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: 1039180
Sex: F
Age: 42
State: AZ

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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: Influenza vaccine , sulfa, Augmentin, Flagyl , Morphine, Robinol, compazine , Reglan , Phenergan, Latex, coffee, melon

Symptom List: Dysphagia, Epiglottitis

Symptoms: I was in observation for about 45 min due to the symptoms I had with the first dose. About 10 min after vaccination, I felt itching on my face, and it progressed to my back and hands. I also started coughing, no rash. In the evening, at home I started feeling shortness of breath and started using my albuterol inhaler and symbicort. I had a feeling like someone was sitting on my back, squeezing my left side, my left lung. I also experienced chest pain. I had to use symbicort and albuterol for about 5 days and the symptoms persisted for at least 3 days, itching, cough, chest pains. The symptoms went away and they returned 3 days ago. Now I am once again starting to experience cough and shortness of breath.

Other Meds: None

Current Illness: None

ID: 1039181
Sex: F
Age: 74
State: FL

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None.

Symptom List: Anxiety, Dyspnoea

Symptoms: Felt light headed about 4 hours after arriving home. Then about 2hours later my arms started to shake/tremors. I took of Ativan and went to bed. No side effects in the morning.

Other Meds: Zyrtec allergy pill, Centrum Silver multivitamin

Current Illness: None

ID: 1039182
Sex: F
Age: 82
State: NY

Vax Date: 01/29/2021
Onset Date: 02/05/2021
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: shellfish, penecillin, depakote.

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

Symptoms: Chest pains, vomiting, chills, aches, dizziness, swollen and red face and neck. Also hallucinating.

Other Meds: Vitamins C, B-12. Cholesterol pills, synthroid, trazadone.

Current Illness: Nothing, but had COVID April 2020

ID: 1039184
Sex: F
Age: 65
State: NC

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Mild Chills 12 - 15 hours after vaccine. Morning of day 2 after vaccine became of swollen and tender lymph node in armpit of vaccinated arm.

Other Meds: Levothyroxine, Famotidine, Aleve

Current Illness:

ID: 1039185
Sex: F
Age: 41
State:

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:

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

Symptoms: Headache x14 days

Other Meds:

Current Illness:

ID: 1039186
Sex: F
Age: 4
State: NH

Vax Date: 02/01/2021
Onset Date: 02/12/2021
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: NKDA/NKA

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

Symptoms: Patient presented with rash on face, upper extremities and trunk spreading to top of thighs 11 days after receiving mmrv vaccine and seen in the office on 2/12/21. Had exposure to covid the day before. Rash was believed to be consistent with post- MMRV vaccine. Patient seen again on 2/14/21 for non-blanching rash that was still slightly spreading and now on left cheek. No fever, cough, sore throat or headaches. Laboratory work was ordered (see next question) On 2/15/21, patient went to the emergency room for acute onset right upper leg pain. Given setting with severe thrombocytopenia, was advised to go to Hospital Emergency Department. 2/16/21 Seen at Hospital Emergency department. Diagnosed with ITP (Idiopathic thrombocytopenic purpura) and positive for covid. Patient was discharged home with instruction to return if leg pain persists or fever develops 2/18/21 Patient seen via telemedicine for a follow-up appointment. Started with fevers 100.4-101.8 and right leg pain. Advised to go to emergency room.

Other Meds: None

Current Illness:

ID: 1039187
Sex: M
Age: 81
State: MN

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

Lab Data:

Allergies: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: WEAKNESS, CONFUSION, LETHARGY

Other Meds: Medications Schedule Med days Assigned Amlodipine 5MG by mouth 06:00 AM Started: 2/12/21 12:34 PM Daily 1 x a day Night shift Leader Aspir Low 325MG by mouth 06:00 AM Started: 12/11/20 8:14 AM Daily 1 x a day Night shift Leader Clonidine 0.

Current Illness: NONE

ID: 1039188
Sex: F
Age: 97
State: MI

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Unknown

Symptom List: Pharyngeal swelling

Symptoms: Approximately 10 minutes after receiving her vaccination patient fainted, then once she gained conciousness she vomitted a small amount of water. Family that was present, said that this is a somewhat common occcurence as she's had several episodes similar to this within the past year.

Other Meds: Unknown

Current Illness: Atrial fibrilation (per family) Transischemic adverse events (TIA)'s (per family) Major stroke in December of 2020

ID: 1039189
Sex: F
Age: 58
State: KY

Vax Date: 01/25/2021
Onset Date: 02/11/2021
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: Seafood, Latex

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: States did have a rash after first dose on 12/28/20 on right arm for 10 days. Did not and chose not to report. Several days post 2nd injection, patient received full body/trunk rash on 2/11/21 and it remains ongoing. Pt. states she is currently taking benadryl for rash

Other Meds: Vitamin D

Current Illness: No

ID: 1039190
Sex: M
Age: 49
State: PA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
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: Only allergies are seasonal and allergic to grass and ragweed

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I developed a rash on the back of my right hand, which the documentation i was provided with at time of vaccination included rash as a severe allergic reaction. I also developed chills that would hit me at random times of the day for a week. These chills occurred every day for a week.

Other Meds: only supplements taken are a pre-workout and protein post workout

Current Illness: None

ID: 1039191
Sex: F
Age: 46
State: PA

Vax Date: 02/10/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Patient developed fast heart rate and shortness of breath 1 day after vaccine, then a very pruritic morbilliform rash 1 week later.

Other Meds: None

Current Illness: None

ID: 1039192
Sex: F
Age: 61
State: WA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Sulfites Corn Eggs preservatives

Symptom List: Rash, Urticaria

Symptoms: Burning at site.. immediately feeling lightheaded, heavy chest pains within 3 minutes and maintained for two hours Rapid rise in Blood Pressure within 5 minutes of injection staying at over 180/109 for two hours Hives 90 minutes after injection Sharp pain in facial nerves, neck lasting days

Other Meds: Aimovig, levothyoxine, Nucynta, Budesomide

Current Illness: Migraines

ID: 1039193
Sex: M
Age: 16
State: IL

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: PCN and dogs,cats

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

Symptoms: Patient received a Moderna vaccine under 18 years old. No adverse effects occurred. Only had a sore arm for 2-3 days. Parent states she will notify the HCP.

Other Meds: None

Current Illness: None

ID: 1039194
Sex: F
Age: 82
State: CA

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

Lab Data:

Allergies: cat allergies, asthma, cold air, scents

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

Symptoms: severe dizziness, severe chills, fever (101.6) , body aches, weakness and flue like symptoms

Other Meds: losartin potasium, levothyroxine

Current Illness: none

ID: 1039195
Sex: F
Age: 92
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: nka

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

Symptoms: VOMITING POST ARRIVAL TO OBSERVATION AREA LASTING 10 MINUTES. 130/98 84 24 X4 ACCOMPANIED BY DAUGHTER VOMITTING STOPPED AND PATIENT WAS STABLE AND WENT HOME WITH DAUGHTER

Other Meds: Effexor, levothyroxine, Dramamine, aspirin, losartan potassium atorvastatin, lutein centrum calcium citrate

Current Illness: none

ID: 1039196
Sex: F
Age: 44
State: WI

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

Lab Data:

Allergies:

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

Symptoms: FEVER HEADACHE DIZZINES BODY PAINS

Other Meds:

Current Illness:

ID: 1039197
Sex: M
Age: 33
State:

Vax Date: 02/16/2021
Onset Date: 02/17/2021
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:

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

Symptoms: Bilateral kidney pain (1 day), low back pain (1 day), headache (1 day)

Other Meds:

Current Illness:

ID: 1039199
Sex: M
Age: 48
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: Very sore arm for approximately 18 hours after the injection in left arm. Applied ice packs. Soreness completely gone after that timeframe. Have been experiencing tingling in left thumb and hand for past 24 hours. Unsure if related to vaccine.

Other Meds:

Current Illness:

ID: 1039200
Sex: F
Age: 50
State: AR

Vax Date: 01/26/2021
Onset Date: 01/27/2021
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 known

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Day after the dose was administered: Fever of 99, pain/soreness/swelling at site of injection, tiredness Two days after the dose was administered: Fever of 101, pain/soreness/swelling at site of injection, tiredness, headache, aches Three days after the dose was administered: pain/soreness/swelling at site of injection, tiredness, aches

Other Meds: Melatonin

Current Illness: None

ID: 1039201
Sex: F
Age: 56
State: CA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: 1416: Pt states heart coming out [sic] and lips and tongue are numb. 1417: HR 108 SpO2 100% 1418: Benadryl 10 ml [25 mg] given. 1440: HR 85 SpO2 100%. I recommended she stay for at least 30 mins. Patient chose to leave against recommendation after Benadryl and assessment.

Other Meds:

Current Illness:

ID: 1039202
Sex: F
Age: 70
State: AR

Vax Date: 01/19/2021
Onset Date: 01/19/2021
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: Sensitive to dairy, wheat, high histamine food and processed foods.

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

Symptoms: Dizziness and Weakness for about 30 hrs diminishing as time passed. Dizziness lessened during this time frame. Weakness also diminished during this timeframe but lasted on and off for a couple more weeks occasionally. Both Completely gone now.

Other Meds: Probiotic, vitamin D3, vitamin b-12 injections, clonazepam (occasionally)

Current Illness: Fibromyalgia

ID: 1039203
Sex: F
Age: 37
State:

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:

Symptom List: Unevaluable event

Symptoms: Heavy arm tingling in right side of neck. Experienced after last shot not as bad. EMS evaluated. Stayed until 2:30 then home

Other Meds:

Current Illness:

ID: 1039204
Sex: M
Age: 85
State: MN

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

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

Symptoms: WEAKNESS, FEVER, BODY ACHES

Other Meds: Medications Schedule Med days Assigned Aspirin 81MG by mouth 08:00 AM Started: 5/10/19 1:00 PM Daily 1 x a day MC LCM Celexa 10MG by mouth 08:00 AM Started: 5/16/19 8:00 AM Daily 1 x a day MC LCM Donepezil 10MG by mouth 08:00 PM Started: 10

Current Illness: NONE

ID: 1039205
Sex: F
Age: 68
State: GA

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Headache, tylenol, no results, only took 4- 500mg tablets because the pain didn't ease I stopped and started using Ice pack, no result, head still hurts on Thursday February 18. So I just rested. Pain at injection site, Tylenol, after the 4 tablets and no relief and used ice pack, arm feels better. Fatigue, rested

Other Meds: Nifedipine, protonix, lisinopril, htcz, zoloft, co q 10, vitamin d3, lipitor, lumigan

Current Illness: None

ID: 1039206
Sex: F
Age: 70
State:

Vax Date: 02/10/2021
Onset Date: 02/12/2021
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: Injection site pain, Menorrhagia

Symptoms: HEADACHE

Other Meds:

Current Illness:

ID: 1039207
Sex: F
Age: 27
State: WA

Vax Date: 02/15/2021
Onset Date: 02/17/2021
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: codeine

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

Symptoms: "COVID arm", large red splotch/rash at injection site, defined borders, no itching, lesion is painful to the touch, swollen lymph nodes in armpit of the same arm as injection

Other Meds: loryna birth control, spironolactone 100mg BID, vitamin D3 2000 IUs, vitamin B12 1000 IUs

Current Illness: NA

ID: 1039208
Sex: F
Age: 44
State: OH

Vax Date: 02/17/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Major chills start 10pm.. lasted most of night. Took Motrin .. tossed and turned will chills with chattery teeth until about 3pm slept an he and a half and chills agains. 9a motrin fever of 102.2.. headache arm sore all over upper arm! Motrin at 2pm headache stopped fever also

Other Meds:

Current Illness:

ID: 1039209
Sex: F
Age: 54
State: OR

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Benadryl, Compazine, Opioids

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 1345 - Vaccine Given 1410 - Pt reported moderate-severe chest tightness that extended down bilateral sides. Lips and fingers were going numb and pt appeared pale. 02 via simple face mask at 5.5L started at this time. 1420 - symptoms "starting to get better" per patient but still reported tightness and that is was now moving slightly higher towards the throat. Ambulance called at this time. 1428 - Epi Pen given in left thigh 1430 - Patient reports feeling anxious and bilateral hands are beginning to contract with patient stating "I can't move my hands" Patient was taken to hospital via ambulance at this time 1430

Other Meds:

Current Illness:

ID: 1039210
Sex: M
Age: 63
State: IN

Vax Date: 02/01/2021
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:
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: Severe arm ache at injection site. Headache. Slight Fever Tired Could not sleep General poor feeling All took place early morning right after shot

Other Meds: Lisinopril Simvastatin Citerizine

Current Illness: None

ID: 1039211
Sex: M
Age: 40
State: AZ

Vax Date: 02/08/2021
Onset Date: 02/10/2021
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: none

Symptom List: Nausea

Symptoms: 2 days post vaccine Pt reports that he experienced sever flu like symptoms with the worse being fatigue, tachycardia, and shortness of breath. He reports the symptoms lasted for about 1 day except the tachycardia and shortness of breath. He reports 8 days after onset of adverse symptoms with complaints of continue shortness of breath with walking or going up stairs. At time of visit Patient positive for tachypnea and tachycardia. Wheezes audible throughout lung fields.

Other Meds: none

Current Illness: none

ID: 1039212
Sex: F
Age: 62
State: PA

Vax Date: 02/06/2021
Onset Date: 02/14/2021
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: First Vaccine was 1/8/21, just had sore arm, Had 2nd vaccine , 13 hours later like many people, chills , almost 103 temperature, sweating, very sore arm. Next day fine. Then on February 14 I got a fever in the afternoon and continued to have a fever until yesterday 2/17/21 On Sunday 2/14/21 the fever started at about 4:00, I went up to about 101.0., then it went between 100 and 100.6, accompanied by chills. On Monday 2/16/21 and Tuesday 2/17/21 I continued with fever and chills, the fevers did not start until the afternoon at about 3:00 and would continue all evening, in the morning when I woke up, no fever, felt okay, a little off Then yesterday on 2/17/21, the highest fever I got was 99.6 and that was at 2:00 p.m. and then I was normal all night and feel great this morning. And it is now 3:18 p.m. which is the bewitching afternoon hour for me and I am good, Feel great , so I think it is over. I was on the phone with my physician twice who said he thought it was a delayed reaction to the 2nd dose. The reactions started on the 8th day post my 2nd vaccine dose

Other Meds: Paxil, Synthroid, Valsartan, and Hydrochlorothiazide

Current Illness: none

ID: 1039213
Sex: F
Age: 83
State: AZ

Vax Date: 02/12/2021
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: Redness, heat, itching, mild swelling in area of approx 7x7 cm surrounding injection site. It is ongoing since first identified on 2/16 at 08:00. Physician consulted this date with diagnosis of cellulitis and/or allergic reaction. Doxycycline prescribed.

Other Meds: Topical clobetasol prn

Current Illness: Chronic scleroderma morphea

ID: 1039214
Sex: F
Age: 22
State: PA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: amoxicillin, Dimetapp, bee stings

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

Symptoms: Extreme muscle fatigue, weakness, diarrhea, headache, dizziness, excessive fatigue.

Other Meds: Lo Loestrin birth control

Current Illness: None

ID: 1039216
Sex: F
Age: 55
State: NC

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

Lab Data:

Allergies: sulfa drugs

Symptom List: Tremor

Symptoms: pt states that she developed itching, redness and swelling around the injection site. The 2nd day the redness and swelling had increased in size and was hot to the touch. The 3rd day the redness has doubled in size but is not as swollen, hard or sore. Pt said she thinks the injection was not given to her in the muscle that is was down to low on her arm. Pt stated she has called her PCP and was not given any medical advice.

Other Meds: no

Current Illness: no

ID: 1039217
Sex: M
Age: 57
State: MN

Vax Date: 02/10/2021
Onset Date: 02/11/2021
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: Barley, Hopps, Tylenol

Symptom List: Erythema, Pruritus

Symptoms: At 10:45 am on 02/11/2021 begin to have difficulty speaking. Reports the symptom as "losing his voice". He states that the symptom continued to get worse and at 11:15 am he could not speak and was experiencing shortness of breath and throat tightness. He was taken to the local emergency room by another staff member. Does report he has had a history of having a anaphylatic response but not to a vaccine. He does not have a epinephrine pen prescribed to him.

Other Meds: Takes blood pressure medication unsure of name

Current Illness: None

ID: 1039218
Sex: M
Age: 29
State: WI

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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:

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

Symptoms: CHILLS, FATIGUE, FEVER

Other Meds:

Current Illness:

ID: 1039219
Sex: F
Age: 38
State: OH

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: 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: Back pain, sciatica. Started day after vaccine and continuing currently.

Other Meds:

Current Illness:

ID: 1039220
Sex: F
Age: 52
State: OK

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

Lab Data:

Allergies: Asthma - have mild allergies to trees, dust, severe to mold and pollen Cannnot take PCN, stay away from ASA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: profound sore arm difficulty in lifting by 8pm after shot, Fever and chills by 12 midnight with temp running 101.9, muscle joints ache had these symptoms until 6:30pm on Saturday 13th

Other Meds: Synthroid, Breo, Lexapro, Singular, Zyrtec

Current Illness: none

ID: 1039221
Sex: M
Age: 76
State: NY

Vax Date: 01/25/2021
Onset Date: 01/29/2021
Rec V Date: 02/18/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Pt is a 76-year old with SIDEROBLASTIC ANEMIA that had been mild and without need for treatment, and IgM MGUS. Presented to ED with newly diagnosed AML, in MDS with WBC counts ~250, 000. He had a normal (EX ANEMIA) CBC on Jan-21. He had COVID vaccine #1 on Jan-25. About 4-days later he developed diffuse dermititis and severe fatigue. He had an ED visit on Feb-8 for these issues and was prescribed Prednisone and Cefalexin (completed Feb-15). CBC was NOT done at that ED visit. He called HEME clininc on Feb-16 (see also the Hematology Note) stating that he was just NOT feeling well in general with increased fatigue and DOE. He noted that the dermatitis was mostly resolved. We rechecked CBC on Feb-17 (results available about 4-PM) that indicated ACUTE LEUKEMIA. Presents to the MC with MDS on FEB18.

Other Meds: Levothyroxine

Current Illness: sideroblastic anemia, BCC. Hypothyrodism, and prostatecancer, SCC

ID: 1039222
Sex: F
Age: 42
State: NJ

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/18/2021
Hospital: Y

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 noted.

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

Symptoms: Rapid onset of obsessive compulsive behavior - rearranging of items, movement of items from one place to another, fixation on colors, fixation on color red (fire, danger), sleeplessness, confusion, irritability, jumbled memory recall Sunday 2/15 - Manic episode experiencing behavior above plus confusion, anxiety related to events. Episode required call to 911 and assistance of EMS to transport patient to the hospital emergency room for evaluation.

Other Meds: Aripiprazole (ABILIFY) 30 MG tablet 1 daily Fluoxetine (PROZAC) 20 MG capsule 1 daily

Current Illness: Possible urinary tract infection - diagnosed 02/15/21 in emergency room visit

ID: 1039223
Sex: F
Age: 43
State: MI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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:

Symptom List: Pain in extremity

Symptoms: The patient received her vaccine but after few minutes she said that she is feeling dizzy. Blood pressure checked and it was 140 over 110. We kept monitoring the patient for 15 more minutes but she said I am feeling okay after that. At 3:20 PM, we called her and she said she left early from her job to home and she is feeling fine now.

Other Meds:

Current Illness:

ID: 1039224
Sex: F
Age: 74
State: UT

Vax Date: 02/18/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Pt was given the Moderna vaccine as the second dose in the covid series, however they received the Pfizer vaccine as their first vaccine

Other Meds:

Current Illness:

ID: 1039225
Sex: F
Age: 70
State: CA

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

Lab Data:

Allergies: PCN Celexa

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

Symptoms: Red blotchy rash, near injection site. Slightly raised, warm and itchy.

Other Meds: Losartan L-thyroxine Liothyronine Lexapro Hydrochlorothyazide Vitamin D3

Current Illness: None

ID: 1039226
Sex: F
Age: 81
State: NC

Vax Date: 01/14/2021
Onset Date: 01/17/2021
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: Penicillin

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

Symptoms: Three days after receiving vaccine, patient noticed rash, which turned to whelps on joint areas. This included patient's wrists, knees, buttocks and ankles. She noticed that where pressure was applied and bending was occurring, the itchy whelps would show. Patient took oral Benadryl which calmed itching and redness and saw primary care Dr. as well as rheumatologist for reaction. Triamcinolone was prescribed and patient used to calm itch. This reaction continued to occur for two weeks after the first vaccine. She received her second dose and the same reaction occurred and continues to occur at this time. Lot# for second Moderna vaccine is 013M20A, given on 2/12/2021.

Other Meds: Crestor, Singulair, Synthroid, Leothyronine, Olmesartan, Flovent, Xopenex, Multi Vitamin, Vit D3, Fish Oil, Baby Aspirin, Volteren Cream

Current Illness: None

ID: 1039227
Sex: F
Age: 71
State: NM

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

Lab Data:

Allergies: sulfa sensitivity to tsetse fly bites after several visits to game parks in East Africa

Symptom List: Vomiting

Symptoms: Delayed reaction to vaccine. On day 8 developed an very itchy, red, hot, slightly raised, inflamed area on left upper arm where injection was given approximately 6" x 5" in size. I still have it 2 days later. Called doctor's office to see if I should get my second shot but have not heard back yet.

Other Meds: fluoxetine

Current Illness: none

ID: 1039228
Sex: F
Age: 78
State: CA

Vax Date: 02/06/2021
Onset Date: 02/09/2021
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: Bactrum

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I had a room spinning dizzy spell on the 3rd day after the shot but didn't think too much of it after it passed. The 4th day I remember thinking I felt dizzy again, and the next thing I knew I was on the floor and hit my head really hard. I think I must have passed out for a nano second. (The first time in my life!) On the 8th day, Feb. 14th, I got a rash on the injection site. It was red, swollen, hot and shaped like a square about 2 inches diameter. I haven't had an event since.

Other Meds: none

Current Illness: none

ID: 1039229
Sex: F
Age: 66
State: PR

Vax Date: 02/17/2021
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: Aspirin Codeine MSG

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

Symptoms: 2 hours after receiving the vaccine I had a nosebleed on the left side of my nose.

Other Meds: Singulair 10mg Neurontin 100mg Breo Ellipta Vit C 1000mg Omega 3 Vit D3 Turmeric 800 mg capsules Moringa capsules

Current Illness: Colitis Asthma Diverticulosis Arthritis

ID: 1039230
Sex: F
Age: 57
State: CA

Vax Date: 02/12/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 3 days post vaccine I began showing signs of shingles on the left side of my face, about 10:00 am-confirmed by Dr. Began treatment of Valacyclovir HCL 1gram, Methylprednisolone 4mg, & gabapentin 300mg

Other Meds: Vyvanse, Dexilant, Armour Throid, Levocetirizine, paroxetine, quercetin with bromelain, vitamin D,C,B12, sinuplex, inflavonoid intensive care, metabolic synergy, zinc, probiotics

Current Illness: None

ID: 1039231
Sex: F
Age: 31
State: IL

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

Lab Data:

Allergies: None

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

Symptoms: I had facial numbness only on my left side of my face. I also had some facial swelling on my left side of my face and my left eye has blurry vision.

Other Meds: JUNEL FE TABLET

Current Illness: None

ID: 1039234
Sex: F
Age: 35
State: WI

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

Lab Data:

Allergies:

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

Symptoms: LIGHTHEADED, DIZZY

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm