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: 1046116
Sex: M
Age: 61
State: IN

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Flu-like symptoms lasting about 36 hours (myalgias, arthralgias, malaise, low grade fever, and intermittent chills)

Other Meds: Levoxyl Omeprazole

Current Illness: none

ID: 1046117
Sex: F
Age: 64
State: OH

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: IBUPROFEN, TORADOL, HEPARIN, CODIENE, BIAXIN, ASPRIN, MORPHINE, DILANTIN, VISTARIL, STADOL, AUGMENTIN, AMOXICILLIN

Symptom List: Anxiety, Dyspnoea

Symptoms: 5:20PM 'SOB, DIZZY, THROAT TIGHT'. PLACED ON COT WITH HEAD ELEVATED. CONTINUES TO HAVE SOB. 5:30PM STATES 'FEELING BETTER'. 5:40PM BECOMING SOB AGAIN. 5:55PM INCREASED SOB/DYSPNEA- SQUAD CALLED. IV ATTEMPT X3 WITHOUT SUCCESS. 6:30PM TRANSPORTED TO ER VIA SQUAD, A/O X3, PINK, W/D, SEVERE DYSPNEA. (2-19-21 3PM TC PT RELEASED FROM HOSPITAL THIS AM. FULL RECOVERY .)

Other Meds:

Current Illness: NONE

ID: 1046118
Sex: M
Age: 82
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046119
Sex: F
Age: 61
State: MI

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: PENICILLIN AND SOME NARCOTICS

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: AFTER RECEIVING THE VACCINE, SHE STARTED HAVING DIFFICULTY BREATHING. ONSITE EMS/PHYSICIAN RESPONDED. VITALS ARE BELOW. EMS WANTED TO TRANSFER HER TO EMERGENCY ROOM BUT SHE REFUSED AND WENT HOME AGAINST MEDICAL ADVICE.

Other Meds: VENTOLIN INHALER, QVAR INHALER

Current Illness:

ID: 1046120
Sex: M
Age: 52
State: NV

Vax Date: 01/13/2021
Onset Date: 01/15/2021
Rec V Date: 02/22/2021
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: Broke out in blistered bumps on legs, lingered for a month

Other Meds:

Current Illness:

ID: 1046121
Sex: M
Age: 87
State: KY

Vax Date: 01/20/2021
Onset Date: 01/23/2021
Rec V Date: 02/22/2021
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: penicillin

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

Symptoms: fatigue, high heart rate, sob, low blood pressure, feels cold all the time, no appetitive, palpitations

Other Meds: toprolol, lipitor, flomax,

Current Illness: no

ID: 1046122
Sex: F
Age: 64
State: PA

Vax Date: 02/17/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
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: sulfa

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: delayed cutaneous hypersensitivity reaction,5 x 7 inches, discomfort, mild itch and redness not bothering me

Other Meds: imitrex 100 mg once,Aleve taken once ,amytriptilline 10 mg once

Current Illness: none

ID: 1046123
Sex: F
Age: 40
State: CA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: Lymphoid under left day swollen and bruised. 2 inches under vaccine site was swollen, red and hot to touch. Now bruising down the arm to her elbow. Last Lymphoid behind her left knee was swollen and enlarged.

Other Meds:

Current Illness:

ID: 1046124
Sex: F
Age: 67
State: NC

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: codeine sensitive, lactose intolerance

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: no pain at injection stie; however very severe chills began 12 hours after vaccine, temperature 99.1, brutal joint pain (wrists, hips, knees, ankles, burning & stinging sensation in around nerves and muscles, mild nausea/headache, no sleep for 24 hours. symptoms improved after 48 hours; mild chills, joint/muscle/nerve pain (however, i had some of these symptoms from the chemotherapy and they are now back to that level) i tried to forego pain relievers, but i had to take 2 advil and 2 benadryl 16 hours after the vaccine (around midnight) and took 2 more of each about 12 hours later. drank lots of lemon water to stay rehydrated. normal appetite.

Other Meds: zyrtec, singulair, metopropol, hydrochlorothyzide, paxil, gabsapentin vit d3, calcium, b12, probiotics

Current Illness:

ID: 1046125
Sex: M
Age: 59
State: NY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
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: NONE REPORTED

Symptom List: Diarrhoea, Nasal congestion

Symptoms: RASH APPEARED ON PATIENTS NECK AND TORSO. BENEDRYL 50MG PO ADMINISTERED.

Other Meds: RASH PRESENTED ON PATIENTS NECK AND TORSO. BENEDRYL 50MG PO ADMINISTERED.

Current Illness: NONE REPORTED

ID: 1046126
Sex: F
Age: 76
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046127
Sex: M
Age: 80
State: NY

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: Patient was observed after 15 minutes of vaccination, appeared to be well. 5 minutes after observation person, patient was in the waiting room and stated he was feeling dizzy and lightheaded

Other Meds: Hydrochlorothiazide, isosorbide, atorvastatin, combigan, finasteride, losartan,

Current Illness:

ID: 1046128
Sex: F
Age: 76
State: FL

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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 Codeine

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

Symptoms: Extreme ache, pain and stiffness in left arm, from elbow up into neck and shoulder area. This began on Day 8 after receiving vaccine and has continued through today - 10 days after vaccine 2 Arthritis Tylenol 650 mg

Other Meds: Pravastatin 40mg Amlodipine Medoxim 10-20 mg Ibandronate Sodium 150 mg Venlafaxine 37.5 mg D3 2000 IU CENTRUM SILVER 50+ PreserVision Areds 2 Aller-chlor 4 mg x2 Omeprazole capsule 20 mg

Current Illness: None

ID: 1046129
Sex: F
Age: 70
State: OH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
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: not allergies but hypersensitive to : latex, ct scan dye, ddavp, fentanyl, levaquin, codeine

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

Symptoms: Approx. 1 hr. & 20 min. post injection, severe reaction: Severe upper abdominal pains, multiple, uncontrollable formed to diarrheal bm's triggered vagal response, passed out, severe diaphoresis, violent chilling loss of control of bowel movements. Lasted approx. 30-35 minutes. crawled with head hanging to floor to keep from passing out, to locate a phone for help. after several of agonizing attempts to try and climb up to couch to elevate legs high above head and laying there for approx. 20 or more min. blood pressure came up some. (Did not call emergency services) afraid of hospitalization due to all chronic health problems, (forgot to report earlier that I am Hypothyroid as well) previously hospitalized for a Thyroid Storm. This is day 10 from injection and still have nausea, dizziness & fatigue, (also have couple episodes of abdominal pain). (I want to add that I felt completely fine prior to receiving 2nd Pfizer Covid dose). I am contacting my doctor today to receive some IV fluids.

Other Meds: pyridostigmine, folic acid, pantoprazole, misoprosotol, sodium chloride, biotin, hydroxychloroquine, famotidine (HS), metoprolol

Current Illness: none

ID: 1046130
Sex: F
Age: 33
State: WI

Vax Date: 02/05/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Received first dose on 1/8/21 and second dose on 2/5/21. Mild side effects after first dose (soreness in arm). During 1st 24 hours of having the 2nd dose I had chills, fever, body aches, sleeplessness. Symptoms subsided within 24-48 hours with the arm soreness taking about a week to completely go away. A week and a half after receiving the 2nd dose I noticed a lump on my neck, lower middle near the collarbone. It is significantly pronounced. I saw my primary doctor for an already scheduled physical and she said I was fighting off an infection and it was normal. I mentioned I had the COVID vaccine and she said it isn't uncommon to see the lymph node swell after vaccination and it should go away in a couple of weeks. I wanted to report this because it can freak people out to see a lump in their neck so long after being vaccinated without any other symptoms. We need to list this as a possible side effect on the vaccine information. I feel completely fine except my neck is a little tender/sore from the swollen lymph node.

Other Meds: Doxycycline monohydrate 100 MG capsule 2x daily Sulfacetamide sodium/sulfur 10-5% cream 2x daily

Current Illness: None

ID: 1046131
Sex: F
Age: 39
State: CO

Vax Date: 02/03/2021
Onset Date: 02/10/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, Tree Nuts, Animals/Nature in general

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

Symptoms: 24 Hour Reaction included headache, dizziness, drowsiness 7 days post injection - large circular(ish) rash/hive/raised welt around the injection site. Itched. Anti-itch cream helped. This spot is still residual but is almost gone now. Unknown but estimated started at 5 days post injection, pain/discomfort/swelling in lymph nodes around breasts, especially left side. This discomfort continued 10 plus days after it appeared.

Other Meds: Xanax, Zoloft, Zyrtec, Clonidine, Asmanex, Ventolin, Pepcid AC, Vit D3, Multi-Vitamin, Probiotic

Current Illness: None

ID: 1046133
Sex: F
Age: 26
State: IA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
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: N/A

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

Symptoms: Fatigue, headache, body aches and chills, fever, nausea and vomiting, blurred vision, loss of appetite.

Other Meds: N/A

Current Illness: N/A

ID: 1046134
Sex: F
Age: 76
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046135
Sex: F
Age: 70
State: NY

Vax Date: 02/06/2021
Onset Date: 02/14/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: Allergic to IV contrast and Bactrim

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: On Day 8, my arm developed a rash, first small about 1 " around then the swelling and rash became large all the way to the bra strap line and all the way to the elbow and about 2 inches under the arm. My entire body also became itchy, area on the neck as the same side as the left arm where I had the vaccine.

Other Meds: NONE

Current Illness: NONE

ID: 1046136
Sex: F
Age: 81
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046137
Sex: F
Age: 65
State: NC

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/22/2021
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: Coedine

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

Symptoms: Seven days after receiving the Moderna vaccine my arm started itching, became swollen and a bright red rash appeared at the injection site. The size of the rash was approximately 6 x 4 inches. The itching subsided in approximately 48 hours but it was 9 days before the swelling and the rash finally improved.

Other Meds: None

Current Illness: None

ID: 1046138
Sex: F
Age: 76
State:

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
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: During monitoring period post Pfizer COVID-19 vaccine, pt states she has mild tongue swelling and tongue numbness. VS: 123/72, Given Benadryl 25mg by mouth. Patient was transferred to: home

Other Meds:

Current Illness:

ID: 1046139
Sex: F
Age: 69
State: PA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: Levaquin, Penicillin, Sulfa

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

Symptoms: Moderna COVID-19 Vaccine. About 15 hours after I received the second injection I experienced severe chills, with chattering teeth, while trying to go to sleep. This lasted for several hours. By the morning the chills were gone. My husband, who received the same vaccine at the same time had the same reaction--severe chills.

Other Meds: Simvastatin, Citrucel, Vitamins C & D, Ocuvite, 81 mg Aspirin

Current Illness:

ID: 1046140
Sex: M
Age: 92
State: NY

Vax Date: 02/14/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: Stomach bleeding with NSAIDS Severe headaches with Demerol

Symptom List: Injection site pain, Pain

Symptoms: Rash at site of vaccine on day 5 Extreme fatigue and weakness on day 6 and 7

Other Meds: Levothyroxin, Creon (pancrelipase), Omeprazole, Vitamin B-12, A-Reds eye vitamin, Carafate, Iron infusions

Current Illness: None

ID: 1046141
Sex: F
Age: 30
State: MI

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Had itchyness on skin around neck/throat area

Other Meds: N/A

Current Illness: N/A

ID: 1046142
Sex: M
Age: 80
State:

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046144
Sex: F
Age: 45
State: IA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
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: Penicillin, Sulfa, Kiwi

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Slight fever (99.3-99.5 degrees); headache, nausea/gagging, whole body aches/ very fatigued for approximately 24-36 hours. Took ibuprofen, and slept it off.

Other Meds: Paroxetine, Metformin, Amlodipine, Tylenol PM

Current Illness: None

ID: 1046145
Sex: M
Age: 68
State: NJ

Vax Date: 01/24/2021
Onset Date: 01/27/2021
Rec V Date: 02/22/2021
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: Headache, 102 fever, diarrhea, nausea, dizziness, body aches for 17 days. Then continued sluggishness for another 7 days.

Other Meds: Nothing

Current Illness: Nothing perfect health

ID: 1046146
Sex: F
Age: 73
State: IL

Vax Date: 02/09/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: aspirin, advil, tetracycline, soy, latex, nickel

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

Symptoms: Itchiness at injection site immediately after injection on 2/9/2021. Large -2-3 inch- raised, red, hard, area at injection site 2/22/2021

Other Meds: Losartan/hctz 100/12.5 amlopidine 5mg carvedilol 12.5 mg

Current Illness: none

ID: 1046147
Sex: M
Age: 76
State:

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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 itching after the 2nd dose Pfizer vaccine was given. Given diphenhydramine 25 mg PO. Patient had reported hives after first dose.

Other Meds:

Current Illness:

ID: 1046148
Sex: F
Age: 80
State: OH

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Meds Insect Bites Latex

Symptom List: Injection site pain

Symptoms: approx 1am I woke up and I was shivering so hard the bed was shaking and I could not get up out of bed safely. I have never experienced a chill like this before. 3-4am I was shivering and shaking and so very cold again. this lasted until at least 4-5pm. I was shaky and my voice was shaky. no appetite.

Other Meds: alopurinol amlodipine bisulfate lisinopril spirolactin Vitamin E Vitamin D

Current Illness: No

ID: 1046149
Sex: F
Age: 70
State: CA

Vax Date: 02/12/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: Latex - Contact Dermatitis Sulfa Drugs Skin very sensitive to topical products

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

Symptoms: Red inflamed rash at site of injection

Other Meds: Progesterone 100mg Cap Estradiol 0.5mg Tab Restasis 0.05% Opth. Centrum Silver Multivitamin Ester C Vitamin Glucosamine - Chondroitin Tablets Probiotic 10

Current Illness: None

ID: 1046152
Sex: F
Age: 66
State: CO

Vax Date: 02/19/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: On day 2 after vaccine (Sunday), woke up with very stiff lower back--I never have lower back issues and did nothing to provoke it. Was very stiff the whole day (took Naproxen Sodium AM and again that night.) Much improved when waking up on Monday.

Other Meds: Losarstan 10 mg Zolpidem 5 mg Maganesium time release Vitamin D 6000IU per week

Current Illness: none

ID: 1046153
Sex: F
Age: 63
State: IL

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin; Erythromycin; Ginger Sensitivity to Latex, Green Bell Peppers, Cardamon, Cucumbers

Symptom List: Tremor

Symptoms: Experienced Double Vision about 30 minutes after injection. Cleared within 20 minutes. After 36 hours: injection site tenderness, swelling, (no redness)

Other Meds: None

Current Illness: None

ID: 1046154
Sex: F
Age: 70
State:

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: Patient reported lip tingling at observation station. Given a dose of diphenhydramine 25 mg PO and instructed to take another dose in 4-6 hours.

Other Meds:

Current Illness:

ID: 1046155
Sex: M
Age: 79
State: LA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
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: Penicillin

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

Symptoms: Patient became dizzy 15 minutes after vaccination. Emergency services was called. Patient went into a sleep state for about 15 seconds but with stimulation was responsive and was able to speak to me immediately. Patient then became nauseated and approximately 10 minutes from start of event vomited. After this the patient began to feel better. Paramedics arrived and evaluated patient. Blood pressure, pulse, oxygen level, glucose level were all normal. Patient was convinced to go to Emergency Room with paramedics to be evaluated.

Other Meds: N/A

Current Illness: Wife mentioned sees Cardiologist. No other information available.

ID: 1046156
Sex: M
Age: 82
State:

Vax Date: 01/26/2021
Onset Date: 02/08/2021
Rec V Date: 02/22/2021
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: Codeine, Shellfish

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

Symptoms: Patient was asymptomatic to COVID and presented to the hospital for other health conditions. While in the hospital, patient was tested for COVID (standard protocol) left nasal swab via SARS-CoV-2 Test (T2 Biosystem/ T2SARS-CoV-2 Panel) and the result came back positive. This is on 2/8, roughly 2 weeks after first dose of Pfizer vaccination. Per physician, "Patient was COVID positive, but asymptomatic, no leucocytosis, no fever, CXR showed no signs of PNA, and pt SaO2 above 95% on RA". Patient was continue to be monitored and isolated. Patient was discharged once stable for his admitting condition other than COVID

Other Meds:

Current Illness:

ID: 1046157
Sex: F
Age: 61
State: AZ

Vax Date: 02/10/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: Levaquin stomach cramping and hallucinations PCN rash

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: developed a skin rash on the same arm where vaccinated, nine days after the shot. It is red, firm and itchy. Then blisters

Other Meds: acyclovir 400 mg tabs, 1 tab tid x 5 days as needed for flare ups

Current Illness: Hyperlipidemia E78.5 Osteopenia M85.88 Herpes simplex infection

ID: 1046158
Sex: M
Age: 63
State: MI

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: Lisinopril

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

Symptoms: Patient experienced Chest pain & was diaphoretic approx 5 minutes after vaccination. Onsite EMS was called vitals BP 168/107 HR 63 100% O2 room air. No past reaction to vaccine, last flu vaccine in September. Patient said he was feeling better after approx 10 minutes. Relased to home.

Other Meds: Lisinopril

Current Illness:

ID: 1046159
Sex: F
Age: 16
State: TX

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: PATIENT HAD NO ADVERSE EVENT. THIS REPORT IS BECAUSE THE PATIENT IS BELOW THE RECOMMENDED AGE. THE PATIENT'S PHYSICIAN AUTHORIZED THE IMMUNIZATION

Other Meds:

Current Illness:

ID: 1046160
Sex: F
Age: 67
State: PA

Vax Date: 02/10/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: milk

Symptom List: Pain in extremity

Symptoms: About 10 days after the vaccine there was itching at the vaccine site. 12 days later there was a rash approximately 4 inches in diameter. I am hoping it goes away on it's own.

Other Meds: multi vitamin, baby aspirin, calcium w/D, B complex, Farxiga, Trulicity, Metformin, glimiperide, omeprazole

Current Illness:

ID: 1046161
Sex: F
Age: 49
State:

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Heart racing, feeling hot, feeling like world is closing in. 10:49 improved and discharged home.

Other Meds:

Current Illness:

ID: 1046162
Sex: F
Age: 71
State: AZ

Vax Date: 02/13/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Phenylpropanolamine

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

Symptoms: Eight days after the first vaccination, the injection site became inflamed, reddened, and itchy in an approximate 3-inch area. I Will continue to observe.

Other Meds: Lisinopril 2.5 mg; Daily NP Thyroid 90 mg Daily

Current Illness: None

ID: 1046163
Sex: F
Age: 54
State: GA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/22/2021
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: Seasonal, grass

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

Symptoms: Itching at injection site and sporadic itching in multiple areas of body. Itching, very dry skin centralized on face starting Friday, February 19 around 5 PM. It continues. Benadryl 25 mg taken by mouth.

Other Meds: Multi-Vitamins

Current Illness: None

ID: 1046164
Sex: F
Age: 75
State:

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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:

Symptom List: Vomiting

Symptoms: Patient self-reported left arm pain traveling down her arm after second dose of covid vaccine (pfizer) administration. Patient has documented history of anaphylaxis with IV contrast. EMS on-site provided cardiac monitoring. Observed elevated BP.

Other Meds:

Current Illness:

ID: 1046165
Sex: F
Age: 44
State: OH

Vax Date: 02/02/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
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: Reglan

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Shingles developed on the right upper back 3 weeks after the rash

Other Meds: Losartan, Lexapro, Klonopin

Current Illness: none

ID: 1046166
Sex: F
Age: 75
State: NY

Vax Date: 02/12/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
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: Cipro, Levaquin (rapid heart beat), anaphylaxis to antihistamines. Vancomycin (passed out during surgery and discontinued), Keflex (doesn't know the reaction was in surgery and almost died from a ruptured uterus, told not to take it).

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

Symptoms: Yesterday 2/21/21 started having itching on her arm, round area when she looked in the mirror at the time of her vaccine. Area is warm, very itchy and 1 1/2" x 1 1/2" in size. The area is also red today, intensely itchy. Did put cortisone cream on it yesterday, which didn't make it go away, possibly reduced the itching some, but not much. She does also have a headache today. She takes a lot of vitamins, and has not taken anything else for the reactions.

Other Meds: Women's multivitamin, Elizine, Chromium, vitamin D3, Selenium, Vitamin C, Zinc, Vitamin A, Biotin, CoQ10, Super B complex, calcium, Magnesium, Lycopene, Resveratrol, Ginseng, chlorella, B1, Elglutamine, black current seed oil, milk thistle

Current Illness: None.

ID: 1046167
Sex: F
Age: 32
State: PA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 12 hours later symptoms of- diarrhea, severe vomiting, chills, body aches, fatigue, light/touch/sound sensitivity, dizziness 24 hours later symptoms continued except for diarrhea and vomiting. New symptoms of heart palpitations, dizziness, difficulty taking deep breaths, continued sxs of light/sound sensitivity, body aches, fatigue, night sweats 48 hours later- most symptoms better but continued fatigue, difficulty taking deep breaths, heart palpitations, night sweats

Other Meds: Escitalopram 10mg daily, Spironolactone 100mg daily

Current Illness: none,

ID: 1046168
Sex: F
Age: 85
State:

Vax Date: 02/20/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Fever 101.5. Chills body aches

Other Meds: Levothroid. Losarten amlopidine plavix

Current Illness:

ID: 1046169
Sex: F
Age: 72
State:

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Pt. reports she developed aches and pain- low back and knee. Chills and an abdominal pain that started yesterday that lasted until she went to bed last night at 10 pm/

Other Meds: Anastrozole, B12, calcium, hydrochlorothiazide, rosuvastatin

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm