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: 0931084
Sex: F
Age: 48
State: OR

Vax Date: 12/30/2020
Onset Date: 01/01/2021
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: LA

Lab Data:

Allergies: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever of 101 for three days. Around 8 pm on January 1st sever vertigo anytime changing position. Went to open MD who recommended epley maneuver . Was told to do this for "several days" and then come back if it did not go away. Maneuver was done for three days before vertigo went away, but constant dizziness for another three days, and then intermittent dizziness still ongoing. Called into work.

Other Meds: Ibuprofen. Vitamin D.

Current Illness: none

ID: 0931085
Sex: F
Age: 43
State: PR

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/09/2021
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: Intolerance to Penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: the area got hardened, hot and red.

Other Meds: Zoloft, Atacand, Vitamin C, Zinc, Vitamin B, Vitamin D

Current Illness: None

ID: 0931086
Sex: F
Age: 26
State: IN

Vax Date: 12/17/2020
Onset Date: 12/22/2020
Rec V Date: 01/09/2021
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: Cervical and supraclavicular lymphadenopathy on the same side as injection. Worsened after second vaccine dose

Other Meds: Birth control Xyzal

Current Illness: None

ID: 0931087
Sex: F
Age: 67
State: PA

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Lidocaine local??

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: on day 8 following the vaccine administration, I developed itching at the vaccination site (L deltoid). On day 9, in the morning I noticed redness, heat, and itching at vaccination site-for an area of about 4" long and 2" wide. Today, the area is slightly less reddened but still very itchy. I have no other signs or symptoms. I was responding daily to V-Safe check ins but the the last text that I received from them was on Wednesday, January 6. I have not been able to contact them to report the change in my signs and symptoms since this reaction has occured after their check-ins with me, stopped. I am a nurse and feel it is improtant for you to know all reactions which I why I am contacting you. I could not find another site or place to report this. Thank you!

Other Meds: Levothyroxine

Current Illness: none

ID: 0931088
Sex: F
Age: 84
State: FL

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: LA

Lab Data:

Allergies: No

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

Symptoms: Headdache Trembling in the Body Tiredness Chills

Other Meds: Losaltan 50mg Lebotirozine 88mg Gripizide 10mg two daily Tradjenta 5mg

Current Illness: No

ID: 0931089
Sex: F
Age: 45
State: TX

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Zpak. Medrol

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

Symptoms: Fever, body aches, headaches, tiredness

Other Meds:

Current Illness:

ID: 0931090
Sex: M
Age: 54
State: NC

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: N/a

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Severe arm and shoulder pain. Unable to lift arm or move back and forth.

Other Meds: Synthroid Crestor Aimovig Hydrocortisone Testosterone Fish oil Senna Multivitamin

Current Illness: N/a

ID: 0931091
Sex: M
Age: 45
State: IN

Vax Date: 01/07/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: Fever, treated with Tylenol Chills Body Aches Fatigue Symptoms lasted about 24 hours

Other Meds: Amlodipine 10MG Clonidine 0.2 MG Cetirizine 10MG HydrAlazine 25MG Metoprolol Tart 100MG Minoxidil 2.5 MG PotaChloride ER 20MEQ Spirono/HCTZ 25/25 Verapamin ER 240MG Pravastatin 40MG

Current Illness: I had Covid with my first symptom started on Dec. 3rd 2021, tested positive on Dec. 7th 2020

ID: 0931092
Sex: F
Age: 42
State: VA

Vax Date: 12/30/2020
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Redness and warmth 1 inch by 4 inch that developed 9 days post vaccine. Treated for cellulite with keflex 500 mg 4x faily

Other Meds: Lisinopril 2.5 mg daily, dexilant 60 mg daily, fish oil, vit b complex, vitamin d

Current Illness: None

ID: 0931093
Sex: F
Age: 23
State: PA

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
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: Axillary pain started on day 4 (1/4) after vaccine and continued until day 7 which was so bad I could not sleep or move that arm. Took 1 Aleve for the pain. Then on day 7 axillary pain went away and a rash started to form on arm where vaccine was given. Day 8 rash spread at was bright red. Around noon on day 8 hives popped up next to left eye. On day 8 did a virtual doctor appointment and the NP prescribed antibiotics because she said the "rash" is cellulitis. At this time took zytec to help with the hives.

Other Meds:

Current Illness:

ID: 0931094
Sex: F
Age: 27
State: IN

Vax Date: 01/07/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Zithromax antibiotic

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

Symptoms: Mild body aches with moderate to severe body chills from 9pm until 5am the evening of the shot. Patient was ?freezing? despite multiple thick layers of clothing and bed linens. Unclear if there was a fever involved - temperature was never taken at home during the event.

Other Meds: Zyrtec

Current Illness: Menstrating at the time of vaccination; no history of illnesses

ID: 0931095
Sex: F
Age: 50
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Gluten and Dairy Intolerant

Symptom List: Rash, Urticaria

Symptoms: Severe muscle aches, headache, fatigue

Other Meds: Claritin, Q10 CoEnzyme, Vitamins, Iron

Current Illness:

ID: 0931096
Sex: F
Age: 25
State: IL

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: LA

Lab Data:

Allergies: NSAIDS

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

Symptoms: FEVER 103

Other Meds: BACLOFEN 15 MG TID,DULCOLAX SUP DAILY,CLONAZEPAM 0.5 MG TID,FLOVENT AER HFA VIA PUFFS BID,KELNOR 1/35 DAILY,MIRALAX 17 GM DAILY,MONTELUKAST 4 MG HS,PRILOSEC 20 MG QPM,TOPIRAMATE 50 MG BID,

Current Illness: NONE

ID: 0931097
Sex: M
Age: 26
State: NY

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: 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: Extreme pain in upper left arm where vaccine was given. Can barely move left arm. Has been 24 hours and still extremely painful.

Other Meds: None

Current Illness: None

ID: 0931098
Sex: F
Age: 51
State: CT

Vax Date: 12/30/2020
Onset Date: 01/06/2021
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: codine Augmenten

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

Symptoms: 7 days after vaccine site started to itch. On the 8th day site was red, inflamed and warm to the touch. Mild pain upon palpation

Other Meds: Hydroxychloroquin 200mg Ibuprofen 600mg

Current Illness:

ID: 0931099
Sex: F
Age: 39
State: MA

Vax Date: 12/29/2020
Onset Date: 01/09/2021
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: Lamisil, bactrim

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

Symptoms: I have a 16 month old daughter and am 15 weeks pregnant with my second, due date July 2, 2021. I noticed today redness and swelling at the injection site after showering, slightly itchy when touched

Other Meds: Levothyroxine, prenatal multivitamin, iron

Current Illness: None

ID: 0931100
Sex: F
Age: 23
State: KY

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
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: precedex latex

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

Symptoms: patient received dose 1 of moderna covid vaccine at 9:32am; pt c/o redness/irritation around chest /neck area at 09:42; 50mg oral benadryl and 20mg oral pepcid administered; 10:23 redness almost resolved and itching almost completely resolved; patient sent home with instructions on reporting to ER if symptoms should worsen and instructions on premedications for next vaccine. pt verbalized understanding of all instructions.

Other Meds: singulair flonase

Current Illness: none

ID: 0931101
Sex: M
Age: 34
State:

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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: Vomitting, chills, fever, body aches. All symptoms were gone about 12 hours after onset

Other Meds:

Current Illness:

ID: 0931102
Sex: F
Age: 34
State: PA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Redness, swelling, subcutaneous fluid at injection site. Still present after over a week. One week after administration onset of pain in armpit. Practicioner prescribed treatment with antibiotics for 5 days because of a likely cellulitis.

Other Meds: Venlafaxine ER 37.5mg

Current Illness:

ID: 0931103
Sex: M
Age: 24
State: PR

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

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

Lab Data:

Allergies: Shellfish

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

Symptoms: Fever, chills, cold sweats, fatigue, dry cough, headache, muscle pain, and weakness lasting 12 hours starting at around 24 hours after vaccine administration. Patient took two Tylenol 500mg to some relief at 2pm and again at 7pm.

Other Meds: Montelukast, alburerol

Current Illness: None

ID: 0931104
Sex: M
Age: 31
State: NY

Vax Date: 12/27/2020
Onset Date: 12/27/2020
Rec V Date: 01/09/2021
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: Ceclor Bactrim

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

Symptoms: Injection Site Pain, Severe, 12/27-12/28, Self-Resolved Chills, 12/27-12/28, mild, Self-Resolved Headaches, 12/27-12/28, Severe, Self-Resolved Malaise, 12/27-12/28, Moderate, Self-Resolved Myalgias, 12/27-12/29, Moderate, Self-Resolved Arthralgias, 12/27-12/28, Moderate, Self-Resolved Lymphadenopathy, 12/27-12/28, Mild, Self-Resolved

Other Meds: Vegan Protein powder

Current Illness: None

ID: 0931105
Sex: F
Age:
State: VA

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: None

Symptom List: Unevaluable event

Symptoms: Severe body aches, fatigue, headache, chills, fever.

Other Meds: None

Current Illness: None

ID: 0931106
Sex: F
Age: 50
State: NY

Vax Date: 12/28/2020
Onset Date: 12/29/2020
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: LA

Lab Data:

Allergies: None

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

Symptoms: Tachycardia, beginning 12/29/20, or noted at time of awakening, heart rate of 68-161 beginning at 6am-7am. I watch documents rate on 12/29/20 from 7am resting rate 76, walking rate of 140. This rate is not the normal as patient normally walks to work but this date chose to take a cab, rate of 140 not normal resting rate. Rate ranges 150-on 12/29-to 55-209 on 12/30/2020, resting rate of 66. Walking rate of 103, Did not not exercise rest of the week because of this elevated rate. Felt colder than normal. One week prior rate was 12/22/2020. Range was 59-127, resting 62, walking 107. Rate week of 1/5/2021 ranges 49-158, resting 55 and walking is 91. 1/8/2021 rate ranges from 54-145, resting 59, walking 100.

Other Meds: None

Current Illness: None

ID: 0931107
Sex: F
Age: 34
State:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: body aches, chills, headache, subjective fever

Other Meds:

Current Illness:

ID: 0931109
Sex: F
Age: 35
State: IN

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: SYR
Vax Site: LA

Lab Data:

Allergies: mobic

Symptom List: Injection site pain, Menorrhagia

Symptoms: 01/07/21 tingling and numbness in whole right arm right after vaccine administration 01/08/21 woke up about 230am with severe body aches (flu like) and severe arm pain not just soreness where vaccine was given but whole upper arm that lasted all day and went on for almost two whole days

Other Meds: none

Current Illness: slight cough

ID: 0931110
Sex: M
Age: 26
State:

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: fever 100.5F, malaise, myalgia, headache, and rigors x 2 days. responded well to acetaminophen and ibuprofen

Other Meds:

Current Illness:

ID: 0931111
Sex: F
Age: 30
State: NY

Vax Date: 12/30/2020
Onset Date: 01/02/2021
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: Lactose

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Tinnitus

Other Meds:

Current Illness:

ID: 0931112
Sex: F
Age: 66
State: NV

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

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chills, headache, low-grade fever

Other Meds: Bupropion SR 150 mg Diclofenac Sodium 75 mg Lisinopril 10 mg Atorvastatin 10 mg

Current Illness: None

ID: 0931113
Sex: F
Age: 26
State: IN

Vax Date: 01/07/2021
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: Fatigue, body aches for 48 hours.

Other Meds:

Current Illness:

ID: 0931114
Sex: M
Age: 45
State: CO

Vax Date: 01/04/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: latex

Symptom List: Nausea

Symptoms: tachycardia, metroprolol

Other Meds: ibuprophen, multivtamin

Current Illness: none

ID: 0931115
Sex: M
Age: 58
State: PR

Vax Date: 01/07/2021
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: NONE KNOWN

Symptom List: Injection site pain

Symptoms: FEVER, CHILLS, FATIGUE, GENERAL MALAISE, HEADACHE, JOINT ACHE, ACETAMINOPHEN 250 EVERY 12 HRS ASPIRIN 250 EVERY 12 HRS

Other Meds: TOPROL XL OXYBUTININ LIPITOR PEPCID ASPIRIN 81 MG

Current Illness: NONE KNOWN

ID: 0931116
Sex: M
Age: 42
State: TX

Vax Date: 12/26/2020
Onset Date: 12/28/2020
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: Penicillin and morphine

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

Symptoms: Chills, high fever, and was very tired.

Other Meds:

Current Illness:

ID: 0931117
Sex: M
Age: 39
State: MA

Vax Date: 01/06/2021
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: RA

Lab Data:

Allergies: none

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

Symptoms: 2 days after vaccination: fever of 100.4F, headache, rigors. As of today, symptoms persist

Other Meds: Krill oil, vitamin D 5000 units, nasal fluticasone spray

Current Illness: none

ID: 0931118
Sex: M
Age: 67
State: MI

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

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: Moderna COVID-19 Vaccine EUA Darker than normal urine for 2 days......I apologize if this is not considered an 'adverse event'. it is unusual for me.

Other Meds: Tylenol 3 Flomax Advodart Multi Vitamin Vitamin B12 Calcium Omega 3

Current Illness: none

ID: 0931119
Sex: M
Age: 50
State: WA

Vax Date: 01/07/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Sharp piercing left sided chest pain that radiated to left shoulder and back 7-8/10 on pain scale. Taking a deep breath made pain worse but no associated shortness of breath. Pain worsened with attempting to eat food. Severe symptoms lasted 2-3 hours and then subsided. Troponin and other cardiac markers negative. No history of GI, cardiac, or pulmonary disorders. Mildly present the first half of the next day (1-2/10) until afternoon then completely resolved

Other Meds: tadalafil, MVI, Vitamin D,

Current Illness: None

ID: 0931120
Sex: F
Age: 44
State: NY

Vax Date: 12/30/2020
Onset Date: 01/07/2021
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: N/A

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

Symptoms: Eight days after injection, I noticed a red lump, warm to the touch at injection site. No pain

Other Meds: spironolactone 50mg

Current Illness: none

ID: 0931121
Sex: M
Age: 60
State: NC

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: 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: light headache Fever for 48 hrs reaching 102

Other Meds:

Current Illness:

ID: 0931122
Sex: F
Age: 47
State: KY

Vax Date: 01/09/2021
Onset Date: 01/09/2021
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: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 09:32--pt received dose 1 moderna vaccine 09:37-pt c/o generalized itching/mild redness on forearms and abdominal area pt took 25mg oral benadryl of own supply and 25mg oral benadryl pharmacy supply + 20mg oral pepcid 10:15--pt reports resolution of symptoms and verbalizes understanding of premedications for next vaccine and will report to ER should symptoms change

Other Meds: hctz singulair daily allergy medication

Current Illness: hypertension endometriosis acid reflex

ID: 0931123
Sex: F
Age: 43
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: Penicillin Sulfa Zantac

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

Symptoms: Headache Body aches Nausea Arm pain

Other Meds: Zinc 5mg Enalapril 5mg

Current Illness:

ID: 0931124
Sex: F
Age: 44
State: NH

Vax Date: 12/30/2020
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: Rash with blood transfusions, Sulfa Drugs

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

Symptoms: Onset of pain of the Arm 1/6/2021. Following day increasing redness and pain. on 1/8 8 x 13 cm on Left arm. Where insertion site was warmth, redness.

Other Meds: Topamax, Effexor, Maxalt, Lorazepam, Oxycodone/Tylenol, Ambien, estradiol

Current Illness: Chronic Migraines, Anxiety

ID: 0931125
Sex: F
Age: 45
State: WI

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: No

Symptom List: Pain in extremity

Symptoms: Diffuse muscle aches Nausea Fever/chills

Other Meds: Advair Wellbutrin Albuterol Synthroid

Current Illness: No

ID: 0931126
Sex: F
Age: 29
State: IN

Vax Date: 01/07/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: none

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

Symptoms: Arm tingling, more prevalent in right arm, face tingling R>L. Tingling started at 0030 1/8, only lasted a few hours. Intense body aches, chills, low grade temp, started at 00:30 and ended by 1800. Still experiencing intermittent chills, flushing, and sweating.

Other Meds: Nortriptyline Adderall multivitamin

Current Illness: none

ID: 0931127
Sex: M
Age: 30
State: MA

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

Lab Data:

Allergies: None

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

Symptoms: Severe chills late that night of the second vaccination. Migrane as well as light sensitivity. Preassure in the head as well as vertigo. Chills have almost resolved this morning into the next day after vaccination. The migranes, head preassure and vertigo still persist.

Other Meds: Dayquil and Nyquil

Current Illness: Cold

ID: 0931128
Sex: F
Age: 43
State: CA

Vax Date: 01/04/2021
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: Propylene Glycol

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

Symptoms: Hives began on hands early morning Wednesday. Friday hives on legs. Saturday both arms, legs, feet have hives. Have headache since receiving vaccination. Swollen, painful axillary lymph nodes on side of injection from Monday and still sore today on Saturday.

Other Meds: Lexapro, Trazodone, Montelukast

Current Illness: None

ID: 0931129
Sex: M
Age: 66
State: CO

Vax Date: 12/31/2020
Onset Date: 01/03/2021
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: Both eyes became very itchy on Saturday January 2. Sunday morning January 3, my left eye was very red. Both eyes very dry and itchy. By noon Sunday, left eye redness gone. Both eyes itchy. Monday the 4th, ithcy gone but both eyes very dry. By Wednesday the 6th all back to normal. No other symptoms related to vaccination during this period.

Other Meds: none

Current Illness: none

ID: 0931130
Sex: M
Age: 34
State: MN

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: headache, muscle pain, joint pain, chills, fever

Other Meds: Adderall, 10 mg 3xdaily Finesteride, 1 mg daily Aspirin, 81 mg daily

Current Illness: none

ID: 0931131
Sex: F
Age: 40
State: MN

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: Percocet Shellfish Fentynal Iohexol Tramadol Erythromycin

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

Symptoms: Shot was given lower in arm than it should have been. There is a hard, warm and red bump where given. Its starting to get itchy as well.

Other Meds: Metoprolol Citalopram Imitrex Wellbutrin Lisinopril-HCTZ Metformin ER Tordol Stelara

Current Illness: Migraine

ID: 0931132
Sex: F
Age: 48
State: NH

Vax Date: 12/30/2020
Onset Date: 01/08/2021
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: Cats, dust, trees, morphine, demoral, sulfa drugs, pcn, adhesive tape

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Localized reaction- redness, swelling, itchy. L, warm to touch. Treated with cortisone cream

Other Meds: Zyrtec, Singulair, fluticasone nasal spray, levothyroxine 150 mcg, multivitamin, vit D 1000 mg, b complex, vit C 1000 mg, probiotics,l, omeprazole, fish oil

Current Illness: None

ID: 0931133
Sex: F
Age: 29
State: IN

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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Started with chills, then fevers, then headaches and extreme fatigue.

Other Meds: None

Current Illness: None

ID: 0931134
Sex: M
Age: 38
State: TX

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: Penicillin, aspirin

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

Symptoms: Chills, body aches, joint pain, weakness

Other Meds: Zyrtec, flonase

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm