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: 1044084
Sex: M
Age: 55
State: PA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/21/2021
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: penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: injection site soreness, shoulder tightness increased to a shock along nerve to back of thumb within 24hrs. Arm began to pull up with pain through forearm and biceps increasing through 72 hrs. Began meloxicam again at 60 hrs. Woke up at 84hrs with severe arm pain, unable to move arm without pain. Cold sweat and nearly fainted. Pressure/pain in shoulder, biceps, elbow/forearm wrist. Called sibling who is physician and began treating shoulder with ice, tylenol and benedryl. Pain controlled to moderate through day 10 but lifting arm at shoulder or extending results in shock at back of thumb and pain through biceps and forearm. Back base of thumb completely numb. Went to urgent care facility 10 days after injection and

Other Meds: meloxicam 15mg (stopped 36 hours prior) loratadine 10mg

Current Illness: none

ID: 1044085
Sex: M
Age: 61
State: MS

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: No

Symptom List: Anxiety, Dyspnoea

Symptoms: Fatigue, headache, chills, nausea, vomiting, dizziness and weakness

Other Meds: Pravastatin 40MG, Fish Oil 500Mg, Docusate 100MG, Cetirizine 10MG, Vitamin D 25Mg, Fluticasone 50MG, Gabapentin 300MG, Sildenafil citrate 50MG.Qunol CoQ10 100MG, Cyclobenzaprine 100MG, Acetaminophen 325MG

Current Illness: None

ID: 1044086
Sex: F
Age: 59
State: IL

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/21/2021
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: none

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

Symptoms: the injection was given high on my arm, very near shoulder bone. very painful going in(unlike first shot) within 2 hours i could not raise or bend my right arm and the entire arm was painful to the touch ice, heat, Tylenol, Ibuprofen were used for 4 days went to an Urgent Care on day 2 to discuss symptoms and treatment-Dr. advised same course of tx as above I believe the injection was given too close to my shoulder/bursa-it was not 2-3 fingers from my shoulder bone

Other Meds: Buproprion, Calcium/D3

Current Illness: none

ID: 1044087
Sex: F
Age: 67
State: WI

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, sulfa, Codeine, Hydrocodone, Valium, Trazadone, Niacin, Nickel

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: At 10 am took 1 Benedryl caplet. Had Vaccine at 10:30am. At 11:30am mouth and throat very dry.Drank water then felt throat starting to tighten and took 1 more Benedryl. A little bit later felt drowsy and somewhat dazed. Approx 12:30 pm got a severe headache and neck pain. At 2:30 pm the pain abruptly disappeared without me taking anything for it. Very sore arm was the only effect left. Still sore after 2 days.

Other Meds: Levethyroxine, Vitamin C @ 6am 1 Benedryl caplet @10 am

Current Illness:

ID: 1044088
Sex: F
Age: 55
State: IL

Vax Date: 02/18/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: E-mycin, Valium

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

Symptoms: Saturday 2-20-21 I woke up with swelling under my left eye. I took ibuprofen and applied ice. Swelling went down slightly but ramped up throughout the day. Sunday 2-21-21 the swelling was under both eyes. The area under the eyes and near the bridge of the nose is sore and sensitive to touch.

Other Meds: Anastrozole, ibuprofen, turmeric, Multi vitamin

Current Illness: None

ID: 1044089
Sex: F
Age: 67
State: MD

Vax Date: 02/16/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
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: Sulfa, Penicillin, Erythromycin, Tetatrycline, Aspirin

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

Symptoms: Received first vaccine without any symptoms. Received second vaccine on 2/16 and on 2/19 she started with hives and itching on her buttocks, migrating to thighs, hands, face. Resolved with Benadryl

Other Meds: None

Current Illness: None

ID: 1044090
Sex: F
Age: 70
State: CA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Headache, nausea, body ache, low energy, fever

Other Meds: colnidine, furosemide, anlodipine, metopeolol succinate, nortriptyline, levothyroxine, atorvastatin, valsartan, atropine, multivitamin, vitamin D

Current Illness: none

ID: 1044091
Sex: F
Age: 71
State: FL

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Vancomycin

Symptom List: Pharyngeal swelling

Symptoms: High fever, Weakness, body sore to touch ( sensitive), tired. Headaches ( horrible). starting about 10 hours later after shot.Till Saturday ( three days later..

Other Meds: nothing. Held my meds for the day

Current Illness: None

ID: 1044092
Sex: F
Age: 29
State: AL

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Shingles onset 5 days after first dose

Other Meds: Doxycycline

Current Illness:

ID: 1044093
Sex: F
Age: 73
State: NY

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
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: Sulfa (Gantrisin), gluten

Symptom List: Diarrhoea, Nasal congestion

Symptoms: fatigue, low grade fever, muscle aches about 36 hours Day 3 - slight red rash on injected arm about a 4 inch diameter circle, slightly itchy

Other Meds: Losartan Potassium 50, Gas-X, Vitamin D3 1000 iu, Loratadine 10 mg

Current Illness: None

ID: 1044094
Sex: F
Age: 42
State: ID

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/21/2021
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: Covid Arm - at day 7 after receiving my 1st dose of the Moderna vaccine my arm became itchy at the injection site. Inspecting it the next morning, it was red and blotchy/inflamed in a circle around the injection site. Also firm and warm to the touch. It lasted about 48 hours.

Other Meds: None

Current Illness: No

ID: 1044095
Sex: F
Age: 32
State: MA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Food: All legumes including soy and peanuts, cantaloupe, shellfish, mustard, almonds, coconut

Symptom List: Rash, Urticaria

Symptoms: Received Vaccine at 2:30pm on 2/19. I felt fine that night and went to bed as usual. When waking the next morning, I had arm soreness, and whole body muscle aches. These lasted throughout the day. I went to bed that night and woke up fine the next day. I did not take Tylenol or other medications during this time.

Other Meds: Flonase (1 spray in each nostril 1X daily), Allegra(180mg), Centrum Daily Womens Multi-Vitamin, Probiotic (Nature's Promise), Vitamin D3 (200iu) Albuterol- as needed but last dose was 2+ weeks prior to the vaccination

Current Illness: Diagnosed with COVID -19 on 1/15/2021. Cleared and returned to work on 2/1/2021.

ID: 1044096
Sex: F
Age: 75
State: FL

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Large Bruse at point of injection

Other Meds: Prempro Klonopin

Current Illness: None

ID: 1044097
Sex: M
Age: 23
State: UT

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
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: None

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

Symptoms: The night I received the second dose, I was unable to sleep and had developed a fever. The next day I had the worst headache of my life and my body kept switching between feeling hot and cold. That night, I was able to sleep, but I woke up drenched in sweat. Day two after vaccination, I had a mild headache.

Other Meds: None

Current Illness: None

ID: 1044098
Sex: M
Age: 79
State: AL

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/21/2021
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: swelling;redness; rash; infection: Treated by Family Doctor. antibiotic Doxycycline, Allegra,Prednisone. Condition cleared the following day after meds.

Other Meds:

Current Illness:

ID: 1044099
Sex: F
Age: 34
State: NJ

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: pineapple

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

Symptoms: "Covid arm" - sudden onset of rash around the site of injection. The area is red, hard, hot, and inflamed. Itchiness upon onset but that subsided. Mild soreness come on later.

Other Meds: Pre-natal vitamins, probiotics, salt sticks

Current Illness: No

ID: 1044100
Sex: F
Age: 43
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Morphine, penicillin, and macrobid

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

Symptoms: After receiving the second dose of the Moderna vaccine, I began exhibiting chills and had some fatigue that afternoon. At 2am, I woke up with a 102.5 degree fever. I took Tylenol at 3:30am. When I woke up for the day, I had a fever between 101-103 degrees all day and felt fatigued. As of today, Sunday, 2/21/22, I still have an elevated temp around 100 degrees a headache, and fatigue.

Other Meds: Vitamin D3 and Airborne daily

Current Illness: Urinary tract infection

ID: 1044101
Sex: F
Age: 68
State: CO

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Contrast for Cat Scans Lortab Foods Environmental grasses weeds trees cats

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Delayed response to arm injection site Itching swelling redness

Other Meds: Armpit thyroid Tymlos daily injection Zrytec

Current Illness: Mast cell Autoimmune. Hashimotos. Microscopic colitis celiac eosinophilia can esophagitis

ID: 1044102
Sex: M
Age: 77
State: OH

Vax Date: 02/09/2021
Onset Date: 02/15/2021
Rec V Date: 02/21/2021
Hospital: Y

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Hayfever and perservatives

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Shortness of Breath causes by multiple large blood clots, put on blood thinners, seems to be fine, but has follow up appointment in March

Other Meds: Multivitamins, Fish oil, Asprin 81mg, vitamin c 1000mg

Current Illness: n/a

ID: 1044103
Sex: F
Age: 39
State: PA

Vax Date: 02/08/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Heavy bleeding with menstrual cycle occurred 10 days after vaccination. This blessing was off cycle from normal cycle. Cycle is regulated with birth control pills

Other Meds: Lo Estrin Fe Doterra vitality supplements

Current Illness: None

ID: 1044104
Sex: F
Age: 74
State: OH

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/21/2021
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: Any form of Codine

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

Symptoms: 2/4/21 woke up sick on stomach and really bad headache. Threw up, weak and sick all day. 2/5/21 little better but very weak and still sick on stomach.2/6/21 woke up with arm hurting bad, looked in mirror and saw red below shot area, arm was very hot. Sun 2/7/21 red spots continue to grow and arm still hot., called nurse hotline and was told to go to ER. Mon. 2/8/21 blood vessels in left eye burst. Red spots lasted for 8 days and as of today 2/21/21 left eye is still red but better.

Other Meds: Levothyroxine 88mg 1 a day Omeprazole 40 mg. 1 a day ex. strength Tylenol

Current Illness: None, but still recovering from Covid 19 (Oct. 2020) and Covid Pneumonia which I was hospitalized from 10/29 until Nov. 10, 2020

ID: 1044105
Sex: F
Age: 39
State: NC

Vax Date: 12/28/2020
Onset Date: 01/05/2021
Rec V Date: 02/21/2021
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: One week after first Pfizer vaccine, awoke with severe right eye pain and light sensitivity. The eye and peri-orbital area was extremely painful, swollen and red. The ophthalmologist said the the urea and surrounding tissues were severely inflamed and the eye pressure was increased. He stated this could have been a delayed inflammatory response to the covid vaccine and advised to refrain from having the second dose. Took steroid eye drops every one hour for several days and have had three follow up ophthalmology visits.

Other Meds:

Current Illness:

ID: 1044106
Sex: F
Age: 66
State: FL

Vax Date: 02/14/2021
Onset Date: 02/17/2021
Rec V Date: 02/21/2021
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: codeine makes nauseous

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

Symptoms: Pain in right breast although shot was in left arm.

Other Meds: Calcium citrate 1200 mg, D3 5000, magnesium 200 mg, flonase (twice a day), DHEA 50

Current Illness: ENT problems

ID: 1044107
Sex: F
Age: 28
State: NY

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Braids Cats Dust

Symptom List: Injection site pain, Pain

Symptoms: Severe pain at injection site and through upper arm and shoulder. Moderate swelling in upper arm, shoulder, armpit

Other Meds: Vitamin D 2000iu Pro B probiotic Magnesium 400mg Sumatriptan 100mg Escitalopram 5mg

Current Illness:

ID: 1044108
Sex: F
Age: 40
State: GA

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/21/2021
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: Delayed vaccine reaction- rash started one week post first dose; a telehealth doctor gave me a 21 pill six-day steroid pack which held it at bay, an urgent care doctor then thought I had a fungal infection and gave me a topical cream but two days post the steroid pack I had a rash in multiple areas of my body and the second urgent care doctor I saw said I was having a delayed reaction to the vaccine. He said since I wasn't having any breathing issues, my reaction was considered mild.

Other Meds: Levothyroxin

Current Illness:

ID: 1044109
Sex: F
Age: 73
State: IL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/21/2021
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: unknown

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

Symptoms: About 5 hours after first shot I developed a hive on my face and a red itchy rash on right hand. The hive disappeared quickly but the rash remained for a few days. 6 days after shot I developed a rash with red blotches on right fore arm that did not itch. It lasted for about 4 days leaving little red marks. A few days after I developed a red rash on upper chest. It did not itch and quickly went away. At this time most symptoms have subsided.

Other Meds: folic acid, methotrexate

Current Illness: none

ID: 1044110
Sex: F
Age: 61
State: IA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/21/2021
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: No known medical allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Headache Fatigue Joint Pain Muscle ache

Other Meds: Gabapentin 300mg BID Lexapro 10mg QD Vitamin D3 5000IU's QD Zinc 50mg QD Vitamin C 1000mg QD ASA 81mg QD Naproxen 220mg, 2 tabs Q am and 1 tab Qpm FISH Oil Turmeric 1000mg BID Omeprazole 40mg QD

Current Illness: None

ID: 1044111
Sex: M
Age: 79
State: AL

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: swelling; rash on both arms: Allegra,Prednisone: Rash cleared 02/20/2021

Other Meds:

Current Illness:

ID: 1044112
Sex: F
Age: 65
State: NY

Vax Date: 02/13/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
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: penicillin cipro clindamycin

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

Symptoms: large rash and swollen itchy arm one week after vaccine

Other Meds: atenolol enalapril paroxetine

Current Illness: none

ID: 1044113
Sex: F
Age: 68
State:

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/21/2021
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: Nausea

Symptoms: Patient had odd symptoms with left ear. Described as ear pain, pressure, buzzy feeling on and off. Patient also experienced dizziness, chills, aching and diarrhea.

Other Meds:

Current Illness:

ID: 1044114
Sex: F
Age: 22
State: NY

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Injection site pain

Symptoms: Fever of 102 and dehydration contributed to a syncope collapse early the morning after vaccination (7:15 AM 02/20/21). Just before collapsing, I experienced nausea, dizziness, confusion, weakness, and seeing all black in my field of vision. Emergency Room doctors say it was very likely related to an adverse reaction to the second Pfizer Covid vaccination. Treatment included Tylenol and Ibuprofen, rest, and fluids.

Other Meds:

Current Illness:

ID: 1044115
Sex: F
Age: 79
State: HI

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/21/2021
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: Day 1: Some blurred vision and labored breathing immediately after injection*, numbness and tingling of the tongue, body aches and pains all day. Day 2: Vision and breathing now normal. Numbness and tingling of tongue has lessened. Body aches and pain more prominent. * Please note that this mobile clinic that came to my mom's home was not set up for a serious reaction, nor did they stay and wait at least 15 minutes. My mom was told that she would have flu like symptoms and then they left.

Other Meds: Pantaprazole sodium delayed release- 40mg- 1 tablet per day Atorvastatin- 1 tablet per day

Current Illness: none-- Patient had COVID in November 2020. Recovered without incident.

ID: 1044116
Sex: F
Age: 93
State: FL

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Patient's daughter reported at 2/20/21 (next day after her shot) that her mother was experiencing chills, fatigue, sore arm and fever (peak 101F). The patient's daughter gave her a Tylenol when she found out she had a fever and this resolved the fever and the patient was feeling back to normal around midnight that same night.

Other Meds: OTC fish oil, vitamin C and D3

Current Illness: None reported

ID: 1044117
Sex: F
Age: 44
State: CA

Vax Date: 02/08/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Aspartame

Symptom List: Tremor

Symptoms: Large, reddened, oval shaped area approximately 6 inches at widest span and approximately 6 inches long, with the start of the area beginning just under the injection site on left arm, warm to touch, reddened area appears 'rash' like and has inconsistency in color as it appears 'patchy' in some areas, darkest reddened area is approximately the last 2.5 to 3 inches of the lower area most distal to the injection site and rightside of the reddenedarea, no pain or itching noted at this time.

Other Meds: N/A

Current Illness: N/A

ID: 1044118
Sex: M
Age: 72
State: NC

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/21/2021
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: Erythema, Pruritus

Symptoms: Received the Pfizer vaccine for dose one on 1/22/2021. He came for dose #2 Pfizer today; however, he was given Moderna vaccine instead. Was immediately told and observed for any adverse reaction. He did not display and adverse reactions during his monitoring period.

Other Meds:

Current Illness:

ID: 1044119
Sex: F
Age: 80
State: SC

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Today , 7 days after shot, the injection site is red, swollen and a bit sore. Before today there has been no affect at all. Don?t know if you would need to know this, but if you are recording this thought it might be useful.

Other Meds: None

Current Illness: None

ID: 1044120
Sex: F
Age: 67
State: CA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
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: Cipro and Codeine

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

Symptoms: Palpitations. Pain at vaccine site, left upper arm. Extreme pain on left arm from vaccine site to elbow, left scapula, left side of neck and ear; extreme headache originating on left side of head. Extreme pain on both legs causing walking difficulties. Generalized malaise, nausea, lack of appetite, and extremely tired.

Other Meds: Vitamin C. Vitamin D. Probiotic

Current Illness: N/A

ID: 1044121
Sex: F
Age: 58
State: MD

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/21/2021
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, Latex, iodine, PCN, Silcone, lanolin, E-mycin, Chocolate

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Headache 15 minutes after vaccination, VSS, no SOB or throat swelling

Other Meds: Singular Symbicort Fexofenodine Xyzal MVI

Current Illness: Asthma, severe had COVID in Jan 2021

ID: 1044122
Sex: F
Age: 70
State: KY

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Budesonide-formoterol Fumarate Diphenhydramine Flu Virus Vaccine Furosemide Gabapentin Hydralazine Hydrochlorothiazide Hydroxyquinolines Mirabegron Leads from EKG monitor Steroids- SOB Blood Clot injection Oxybutynin Pepcid [Famotidine] Adhesive Prednisone Ipratropium Clonidine Clonidine Derivatives Hydroxychloroquine Pantoprazole

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

Symptoms: RECEIVED PFIZER COVID VACCINE ON 02/13/21 02/18/21 CALLED SURGERY OFFICE AND REPORTED A SWOLLEN LEFT LEG TO AN NP. SHE HAD AN EMG PRIOR TO CALL AND TOLD THEM ABOUT VACCINE FROM 02/13. 02/20/21 CALLED AFTER HOURS REP ABOUT COVID VACCINE REACTION 0 DESCRIBED ITCHING CERVICAL LYMPHADENOPATHY, AND WEAKNESS IN LEFT ARM, AND GENERALIZED FATIGUE. INSTRUCTE DTO GO TO THE ER. 02/20/21 REPORTED TO AND DISCHARGED TO HOME/SELF CARE WITH DIAGNOSIS OF SHORTNESS OF BREATH AND ITCHING.

Other Meds:

Current Illness:

ID: 1044123
Sex: F
Age: 67
State: FL

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: No initial discomfort at site but started feeling it more over the course of the week. On the 20th (yesterday) after working outside most of the day I came in and showered following which my left arm at site began itching and I noticed it was red. Later that evening I developed chills, a mild headache, & fever of 100.3F. Took 2 Tylenol XS before bed. This morning red area on arm larger & still consistently itchy. Headache less to gone. Temperature currently 99F with no antipyretic. None of these symptoms have impeded my activities of daily living but I feel they are important to report. I have not contacted my doctor or the Pharmacy where I received the injection.

Other Meds: Levothyroxine 0.075mg daily; Multiple vitamin daily; Advil prn; Biotin 5000mcg daily; Caltrate 600/D3 twice weekly

Current Illness: None

ID: 1044124
Sex: F
Age: 24
State: NY

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: Rash

Other Meds:

Current Illness:

ID: 1044125
Sex: M
Age: 65
State: FL

Vax Date: 02/08/2021
Onset Date: 02/16/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: ACE inhibitors

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

Symptoms: Red rash approximately 4 inches in diameter at injection site. No swelling, pain, or itch. Fading now.

Other Meds: Amlodipine 10 mg 1X day

Current Illness: None

ID: 1044126
Sex: F
Age: 37
State: TX

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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:

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

Symptoms: 7 days after injection, experienced delayed injection site swelling, redness, and itching. Symptoms are a minor discomfort.

Other Meds: Loryna birth control pill, sertraline, rescue inhaler

Current Illness:

ID: 1044127
Sex: F
Age: 29
State: IA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
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: Corn, citric acid, gluten

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

Symptoms: Sore arm, headache, dizziness, fatigue, nausea, body aches, chills, low-grade fever

Other Meds: spironalactone

Current Illness:

ID: 1044128
Sex: F
Age: 66
State: MO

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/21/2021
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: Chills, body ache, head ache, sore swollen arm at vaccine site

Other Meds: Vitamin D, Cholecalciferol, 1000 UNITS CAPS lisinopril-hydroCHLOROthiazide 10-12.5 MG tablet pravastatin 20 MG tablet

Current Illness:

ID: 1044129
Sex: F
Age: 80
State: ME

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/21/2021
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: egg latex

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Where shot was given, noticed a severe itch and on inspection found a rash at site which was approx 3 x 3'". Also very warm at site of injection.

Other Meds: none

Current Illness: none

ID: 1044130
Sex: M
Age: 0
State: NY

Vax Date: 02/21/2021
Onset Date:
Rec V Date: 02/21/2021
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: Soreness at injection site that day, started less sore after 48 hours

Other Meds: The Dr. that gave me the vaccine asked me to report that I take Eliquis 5mg twice a day and have been on it more than a year now

Current Illness: none

ID: 1044131
Sex: F
Age: 29
State: OH

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 02/21/2021
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: Latex, contrast dye

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Altered sense of smell for two weeks. Alteration lingering, but not overwhelming. I also had sore arm, chills, myalgia, joint pain, and fatigue after 1st shot. Second shot just had a sore arm and fatigue.

Other Meds: Birth control

Current Illness: None

ID: 1044132
Sex: F
Age: 17
State: IL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/21/2021
Hospital:

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

Lab Data:

Allergies: Seasonal, Hay fever

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

Symptoms: 17 years old received the first dose of Moderna's COVID -19 vaccine. Moderna recommended that person who receive the vaccine should be 18 years old and older.

Other Meds: Unknown

Current Illness: Unknown

ID: 1044133
Sex: M
Age: 72
State: FL

Vax Date: 02/19/2021
Onset Date: 02/21/2021
Rec V Date: 02/21/2021
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: Penicillin

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Extreme sudden lethargy, similar to blood sugar drop, slurred words, couldn?t keep eyes open.

Other Meds: Omeprazole, propranolol, sertraline, atorvastatin, brupropion, hctz, zolpidem

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm