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: 1038186
Sex: F
Age: 70
State: TX

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
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: NKDA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient started to become short of breath. 911 was called, Pt was evaluated. Pt CAOX4 and refused transport incident #21-0011110

Other Meds: None

Current Illness: Unknown

ID: 1038187
Sex: F
Age: 27
State: NJ

Vax Date: 02/07/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: About two inches below the injection side, I have had a red mark on my arm that has grown in size over the last 3 days. The spot was dark red but has lightened in color. The spot is slightly warm, but not itchy or painful.

Other Meds: Taytulla and desloratadin

Current Illness: None

ID: 1038188
Sex: F
Age: 90
State: MN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: NKA

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

Symptoms: Client had pressed her call pendant this morning (2/18/2021) at 0750, LPN found client in her bed unable to stand. Client reported she had to use the restroom, upon standing client, LPN noticed blood on client's pillow. After assisting with ambulation to her bathroom, LPN noticed blood covering the floor near her shower. After further assessment, blood appeared to me coming from the back of client's head. Vital signs assessed while she sits on the toilet. BP: 128/92 O2: 89% on RA RR: 18 HR: 69 T: 99.1 Client reported significant dizziness, lightheadedness, and nausea. She reported unsteadiness when standing. Quarter sized lump with dried blood noted on the back of client's head. She does report left arm soreness, likely from where vaccine was administered. Ambulance was contacted while LPN assisted dressing client. Client was unable to recall the incident that occurred overnight, she did not utilize her call pendant during initial fall. Time of fall/incident unknown.

Other Meds: Tylenol, amlodipine, Aricept, ASA, Antacid, Cartia, Lipitor, Lisinopril, memantine, preservision

Current Illness: NA

ID: 1038189
Sex: F
Age: 46
State: PA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Chlorhexadine topical

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Day after shot, felt nauseated, headache, sore throat, profound fatigue, fever 101.5. Expected this- alt.tylenol/nsaid to get by. Next AM-felt better briefly, but declined back to above. I am now day 7 s/p 2nd shot and still running low grade temps: Today 100.8. I feel intermittent nausea, dizzy/LH spells (I am pushing fluids-BP running my usual 100's/60-70's, HR high 50's- low 80's), intermittent sore throat, cough, swollen glands, chest/muscle soreness. What seems constant is the TIREDNESS and fevers.

Other Meds: Turmeric, Mag 250, Elderberry, Ca+ w/D, Multi, Fish oil, Pro-biotic

Current Illness: None

ID: 1038190
Sex: F
Age: 70
State: MD

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Patient is pron to seizures. She received the Covid shot. At about 4:00 pm that afternoon she began to have a seizure. I was very atypical of her previous seizures. She began the seizure at a very low level (no outward signs other than total confusion and unable to speak. This condition lasted until about 8:pm. Now and again she would do her normal "shake". The seizure eventually stopped. Additional dose of Keppra was given as well a a few drops of Lorazapam.

Other Meds: Synthroid .112mg 1/day Eliquis 5mg 2/day Lisinopril/HCTZ 10/12.5mg 1/day Keppra 125mg 1/day Atorvastat

Current Illness: none

ID: 1038191
Sex: F
Age: 74
State: MD

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: PCN caused rash

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

Symptoms: Moderna vaccine # 1 caused left arm pain, difficulty moving the arm, unable to drive for 3 days, disabling. LIke a frozen shoulder. Patient recovering partially by day 4. Advised ice, pain meds and mobilizing shoulder

Other Meds: rosuvastatin, muro eyedrops, lisinopril, omeprazole and vitamin D

Current Illness: None

ID: 1038192
Sex: F
Age: 26
State: PA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
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: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Started feeling muscle soreness about 10 hours post-injection, took an Advil, then woke up in the middle of the night to moderate muscle and joint pain and fatigue and nausea. Took another Advil.

Other Meds: N/A

Current Illness: N/A

ID: 1038193
Sex: F
Age: 52
State: NY

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: about 31 hours later I developed hives all over my body including my lip and in my mouth. I went to an Urgent Care and was given a Benadryl shot and Prednisone. they are getting better, about half of them are gone but they are still there. they are not as raised as they were. I took another Benadryl this morning (02/18/2021)

Other Meds: Multi vitamin Vitamin D Vitamin C fat burning drink additive

Current Illness: No

ID: 1038194
Sex: F
Age: 48
State: MO

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Z pack

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever (102.4), headache, fatigue, neck pain, chills, body ache, sore arm at injection site. Fever ,chills, neck pain gone after 24 hours. Fatigue, minor headache and sore arm ongoing

Other Meds: Lexapro, wellbutrin, acyclovir, Flonase, omeprozole, melatonin

Current Illness: None

ID: 1038195
Sex: F
Age: 46
State:

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
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: Pt receive second dose of Pfizer vaccine and 5 minutes later started to have chest heaviness and cough. Allergy paged and recommended 2 puffs of albuterol which were given and for pt to be observed 20-30 minutes longer. Pt then started to have itchy throat and Rapid response called. epi IM and zrytec 10 mg given. Emesis X1. Pt transported to ED in wheelchair.

Other Meds:

Current Illness:

ID: 1038196
Sex: F
Age: 76
State:

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: Rash on arm at the injection site

Other Meds:

Current Illness:

ID: 1038197
Sex: F
Age: 47
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/18/2021
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: About an hour later I felt dizzy and a little disillusioned. I did experience the expected migraines and nausea. I also had chills and lost of appetite.

Other Meds: None

Current Illness: None

ID: 1038198
Sex: M
Age: 27
State: MN

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/18/2021
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: Before 2nd dose screening reported throat tightness lasting 1-2 hours after dose 1. Possibly anxiety/OCD symptom per patient. Dose 2 not given.

Other Meds: Sertraline, cetirizine, multivitamin

Current Illness: Chronic anxiety and OCD

ID: 1038199
Sex: F
Age: 59
State: MA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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:

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

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038200
Sex: F
Age:
State:

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: Chest warm and tingling sensation. EMS evaluated. Stayed for40 minutes sensation transient went home

Other Meds:

Current Illness:

ID: 1038201
Sex: F
Age: 51
State: FL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/18/2021
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 allergies

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

Symptoms: Temperature of 100 for 4 days with administration of acetaminophen by mouth every 4-6 hours. Red rash for 4 days located on injection site R Deltoid, chest, torso, abdomen, and back. Headache, fatigue, malaise. Sore, swollen throat 6 days after second dose. Diphenhydramine by mouth taken at 9P every day after second dose.

Other Meds: acetaminophen, omega, magnesium, multivitamin

Current Illness: No illnesses one month prior to first or second dose of Moderna COVID vaccine

ID: 1038202
Sex: F
Age: 50
State: VA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
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: Alfpha Gal, any food with acid, PCN, Hydrocodone

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

Symptoms: Flu like symptoms, headache, muscle aches, low grade fever, sore chest wall, injection site pain, nausea

Other Meds: Zyrtec, Thyroid med, Famodaline, Graves dx med

Current Illness: None

ID: 1038203
Sex: F
Age: 56
State: MA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038204
Sex: F
Age: 77
State: FL

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/18/2021
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: Severe flu-like symptoms--headache, achy body, queasy stomach, extreme fatigue lasting for two days keeping patient bedfast.

Other Meds: RX Levothyroxine sodium tab; montelukast tab; Hydrocholorothiazide tab;Losartan tab; Pulmicort inhaler L-Lysine; B-12 tab; Vitamin C; Women's multivitamin daily tab; cod liver oil

Current Illness: None

ID: 1038205
Sex: F
Age: 52
State: MN

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
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: Fever of 100.4 Chills Achy body

Other Meds:

Current Illness:

ID: 1038206
Sex: M
Age: 18
State: OH

Vax Date: 10/27/2020
Onset Date: 10/27/2020
Rec V Date: 02/18/2021
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 known

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

Symptoms: Administered vaccines were involved in an excursion and so were deemed non viable.

Other Meds: None

Current Illness: None

ID: 1038207
Sex: F
Age: 53
State: PA

Vax Date: 02/09/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Swelling, hot to the touch, redness, rash and hives at injection site.

Other Meds: Gabapentin, Hydroxychloroquine, Multi Vitamin, CBD gels and Melatonin

Current Illness: None

ID: 1038208
Sex: F
Age: 56
State: NY

Vax Date: 02/13/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: An inability to feel cold. It was very strange for me, I'm always cold. I wasn't running a fever, at the time, but even though it was in the Thirties, I didn't feel it. This only lasted for a few hours, but very strange for me.

Other Meds: Tylenol, buspirone, atorvastatin

Current Illness:

ID: 1038209
Sex: M
Age: 70
State: CT

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
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: Penicillin, bananas

Symptom List: Injection site pain, Pain

Symptoms: when i first got the shot i could feel a difference in my body immediately. i started hurt on my left side of my throat, then started getting puffy face and eyes. was given some Benadryl pulse 45 blood pressure 90/54 and did an EKG , then medic didn't like what he was seeing and called 911 . Medic gave him an epi pen because his throat started swelling. Went to the hospital where he was there for 5 hrs.

Other Meds:

Current Illness:

ID: 1038210
Sex: F
Age: 89
State: NC

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/18/2021
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: difficulty with balance, lethargy, elevated BP, fell in the floor, on 2/16 could not walk and was poorly responsive had to report to the ER, had two seperate ER visits due to lethargy and unable to walk. on 2/17 patient returned to baseline.

Other Meds: Fluoxetine, Losartan, risperidone, melatonin, vitamin B12.

Current Illness: noe

ID: 1038211
Sex: F
Age: 69
State: CA

Vax Date: 02/04/2021
Onset Date: 02/13/2021
Rec V Date: 02/18/2021
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: "Covid Arm" redness and itching around the injection site (about 3-4 inches diameter)

Other Meds: magnesium, montelukast sodium, Pepcid, Biotin, Blink eye drops

Current Illness: None

ID: 1038212
Sex: F
Age: 72
State: IN

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/18/2021
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: Chills, fever and achy

Other Meds: None

Current Illness: None

ID: 1038213
Sex: F
Age: 73
State: MI

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I had been positive for a COVID 19 test in late November and hardly had any symptoms and when I got the vaccine I has body aches headache my skin hurt I couldn?t sleep.

Other Meds: Atorvastatin 10mg, Losartan 100mg, Hydralazine 25mg, Levothyroxine 75mcg, pantoprazole 40mg

Current Illness: None

ID: 1038215
Sex: F
Age: 24
State: IN

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
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: Nausea and throwing up. Migraine. Body aches(sore arm). Fever 102.4 at peak. Swollen lymph node on same side as injection. Swollen arm.

Other Meds: None

Current Illness: None

ID: 1038216
Sex: F
Age: 77
State: GA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Nausea

Symptoms: Itching/hives bilateral axilla. Sensation of lump in throat/itching tingling in throat. EMS on site. Patient's Epi-pen used left thigh. EMS started IV in left AC gave fluids and gave 25 mg Benadryl IV. Vitals monitored. Symptoms improved shortly after medication administration. Med unit transported patient to hospital for further evaluation.

Other Meds: unknown

Current Illness: unknown

ID: 1038217
Sex: F
Age: 42
State: TX

Vax Date: 02/14/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
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: Had a massive headache for 2 days, then a rash for the past 3 days on injection rate that felt hot to touch and soreness. Rash has slowly gone away.

Other Meds: none

Current Illness: none

ID: 1038218
Sex: F
Age: 52
State: FL

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: left arm pain and soreness

Other Meds: None

Current Illness: NOne

ID: 1038219
Sex: M
Age: 85
State: NY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
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: NKDA

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

Symptoms: ound patient in sitting position in elevator s/p 2nd dose of vaccine. Patient awake, opening eyes, mumbling, incoherent speech, noted to be pale. As per patient's wife, "He felt dizzy and used walker to assist himself into a sitting position on elevator floor. He did not hit his head, I do not think he lost consciousness. He waited in the waiting room for more than 15 minutes and drank 2 cups of juice before we left." No obvious injuries noted. Palpated weak, thready pulse. Patient tachypneic w/ shallow respirations. Called for assistance. Vital signs: B/P 98/34, HR 121, RR 23, unappreciated O2 sat. Fingers cool to touch. FS = 139. Attempted to re-orient patient, given small sip of apple juice. 911 activated. Patient transported to ER with wife. Noted patient to be more alert, responsive with clearer speech upon arrival to ER. After monitored in the ER, the patient was cleared for discharge.

Other Meds: Risperidone 0.5 mg 1 tablet PO twice daily Docusate 100 mg once daily Vitamin D2 50,000 units PO once a week Gabapentin 100 mg PO 3 times a day Losartan 50 mg 1 tablet PO once a day Brimonidine 0.2 % ophthalmic solution 1 drop into both e

Current Illness: NA

ID: 1038220
Sex: F
Age: 70
State: CO

Vax Date: 01/28/2021
Onset Date: 02/05/2021
Rec V Date: 02/18/2021
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: Erhtyamicin

Symptom List: Tremor

Symptoms: Exactly 8 days after first vaccine an approx 3? red circle rash appeared around the injection site. It didn?t hurt but was tender to the touch and itched non stop. I took Benadryl by mouth and bought topical Benadryl to help control the itching. After 1 day after a week the rash was totally gone.

Other Meds: Lottel and atorvastatin

Current Illness: None

ID: 1038221
Sex: F
Age: 74
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
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: Possible sulfa allergy, reacted to Sulamyd eye drops. Caffeine causes PVCs.

Symptom List: Erythema, Pruritus

Symptoms: Developed red itchy rash at injection site one week after injection. Started as diffuse area 5x7cm and by the following day area was circumscribed 8x10cm and edematous. No medical visit as research showed this to be a documented side effect in some patients. Used Benadryl oral and OTC cortizone cream topically.

Other Meds: Zetia, Prolia injections every 6 mos, B comp+C, glucosamine/chondroitin/msm joint supplement, Celadrin, Biotin 5000mcg, Lutein 6mg, CoQ-10 100mg, Niacin 1000mg, Vit D 2000 iu, Folate 800mg,Calcium 600mg, Magnesium 500mg, Black Cherry 1000mg

Current Illness: None

ID: 1038222
Sex: F
Age: 60
State: WV

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
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: no

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

Symptoms: The morning after my vaccine, I drank a half of cup of coffee and started feeling funny, went to the restroom and threw up and than I had this weird feeling kind of like a numbness that went from my arms down to my legs and my hands turned in like they were going to cramp up, I started breathing slowly and it all went away, I was fine after that. My left arm stayed sore for about 3 days, also when they gave me the shot I bled a little.

Other Meds: Vitamins: Calcium 400 mg, One a day 50 plus, B12 1,000 mcg, D3 25mcg, Cherry Fruit 1,000 mg

Current Illness: no

ID: 1038223
Sex: F
Age: 23
State: KY

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/18/2021
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: Allergic to strawberries and coconut

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

Symptoms: Ever since I received the vaccine, my arm has been extremely sore. Over the next few days, I became incredibly itchy and developed a rash on both of my arms. I now have what I think is considered, "COVID Arm". There is a red circle around the injection site that is swollen, red, and tender. I then noticed the inside of my mouth was sore and I had blisters developing on the roof of my mouth near my gums. My throat is super sore and swollen and has a yellow pocket on the back of my throat. I am also having body aches under my arms near my ribs and back.

Other Meds: None

Current Illness: None

ID: 1038224
Sex: M
Age: 96
State: MD

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/18/2021
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: NKDA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: No adverse event suffered. Due to improper record keeping upon the facility, the patient received a 3rd dose of a vaccine that only requires 2 doses. Followed up with the facility to check on the patient after one day and after one week. no adverse events reported. Facility does not believe the patient received a third dose.

Other Meds: information unavailable

Current Illness: information not available

Date Died: 02/17/2021

ID: 1038225
Sex: M
Age: 83
State: AK

Vax Date: 01/11/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
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: Tomato, cheese

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

Symptoms: Death, 2-17-21 at 1802 hours

Other Meds: Metoprolol, Pramipexole, Furosemide, Aspirin, Haloperidol, Lorazepam, Morphine

Current Illness: G60.9, D72.1,

ID: 1038226
Sex: F
Age: 15
State: WI

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
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:

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

Symptoms: Vaccination was administered without adverse event at COVID-19 clinic. Individual was noted to be a healthcare volunteer. Upon logging person into tracking process for scheduling a second dose appointment, it was identified that this recipient was under the age of 16, not in the correct age range for vaccination with the Pfizer BioNtech COVID19 vaccine.

Other Meds:

Current Illness:

ID: 1038227
Sex: F
Age: 62
State: AZ

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: Penecilin

Symptom List: Pain in extremity

Symptoms: Initial Events - started morning 2/15/21 - dizziness, lightheadedness, fatigue, nausea, chills - resolved by 6pm 2/16/21. Subsequent Event - started morning 2/16/21 - leg pain in calf area and formation of lump in armpit of right arm. Leg pain migrating to upper rear of legs and into lower back from 2/16/21 to 2/18/21. These events are ongoing and unresolved.

Other Meds: levothroxine - .137mg vitamin D - 2000 IU Probiotic Baby Aspirin - .81 mg

Current Illness: None

ID: 1038228
Sex: F
Age: 38
State: FL

Vax Date: 02/08/2021
Onset Date: 02/11/2021
Rec V Date: 02/18/2021
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: Levaquin

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

Symptoms: 3 days after the second Moderna vaccine patient developed right arm and leg weakness, tingling over the whole body

Other Meds: N/A

Current Illness: None

ID: 1038229
Sex: M
Age: 75
State: NY

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, shell fish

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

Symptoms: 26 hours after receiving the injection, I became very nauseous and had diarrhea. At one time I passed out and when I woke up I was covered in feces and vomit. The symptoms remained until about 3:00 a.m. on the 18th of this month. Today, the 18th, the vomiting and diarrhea subsided; but I remain very weak; and I have no appetite.

Other Meds: Xarelto, Atorvastatin, fenofibrate, Silodosin Dutasteride, Tums

Current Illness:

ID: 1038230
Sex: U
Age: 63
State: MA

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 02/18/2021
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: NKA

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

Symptoms: Received 2nd vaccine dose 1/11 and started with GI symptoms 1/13. 1/14 had covid and flu test, tested negative for both. She had stool culture ? normal flora, negative for c-diff, camphobacter, shigella, echoli and salmonella. Was started on flaggyl 1/20 and taking prescription strength probiotics. Other than diarrhea having no symptoms. Had 5-6 episodes in a day, slowly reducing. Feels little bit weak and tired from the diarrhea ? has been doing BRAT diet. Rx viral gastroenteritis, babesiosis (likely latent). Travelled to upper Midwest in 2020. Energy and strength better + back to work on modified schedule with restrictions. Being treated currently for babesiosis.

Other Meds: Daily vitamins, aspirin, Advair BID

Current Illness:

ID: 1038231
Sex: F
Age: 80
State: NY

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 02/18/2021
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: 80 y/o F presents for tingling sensation to B/L hands and high blood pressure after receiving the 2nd dose of the Covid-19. Patient was taken to the ED for monitoring; she denied any allergic reaction, CP, fever, chills, lightheadedness, dizziness, N/V/D/C, abdominal pain or other symptoms aside from tingling of all fingers. Her blood pressure was 197/92 at the time. EKG was performed, which was normal. No medications were administered. After 2 hours, the blood pressure normalized to 140/80 and patient was discharged.

Other Meds: Unknown

Current Illness: NA

ID: 1038232
Sex: F
Age: 65
State: GA

Vax Date: 02/12/2021
Onset Date: 02/25/2021
Rec V Date: 02/18/2021
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: Aspirin , Bactrim erthromycin macrobid tetanus injection crabs shrimps

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Generalized itchiness that started on the day after the shot. It?s almost 6 days now and the itchiness did not go away. I have been alternating Benadryl , Zyrtec and Pepcid Ac. Find relief from itchiness but did not completely went away. I only had one elevated rash on my shoulder but went away next day. I also experienced diarrhea but it stopped after two days. The one that concerns me the most is the prolonged itchiness .

Other Meds: Tylenol Benadryl metformin atenalol hydrochlorothiazide

Current Illness: None

ID: 1038233
Sex: F
Age: 70
State: WI

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Itchy, swollen injection site with surrounding rash.,

Other Meds: Lisinopril, Hydrochlorot

Current Illness: None

Date Died: 02/13/2021

ID: 1038234
Sex: F
Age: 84
State: MA

Vax Date: 01/14/2021
Onset Date:
Rec V Date: 02/18/2021
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: Sulfa, Aricept

Symptom List: Injection site swelling, Limb discomfort

Symptoms: First dose Pfizer given at assisted living on 1/14/21 she was subsequently admitted to hospital and got her second dose but Moderna was given instead of Pfizer on 2/8/21. She had been improving but in the days following the Moderna vaccine she developed fever and then her mental status declined. She was discharged back to assisted living. Suspected UTI, and moderate dementia, placed on hospice (2/12/21). Died on 2/13/21.

Other Meds: Cephalexin Spiriva, Nitro, Probiotic, Albuterol, Vitamin D3, Multivitamin Aspirin, Glucosamine, Metamucil, Tylenol, Cranberry, Claritin, Quetiapine

Current Illness: Dementia with mental status change Urinary tract infection

ID: 1038247
Sex: F
Age: 56
State: NY

Vax Date: 07/01/2020
Onset Date:
Rec V Date: 02/18/2021
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: preseptal cellulitis/left facial cellulitis; facial asymmetry; sagging of left upper lid; This case was reported by a physician via call center representative and described the occurrence of preseptal cellulitis in a 55-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of periorbital cellulitis (1st dose received in December 2019, refer case US2021018328). In July 2020, the patient received the 2nd dose of Shingrix. In July 2020, 1 week after receiving Shingrix, the patient experienced preseptal cellulitis (serious criteria GSK medically significant). On an unknown date, the patient experienced facial asymmetry and sagging eyelid skin. The patient was treated with amoxicillin sodium, potassium clavulanate (Augmentin) and sulfamethoxazole + trimethoprim (Bactrim). Rechallenge with Shingrix was positive. In August 2020, the outcome of the preseptal cellulitis was resolved with sequelae. On an unknown date, the outcome of the facial asymmetry and sagging eyelid skin were not recovered/not resolved. The reporter considered the preseptal cellulitis to be almost certainly related to Shingrix. It was unknown if the reporter considered the facial asymmetry and sagging eyelid skin to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported but could be 54 or 55 years. The physician stated that because of COVID epidemics the delivery of the 2nd dose was delayed till July 2020/ some 6 months later. The patient about 1 week later of vaccination, developed preseptal cellulitis and was treated successfully with combination of oral Bactrim and Augmentin for 10 days. The physician stated that less than 9 months after receiving Shingrix, some facial asymmetry and sagging of left upper lid persisted. In August 2020, CT brain done had not revealed any significant abnormalities. The physician stated that the patient never suffered preseptal cellulitis before or after these two episodes. The reporter consented to follow-up.; Sender's Comments: US-GLAXOSMITHKLINE-US2021018328:Same reporter

Other Meds:

Current Illness:

ID: 1038249
Sex: F
Age: 56
State: KY

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 02/18/2021
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: Moderate allergic reaction; Felt light headed and dizzy; Cough; dry throat; Scratchy throat; Nose Tingling; did not sleep well; O2 saturation levels fluctuating from 97-86; A spontaneous report was received from nurse concerning a 56-year-old female patient who felt lightheaded and dizzy and experienced moderate allergic reaction, cough, nose tingling, dry and scratchy throat, unwell sleep, and oxygen saturation fluctuations. The patient has past medical history of Chronic obstructive pulmonary disease (COPD) and emphysema. No relevant concomitant medications were reported. On 29 Dec 2020, the patient received their first of two planned doses of mRNA-1273, for prophylaxis of COVID-19 infection. On 29 Dec 2020, immediately after the vaccine shot, she felt lightheaded and dizzy. She experienced nose tingling, cough and her throat was dry and scratchy. Her symptoms were considered severe by clinic staff and the patient was taken to the emergency Room (ER). Her oxygen levels were reported to be fluctuating from 97-86. The reaction was considered a moderate allergic reaction. Treatment with diphenhydramine and steroid shot was given. The patient condition improved and was discharged from the ER with prescription for steroid taper. The patient did not sleep well and did not contact the provider about any symptoms. Action taken with mRNA-1273 in response to the events was not reported. The outcome for the events, moderate allergic reaction, felt lightheaded and dizzy, cough, nose tingling, dry and scratchy throat, unwell sleep, and oxygen saturation fluctuation was unknown. The causality assessment for the events, moderate allergic reaction, felt lightheaded and dizzy, cough, nose tingling, dry and scratchy throat, unwell sleep, and oxygen saturation fluctuation was not provided.; Reporter's Comments: This case concerns a 56-year-old female patient with a relevant medical history of COPD and emphysema who received their first of two planned doses of mRNA-1273 (Lot 041L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. Patient experienced the serious unlisted event of Hypersensitivity, and non--serious unlisted event of Dizziness, Cough, Dry throat, Throat irritation, Poor quality sleep, and Oxygen saturation decreased. The events occurred on the same day after first dose of mRNA-1273, lot # unknown. Treatment for the events included diphenhydramine and steroid shot. Based on the temporal association between the use of the product and the events occurring after receiving the vaccine, a causal relationship cannot be excluded and the events are considered possibly related to the product.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm