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: 1029761
Sex: F
Age: 30
State: AZ

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever of approximately 101 for four days while alternating Tylenol and Advil. Welt on arm. Body aches and sharp shooting pains. Stomach pain. Chills. Headache.

Other Meds: Esomeprazole

Current Illness: None

ID: 1029762
Sex: F
Age: 71
State: CA

Vax Date: 02/01/2021
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: No known serious allegies.

Symptom List: Anxiety, Dyspnoea

Symptoms: I received a Moderna Covid-19 immunization on 2/1/2021. Here are the after effects I am experiencing: (1) mild sore throat and mild flu-like symptoms (slight headache, malaise, & fatigue) beginning 3 days after my shot continuing to this day, 13 days after shot (2/14/2021). (2) A lump, between the inside of my mouth & the outside of my cheek, which began on 2/6/21, 5 days after Covid-19 Moderna vaccination. On 2/6/21, I discovered a raison-size lump in my cheek. I could feel it with my tongue. By midnight, swelling visible from outside, in the mirror, was .5 inch from top to bottom & 1.5 inches from side to side, from below the left edge of my mouth toward the middle of my mouth. On 2/7/21, at 1:30 p.m., I could see the lump in the mirror, inside of my mouth, about .75" wide; I could see it from the outside of my cheek in the mirror, a swollen area about .75" from top to bottom & 1.5 inches wide. I felt puffiness, which I couldn't see, which extended 4" up my cheek & down across the visibly puffy area. Slightly after midnight on the morning of 2/11/21, what I felt with my tongue was between the size of a raison & an almond; from the outside, the swelling was about .75" from top to bottom & 1.75" across. Now, 13 days after my vaccine shot, the lump has receded to be about the size of a BB and the swelling outside of my mouth is going down. Is this a Covid-19 vaccination reaction? Is it serious? I read in the Washington Post that folks who have a reaction to shot #1 tend to have more of a reaction to shot #2, so that makes me anxious. Should I even take shot #2?

Other Meds: (1) Nucala shots, for Hyper Eosinophil Syndrome; 3 in early Dec.; 3 in early January; 3 were scheduled for 2/1/2021 but, after I got a date for a covid-19 shot on 2/1/2021, my doctor cancelled the 3 Nucala shots I was scheduled to get th

Current Illness: Hyper Eosinophil Syndrome

ID: 1029763
Sex: F
Age: 50
State: OR

Vax Date: 02/01/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Large raised welt, at least 3" diameter. Hard, red, painful to touch.

Other Meds: Venlafaxine, spironolactone, adderall,

Current Illness: None

ID: 1029764
Sex: F
Age: 21
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Sore arm, body aches onset at 12:30am

Other Meds: Prescriptions: Junel Fe (birth control), glycopyrrolate OTC: generic allergy medicine, baby aspirin Supplements: vitamin D

Current Illness:

ID: 1029765
Sex: F
Age: 33
State: IA

Vax Date: 02/11/2021
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:

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

Symptoms: Visual disturbances 3 days after 2nd Pfizer dose - Floaters in the middle of my visual field wouldn't move and blurred my vision. Flashes/swirls of light. Struggled to read text. This lasted 2 hrs or so and finally gradually improved. I have NEVER had anything like this before. My mom had this EXACT same thing happen 2 days after her 2nd Moderna dose except hers hasn't gone away.

Other Meds: Ortho Tri Cyclen

Current Illness:

ID: 1029766
Sex: F
Age: 66
State: FL

Vax Date: 02/07/2021
Onset Date: 02/14/2021
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: N/A

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

Symptoms: Rash on arm that got vaccine. A bit itchy. Area around injection site is slightly raised relative to the injection site, which slightly indents. Also, I still have a bruise from the shot.

Other Meds: Vitamins A, B complex, C, E, multi , fish oil

Current Illness: None

ID: 1029767
Sex: M
Age: 63
State: MO

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: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Swollen groin lymph area. Possible hernia with no history or contributing cause.

Other Meds: Zyrtec and 81mg aspirin

Current Illness: None

ID: 1029768
Sex: F
Age: 60
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: keflex; sulfa

Symptom List: Pharyngeal swelling

Symptoms: Moderna Covid 19 Vaccine EUA. I hope I read the lot number correctly. I can't discern it the 0 should be a O. This the what happened. I received dose #2 on 2/12 in the afternoon. Approximately ten hours later around 2:00am I had flu-like symptoms which included body aches, chills, fever, nasal congestion which lasted all of 2/13. Upon awakening on 2/14 I noticed a bright red rash on the truck of my body (front and back.) The flu symptoms have abated.

Other Meds: Crestor; Evista; Vit D; Vit B12; Calcium

Current Illness: None

ID: 1029769
Sex: F
Age: 43
State: VA

Vax Date: 02/04/2021
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Covid Arm. Itchy swelling rash

Other Meds: Daily vitamins

Current Illness: Penicillin, SPF ingredient

ID: 1029770
Sex: F
Age: 55
State: CT

Vax Date: 01/06/2021
Onset Date: 01/09/2021
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: Nonenone

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Rash over entire body

Other Meds: None

Current Illness: None

ID: 1029771
Sex: F
Age: 71
State: GA

Vax Date: 01/28/2021
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: Codeine

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

Symptoms: 7? x 8 ? red rash, tender to touch, warm and hard.

Other Meds: Lorastan Levthroxin Benadryl Tylenol Ibuprofen

Current Illness:

ID: 1029772
Sex: F
Age: 41
State: MO

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

Lab Data:

Allergies: Sulfa

Symptom List: Rash, Urticaria

Symptoms: Severe back and abdominal pain, pain in left leg, pain in neck, hives on upper extremities 6 hours after shot, general malaise

Other Meds: Zoloft 200mg, losartan 50mg

Current Illness: None

ID: 1029773
Sex: F
Age: 31
State: CA

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: None

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

Symptoms: Fever, sore arm, pain and redness at injection site

Other Meds: Multivitamins

Current Illness:

ID: 1029774
Sex: M
Age: 54
State: PA

Vax Date: 01/27/2021
Onset Date: 01/30/2021
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: Aspirin (full strength)

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

Symptoms: Dizziness weakness of my legs Unsteady on my legs Really bad headaches Nausea especially in the mornings Sick to my stomach and ongoing

Other Meds: Isosorbide45mg Topiramate 200mg 2x dly Ranexa 1000mg 2x Naproxyn gabapentin 300mg 2x dly

Current Illness: Prinzmetal Angina Thalassemia GERD Migraine

ID: 1029775
Sex: F
Age: 44
State: FL

Vax Date: 01/07/2021
Onset Date: 01/10/2021
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:

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

Symptoms: 01/10/21 - exacerbated trigeminal neuralgia and polymyalgia bilateral shoulder pain, had to take prednisone taper for 10 days 02/02/21 - migraine like headache started and shoulder pain continued, on 02/04/21 seen by neurologist ARNP telehealth and prescribed Cymbalta 20mg, on 02/09/21 seen in ER, Covid test negative, given migraine medicine Fioricet on 02/11 /21 seen by neurologist ARNP to restart prednisone taper and take migraine med Fioricet Migraine symptoms lessened but still present

Other Meds: Vistaril 50mg bedtime Singulair 10mg bedtime Fish oil 1 daily Neocell collagen 2 tabs daily Aloe Vera 6 tablets daily

Current Illness:

ID: 1029776
Sex: F
Age: 57
State: IN

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

Lab Data:

Allergies: None Known

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

Symptoms: Red Bumps (rash) over torso, under arm pits, over breasts, upper thighs near groin area Shortness of breath

Other Meds: Trokendi 50mg daily, Effexer 225 mg daily, - both for vestibular migraine Celebrex 200 mg daily (osteoarthritis) Tramadol 50 mg daily when needed Alphagan Eye drops Once a day multivitamin, Echinacea, 50 mg zinc

Current Illness: None

ID: 1029777
Sex: F
Age: 22
State: MI

Vax Date: 02/14/2021
Onset Date: 02/14/2021
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: None

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

Symptoms: Chills, aches, nausea/vomiting

Other Meds: Vitamin D, B complex, and Omega 3

Current Illness: None

ID: 1029778
Sex: M
Age: 75
State: HI

Vax Date: 01/27/2021
Onset Date: 02/03/2021
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: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Rash/hives appearing all over torso

Other Meds: Losartan potassium 25mg, Rosuvastatin calciu, 5mg

Current Illness: none

ID: 1029779
Sex: F
Age: 65
State: IL

Vax Date: 02/13/2021
Onset Date: 02/14/2021
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: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: red, swelling and itching just below injection site in left arm

Other Meds:

Current Illness: none

ID: 1029780
Sex: F
Age: 28
State: CA

Vax Date: 02/11/2021
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: Allergy to certain lip balms

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

Symptoms: At about 9:45pm on 2/11/21 I started having body chills. Throughout the night I was freezing but my body was warm. At 3:30am my temperature was 101 degrees. I took one dose of Tylenol. At 10am on 2/12 I was fatigued, weak and had body chills. At 11am my temperature was 100 degrees. Throughout the day, I was tired and body chills on and off. I took two more doses of Tylenol throughout the day. At 4pm my temperature was 97 degrees. On 2/13 I woke up nauseated with no appetite for food up until 1pm. I took a nap and had an appetite for food at 3pm. On 2/14 I had NO symptoms.

Other Meds: Tri Sprintec

Current Illness: N/a

ID: 1029781
Sex: M
Age: 64
State: NY

Vax Date: 02/06/2021
Onset Date: 02/08/2021
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: none

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

Symptoms: Twitching in right shoulder area, twitching in right butt area, or another word to use is TREMORS. ITS BEEN ABOUT A WEEK NOW.

Other Meds: none

Current Illness: high blood pressure

ID: 1029782
Sex: F
Age: 71
State: CA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
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, amoxicillin, some sulfa drugs, and cilantro

Symptom List: Unevaluable event

Symptoms: Heart palpatations and afib, See above

Other Meds: Pradaxa, 150 mg twice a day, DIlt-XR, 180 mg, Levothroxine,75 mvg, K-tab10 mEg, Triameeterene and Hydorchlorethiaszide, 375.mg. Phenobarbital 97.2 mg,, Atorvastatin 40 mg,, Vitamin B Complex, Folic Acid, Senior Multivitamin, and Calcium+D

Current Illness: NO illness, but underlying conditions mentioned above

ID: 1029783
Sex: F
Age: 90
State: DE

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: PCN

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

Symptoms: Shortly after receiving the Moderna COVID-19 vaccine, patient complained of chest and stomach pain, then became very sleepy and fainted. RN was unable to obtain a manual BP; Apical pulse 36. Pulse Ox in the 70s. She was placed in bed and eventually regained consciousness. Her pulse ox improved to the 90s. BP 92/55. Her only complaint was that her hands were cold. Medical Director believes it was vasovagal syncopy due to receiving the vaccine. Patient died on 1/28/2021, due to progressive dementia.

Other Meds: CLOTRIMAZOLE TOPICAL 1% cream topical 1 app applied topically BID COLACE sodium 100 mg capsule oral 1 cap(s) orally daily MELATONIN 10 mg capsule oral 1 cap(s) orally once a day (at bedtime) MEMANTINE 10 mg tablet oral 1 tab(s) orally BID P

Current Illness: Progressive decline in ability to ambulate. Appetite and oral intake has continued to decline over the past 2 weeks.

ID: 1029784
Sex: F
Age: 75
State: MT

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/14/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: timolol (burning)

Symptom List: Injection site pain, Pain

Symptoms: Patient presented on 1/24 with acute onset weakness and numbness of the left leg so a stroke alert was activated. NIHSS 3. Head Ct and CTA head/neck were unremarkable. Not a candidate for tPA given on Eliquis. Initial exam was notable for weakness and sensory loss in the left leg, but a sensory level was also found to the umbilicus raising concern for a myelitis. Of note, the patient also reported that certain red colored things she looked at appeared black. Labs unrevealing- CBC, CMP unremarkable. ESR, CRP normal. UA and UCx positive for E. Coli UTI, she was treated with ceftriaxone. MRIs were done of her brain, cervical and thoracic spine which were unrevealing. On 1/25, her exam worsened including worsening weakness in the left leg and new numbness and paresthesias in the right leg. Reflexes were preserved. MRI L spine was done which was unrevealing. Lumbar puncture was done which showed 2 nucleated cells and mildly elevated protein at 50, but was otherwise unrevealing. IgG Index normal. No oligoclonal bands. She developed mild hyperreflexia in the left leg and continued to have a sensory level, now at around T5-6. Repeat imaging of her cervical and thoracic spine were completed on 1/28 which showed a contrast enhancing hyperintensity at T5. The patient was diagnosed with myelitis and she was started on IV methylprednisolone x5 days and sent to rehab. Patient is now significantly improved though continues to report some numbness in the left leg.

Other Meds: albuterol, apixaban, cleocin topical gel, diclofenac, diprolene ointment, estradiol, fluorometholone, lipitor, losartan, multivitamin, prilosec, tretinoin topical, valacyclovir, vitamin D3

Current Illness: None

ID: 1029785
Sex: F
Age: 35
State: AZ

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

Lab Data:

Allergies: Ceclor

Symptom List: Injection site pain, Menorrhagia

Symptoms: Severe full body aching, headache, fever, chills, sweating

Other Meds: None

Current Illness: None

ID: 1029786
Sex: F
Age: 58
State: MD

Vax Date: 01/13/2021
Onset Date: 01/13/2021
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: None

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

Symptoms: Jan vaccine- 1 hour later and persisting for 1 week- left facial nerve neuralgia with left eye twitching (up to 2 weeks afterwards) Feb vaccine(2/11/24)- 24 hrs after vaccine- extreme SI, hip pain with inability to sit or stand- lasting 24 hours

Other Meds: General women's vitamin, vit C, vit D

Current Illness: None

ID: 1029787
Sex: M
Age: 93
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Weakness (ended up falling, hitting head/hematoma)

Other Meds: None

Current Illness: None

ID: 1029788
Sex: F
Age: 72
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: Codeine / Erethromycin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Day 1: headache and chills, no fever. Day 2: fatigue and chills, no fever Day 3-4 : fatigue and chills, no fever Day 5: Strong heart palpitations, chills and fatigue . Day 6-7 Heart pain, palpitations, chills and fatigue/ Had to rest constantly. Began taking ibuprofen to calm the inflammation. Day 8: Heart pain, pressure & palpitations worsening, fatigue. Primary and Cardiologist recommended going to ER. Diagnosed with mild pericarditis. Day 9-10: Home on bedrest taking ibuprofen 3x day with continued heart palpitations, pain, chils and fatigue.

Other Meds: Toprol XL / Tapazole / Multivitamin / Omega 3 Fish Oil

Current Illness: None

ID: 1029789
Sex: F
Age: 35
State: TX

Vax Date: 02/06/2021
Onset Date: 02/14/2021
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: Rash (red, itchy) and hardness/slight sweeling at injection site.

Other Meds: Propanol, Claritin, Singular, Omitsaprol, Frova, Cambia, inhaler, CQ10, B-Complex, cylobenzoprin

Current Illness: N/a

Date Died: 02/05/2021

ID: 1029790
Sex: F
Age: 95
State: CA

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Taken to Emergency about 8 hours later and died in ER

Other Meds: Escitalophram Over the Counter - B12, Iron, Calcium, Senna

Current Illness: Dementia

ID: 1029791
Sex: F
Age: 53
State:

Vax Date: 02/05/2021
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: Approx 8 days after vaccination I developed a reddened, warm, slightly itchy, firm lesion around the.injection site

Other Meds: Multi vitamin, vitamin D, fish oil

Current Illness: None

ID: 1029792
Sex: F
Age: 64
State: MA

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: penicillin, sulfa, dust, mold

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

Symptoms: Starting after one week, injection site is swollen, itchy, red, slightly painful, rash

Other Meds: Protonix, pepcid

Current Illness: none

ID: 1029793
Sex: F
Age: 31
State: PA

Vax Date: 02/03/2021
Onset Date: 02/05/2021
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: Ceclor Sulfa Betadine Ferric Subsulfate Clindamycin Shellfish/Seafood

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

Symptoms: 2/5/21 around 9:30am - started developing shortness of breath, palpitations, and tachycardia upon exertion. I would become winded just walking to another room or brushing my hair. I reached out to the contact tracing center at hospital to find out if this was a reported side effect of the vaccine. The symptoms continued throughout the weekend and I was unable to work. My next workday was Tuesday and I was still short of breath so I reached back out to the contact tracing center who sent me to be tested for COVID. The results came back negative. I contacted my PCP who ordered a chest X-ray and had me get a pulse ox. My heart rate would go up to 138 with one flight of stairs. Sitting eating dinner my heart rate would sit at 108. Brushing my teeth my heart rate was 119. Thursday, 2/11 - I woke up for my chest X-ray and was light-headed. I put on my pulse ox and my SpO2 was 87%. I went for my chest X-ray and then went straight to the ED. I was hypertensive and tachycardic when I arrived. My blood work and imaging were all normal. 2/12 - I saw a cardiologist who put me on a beta-blocker to temporarily control my symptoms. He believes I am having a secondary reaction to the vaccines as opposed to a primary issue with the heart. I am scheduled for an echo on 2/15 to cover all bases. Symptoms have NOT subsided to date - I am still short of breath, have chest pressure, palpitations and tachycardia are being controlled with a beta-blocker (resting HR is 60s but will jump to high 90s with any movement), blood pressure being controlled with beta-blocker. **I was evaluated for palpitations in 2018 but they were found to be minor and no specific cause was to be found, nor was the cardiologist concerned at the time. I have NO known heart issues or defects.

Other Meds: Effexor XR Vitamin D Probiotic Gabapentin Minastrin FE 24 Hydroxychloriquine Ursodiol Allegra Allergy Topamax Singulair Stelara Hizentra

Current Illness: Sinus Infection

ID: 1029794
Sex: F
Age: 43
State: FL

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

Lab Data:

Allergies: Benadryl, radishes

Symptom List: Tremor

Symptoms: Redness (small at first, then grew larger), tenderness, swelling, itching, and an extremely painful-to-touch lump under/at/around at the injection site. Redness is also hot to the touch. Severe headache bordering on migraine-level. Treated headache w my normal migraine regime. Applied cold pack to the injection site. Used lidocaine topical ointment to numb the skin and help control the itching. It is 3 days after the injection and whilst the itching is under control the lump is still painful, red, and very warm.

Other Meds: Hydrochlorothiazide 25mg Burrowing XL 300mg Methocarbamol 750mg Potassium 250mg Magnesium 400mg D3 1000 IU Famotidine 20mg Belbuca 75mg

Current Illness:

ID: 1029795
Sex: F
Age: 69
State: CA

Vax Date: 02/06/2021
Onset Date: 02/14/2021
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: Sulfa drugs

Symptom List: Erythema, Pruritus

Symptoms: No side effects until this orning, day #8. My arm at the injection site has been itching and the area is about a 3-4 inch oval, red and swollen. Not painful, just itchy.

Other Meds: Magnesium 400mg daily Melatonin 5mg nightly Centrum Silver daily Vitamn D3 5000 IUI 3x/week Viactiv Calcium plus D chews: 1/day 650 mg

Current Illness: none

ID: 1029796
Sex: F
Age: 60
State: CA

Vax Date: 01/31/2021
Onset Date: 02/02/2021
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: Sulfa

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

Symptoms: Strong pain on left arm and shoulder, it started 2 after the vaccine, and is still present, it had never hurt like this.

Other Meds: Tramadol, Lyrica,Advil,omeprazole,Levothyroxine

Current Illness: Herniated discs in the neck

ID: 1029797
Sex: F
Age: 42
State: UT

Vax Date: 02/06/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Red, hard lump on arm, itchy and hot to the touch

Other Meds: Vita fusion women?s multivitamin, vitamin C

Current Illness: None

ID: 1029798
Sex: F
Age: 54
State: WI

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

Lab Data:

Allergies: Cherries

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Day 7 got red patch and hardening 2.5? circumference around injection site, comes and goes with occasional itching. Hardening and redness still here after 4 days

Other Meds: Ocella, losartin, omeprazole, vitamin D, made sound/calcium/zinc

Current Illness: None

ID: 1029799
Sex: F
Age: 59
State: KY

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

Lab Data:

Allergies: IV Contrast dye foods made with processed sugar and/or flour

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

Symptoms: One week later injection site red, itchy rash

Other Meds: Toporol, Levothyroxin, Low Dose Aspirin

Current Illness: none

ID: 1029800
Sex: F
Age: 49
State: NE

Vax Date: 01/11/2021
Onset Date: 01/23/2021
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: On the thirteenth day following first dose, developed a 3-inch diameter rash surrounding injection site; rash lasted two to three days, improved with use of topical Benadryl. Soreness at injection site persisted for approximately three to three and one-half weeks from first dose.

Other Meds: Zinc, calcium with vitamin D, pseudoephedrine hydrochloride 12-hr (120 mg extended release caplet: once daily),super B complex

Current Illness: none

ID: 1029801
Sex: M
Age: 34
State: CA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
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: Pediazol, Ceclor

Symptom List: Pain in extremity

Symptoms: 01/31/21 approx 12 hours after receiving the second dose of Moderna vaccine I experienced blurred vision to right eye. Upon further eval I confirmed 30% loss of vision to right eye. No other symptoms noted. To date no change in symptoms. Since onset of symptoms I have been evaluated by various providers. 02/03 MD, 02/04 MD, 02/04 emergency room intake with blood work and MRI at hospital, 02/12 MD.

Other Meds: Mesalamine 1.2 Gm x2 daily PO

Current Illness: Ulcerative colitis exacerbation from November through December 2020.

ID: 1029802
Sex: M
Age: 40
State: WA

Vax Date: 02/04/2021
Onset Date: 02/14/2021
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: Allergies to Bee stings

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

Symptoms: My are was sore for a week then my arm pit hurt for 3 days and a red rash/hive appeared at the injection site.

Other Meds: None

Current Illness: None

ID: 1029803
Sex: F
Age: 79
State: IL

Vax Date: 02/04/2021
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: strawberries, Echinacea,

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

Symptoms: Itchy, hot bumps on shoulder at site of vaccination.

Other Meds: Irbisartin, Fluoxitine, Triamterine, D, B12, Flonase,

Current Illness:

ID: 1029804
Sex: F
Age: 39
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Haloperidol, Cefaclor, Trazodone, Ziprasidone Hcl, Citalopram Hydrobromide, Olanzapine, Serotonin 5ht-3 Antagonists, Scopolamine, Aripiprazole, Paliperidone, Clarithromycin, Quetiapine Fumarate, Bee Sting, Sulfamethoxazole Trimethoprim, Tramadol, Aspartame, Serotonin, Topiramate, Penicillins, Serotonin Reuptake Inhibitors, Latex, Beef, Dairy & Eggs

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

Symptoms: Itching in Injection Site, Waited 30 Minutes after injection and itching persisted in the same area, was discharged from vaccination clinic waiting area however the itching persisted as time went on then progressed throughout my entire body. Its 11:24pm on 02/14/2021 and my entire body itches extremely bad. The injection site is not raised or red.

Other Meds: atorvastatin 20 mg tablet (Take 1 tablet by mouth once daily), ergocalciferol (vitamin D2) 50,000 unit capsule (Take 1 capsule by mouth one time a week), Nurtec ODT 75 mg Odt (Take one tab at onset of acute migraine as needed. do not repeat

Current Illness: Asthma, Allergies, High Cholesterol & Extreme Obesity

ID: 1029805
Sex: F
Age: 38
State: NV

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Nkda

Symptom List: Vomiting

Symptoms: Arm painful, worse than 1st dose Horrible joint and body pains, couldn't get comfortable, hurt to touch skin and dogs lick Fever 101.3, chills dehydration Fatigue, feels like.hit by bus

Other Meds: Lialda. Venlafaxine. Buproprion. Oxycodone Milk thistle. omega 3 w calcium d3 Cyclobenzaprine

Current Illness: Auto immune Lupus anticoagulant UC Inflammatory arthritis

ID: 1029806
Sex: M
Age: 41
State: CT

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: muscle aches, muscle soreness in all arms and legs from 16-24 hours after vaccine

Other Meds:

Current Illness:

ID: 1029807
Sex: F
Age: 35
State: NJ

Vax Date: 01/18/2021
Onset Date: 01/25/2021
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: No

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

Symptoms: One week later red, itchy, hot rash at injection site

Other Meds: No

Current Illness: Nothing

ID: 1029808
Sex: M
Age: 55
State: WA

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

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Sore arm, injection area. At about 40-60% use of arm. Slowly getting better.

Other Meds: Muti vitamin, e vitamin, c vitamin

Current Illness: None

ID: 1029809
Sex: F
Age: 65
State: IL

Vax Date: 01/27/2021
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: Penicillin (hives) Clindamycin (diarrhea)

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

Symptoms: While working online the morning of Thursday, Feb. 4, my arm was itching. I felt a lump. When checked, I had a prominent red rash from the injection site extending 2/3 of the way to the elbow. There were 2 red patches and 2 "lumps" both in the lower patch. One lump was larger than the other and looked purple, like a bruise. That was the itchiest point. There was no pain. Onset was 8 days after injection. I notified my doctor's office. I took Tylenol PM 3 times (mostly for the Benedryl it contains) when I went to bed on the nights of Feb. 5, Feb. 7 and Feb. 9. It is mostly gone, but I can still see where the lower rash patch and lump were - they are still minimally present. Therefore, I am checking "unknown" below where it asks if patient has recovered from the adverse event. I took pictures of the rash if needed.

Other Meds: Triamterene Azelastine HCl Nasocort one daily multivitamin with iron Calcium + D

Current Illness: none

ID: 1029810
Sex: F
Age: 74
State: NY

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Severe shaking chills lasted 2 hrs Moderate headache, ear ache 2 hr General body ache 12 hrs

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm