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: 0977476
Sex: M
Age: 49
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/08/2021
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: Bruise and lump at iinjection site

Other Meds:

Current Illness:

ID: 0977489
Sex: M
Age: 57
State:

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/08/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Myalgia Narrative:

Other Meds:

Current Illness:

ID: 0977495
Sex: M
Age: 52
State:

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/08/2021
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:

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

Symptoms: Soreness at injection site

Other Meds:

Current Illness:

ID: 0977500
Sex: F
Age: 57
State:

Vax Date: 12/27/2020
Onset Date: 12/27/2020
Rec V Date: 01/08/2021
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: 12/29-developed a severe sore throat; Wednesday, 12/30/2020 with runny nose and nasal congestion. She continues to be congested Narrative: 12/29-developed a severe sore throat; Wednesday, 12/30/2020 with runny nose and nasal congestion. She continues to be congested

Other Meds:

Current Illness:

ID: 0977583
Sex: M
Age: 29
State:

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/08/2021
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: Rash

Other Meds:

Current Illness:

ID: 0977591
Sex: M
Age: 31
State:

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/08/2021
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:

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

Symptoms: Headache, NauseaVomiting, fever, chills, headache, N/V, bone aches, fatigue, SOB, injection site pain Narrative: Patient had COVID and recovered in March. Hx of asthma Was fine until vaccination on Monday. Reports experiencing all of the same side effects as when he had COVID: fever (101 F) nausea/ vomiting bone aches, chills, fatigue, chest tightness/SOB persistent headache injection site pain

Other Meds:

Current Illness:

ID: 0977604
Sex: M
Age: 43
State:

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/08/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Headache, Myalgia, sore arm at injection site Narrative: phone call

Other Meds:

Current Illness:

ID: 0977612
Sex: F
Age: 49
State:

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Palpitations felt warm, skin flushing Narrative: Per EOH report on 12/23/2020: "Employee had an adverse reaction pm 12/22/2020 on day of vaccination." Report states employee "felt warm, palpitations, flushing. Had high blood pressure (no history of). Was released, driven home by family member." Systolic BP in 180s-190s, diastolic BP in 100s-120s. BP was monitored to progressively decrease to 140s/90s and employee was released to husband to be taken home. Was recommended that husband take employee to ER for further assessment if symptoms persist or if condition worsens. Employee was in no further distress and was released home.

Other Meds:

Current Illness:

ID: 0977618
Sex: M
Age: 35
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache, Myalgia, CHILLS Narrative: EMPLOYEE REPORTS THAT HE WOKE UP 1/1/2021 WITH CHILLS, BODY ACHES, AND FATIGUE THAT RESOLVED WITHIN 24 HOURS. RECENTLY HAD COVID INFECTION.

Other Meds:

Current Illness:

ID: 0977625
Sex: F
Age: 38
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/08/2021
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: Dizziness & Headache Narrative: reported that day after the injection woke up with a massive headache and was dizzy. the dizziness lasted half of the day. spent the day in bed.

Other Meds:

Current Illness:

ID: 0977779
Sex: M
Age: 35
State:

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/08/2021
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: FATIGUE AND SORENESS AT IINJECTION SITE Narrative:

Other Meds:

Current Illness:

ID: 0977783
Sex: M
Age: 31
State:

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/08/2021
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:

Symptom List: Rash, Urticaria

Symptoms: SWOLLEN LYMPH NODES IN ARMPIT, MILD PAIN AND INFLAMMATION Narrative: PATIENT REPORTS SWOLLEN LYMPH NODES LOCATED IN THE ARMPUIT FOR ABOUT 2 DAYS, MILD PAIN AND INFLAMMATION

Other Meds:

Current Illness:

ID: 0977791
Sex: M
Age: 48
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache, arthralgia, metallic taste Narrative: Patient previous covid dx: 3/19/2020; antibodies at least as of 10/22/2020 vaccine: 12/31/2020, the next day awaoke with sore arm and mild headache sx progressed over next 4 hours to severe headache and neck/bilat shoulder pain and profound malaise. Some migratory arthralgias, transient lower extremity pains, and a metallic taste. Reminiscent of covid for about 6 hours. Some relief with nsaids and apap. By 30 hours later, just tired and soreness at injection site

Other Meds:

Current Illness:

ID: 0977801
Sex: F
Age: 31
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/08/2021
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: SkinRash, Rash, Reported itchiness and skin rash radiating to the rest of her body. Narrative:

Other Meds:

Current Illness:

ID: 0977858
Sex: F
Age: 51
State:

Vax Date: 12/31/2020
Onset Date: 01/04/2021
Rec V Date: 01/08/2021
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: Headache, Myalgia, fatigue, sore throat, ear pain

Other Meds:

Current Illness:

ID: 0977970
Sex: F
Age: 37
State:

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/08/2021
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: Body tingling; arthralgia, fatigue, night sweats Narrative: Some body tingling for a couple of hours beginning approx 1 hour after administration. Following day: moderate deltoid pain/soreness, mild arthralgia and myalgia, fatigue, night sweats. By day 2 after injection all sx resolved

Other Meds:

Current Illness:

ID: 0977977
Sex: M
Age: 72
State:

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/08/2021
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: Arthralgia, NauseaVomiting, chills Narrative:

Other Meds:

Current Illness:

ID: 0978181
Sex: M
Age: 75
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/08/2021
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: TENDERNESS AT INJECTIONS SITE Narrative:

Other Meds:

Current Illness:

ID: 1279598
Sex: F
Age: 33
State: CO

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/08/2021
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: Benadryl 25mg taken at 1620 Vaccine #2 given at 1630 Rash developed on forearms with chest tightness and "feeling strange" at 1643, temp 99.2F Throat became itchy at 1650 1654 Vitals: 119/63 MAP 81, RR 20 SpO2 98% RA, 98.2F Lungs clear, rash has not spread as of 1654 Transfer care to ED 1656 Admitted early morning after discharge from ED due to increase in sxs. Unable to enter Hospital Name under 21. Unknown days, Hospital same as giving facility.

Other Meds:

Current Illness:

ID: 1279599
Sex: M
Age: 43
State: CA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/08/2021
Hospital:

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

Lab Data:

Allergies: ceclor

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

Symptoms: Patient had onset of parasthesia and itching distal to right elbow down to right wrist. No other complaints, denies itchy throat or shortness of breath. No hives or rash noted. Contacted medical director and observed for 1 hour. Will have patient recontact MD for any change in symptoms.

Other Meds: Vitamins & Fishoil

Current Illness: none

ID: 1279600
Sex: F
Age: 27
State: CA

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: *Body aches *headache *Severe muscle pain *Inflamed lymphnode *Chills

Other Meds: None

Current Illness: None

ID: 0930904
Sex: M
Age: 40
State: CA

Vax Date: 12/18/2020
Onset Date: 01/02/2021
Rec V Date: 01/09/2021
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: Symptoms began on 1/2/21 Self isolating Start of symptoms similar to a cold with mild discombobulation Symptoms are mild with a loss of taste and smell continuing

Other Meds: None

Current Illness: None

ID: 0930905
Sex: F
Age: 58
State: NJ

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Dizziness, kept patient in observation for 30 min.

Other Meds:

Current Illness:

ID: 0930906
Sex: F
Age: 52
State: AZ

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Sulfa drugs

Symptom List: Injection site pain, Pain

Symptoms: Thought I felt fine, but lightheaded, dizzy upon leaving clinic, waited in my car for a while drove home with adult daughter passenger, still felt lightheaded and dizzy. About an hour later headache, body aches. Injection site not bothersome. Came home, rested, still resting, still feel ?off? continuing mild symptoms at 10 pm.

Other Meds: Metformin, zoloft, buspar, hydroxizine, trazadone, lithium,

Current Illness:

ID: 0930907
Sex: F
Age: 23
State: CO

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Benadryl

Symptom List: Injection site pain, Menorrhagia

Symptoms: On 1/4/2020 at roughly 07:00 PM, a dull ache started in my right arm where the vaccine was injected, it radiated from my right shoulder, to my right shoulder blade. My arm felt very heavy. There was also a small hard lump beginning to form with a little heat at the injection site. I had difficulty sleeping due to the aching pain. On 1/5/2020, I woke up at 06:30 AM, the lump had grown in size, and was much more red and hot to the touch, in an oval shape. By roughly 11:30 AM same day, it began to itch, I had checked it and the lump had raised significantly. Hot to the touch. The dull ache had begun radiating into my right armpit as well as down to my right elbow. By 06:00 PM, same day, the aching had continued, the lump was still very raised, itchy, red, and hot. It looked like a large hive. By 06:30 AM on 1/6/2020, the dull ache had mostly subsided, my shoulder blade still felt uncomfortable. The itching continued. The redness spread in size, however the swelling of the lump had gone down slightly. By 06:30 AM on 1/7/2020, the lump had mostly gone down in size significantly, the dull ache had subsided completely, the redness had gone away. By 1/8/2020, 10:00 PM, the lump and swelling are gone, no ache, no itch, still a slight discoloration where lump was.

Other Meds: Paroxetine, 10mg. Norgestimate and Ethinyl Estradiol, 0.25 mg/0.035 mg, Omeprazole, 40 mg.

Current Illness: None

ID: 0930908
Sex: F
Age: 33
State: TX

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
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: N/a

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

Symptoms: Headache, muscleweakness,chills, swollen left limp notes

Other Meds: asa 81mg

Current Illness: N/a

ID: 0930909
Sex: F
Age: 50
State: NJ

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Flushing, kept in Observation area for 30 minutes

Other Meds:

Current Illness:

Date Died: 01/08/2021

ID: 0930910
Sex: F
Age: 52
State: HI

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Metformin, morphine, statins, latex

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient received COVID vaccination around 12:15pm. Patient was monitored for the appropriate amount of time by nursing staff. Patient passed away at 2:15pm.

Other Meds: Patient was refusing to take all medications for over a year

Current Illness: None

ID: 0930911
Sex: F
Age: 43
State: NJ

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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:

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

Symptoms: Tingling in right arm that radiated up to cheek and eye

Other Meds:

Current Illness:

Date Died: 01/08/2001

ID: 0930912
Sex: M
Age: 73
State: NY

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Diarrhea followed by death 24 hrs after vaccination

Other Meds: None

Current Illness: None

ID: 0930913
Sex: F
Age: 37
State: NM

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Cipro, Levaquin, Sulfa, TB screen

Symptom List: Injection site pain

Symptoms: Day 1: shoulder pain, headache, fatigue, and temp of 99 Day 2: severe nausea, fatigue, headache, and body aches

Other Meds: Keppra Lamotrigine Novalog

Current Illness:

ID: 0930914
Sex: M
Age: 51
State: IL

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Wellbutrin, epinephrine

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

Symptoms: Extreme fatigue excessive shaking, pale color

Other Meds: None

Current Illness: None

ID: 0930915
Sex: M
Age: 29
State: NJ

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/09/2021
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: Ibuprofen

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

Symptoms: Broke out in mild hives on face a few hours after the shot.

Other Meds:

Current Illness:

ID: 0930916
Sex: F
Age: 32
State: NM

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Tremor

Symptoms: Patient is a 32 yo G2P1001 with EDD 5/2/2021 by 7w US. She had the first dose of the Pfizer Covid 19 vaccination on 12/17/2020 at the Health Clinic and the second dose on 1/7/2021 at 1115 am. She began having abdominal pain and vaginal bleeding at 315 sm on 1/8/2021 progressing to a previable (22w2d) preterm birth at 739pm on 1/8/2021.

Other Meds: prenatal vitamin calcium supplement 1200 mg vitamin d3 1000 iu Aspirin 81 mg

Current Illness: none

ID: 0930917
Sex: F
Age: 57
State: NJ

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
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: Pepcid.textracyvline. doxycycline.vistaril. lima beans.aloe

Symptom List: Erythema, Pruritus

Symptoms: 2hours post began with tingling in tip of tongue and bottom lip. Took otc benadryl.48hours later all right side of face became numb.Was sent for evaluation by employer to hospital.dx with adverse reaction.bells palsy I was given Decadron IM and medrol dose pack.

Other Meds: Metformin.prilosec.glyburide.januvia.vitimin B12.vitamin c.vitamin d claritin.

Current Illness: None

ID: 0930918
Sex: M
Age: 62
State: NM

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Stomach has pains. Drank lots of water and got lots of walking at work. Symptoms slowly lessened throughout the day but still feeling them at 10:30 pm.

Other Meds: 3000 units vitamin D

Current Illness: None

ID: 0930919
Sex: M
Age: 62
State: NM

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Stomach gas pains. Drank lots of water and got lots of did a lot ofwalking at work. Pain slowly subsided throughout the day but was still somewhat present at 11:00 pm.

Other Meds: 3000 IU vitamin D 3

Current Illness: None

ID: 0930920
Sex: M
Age: 30
State: CA

Vax Date: 01/02/2021
Onset Date: 01/05/2021
Rec V Date: 01/09/2021
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: Right after the injection I did not notice any symptoms, I sat for 15 minutes and felt fine. A few days later I noticed some red bumps on my stomach and back area only. The bumps seem to be staying the same, they do not itch and are not in any kind of specific pattern. I do not have any other major symptoms. The rash is not painful, not hot, and i do not believe it was due to anything else.

Other Meds: Take a daily vitamin and probiotic daily

Current Illness: I did have a sebaceous cyst that was drained at the end of November and completed a 10 day course of antibiotics doxycycline mono 100 mg tabl 2x daily

ID: 0930921
Sex: F
Age: 35
State: WA

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/09/2021
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: doxycycline, sulfa antibiotics, tramadol, kiwi, mushrooms

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

Symptoms: 15 hours after immunization patient reported swelling of tongue. Gums and tongue felt raw. Swelling resolved ~36 hours after onset

Other Meds: albuterol, cetirizine, esomeprazole, gluticasone inhaler, melatonin, montelukast, Armour thyroid,

Current Illness:

ID: 0930922
Sex: F
Age: 51
State: CA

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
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: Celiac disease - gluten intolerance

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

Symptoms: Approximately 28 hours after receiving my first dose of the Moderna vaccine, I experienced intense pain and immobility in my left arm. I had soreness as one would expect after receiving the injection but this was different. I took ibuprofen and went to bed. I awoke several times in the night after rolling over in bed with pain. I awoke in the morning and could not move my arm. My husband had to assist me in dressing. That day (two days following vaccine), I had myalgia, neck pain, mild headache, fatigue, and a low grade fever. My arm continued to be very painful although no swelling or redness. The following morning (three days following vaccine), although I still had pain and decreased mobility, it was improved. I am filing this report on the evening of 1/8/2021. Although I am not back to baseline, I anticipate that I will be in the next few days. I thought it was important to report this given the severity of my symptoms.

Other Meds: None

Current Illness: None

ID: 0930923
Sex: F
Age: 39
State: TN

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Pain in extremity

Symptoms: 10-12hrs after... 30min of aches and chills that subsided with Tylenol and nap 1 week later - current: redness at injection site that is spreading and slightly feverish on spot

Other Meds: Zyrtec Elderberry Tri-Previfem

Current Illness: None

ID: 0930924
Sex: F
Age: 25
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Muscle soreness of the left arm (injection site arm) was reported a few hours after the vaccination. The soreness continued to get worse throughout the rest of the day after administration. The next day, muscle soreness was significantly reduced and by the end of the day (1/8/21) it was completely resolved.

Other Meds: N/A

Current Illness: N/A

ID: 0930925
Sex: F
Age: 36
State: WA

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/09/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: 25 minutes after receiving vaccination ascending numbness of left half of tongue (ipsilateral to location of vaccination site) with associated moderate headache. No tongue swelling or weakness. No breathing difficulty. This was followed by left arm numbness and mild left leg numbness. Left-sided paresthesias /numbness resolved within 3 hours of vaccination. The severity was mild-moderate without there ever being complete loss of sensation. No vision problems or weakness.

Other Meds: None

Current Illness: none

ID: 0930926
Sex: F
Age: 24
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
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: N/A

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

Symptoms: muscle soreness in arm

Other Meds: Birth Control Pill

Current Illness: N/A

ID: 0930927
Sex: F
Age: 36
State: WA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: None

Symptom List: Vomiting

Symptoms: Approximately 10 minutes after injection I started driving home. I began to feel like my mind was foggy and some fatigue, then my lower lip and tongue started to tingle. I stopped driving and waited to see if anything further developed. I then felt flush and my hands became clammy. After maybe 2 minutes these symptoms resolved, I never had any trouble breathing so I continued home and did not seek any medical attention. The whole time frame was about 5 to 10 minutes.

Other Meds: Vitamin D Women's prenatal daily vitamin

Current Illness: None

ID: 0930928
Sex: F
Age: 34
State: HI

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Shellfish Latex Peanuts

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Within minutes after taking the vaccination I started to have a little bit of a heavy breathing heart beat racing high blood pressure sweating headaches, sensitive sight fever. Paramedics, doctors, National Guard, nurses, all came to try to help me and my blood pressure was raising high at about 160/100 or something like that, heartbeat was at 1:52 after an hour of vaccination throat started closing in itchy eyes and wheezing was rushed to Kaiser to get an antihistamine IV and famotidine

Other Meds: Allertec, losartan

Current Illness: None prior to vaccination.

ID: 0930929
Sex: F
Age: 28
State: NE

Vax Date: 12/21/2020
Onset Date: 12/26/2020
Rec V Date: 01/09/2021
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: Dizzy, lightheaded, vertigo, nausea, vision out of focus, unable to walk straight and have to stabilize myself on the wall. I have had 6 episodes lasting 3-24 hours. It has been over 2 weeks (since 12/26/2020 - now).

Other Meds: Trazodone and Wellbutrin XL

Current Illness: None

ID: 0930930
Sex: M
Age: 42
State: WA

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Moderna COVID-19 Vaccine EUA Nausea ongoing Vomiting 12 hours Diarrhea ongoing Gas ongoing Headache ongoing Fever 12 hours Chills 6 hours Injection site soreness 48 hours

Other Meds:

Current Illness:

ID: 0930931
Sex: F
Age: 38
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: NA

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

Symptoms: Left armpit swelling with pain and soreness

Other Meds: Multivitamin

Current Illness: NA

ID: 0930932
Sex: F
Age: 44
State: CA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Macrobid latex

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

Symptoms: Fever 101.2 Chills Body aches Headache Losses of appetite

Other Meds:

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm