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: 1030652
Sex: M
Age: 76
State: CT

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chills, fever 100.7, tender/warm arm

Other Meds:

Current Illness:

ID: 1030653
Sex: F
Age: 68
State: FL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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 of these

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever, muscle aches entire body, chills, shaking, headache, nausea

Other Meds: Amlodipine Omeprazole Omega 3 Vitamin D Multi vitamin

Current Illness: MS

ID: 1030654
Sex: F
Age: 47
State: PA

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: ZOLOFT

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

Symptoms: Moderna COVID-19 Vaccine EUA 3 days after my second vaccine, I rapidly developed what felt like a marble on my neck (moveable), then swelling appeared rapidly to about the size of 4 inches in diameter. I had a nurse at work check me out, sent me to urgent care. They couldn't confirm, had not seen that before, but told me to apply heat and if it gets worse go to ER. It didn't go down until evening, slowly until today 2-15, is barely noticeable. No pain, just panic.

Other Meds: PANTOPRAZOL, ELIQUIS, FLUTICASONE, CBD PATCH, MAGNESIUM, IRON

Current Illness: N/A

ID: 1030655
Sex: F
Age: 53
State: MD

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Initially reported numbness and tingling of lips and ringer after first dose of vaccine. She was given Benadryl 50mg IM. Within 15 seconds she reported not feeling well. Then she started seizing for about 30 seconds. Initial BP 148/88 and pulse ox 98. After 5 mins BP of 125/77 and pulse ox 99%. Patient regained consciousness, was A&O x3 but felt weak/tired. She was transported to the hospital.

Other Meds:

Current Illness:

ID: 1030656
Sex: F
Age: 50
State: VA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies: codeine, tramadol, oxycodone, hydrocodone, acetaminophen, cefoxitin, moxifloxacin, cortisone, hydrocortisone, ketorolac, gluten, cinnamon

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

Symptoms: swelling in L axilla hair loss swelling under L breast hives (happened after eating eggs, but never had any history of egg allergy in the past)

Other Meds: levothyroxine 112mcg po qd, vitamin d3 5000u qd, iron chews qd

Current Illness: none

ID: 1030657
Sex: F
Age: 23
State: CA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/15/2021
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: No known allergies

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

Symptoms: Patient received the Pfizer-BioNTech COVID-19 Vaccine at 1000. Reported onset of symptoms at 1040 with tingling in upper body, headache, flash heat, and flash nausea. Given Benadryl 25mg PO and kept for additional observation.

Other Meds: Unknown

Current Illness: Unknown

ID: 1030658
Sex: M
Age: 78
State: NY

Vax Date: 02/05/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
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: On Thursday following shot. Legs of both legs became itchy. Felt like they were on fire. skin was still clear. . After applying a some steroid cream it settled dawn and I went to sleep. Next morning I awoke with spots on my legs, and over the last few days, there were deliniated spots everywhere on my body - front and back - with the exception of my face. I thought it was measle, though my temperature was nomal (no fever) . I've not been able to contact my doctor. The spots have becom less definite and delineated, have grown into one another.. In general they're not teribly itchy, but they're everywhere. I'll see my Doctor tomorrow. I have spent the days in bed, not feeling my usual self. I feel a little better today but the spts (rash are everywhere.

Other Meds: allopurinol, Vasotec, levoxl,Metoprolol, warfarin, calcitriol, vit d,

Current Illness: none

ID: 1030659
Sex: F
Age: 55
State: MD

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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: Pharyngeal swelling

Symptoms: Throat pain/swelling /exsoriation /erythema /drooling/ lose of voice/ fever /chills /diarrhea vomiting /elevated LFT/ and WBC/ negative for covid /strep and mono. No throat abscess. I was seen in urgent care treated with augmentin 875mg 36 hours later much worse nor drooling not able to talk drink or eat. Seen in ED. Given fluids steroids and pain meds.... felt much better. .... got home the next day started vomiting and diarrhea throat pain continues can only swallow liquids

Other Meds: Diovan Lasix Kdur Protonic Pepcid Lipitor Ambian Trillrindix Multiple vit Biotin Vit C

Current Illness: None

ID: 1030660
Sex: F
Age: 35
State: AZ

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
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: Fever (102F) for ~24 hours, chills, fatigue

Other Meds: Birth control, multivitamin

Current Illness: none

ID: 1030661
Sex: F
Age: 81
State: AL

Vax Date: 01/01/2021
Onset Date: 02/08/2021
Rec V Date: 02/15/2021
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: Demerol

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Rash on Lt arm approx size 3"X 5" with itching that started on 02/08/2021 and continues to be present and uncomfortable. Due to have 2nd injection on 03/01/2021. Recommendations state probably need to receive 2nd dose in Rt. arm, but can't due to having lymph node removed due to breast cancer.

Other Meds: Centrum multivitamins and Caltrate calcium

Current Illness:

ID: 1030662
Sex: F
Age: 66
State: NY

Vax Date: 02/05/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 3? red circle after one week. Lump. Sensitive to touch.

Other Meds:

Current Illness:

ID: 1030663
Sex: M
Age: 71
State: MN

Vax Date: 02/09/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
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: Penicillin

Symptom List: Rash, Urticaria

Symptoms: Injection site rash.

Other Meds: Multi vitamin, potassium supplement, D3 supplement, 160/4.5 Symbicort

Current Illness: Asthma, sleep apnea

ID: 1030664
Sex: F
Age: 89
State: IL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies: Influenza Vaccine per long-term care facility

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

Symptoms: Patient was incorrectly identified and pharmacy staff hosting a vaccination clinic administered the vaccine. Patient had already received two doses of the Pfizer vaccine and this was the patient's third dose of the vaccine which is just a two dose series. Patient has experienced no side effects nor issues after receiving the vaccine for a third time.

Other Meds:

Current Illness:

ID: 1030665
Sex: F
Age: 95
State: FL

Vax Date: 02/05/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: N/a

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

Symptoms: Itching and redness near injection site after 8 days.

Other Meds: Lithium, vimpat, metoprolol, losartan, sertraline, Eye supplements, vitamin d3, multivitamin, b12, turmeric, melatonin

Current Illness: N/a

ID: 1030666
Sex: F
Age: 77
State: CA

Vax Date: 02/07/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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: many allergies to antibiotics, side effects from OTC anti inflammatories

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

Symptoms: This event , because so many elderly people have the fillers in their knees should be widely publicized! We have fillers that help so much to be able to walk without pain, but this vaccine has caused me to have extreme pain and burning and not be able to walk without pain for 4 days now. NO ONE has said anything about how this Moderna vaccine would affect us because of the Hyaronolic Acid injections to our knees. We should have been allowed to get Pfizer!!!! I am so upset about this and extremely disappointed in our government's lack of disclosure.

Other Meds: thyroid medication

Current Illness: none

ID: 1030667
Sex: M
Age: 28
State: NC

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
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: No known food or drug allergies.

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

Symptoms: Extreme fatigue, nausea, soreness, and muscle aches.

Other Meds: Pristiq 100 mg buproprion 150 mg x2 per day atomoxetine 80 mg metformin 1000 mg campral 666 mg x3 per day

Current Illness: None

ID: 1030668
Sex: F
Age: 76
State: MA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: Seasonal

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

Symptoms: Extreme chills, shakes, aches, fever sore arm

Other Meds: Eliquis, Losartan, Vitamin D, Celexa,,Synthroid

Current Illness: NONE

ID: 1030669
Sex: F
Age: 71
State: GA

Vax Date: 01/25/2021
Onset Date: 01/30/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient states that about a week after receiving the Moderna she noticed a rash on her arms and L leg. Rash was red, painful and itchy.Patient states she had some prednisone at her house and she took that and some Benadryl at night. She called her primary care and was instructed to notify the Health Department.

Other Meds: Estrogen patch, Levothyroxine, Tumeric, Coconut oil, Vitamins

Current Illness: none

ID: 1030670
Sex: F
Age: 42
State: PA

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/15/2021
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: Patient is having painful swelling of the lymph nodes in axillary region.

Other Meds:

Current Illness:

ID: 1030671
Sex: F
Age: 54
State: CO

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt with history of immune suppression due to rheumatoid arthritis and allergy to latex, was given a Moderna Covid-19 vaccination and approximately 2 minutes later developed redness and increased warmth in the right arm where she received the injection and developed nausea and felt like she needed to take a puff from her albuterol inhaler. She was immediately directed to the urgent care for treatment.

Other Meds: Unknown

Current Illness:

ID: 1030672
Sex: F
Age: 69
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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: Tolectin

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

Symptoms: 5:30pm: hands and feet felt very cold. Mild chills began. 6:10pm: temp was 98.3F Bundled up on the couch - socks, boots, leggings, sweatshirt, 2 blankets - and napped. 9:00pm; finally felt warm. Back and shoulder muscles were very sore. Temp had risen to 100.3F. Took 400mg ibuprofen and went to bed. Awoke the next morning feeling great. No residual effects.

Other Meds: Atorvastatin, Vitamin D, Biotin, Cranberry. Extract

Current Illness: None

ID: 1030673
Sex: F
Age: 85
State: IL

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

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

Lab Data:

Allergies: Shell fish allergy

Symptom List: Unevaluable event

Symptoms: Numb tongue

Other Meds: Donepezil, Metoprolol, Amlodipine, Furosemide, Atorvastatin, Memantine, Clonidine, Lisinopril, Synthroid, B100 vitamin, 81 ml aspirin

Current Illness: None

ID: 1030674
Sex: F
Age: 61
State: FL

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I became light headed by 8 am and it continued all day long. By 2pm I developed a bad headache. I was really dizzy, nauseated really bad, my arm was hurting and swelling. The next day I woke up with the worst migraine headache I ever had. My arm was red at the injection site, painful and swollen. I had to take Prednisone to calm it down, it did not go completely away with the Prednisone, I still have a small uncomfortable area that hurts and is uncomfortable to touch. I had to get an ointment with Prednisone to help control the itching, it did not help very much since I feel the itching was coming from the muscle. I had a large hard knot on my arm, I finally had to give in an itch it, I felt the area about 5 hours later and the know had gotten vey small. I guess I broke up the knot but intensely itching it.

Other Meds:

Current Illness:

ID: 1030675
Sex: M
Age: 50
State: NJ

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Pfizer-BioNTech COVID-19 Vaccine: About 15 minutes after vaccination, patient started to feel that there is a lump in his throat and both hands had tingling. Paramedic was on site and put patient on EKG monitor and observed patient for 20 minutes. The patient left the site independently and stated no further issues.

Other Meds:

Current Illness:

ID: 1030676
Sex: F
Age: 45
State: CA

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
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: Swelling and large red rash around site. Hot to the touch. This may have happened sooner after vaccination but was not noticed until date reported. Prior was high fever, chills body aches. Those have passed.

Other Meds: Chlorthalidone 25mg Spironolactone 25mg Multi vitamin

Current Illness: None

ID: 1030677
Sex: M
Age: 76
State: AZ

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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: morphhine niacin prepasations levoflox acin

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

Symptoms: very bad abdomen pain and back kidney area pain chills and weakness for 24 hours and still four days later very week and unable to do much activity

Other Meds: 81 mg aspirin omega-3 fatty acid fish oil magnesium Q10 zyrtec multa vit vit d3

Current Illness: none

ID: 1030678
Sex: M
Age: 90
State: SC

Vax Date: 02/04/2021
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
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: Patient stated he got shortness of breath and rapid heartrate. Went to the hospital where they performed cardioconversion and shocked heart into rhythm.

Other Meds: none

Current Illness: none

ID: 1030679
Sex: F
Age: 40
State: NJ

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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, Aspirin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Rash below injection site; redness, warm to the touch. Noticed 2/14/21. On 2/15/21, rash has grown in size towards bicep.

Other Meds: Xyzal, singulair, multi-vitamin

Current Illness: None

ID: 1030680
Sex: M
Age: 67
State: AZ

Vax Date: 02/13/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Patient felt dizzy, which passed quickly. Patient then had breakfast and became nauseous and vomited.

Other Meds:

Current Illness: None

ID: 1030681
Sex: M
Age: 59
State: WA

Vax Date: 12/29/2020
Onset Date: 02/01/2021
Rec V Date: 02/15/2021
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: Hives and rashes start out as hallow or red rings and itchy on arms , legs, back and front of body, necks both left and right side of body. then become red patches rashes. Benadryl help a little. I took Zyrtec the red hives goes away until after 24hrs then it come back. not sure if I should take the second doses.

Other Meds: none

Current Illness: none

ID: 1030682
Sex: F
Age: 39
State: VA

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: at 4:00 am on 2/14 (14 hours after shot)woke up to injection sight rash 3 inch wide, swollen and red fast heart rate 184 , chest pain and fast breathing was addmited to hospital hospital didn't mention vaccine on the hospital visit i have no heart issues prior to this.

Other Meds: vitamin D probiotic

Current Illness:

ID: 1030683
Sex: F
Age: 76
State: MI

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies: Aspirin, Penicillin, Codeine, albuterol

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

Symptoms: She had emesis within 30 minutes of 2nd dose of vaccine. Her nausea continued for 1 hour with abdominal and chest discomfort. She was taken to ED. Her vital signs remained stable. All work-up for cardiac event was negative. This was determined to be a vaccine reaction leading to nausea with 1 episode of emesis.

Other Meds: Amlodipine, atorvastatin, donepezil, valsartan-hydrochlorothiazide, calcium, vitamin D3 and multivitamin

Current Illness: No acute illness

ID: 1030684
Sex: F
Age: 65
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: sulfur medications

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

Symptoms: tiredness, headache, muscle pain, chills, joint pain, nausea, feeling unwell

Other Meds: D3 - 125 mcg, b12- 5000 mcg, atorvastatin - 10 mc, bupropion hcl - xl 300 mg, Ramipril - 5 mg, synthroid 88 mcg

Current Illness: none

ID: 1030685
Sex: F
Age: 68
State: WI

Vax Date: 02/02/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
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: Moderna COVID-19 Vaccine EUA Itching, circular rash around the injection site

Other Meds: multi vitamin vitamin D fluoxetine estrogen progesterone meloxicam levothyroxine

Current Illness: none

ID: 1030686
Sex: F
Age: 32
State: NC

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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: Erythema, Pruritus

Symptoms: Fever greater than 101F for 24 hours, severe joint pain, severe headache, fatigue. Treated over the counter with NyQuil, followed by Tylenol, which did not alleviate symptoms.

Other Meds: Nexplanon, duloxetine

Current Illness: None known

ID: 1030687
Sex: F
Age: 30
State: WV

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: I am experiencing a little bit of muscle spasm around the injection site and I have a large red bump that is horribly itchy and sore. The first 24 hours after the injection, I could not lift my arm without pain, however, Ibuprofen took care of the pain I was having. It has been very itchy and still slightly sore since then. I'm not sure if this is normal so thought I would report it. No need to contact me, just wanted to add to the side effect reports in case this is unusual.

Other Meds: None

Current Illness: None

ID: 1030688
Sex: F
Age: 76
State: CA

Vax Date: 01/01/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: Have not felt well fir a few days and night before last night had a fever.

Other Meds:

Current Illness:

ID: 1030689
Sex: F
Age: 61
State: OH

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: Bactrim

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe all arm pain for short period of time, chills, headache, fatigue, swollen lymph nodes and continuing nausea.

Other Meds: Gabapentin, Modafinil, Prednisone, Magnesium Oxide, One A Day, Vitamin D2 50,000 unit, Mucinex, Duloxetine, Klor-Con M20, Acetaminophen, Rizatriptan Benzoate, Budesonide Nasal Spray

Current Illness: COVID 19, sinus infection

ID: 1030690
Sex: F
Age: 24
State: NC

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/15/2021
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: allergic to codeine, ciprofloxacin

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

Symptoms: sever body aches, chills (no fever), extreme fatigue, malaise, brain fog

Other Meds: citalopram (40mg), melatonin (3mg), Junel Fe (birth control)

Current Illness:

ID: 1030691
Sex: F
Age: 64
State: ND

Vax Date: 01/25/2021
Onset Date: 02/06/2021
Rec V Date: 02/15/2021
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: vioxx

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

Symptoms: 12 days after getting my 2nd vaccine I starting having lymph node enlargement on my left neck and left occiptal area. It was painful and then a rash started on my left jaw, ear and skull area. It is now 9 days later and it has gotten somewhat better but still concerning to me

Other Meds: Myrbetriq 50 mg 1 tablet daily 81 mg aspirin 1 daily Sertraline 100 mg 2 tablets daily Vitamin D3 50 mcg 1 daily Vitamin c 60 mg and zinc 15 mg both in 1 tablet 1 per day

Current Illness: na

ID: 1030692
Sex: F
Age: 66
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

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

Lab Data:

Allergies: allergic to sulpha drugs. I take no antibiotics

Symptom List: Pain in extremity

Symptoms: 7 days after getting vaccine, I developed red itchy rash under injection site. Arm soreness, which had resolved, returned. Also, that same day I developed a non-itchy blotchy rash on my back, stomach & chest. The arm rash has faded somewhat & itching stopped. However the blotchy rash has remained

Other Meds: multi vitamin, Vit. D, Vit. C, zinc, turmeric, glucosamine/chondroitin, Align probiotic

Current Illness: none

ID: 1030693
Sex: F
Age: 64
State: NC

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
Hospital: Y

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

Lab Data:

Allergies: lisinopril, amlodipine, zithromax

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

Symptoms: extreme swelling and severe pain in both wrists/ hands starting 2/7/21.seen in urgent care 2/8/21 and admitted through ER on 2/10/21. Inpatient for 3 days. IV antibiotic DC'd when blood cultures negative. Ultrasound left arm negative for DVT. Seen by Infectious Disease and he felt it was due to covid vaccine reaction. Started on steroid

Other Meds: protonix, celexa, losartan, vesicare MVI, Vit D3, red yeast rice, calcium, glucosamine

Current Illness: none

ID: 1030694
Sex: F
Age: 40
State: IL

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
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: No

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

Symptoms: My arm right away was sore and kinda numb while still in the store after the shot. My neck became more sore that evening. Sunday my neck was swollen and hurt to turn. My glands are swollen in my clavicle and up the neck. I felt fatigued all day. Monday my breast is sore on that same side, the glands are sure down my side by my breast. I have some soreness in my neck but better.

Other Meds: Omeprazole at bed

Current Illness: Sinus pressure/stuffy nose

ID: 1030695
Sex: M
Age: 35
State: NY

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: Not known

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

Symptoms: Developed high fever, 101.5F, body aches and head ache around 9:30pm on 2/13/21. Took 500mg paracetamol at 11pm on 2/13, the fever was still 101.5F and body aches continued. At 03:00am on 2/14 took another 500mg paracetamol, the fever was around 101F. At 09:30am on 2/14 the fever was 99.5F, body aches and head ache were stronger. Took another 500mg paracetamol. By early afternoon on Saturday, the fever was down to 97.5F, body aches and head ache were mild and subsiding. On Monday 2/15 - I was not experiencing any symptoms anymore.

Other Meds: Biktarvi 50-200-25 mg tabs Crestor 20mg Finasteride 1mg

Current Illness: Not known

ID: 1030696
Sex: F
Age: 72
State: MA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Site: Bruising at Injection Site-Mild, Site: Swelling at Injection Site-Mild

Other Meds:

Current Illness:

ID: 1030697
Sex: M
Age: 32
State: AZ

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
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: NKA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Muscle Ache

Other Meds: Fish Oil and Vitamin D Supplement.

Current Illness: None

ID: 1030698
Sex: F
Age: 70
State: FL

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/15/2021
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: Aspirin

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

Symptoms: + PAIN AT INJECTION SITE IMMEDIATELY AFTER INJECTION. + SHOULDER PAIN IN LEFT ARM, OCCURED ABOUT EVERY FEW MINUTES, EXTREME PAIN LASTING ABOUT 7 SECONDS AND THEN WOULD SUBSIDE FOR ABOUT 3/4 MINUTES. THIS WENT ON FOR ABOUT 15 MINUTES THEN MORE TIME INBETWEEN PAIN. GONE IN ABOUT 5 HOURS. + RASH DEVELOPED ON LEFT SIDE OF NECK, LEFT SHOULDER AND A LITTLE ON LEFT ARM INSIDE BICEP. WAS GONE BY MORNING OF FEB. 6TH. + INJECTION SITE, AS OF TODAY FEB. 15, STILL TENDER, SWOLLEN AND YOU CAN FEEL HEAT WHEN TOUCHING. DOCTORS OFFICE CALLED THIS MORNING WITH NO CALL BACK AS OF THIS SUBMISSION.

Other Meds: Atorvastatin 10mg; CoQ10 100mg; Zolpidem 10 mg; E 400IU; D3; 40IU; B complex; Zinc; Calcium 600mg; Fish Oil 1000mg; Fish oil 300mg; Multi vitamin

Current Illness: None

ID: 1030699
Sex: M
Age: 37
State: MD

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: At the time of the incident (3:00 A.M.) I was experiencing chills, a fever, and nightmares. When I went to the bathroom I fainted. Once I regained consciousness and got to a standing position I fainted a second time after I took a few steps.

Other Meds: Lexapro - 10mg - Daily

Current Illness: None

ID: 1030700
Sex: F
Age: 61
State: PA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient woke on Saturday morning at 1am after receiving Moderna coronavirus vaccine on Friday afternoon with the sensation that her tongue was swollen. She saw that it looked swollen and took Benadryl. She has continued to need Benadryl for the past 2 days because as the dose wears out of her system, the swelling reoccurs. She denies SOB, lips/facial swelling, or dysphagia. Course is stable.

Other Meds:

Current Illness:

Date Died: 02/15/2021

ID: 1030701
Sex: F
Age: 76
State: FL

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital: Y

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: unknown, husband reported hospitalization 02/12 and deceased 02/15

Other Meds: pregabalin, metoprolol succ, losartan, rosuvastatin, furosemide, duloxetine, Eliquis, ferrex, diltiazem, latanoprost

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm