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: 1046220
Sex: F
Age: 29
State:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Redness chest, neck , upper body shoulders and neck. 10:30 am redness and itching improving. 11:15am improved, discharged home.

Other Meds:

Current Illness:

ID: 1046221
Sex: F
Age: 51
State: MD

Vax Date: 02/08/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
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: nka

Symptom List: Anxiety, Dyspnoea

Symptoms: Large red, itchy rash spreading from injection site down and across arm starting 12 days after 1st vaccine dose, continues to itch 2 days later, has gotten larger and has raised edges.

Other Meds: carvedilol, telmisartan, fish oil cap, ginger cap, cinnamon cap, marine collagen cap, multivitamin, probiotic cap

Current Illness: none

ID: 1046222
Sex: F
Age: 48
State:

Vax Date: 02/17/2021
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: 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: Big blister on right ankle since 02/17/2021 minutes after my second vaccine dose

Other Meds: None

Current Illness: None

ID: 1046223
Sex: F
Age: 77
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

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

Other Meds:

Current Illness:

ID: 1046224
Sex: U
Age:
State: IL

Vax Date:
Onset Date:
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: SEVERE HEADACHE

Other Meds:

Current Illness:

ID: 1046225
Sex: F
Age: 44
State:

Vax Date: 02/12/2021
Onset Date: 02/16/2021
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: Codeine - itching

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

Symptoms: 4 days after injection developed axillary lymphadenopathy with soreness from under the arm extending to the L breast causing pain with sleeping on that side, no erythema or edema, no fever or chills, resolved after 2 days with ibuprofen, cool/ice compresses

Other Meds:

Current Illness:

ID: 1046226
Sex: F
Age: 68
State: CA

Vax Date: 02/16/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Itchy red upper arm started approximately 5 days post-injection on the deltoid muscle of the left arm. Had been given a Vit B-12 shot in the same arm 4 days prior. Approximately 4 inches in circumference.

Other Meds: Revlimid, colesevelam, acyclovir, aspirin 81 mg, vitamin c

Current Illness:

ID: 1046227
Sex: M
Age: 71
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: About an hour after the shot I felt nauseous and light-headed and a little mild weakness. It sort of came in mild waves over the course of 2 to 3 hours. Never really disabled me just bothersome and made me want to just sit. Symptoms seemed to disappear after I ate supper. I felt fine the next morning save fore some soreness just below the injection site.

Other Meds: None

Current Illness: None

ID: 1046228
Sex: F
Age: 34
State: DE

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

Lab Data:

Allergies: Tetracycline

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Face became tingly and numb - lasted about 10 minutes Later that night I also experienced tingling and numbness and heaviness of the left side of my body (specifically arm and leg) on the affected/vaccinated side, drouth, and sleeplessness for about 2 hours

Other Meds: Plexus supplements: slim hunger control, bio cleanse (magnesium), pro biotic, metaburn Fluoxetine 20mg Claritin 24 hr 10mg B12 supplement Cal-mag-zinc D3 (2000IU)

Current Illness: N/A

ID: 1046229
Sex: M
Age: 78
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

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

Other Meds:

Current Illness:

Date Died: 02/20/2021

ID: 1046230
Sex: M
Age: 68
State: OK

Vax Date: 02/04/2021
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:

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

Symptoms: Death. My father-in-law was found unexpectedly deceased in his home Saturday morning. He worked the previous day.

Other Meds:

Current Illness: Diabetes

ID: 1046231
Sex: F
Age: 51
State: IL

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: SYR
Vax Site: RA

Lab Data:

Allergies: sulfa, penicillin, ibuprofen, codeine

Symptom List: Rash, Urticaria

Symptoms: Covid Arm - red and sore at injection site 8 days following vaccine.

Other Meds: Zyrtec, Fish oil, Curcumin, probiotics

Current Illness: None

ID: 1046232
Sex: F
Age: 80
State: MI

Vax Date: 01/30/2021
Onset Date: 01/31/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Emesis X 2

Other Meds:

Current Illness:

ID: 1046233
Sex: M
Age: 78
State: KY

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:

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

Symptoms: Boost dose given prior to recommended 28 day interval. (given on day 20)

Other Meds:

Current Illness:

ID: 1046234
Sex: F
Age: 78
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: 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: Administration error - Vaccine was under diluted, and patient received dose calculated to be approximately 25% more than recommended.

Other Meds:

Current Illness:

ID: 1046235
Sex: F
Age: 34
State: IL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: NEXIUM

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

Symptoms: PATIENT STARTED ITCHING WITHIN 15 MINUTES OF BEING VACCINATED AND DEVELOPED HIVES. SHE WAS GIVEN BENADRYL IM AND WAS ADVISED TO TAKE BENARYL LATER IN THE DAY IF NEEDED. SHE STATES SHE TOOK MOVE BENADRYL LATER IN THE EVENING. SHE STATED SHE WAS WEAK, DEVELOPED A LOW-GRADE FEVER, AND OTHER FLU-LIKE SYMPTOMS.

Other Meds: UNKNOWN

Current Illness: RHEUMATOID ARTHITIS AND ANEMIA

ID: 1046236
Sex: F
Age: 74
State: CA

Vax Date: 02/14/2021
Onset Date: 02/16/2021
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: Latex

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

Symptoms: Redness at vaccination site, hardness and itching around site - Covid arm.

Other Meds: Vitamins

Current Illness: None

ID: 1046237
Sex: F
Age: 75
State: FL

Vax Date: 02/13/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Tightness, a little itchy, swollen, red rash today, a little sore (02/22/2021)

Other Meds: Only prescription is Atorvastatin. Over the counter supplements include Daily multivitamin, Omega 3, calcium, vitamin C, PreserVision, Turmuric, Magnesium

Current Illness: None

ID: 1046238
Sex: U
Age:
State:

Vax Date:
Onset Date:
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: HEADACHE, BODY PAIN, AND FEVER

Other Meds:

Current Illness:

ID: 1046239
Sex: F
Age: 25
State: MD

Vax Date: 12/28/2020
Onset Date: 01/04/2021
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: Latex (sensitivity)

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

Symptoms: 12/28 Vaccination 1/4 6-7 days lays, adenopathy, cervical lymph node swelling. HA relieved by Tylenol. Mild arm pain, similar flu shot. 48 hours later cleared up after taking Benadryl. Saw occupational health. Prescribed Claritin, hydrocortisone cream.

Other Meds: Birth control

Current Illness: n/a

ID: 1046240
Sex: F
Age: 79
State: AZ

Vax Date: 02/11/2021
Onset Date: 02/13/2021
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: Penicillin Vicodin

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

Symptoms: Redness on the thighs, legs, and chest. very little redness on my arm(s). I was watching tv 3 days after receiving the vaccine and my palms were suddenly blue and I could see every vein in my hands and fingers. they were cold and color returned after submerging them in warm water.

Other Meds: Plavix Losartan Toprol Zetia Aspirin Multi vitamin D C Fish oil

Current Illness: No

ID: 1046242
Sex: F
Age: 31
State:

Vax Date: 02/12/2021
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: penicillin, Ceclor - hives; unknown substance-anaphylaxis

Symptom List: Unevaluable event

Symptoms: 6 days after injection developed redness (2 inch diameter), edema, itching, firmness to injection site and axillary lymphadenopathy with soreness from under the arm extending to the L breast causing pain with sleeping on that side, no erythema or edema to axillary or chest areas, no fever or chills, resolving after 2 days with ibuprofen, cool/ice compresses, benadryl cream to site Saw pt by televisit and looks like injection might have been given too low and might have been SC instead of IM

Other Meds:

Current Illness:

ID: 1046243
Sex: F
Age: 45
State:

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

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

Symptoms: First Lot 025L20A Moderna Reactions Head ache, lips swelling. Diarrhea, stomach issues, dizzy, fatigue, chills in feet and hands. Second one Headache, nausea, fatigue, body aches, joint pain. Vaccine site real sore.

Other Meds:

Current Illness:

ID: 1046244
Sex: F
Age: 45
State: OH

Vax Date: 02/13/2021
Onset Date: 02/14/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: Woke up on 02/14/2021 and had no sense of taste or smell. 2 negative covid tests. Also extreme fatigue, shortness of breath, increased HR with little to no movement noticed. Occasional chest pains. To this date, the symptoms still exist.

Other Meds: Tylenol, Nasal Saline rinse, flonase, singular

Current Illness: None

ID: 1046245
Sex: M
Age: 75
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: Injection site pain, Menorrhagia

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

Other Meds:

Current Illness:

ID: 1046246
Sex: F
Age: 46
State: NJ

Vax Date: 02/17/2021
Onset Date: 02/19/2021
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: N/A

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

Symptoms: I already have chronic urticaria but it is well-managed by taking Allegra, QD (OTC). I had to increase my dose of Allegra to BID because the itching has intensified. I am getting an increased amount of random red/swollen itchy spots, mostly in my extremities. Other adverse events present post dose include: nausea, fatigue, mild headache and mild dizziness.

Other Meds: Allegra; Zoloft; Spironolactone; Vitamin C, Zinc

Current Illness:

ID: 1046247
Sex: F
Age: 76
State: KY

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Boost doses given prior to 28 days (given on day 20)

Other Meds:

Current Illness:

ID: 1046249
Sex: F
Age: 72
State: KY

Vax Date: 02/05/2021
Onset Date: 02/07/2021
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: food dyes(red, yellow and blue)-rash macrolides-rash Quinolones-rash Penicillin-rash ceftin-rash Benazepril-rash Imiquimod topical-bumps on scalp after applying to chest

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient received Pfizer Covid vaccine # 1 02/05/2021. She developed the bumps on scalp (15 raised nodules and sores around her mouth). She states the bumps wer not itchy and were no where else but on scalp. The sores around mouth were non vessicular. She did not present until 02/13/2021 and had taken steroids at home as she has so many reactions. 1 day she took 20 mg and the next 10 mg. several days later another 10 mg pill. On 02/13/2021 the scalp bumps not the lip sores were non visible. The was 1 raised area on the side of left face that appeared to be a stuck on lesion. She states the steroids took car of the rest. She was instructed to follow up with PCP and Dr to see if she should take second vaccine. Er for any s/s of distress. I dod not give her any additional therapy as the symptoms had abated.

Other Meds: zyrtec 10 mg daily by mouth, Vitamin D3 2000iu daily by mouth, Calcium 600 plus twice daily by mouth, vitamin B-12 500 daily by mouth, Multi-vitamin with minerals for women daily by mouth, Vitamin C 500 mg daily by mouty, Losartan daily

Current Illness: none

ID: 1046250
Sex: F
Age: 68
State: MI

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: RA

Lab Data:

Allergies: wasp sting caused anaphalyxis

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

Symptoms: Moderna injection on Thursday 2/18/2021, Friday at 7 pm facial swelling and redness appeared. Eyes are swollen, whole face and welts all over, sore throat for 2 days, Denies fever. Mild wheezing/little winded. Welts over whole body, hips and ankle. Itching in unusual places. Denies swollen tongue. Seen on 2/20/21 at urgent care.

Other Meds: albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler aspirin-acetaminophen-caffeine (EXCEDRIN MIGRAINE) 250-250-65 MG per tablet EPINEPHrine 0.3 MG/0.3ML auto-injector Fluticasone-Salmeterol 113-14 MCG/ACT i

Current Illness:

ID: 1046251
Sex: F
Age: 29
State: AZ

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: RA

Lab Data:

Allergies: Na

Symptom List: Nausea

Symptoms: Headache: in middle of forehead start date: 2-20-2021 at 9:30pm and ended on 2-21-2021 at 8am. No conmeds taken.

Other Meds: NA

Current Illness: Na

ID: 1046252
Sex: F
Age: 81
State: WI

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None.

Symptom List: Injection site pain

Symptoms: A few hours after the vaccine, came home and got a headache, then she got nausea. She went to bed, and all night and into the next day had fever/chills. She got up during the night to get some water she collapsed and could not get up as she was so weak. Her husband found her and helped her back to bed. Today, 2/22/21 she is better today and feels almost to normal. She took Pepto-Bismol for the nausea. Tylenol/Ibuprofen did not take the headache, but it did finally go away. The headache was on the top of her head.

Other Meds: Centrum one a day.

Current Illness: None.

ID: 1046253
Sex: F
Age: 37
State: MD

Vax Date: 01/24/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: Patient was admitted for community-acquired pneumonia

Other Meds: Incruse, quetiapine, albuterol, amlodipine, aspirin, benzonatate, Symbicort, buspirone, vitamin D, clonazepam, gabapentin, insulin aspart, insulin detemir, lisinopril, lurasidone, metformin, metoprolol tartrate, mirtazapine, Montelukast, pa

Current Illness:

ID: 1046254
Sex: F
Age: 89
State: MI

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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:

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

Symptoms: Fatigue, Diarrhea

Other Meds:

Current Illness:

ID: 1046255
Sex: F
Age: 52
State: CO

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

Symptom List: Tremor

Symptoms: Approximately 1 1/2 hours after injection, severe pain in left shoulder. Injection was given very high-into my shoulder. It has been 16 days and I still have serious pain in my left shoulder. I have never had trouble with either shoulder previously..

Other Meds:

Current Illness:

ID: 1046256
Sex: F
Age: 55
State: TX

Vax Date: 02/14/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Erythema, Pruritus

Symptoms: It started out with itching and redness at the injection site on the morning of the 14th. And this morning its not as red or itchy but the armpit area is sore. This morning I took three Advil. Also the redness is warm to the touch.

Other Meds: levothyroxine 50 mcg daily hydrochlorthiside 25 mg daily progesterone 200 mg daily B complex 500 mg daily vitmine d3+K2 5000 IU and 80 mcg multivitamin probiotic calcium 1200 mg omega 3 w/ EPA + BHA 1400 mg 647 mg (EPA) 253 mg (BHA)

Current Illness: No

ID: 1046257
Sex: F
Age: 64
State: WI

Vax Date: 02/12/2021
Onset Date: 02/20/2021
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: latex, thimersol (contact not systemic allergy), adhesive on bandaids etc.

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

Symptoms: Arm was very sore starting day after injection and for a couple of days. After that there was very slight periodic itch at injection site. Happened a few times a day for several days. On day 8 after vaccine, Feb 20, a raised welt-like patch appeared on arm near the injection site. Measured approximately 2" x 3". Lasted for 24 hours. The red area increased and the welt-like raised area subsided the next day. By Feb 22 there was a larger slightly red area left and the periodic itching returned. I am reporting this as it happened so many days after the injection.

Other Meds: vitamin D, vitamin C, biotin

Current Illness: none

ID: 1046258
Sex: F
Age: 79
State: IN

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

Lab Data:

Allergies: dust mite allergen

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

Symptoms: very bad pain from head to toe in every muscle, bone and joint, nausea, weakness, freezing cold and the worst was from about 10 pm feb 18 to about 11 am feb 19 but the weakness went on through feb 20. Felt pretty much over it by Feb 21 but still some weakness and fatigue. Also a very sore arm that turned pink and feb 22 is still sore and pink and itchy but not as bad as the previous days. I have always gotten a sore arm with flu shots but not as bad as this time so I didn't consider that a bad reaction.

Other Meds: Armour thyroid, ezetimibe, losartan, latanoprost eye drops, azelastine HCl nasal spray, mometasone furoate nasal spray, vitamin C, Osteoporosis Biflex, one-a-day 50+ female, calcium, super B Complex, Vitamin D3.

Current Illness: none

ID: 1046259
Sex: M
Age: 77
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, 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: 1046260
Sex: F
Age: 35
State: FL

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

Lab Data:

Allergies: Gluten, soy & beets. KNDA

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

Symptoms: ear pruritus in right ear, itchy skin just above affected ear on scalp, and skin behind affected ear and just under ear on throat/neck. All related mild and just a little annoying but I was advised to report it all the same.

Other Meds: Albuteral, evening primrose oil capsules, multivitamin.

Current Illness: None

ID: 1046261
Sex: M
Age: 51
State: KY

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

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

Symptoms: Severe pain at/around injection site lasting 2 days; moderate headache lasting 2 days; mild dizziness lasting 1 day; mild fever lasting 1 day; strong muscle and joint pain lasting 2 days; strong fatigue lasting 3 days; general malaise lasting 3 days.

Other Meds:

Current Illness: none

ID: 1046262
Sex: F
Age: 80
State: CA

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: LA

Lab Data:

Allergies: ukn

Symptom List: Pain in extremity

Symptoms: Patient received her 2nd dose of moderna vaccine 3 days early then recommended per CDC (on day 21). No adverse RXN.

Other Meds: ukn

Current Illness: na

ID: 1046263
Sex: F
Age: 35
State: IL

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: ceftin, codine

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

Symptoms: Fatigue, Headache, Muscle pain, Joint pain, Chills/sweats, Nausea/vomiting, hard time sleeping, very sever migraine ( rescue medication didnt help)

Other Meds: Amox-Clav, Relpax, Amitriptyline, Dicyclomine, Microgestin 1.5/30 FE Tab, Aimovig Sureclick 140mg/ml Inj (once a month 2/18 - last dose), Spironolactone 25mg

Current Illness: sinus infection

ID: 1046264
Sex: M
Age: 74
State: ME

Vax Date: 02/17/2021
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: none

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

Symptoms: Nausea, weakness, right arm in pain, extreme tiredness, black patches crossing left eye. Started two days after shot and lasted for 2 days. Bedridden for 2 days.

Other Meds: Atenolol, simvistatin

Current Illness: none

Date Died: 02/19/2021

ID: 1046265
Sex: M
Age: 85
State: WA

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

Lab Data:

Allergies: No known allergies.

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

Symptoms: Received 2nd dose of COVID19 Pfizer vaccine at 1103 am on 2/19/21, was last seen at 1159, found around 1615 by kitchen staff who were serving dinner.

Other Meds:

Current Illness:

ID: 1046266
Sex: F
Age: 75
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

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

Other Meds:

Current Illness:

ID: 1046267
Sex: F
Age: 38
State: CA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: nkda

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 5:30 pm started with mild Headache. Progressed to nausea and more prnounced HA. At 7:30 began having chills and fever. Slept all day. Awoke with HA and fatigue. My heart felt like it was beating fast with physical activity. Then developed a sorethroat.,

Other Meds: none

Current Illness: none

ID: 1046268
Sex: U
Age:
State: IL

Vax Date:
Onset Date:
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:

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

Symptoms: LEFT PAIN AND HEADACHE

Other Meds:

Current Illness:

ID: 1046269
Sex: M
Age: 70
State: AZ

Vax Date: 02/01/2021
Onset Date: 02/07/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Minor rash on chest and lower abdomen

Other Meds: Valocyclovir Lovastatin

Current Illness: None

ID: 1046270
Sex: F
Age: 51
State:

Vax Date: 12/21/2020
Onset Date: 12/21/2020
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Immediate erythema from injection site down to wrist. Rash on wrist. Resolved in 1-2 hours.

Other Meds:

Current Illness:

ID: 1046271
Sex: M
Age: 77
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm