: NY

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Codeine

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

Symptoms: Besides sore arm, started with dizziness, upset stomach, 99? fever, chills, headache and vomiting that would not stop abusing dehydration.

Other Meds: Synthroid Pregabalin Pravastatin Lisinopril Vitamin E Multivitamin

Current Illness: None

ID: 1029466
Sex: M
Age: 61
State: NC

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

Lab Data:

Allergies: Shellfish Fish

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

Symptoms: Hives, Itchiness, Difficulty Breathing Benadryl and later when difficulty in breathing increased an Epipen Administered Symptoms Reduced, no further issues

Other Meds: lisinopril Oxybutynin metFormin sertraline

Current Illness:

ID: 1029468
Sex: F
Age: 67
State: WI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Penicillins

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

Symptoms: One of our Greenfield patients called today (2/12/21) to discuss the adverse effects she experienced following her first dose of the COVID vaccine (received last Friday, January 29). The patient indicated that several hours after receiving her vaccine, she experienced pronounced dyspnea and tachycardia. She stated these symptoms lasted throughout the weekend and were severe enough to prevent her from conducting her daily activities. The patient mentioned that, at one point, she nearly passed out while showering from not being able to catch her breath. The patient reported that she contacted her PCP for guidance, who instructed her to visit the ER for a thorough workup; however, the patient stated she did not follow these orders due to concerns of having a high copay. When speaking with her today, the patient assured me that her symptoms have since resolved.

Other Meds: Metoprolol ER, Amlodipine, Trazodone, Atorvastatin

Current Illness:

ID: 1029469
Sex: F
Age: 42
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/27/2021
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: Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: COVID vaccine arm - redness, swelling, soreness, itching, 4-5? diameter. Center of swelling 4? south of injection site.

Other Meds: Asmanex; Albuterol

Current Illness: None

ID: 1029470
Sex: F
Age: 68
State:

Vax Date: 02/03/2021
Onset Date: 02/12/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Covid arm for both myself and husband. Warm, red large circle, slightly itchy.no pain. Thought you should know for stats.

Other Meds:

Current Illness:

ID: 1029471
Sex: F
Age: 69
State: CA

Vax Date: 02/04/2021
Onset Date: 02/11/2021
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: Penicillin

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

Symptoms: On day 8, post vaccination, an itchy, swollen, red rash about 3" x 2" in my upper right arm at the injection site, that is painful and hot to the touch.

Other Meds: None

Current Illness: None

ID: 1029472
Sex: F
Age: 52
State: MA

Vax Date: 02/11/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: Starting 10 hours after vaccine I experienced rigors, fever to 103 lasting 12 Hours, Then fever to 100.7 lasting an additional 24 hours, one episode of vomiting, severe headache, body aches and fatigue lasting 48 hours, tho only first 24 hours were severe. I also have painful swollen axillary lymph nodes on that side three days later. My arm is only moderately sore. I did many arm circles the day of the vaccine, which may have helped, because arm soreness was much worse after dose 1.

Other Meds: Levothyroxine, vitamin C, vitamin D

Current Illness: None

ID: 1029473
Sex: F
Age: 26
State: NY

Vax Date: 01/17/2021
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: N/A

Symptom List: Unevaluable event

Symptoms: I felt nauseous around 12 hours later and had insomnia until around 5am. I do not ever feel nauseous or have insomnia. There was pain at the site of injection for around 72 hours. I felt shaky and had chills the following day and was just a little hazy as well.

Other Meds: N/A

Current Illness: N/A

ID: 1029474
Sex: F
Age: 65
State: CA

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: No

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

Symptoms: Started with chills at night, left arm hurt a lot. Today Sunday Still hurt but not too much. I start to fell very tired and cold, also sleep. I told my temperature around 12pm and it is at 100.1. Slightly have a headache. Also lost of appetite .

Other Meds: Accient Multi woman's 40+daily supplement, 1 tablet daily. Cranberry support urinary tablet 2x a day, Passion Flower dietary supplement 350mg, Hawthorne Aerial Extract 600mg, 2,2x a day, Calcium Magnesium 1000mg: 500mg, 1 tablet 2x a day,

Current Illness: Hperthyroidism

ID: 1029475
Sex: F
Age: 36
State: OH

Vax Date: 02/14/2021
Onset Date: 02/14/2021
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: Sulfas

Symptom List: Injection site pain, Pain

Symptoms: Matallic taste in mouth, then right leg coldness and burning. EMT on site evaluated client in recovery area. EMS staff noted that symptoms progressed to right leg itching and right arm coldness and burning. At client request she walked to EMS unit outside and was transported to local hospital for evaluation.

Other Meds:

Current Illness: POTTS

ID: 1029476
Sex: F
Age: 74
State: TN

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

Lab Data:

Allergies: latex

Symptom List: Injection site pain, Menorrhagia

Symptoms: I woke up at about 4:30 am shivering. Got an additional blanket and tried to warm myself. snuggled into husbands back to get very nauseated and vomited several times. Slept most of the day with little appetite. Had difficulty maintaining body temp but never ran a temperature. Lots of body aches.

Other Meds: Ibuprofen

Current Illness: Covid

ID: 1029477
Sex: F
Age: 68
State: FL

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

Lab Data:

Allergies: Macrodantin, erythromycin, levaquin

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

Symptoms: Very severe muscles aches. Lesser headache and chills. In bed for 40 hours. No symptoms now other than a little tiredness

Other Meds: Tamoxifen

Current Illness: None

ID: 1029478
Sex: M
Age: 36
State: MA

Vax Date: 02/05/2021
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: mango rind, poison ivy

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Not sure when it began. I noticed a warm red blotch (size of an apple) at the injection site a week after the injection. It's slightly itchy. Feels like an allergic reaction.

Other Meds: Citalopram, essential amino acids, deer antler velvet

Current Illness:

ID: 1029479
Sex: F
Age: 71
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: Sulfa Penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The day after the vaccination my arm and shoulder into my back was so sore I could barely touch it. It was sore for a week and then it got better. After that it started to itch. My face also was itching and across the top of my back. The itch was excruciating and I tried topical ointment and Tylenol but nothing stopped the itch. After the week my arm around the injection site swelled, was red and hot. It still itched but was better. I watched it to be sure it was not getting bigger or more heated. It stayed that way for about four days and returned to normal. It still itches but not as much.

Other Meds: Sertraline Lorazapam Levothyroxine Vitamin D

Current Illness: None

ID: 1029480
Sex: F
Age: 43
State: MS

Vax Date: 02/12/2021
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: RA

Lab Data:

Allergies: Sulfur, penicillin, doycyclene

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

Symptoms: Low grade fever, chills, blotchy red spots at injection site

Other Meds: Metoprolol Er 25 mg, Lo Lo Estrin 24

Current Illness:

ID: 1029481
Sex: M
Age: 65
State:

Vax Date: 01/23/2021
Onset Date: 02/12/2021
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: NSAIDS, Morphine, Bextra

Symptom List: Nausea

Symptoms: Only side effect was on day 21 was HA and chills lasting one day and on day 22 was ST lasting one day.

Other Meds: None

Current Illness: none

ID: 1029482
Sex: F
Age: 82
State: NC

Vax Date: 02/05/2021
Onset Date: 02/09/2021
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: Large red swelling the size of a silver dollar. Hot to touch, became very itchy. Applied benadryl to the site and then took one antihistamine pill after the second or third day. That helped and while it is still red it doesn't itch anymore. It is now about the 10th day after injection. The swelling and redness is abating.

Other Meds: eye drops for glaucoma Vit. D, zinc.

Current Illness: None

ID: 1029483
Sex: F
Age: 75
State: AZ

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: sulfonamides, donnatol, phenobarbitol, erythromycin, crab

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

Symptoms: 1:30AM on 2/12/21 awoke with headache and severe chills. Could not get warm with multiple blankets. Temperature rose to 102 degrees by 6AM. Could not sleep as body aches and shivering were intense. Took tylenol at6AM. Temperature started to decline and was only 100 degrees after 3 hours. Temperature rose again to 101 degrees as tylenol wore off. Took tylenol again at around noon. Shivering had abated. still headache and body aches. Was able to sleep but temperature remained elevated into the night. By 2/13/21 temp low grade, body aches, tired. Arm very sore throughout. Started to feel somewhat normal by 2/14/21 but still exhausted and having body aches and a very sore arm.

Other Meds: tirosint, metoprolol

Current Illness: none

ID: 1029484
Sex: M
Age: 67
State: CO

Vax Date: 01/26/2021
Onset Date: 01/27/2021
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: none

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

Symptoms: Spouse woke at 3am got up for a drink of water and fainted - fell on a tile floor damaging lips and teeth. I got up to help, cleaning up blood and checking injury. After a while I got dizzy and fainted, got up too soon and fainted again. I fainted a third time, had convulsions and lost bladder control. Visited my PCP a week later. Now have a neurologist appt scheduled, a month out. Currently, I have no apparent issues.

Other Meds: atorvastatin; lansoprosole; multi; glucosamine; aspirin

Current Illness: none

ID: 1029485
Sex: M
Age: 53
State: WV

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: 12 hours after injection, mild body aches and chills 24 hours after injection, rash on left arm, chest, back and neck; swollen lymph node in neck about the size of a grape, left side near clavicle, possible swelling in lymph nodes in arms pits. Rash felt warm, like a mild sunburn 36 hours after injection, rash disappeared. Lymph node in neck seems smaller.

Other Meds: None

Current Illness: None

ID: 1029486
Sex: F
Age: 42
State: IL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: Amoxicillin

Symptom List: Erythema, Pruritus

Symptoms: First dose after effect symptoms were mild to moderate chills, body malaise, feverish feeling and pain on injection site that lasted for 3 days. On the third day, took Advil and symptoms disappeared the next day and feeling were fine. The second dose was moderate chills, severe body malaise and feeling feverish, decrease concentration ,minimal headache and moderate pain and redness on injection site. On 2/13/2021 had a routine lab follow-up on MD clinic and surprisingly my PCP called me up today due to decrease WBC at 2.0. This has never happened to me before. I told my PCP I had just received my second dose 2 days prior and could be related somehow ? They will run a repeat CBC on me next week and we will see from there. Hope nothing serious will come out from this.

Other Meds: Valsartan, rosuvastatin, turmeric, ferrous sulfate

Current Illness: None

ID: 1029487
Sex: F
Age: 66
State: AZ

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

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

Symptoms: On day of vaccination some heart racing, and metallic taste in my mouth. Resolved in 24 hours. Second day developed shortness of breath and cough. Resolved in 48 hours. Today generalized but very pronounced generalized rash with itch. None necessary for doctor's care but all very present. Not fully recovered but each symptom is still slowly resolving.

Other Meds: Losartan, Metoprolol, Rosuvastatin, Lasix, aspirin, Bactrim

Current Illness: none

ID: 1029488
Sex: M
Age: 30
State: SC

Vax Date: 02/11/2021
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: LA

Lab Data:

Allergies: Sulfur

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

Symptoms: Headaches, site pain, neck pain, numbness in arms and fingers on side if injection site. Extreme fatigue.

Other Meds: Tylenol

Current Illness: None

ID: 1029489
Sex: M
Age: 75
State: FL

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: This morning (2/14/2020) began feeling cold and not very well. Took temperature - 100 degrees F. Took temperature again about 4:30 PM - 101 degrees F. I just generally don't feel well. Have not received any treatment or notified any doctor. It is Sunday.

Other Meds: Ibrance, Prolia, Letrozole, Tamulosin, Losartan, Vitamin D3, Vitamin B complex Centrum Silver Vitamins, Niacin, Aspirin

Current Illness: None

ID: 1029490
Sex: M
Age: 47
State: MA

Vax Date: 12/29/2020
Onset Date: 12/01/2020
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:

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

Symptoms: Patient called pharmacy 2/14/21 complaining of shoulder pain since got flu shot 12/29/20. Advised to call PCP.

Other Meds:

Current Illness:

ID: 1029491
Sex: F
Age: 32
State:

Vax Date: 01/08/2021
Onset Date: 01/11/2021
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

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

Symptoms: Flu like symptoms. fever, chills, bodyaches, headaches, muscle pain

Other Meds:

Current Illness: None

ID: 1029492
Sex: F
Age: 36
State: NY

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

Lab Data:

Allergies: Pcn and squid

Symptom List: Pain in extremity

Symptoms: Methadone withdrawal symptoms. Chills. Irritability Mood swings. Body aches. Nausea. Migraine headache fatigue

Other Meds: Methadone .Zoloft. Latuda. Atarax. Bromocriptine. Nurtec. Imitrex. Zofran.

Current Illness:

ID: 1029493
Sex: F
Age: 73
State: OH

Vax Date: 02/06/2021
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:

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

Symptoms: Red arm

Other Meds:

Current Illness:

ID: 1029494
Sex: F
Age: 85
State: FL

Vax Date: 02/07/2021
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: Sulfa

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

Symptoms: My left arm at injection sight It was red and very itchy. Below by approximately one inch was another red area and it was itchy too, they both had red lines extending from the red area. I put a cortisone cream on the areas and went to sleep. When I awoke this morning it was still red and itchy. I called my pharmacist to see if I could take Zyrtec liquid gels. I was told to take one per day and to call my doctor to report it. The itching stopped and the red faded more at the injection site . The redness below is still there although slightly lighter. It is now 5:17 pm on Feb. 14. 2021.

Other Meds: Eliquis 2.5 mg 2 times a day Multaq 400 mg 2 times a day Rosuvastatin 10 mg 1 time a day Metropol er succinate 25 mg tabs 1 time a day Spironolactone 25 mg 1 time per day Calcium Vitamin D Fish oil

Current Illness:

ID: 1029495
Sex: M
Age: 27
State: SC

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

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

Symptoms: Rash and itchy arm

Other Meds: n/a

Current Illness: n/a

ID: 1029496
Sex: M
Age: 59
State: VA

Vax Date: 02/10/2021
Onset Date: 02/12/2021
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: erythromycin

Symptom List: Vomiting

Symptoms: Severe, persistent headache following the second dose of the vaccine, beginning approximately 22 hours after the administration of the vaccine and continuing, so far, for three days.

Other Meds: levothryroxine, 175mcg daily

Current Illness: none

ID: 1029497
Sex: F
Age: 65
State: WA

Vax Date: 12/30/2020
Onset Date: 01/06/2021
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: Gluten Vancomycin Sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever of 99.4 for 3 hours one week post injection. Got the shot on Wednesday. Spent the weekend giving riding lessons to 4H kids in open arena. 6 foot distancing, no masks as we were shouting instructions to kids. One girl came down with Covid on Monday. I had fever on following Wednesday. Better by evening.

Other Meds: Prozac Oxybutin Cozar Lipitor Metformin Melatonin

Current Illness: None

ID: 1029499
Sex: F
Age: 55
State: CO

Vax Date: 01/26/2020
Onset Date: 01/27/2020
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: Penicillin

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

Symptoms: I got up at 3:00 a.m. (11 hours after receiving the vaccination) to get a drink of water. I lost consciousness suddenly, resulting in a face plant on tile floor, which caused serious facial and dental injuries. While attending to my injuries, my husband also experienced loss of consciousness and convulsions (three times). He has submitted his own paperwork.

Other Meds: sprycel 25 mg daily

Current Illness: none

ID: 1029500
Sex: F
Age: 45
State: OH

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

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Received vaccine 2/12 at 1130am. Woke on 2/13 with red, warm to touch, painful lump on right deltoid approx silver dollar size. Also migraine headache, joint and muscle pain, shortness of breath, vertigo and chills alternating with sweats. This continues into today 2/14 and now the area on my arm is approx size of a grapefruit with swelling and bruising in armpit area and across chest over right breast. Headache and vertigo continue today also.

Other Meds: Metoprolol, lisinopril, citalopram

Current Illness: None

ID: 1029501
Sex: M
Age: 71
State: NY

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

Lab Data:

Allergies: NONE

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

Symptoms: Slight rash at sight of injection

Other Meds: SIMVASATIN 40MG LISINOPRIL 10MG

Current Illness: NONE

ID: 1029502
Sex: F
Age: 37
State:

Vax Date: 02/03/2021
Onset Date: 02/10/2021
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:

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

Symptoms: 2/3/21 I started to have a very sore left arm for several days as well as a sore left leg. 2/10/21 I started to get a rash at the injection site.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm