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: 1047159
Sex: M
Age: 91
State: MO

Vax Date: 01/13/2021
Onset Date: 01/01/2021
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: We arrived on 02/10/2021 to give second doses to residents. Upon arrival we were told several had contracted COVID-19 after their first immunization. Upon reviewing their records, it had been greater than 14 days of recovery, per agency recommendations, they should have received their second doses. The director of nursing and the facility physician however told us we were not to vaccinate the residents until 30 days from their last negative test. After discussing guidelines and recommendations they would not change their minds. This is 1 of 18 patients that did not receive their second dose in the 6-week window at this facility.

Other Meds:

Current Illness:

ID: 1047160
Sex: F
Age: 36
State: IL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: LEFT ARM SORENESS, RAPID HEARTBEAT, TIGHTNESS IN CHEST, AND CHILLS.

Other Meds:

Current Illness:

ID: 1047161
Sex: F
Age: 68
State: AS

Vax Date: 01/20/2021
Onset Date: 01/30/2021
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: Sulfa based anitbiotics

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

Symptoms: Started getting some burning around the left eye & nose.Same area I had shingles 10 years ago. By Monday left eye swollen shut. Saw opthmologist prescribed Acyclovir. Over a couple days swelling dissapeared and burning, itching subsided. The thing is, I had my second COVID dose on 02/10/2021, 10:00AM Pitzer Lot #9581. On 02/18/2021 late evening, started to feel burning in left eye nose area again, next morning eye swollen shut. Saw Dr, said I was having an allergic reaction and put me on prednesone and Amoxicylin. No reduction of swelling and burning, blisters were forming. Went to Urgent Care on 2/20/2021 and was prescribed Acyclovir again. Swelling now gone and itching burning diminished.

Other Meds: pregabalan, bupropion, fluoxetine, meloxicam, symbacort,lisino

Current Illness: none

ID: 1047162
Sex: F
Age: 40
State: AZ

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: Morphine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient felt lightheaded and was unable to stand without assistance. Was hypotensive. IV established and fluid administered IV. Transported to medical center via ambulance.

Other Meds: Hydroxizine, diet supplements

Current Illness: None

ID: 1047164
Sex: F
Age: 58
State: CA

Vax Date: 02/19/2021
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:

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

Symptoms: Fever headache no energy body aches nausea fatigue muscle aches

Other Meds:

Current Illness:

ID: 1047165
Sex: M
Age: 56
State: TX

Vax Date: 02/15/2021
Onset Date: 02/20/2021
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: n/a

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

Symptoms: Developed Shingles 5 days after vaccination

Other Meds: Enbrel

Current Illness: n/a

ID: 1047166
Sex: F
Age: 47
State: KY

Vax Date: 02/19/2021
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: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Received 2nd vaccine on 2/19/21 and started having fatigue the next day that progressed into Chest pain that radiates into shoulders.

Other Meds:

Current Illness:

ID: 1047167
Sex: F
Age: 62
State: MO

Vax Date: 01/13/2021
Onset Date: 01/01/2021
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: We arrived on 02/10/2021 to give second doses to residents. Upon arrival we were told several had contracted COVID-19 after their first immunization. Upon reviewing their records, it had been greater than 14 days of recovery, per CDC recommendations, they should have received their second doses. The director of nursing and the facility physician however told us we were not to vaccinate the residents until 30 days from their last negative test. After discussing guidelines and recommendations they would not change their minds. This is 1 of 18 patients that did not receive their second dose in the 6-week window at this facility.

Other Meds:

Current Illness:

ID: 1047168
Sex: F
Age: 36
State: MT

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Body aches and upset stomach

Other Meds:

Current Illness:

Date Died: 02/20/2021

ID: 1047169
Sex: F
Age: 83
State: TX

Vax Date: 02/06/2021
Onset Date: 02/13/2021
Rec V Date: 02/22/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: jaundice->hemolytic anemia-> hemorrhagic shock->multi organ failure->death pt admitted to ICU 2/16 with Hgb=3.4, treated with steroids, supportive care , pressors, pt died 2/20/21

Other Meds: risedronate 35 mg po q week levothyroxine 25 mcg po daily lipitor 10 mg po daily azelastine nasal spray 2 sprays nasally as needed

Current Illness: none

ID: 1047170
Sex: M
Age: 70
State: UT

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: On January 28 around 9 am, I started feeling sick. About an hour later, I felt nauseated and then started vomiting. I vomited throughout the day, about 6 times. I assumed this was a fairly common reaction to the vaccine. The following day (Jan. 29) I felt very weak and noticed that when I signed my name, my hand felt numb and I couldn't control it very well. On Saturday, my left leg began to feel abnormal. I called a friend who is a retired doctor and he said that he had heard of some neurological reactions to the vaccine. By Sunday, I was having a difficult time walking so I called my GPs office and set up an appointment for Monday morning. As soon as she saw my face without a mask, she said that I had had a stroke. I had a slight droop on my left cheek and mouth which indicated to the doctor that a stroke had occurred. She scheduled me for a MRI the following morning, Feb. 3. As soon as the MRI was completed, my GP scheduled me with a neurosurgeon whom I was able to see the same afternoon. The diagnosis was a right medullary ischemic stroke. She ordered a number of tests to be run and scheduled me for March 9 to come back for the result of all the tests and blood work. Doctor referred me for physical therapy to help me regain the use of my left leg and hand.

Other Meds: Simvastatin 40 mg, amLODIPone BESYLATE 2.5 mg, Lisinopril 40 M, low dose aspirin

Current Illness:

ID: 1047171
Sex: F
Age: 48
State: MN

Vax Date: 02/06/2021
Onset Date: 02/16/2021
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: penicillin - rash and hives Cefprozil - rash and hives

Symptom List: Rash, Urticaria

Symptoms: I received the vaccine on February 6th. My arm was sore for about 5 days. The soreness went away. On February 16th, I noticed a red itchy spot where I had the vaccine. On the 17th, the red itchy spot grew larger. It was slightly swollen, red, warm to touch, and pinkish. I did a video conference with a doctor. She said it could be a delayed reaction to the vaccine or cellulitis. I was prescribed CLEOCIN (Take 3 capsules by mouth three times a day for 7 days). It continued to swell and spread on 18th and 19th. I saw another doctor on the 19th. She prescribed predniSONE for three days and BACTRIM DS for 10 days. She mentioned it could be a reaction to the vaccine or cellulitis. I am concerned about getting the 2nd vaccine on March 6th. I won't be done with the meds until March 1st. As of Monday, February 22nd, the spot is not longer swollen. It is slightly pink and much smaller.

Other Meds: Albuterol desogestrel-ethinyl estradiol daily vitamin Advair Zyrtec Singular pramipexole probiotic

Current Illness: None

ID: 1047172
Sex: F
Age: 74
State: SC

Vax Date: 02/17/2021
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: Benadryl

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

Symptoms: 2/22/21 patient reports that the next day after her injection her throat and the inside of her mouth felt tight. She had body aches and had not energy. Today she reports that her lips and inside of mouth still feel numb. Patient wondered what she should do about her next injection. This was reported to CNP and she advised that patient does not receive the second dose of the COVID vaccine as scheduled. Continue to observe and report any new findings. Patient was called with instructions from CNP

Other Meds: See attached sheet

Current Illness: Had ( L) glenohumeral intra-articular steroid injection 1/27/2

ID: 1047173
Sex: F
Age: 80
State: IN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
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: LATEX

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

Symptoms: BOTH SHOULDERS HURT. HEAD AND BODY FELT HEAVY COULD NOT GET UP. LEFT ARM SWOLLEN, RED AND PAINFUL FOR 5 DAYS

Other Meds: AMANTADINE 100 MG CITRIZINE 10 MG OMEPRAZOL

Current Illness: NONE

ID: 1047174
Sex: F
Age: 24
State: IL

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: 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: The next day after receiving the vaccine I noticed the band aid over the injection site was wet, so I removed the band aid and there was a small (pencil eraser size) area of desquamated skin with clear liquid coming out. Over the next day it developed into a blister that did not rupture, and is now a dark red slightly raised area with scabbing/crusting around the edges. It is mildly pruritic but otherwise not bothersome

Other Meds: Completed Metronidazole 2 days prior to vaccine. Was not taking anything during the vaccine. Pt. uses NuvaRing and had ring in during vaccination

Current Illness: Fever, chills, headache, and heart burn for 24 hours after first dose of vaccine (1/22/21).

ID: 1047175
Sex: M
Age: 70
State: MA

Vax Date: 02/19/2021
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: None

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

Symptoms: Intermittent dizziness.

Other Meds: Avorstatin, Baby Aspirin, Multi Vitamin. Vitamin D3

Current Illness: None

ID: 1047176
Sex: M
Age: 83
State: LA

Vax Date: 01/27/2021
Onset Date: 02/19/2021
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: no drug allergies, no food allergies, no other allergies

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

Symptoms: On Friday morning, February 19 around 9 am, patient felt like he was biting his lip but didn't say/do anything about it. He got up and got dressed, went about his day. Around 12:30 his nephew saw him and commented that his left eye was puffy and red, his face was swollen and drooped and he looked like he was having an allergic reaction of some kind. At that time, his speech became slurred. They got a neighbor, who is a nurse, to come over. She recommended medical attention. They went to an urgent care center and were immediately sent to the hospital.. Left side of his face was drooping and his speech was slurred. There were no cognitive issues. Arrived at hospital around 1:30. He was assessed immediately for a stroke and it was determined that he had not had a stroke. Bell's Palsy was diagnosed. He was given a steroid injection at the hospital and given a Medrol dosepak to begin on Saturday, Feb. 20 and sent home. As of today, Monday, February 22, his symptoms are improving.

Other Meds: finasteride, oxybutynin, famotidine (prn), lovastatin, super vitamin B complex, Bayer Aspirin 325 mg, ibuprofen

Current Illness: none

ID: 1047177
Sex: F
Age: 77
State: NC

Vax Date: 02/13/2021
Onset Date: 02/13/2021
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 listed

Symptom List: Ear pain, Hypoaesthesia

Symptoms: patient c/o lightheadness at 11:55am. Blood pressure was 142/90. Consulted with Doctor. observed for 10 more minutes. Patient started c/o numbness in face, shortness of breath and chest pain around 12:05pm. 02 was 99%. Consulted with Doctor and paramedics called. Patient was confused and had difficulty with balance while being transferred to ambulance. Transported to medical Center at 12:18pm

Other Meds: baby Aspirin

Current Illness: unknown

ID: 1047178
Sex: F
Age: 64
State: NM

Vax Date: 02/12/2021
Onset Date: 02/19/2021
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: Penicillen food sensitivities: dairy, egg, wheat

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: One week after receiving my first Moderna vaccine, I developed a rash and swelling at the injection site. The rash was about 6-8 inches across, and slightly itchy. The site is swollen and warm to the touch. I've had the rash now for 3 days.

Other Meds: Fluoxetine Hcl Tabs 10 Mg Multivitamin Calcium/magnesium supplement

Current Illness:

ID: 1047179
Sex: F
Age: 28
State: MT

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: Body aches & Headache

Other Meds:

Current Illness:

ID: 1047180
Sex: F
Age: 45
State: MS

Vax Date: 01/14/2021
Onset Date: 02/08/2021
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: NKA

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

Symptoms: OUTER SIDE OF RIGHT FOOT AND 3RD AND 5TH DIGIT ARE BLUISH/PURPLE, THEN RED, SWOLLEN AND PAINFUL. NO OTHER EXPLANATION FOUND FOR THIS ISSUE

Other Meds: XIGDUO, METOPROLOL, LOSARTAN, OZEMPIC, ZETIA

Current Illness: NONE

ID: 1047181
Sex: F
Age: 82
State: TX

Vax Date: 02/12/2021
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:

Symptom List: Unevaluable event

Symptoms: Hospitalized for possible TIA or stroke or maybe Guillain Barre syndrome

Other Meds: Valsartan/HCTZ 160mg/25mg Gemfibrozil 600 mg

Current Illness:

ID: 1047182
Sex: M
Age: 71
State: CT

Vax Date: 02/11/2021
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: Nsaids

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

Symptoms: pt states the next day after he got the covid vax that he wasnt feeling well, he didnt feel right, foggy headed, felt disoriented and confused. He couldnt put words together to make a sentence. He got up to go into the kitchen and then urinated all over himself. He was worried about falling sleep, scared he would die in his sleep. The 3rd woke up and was feeling some better but still foggy headed. Pt went to the ER about 5 days later. They did a CT and blood work. He thinks the tests results came back negative. They wanted him to stay longer and maybe see a Neurologist but since there wasnt one available to see at that time the pt decided to go home. He has blood work and urine labs to be done at the facility on 2/23/2021. Pt states he is feeling better at this time.

Other Meds: probiotic 10, acetophetomine325 x4 daily, apixaban 5mg x1 every 12 hrs, folic acid 1mg, fluconazole 200mg x2 every 12 hrs, buprenorphine 8mg x 3 daily, simvastatin 40 mg, metoprolol 50mg 1 1/2 tab x2 daily, gabapentin 300mg 3 tabs x 3 dail

Current Illness: no

Date Died: 01/01/2021

ID: 1047183
Sex: F
Age: 82
State: MO

Vax Date: 01/14/2021
Onset Date: 01/01/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Pt had expired before second dose was delivered.

Other Meds:

Current Illness:

ID: 1047184
Sex: F
Age: 44
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin, Sulfa, Bactrim, Codeine, Shell Fish

Symptom List: Injection site pain, Menorrhagia

Symptoms: 1/27/21-About 2 hours after injection; developed facial, neck and chest rash, and itchy throat. 75mg Benadryl taken orally. - 1 hour later dizziness, heart rate 44, lost voice, face looked swollen. - 5 hours after vaccine administered went to outpatient clinic, heart rate 48 there. - After 1 hour, heart rate 120, sweaty, dyspnea and went to Emergency Room. 1/27/21-Amitted to Hospital -Given Solumedrol, Benadryl and Pepcid. Slowly improved. 1/29/21-Discharged Home on Pepcid 20mg BID x15 Days and PRN Benadryl. 2/8/21-Returned to work, but still has to take Benadryl daily for rash and uses Albuterol inhaler intermittently for "tightness" in throat.

Other Meds: Levothyroxin, Ibuprofen, Tylenol

Current Illness: None

ID: 1047185
Sex: F
Age: 75
State: NY

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

Lab Data:

Allergies:

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

Symptoms: Site of vaccination began itching about one week after injection. A red area surrounding the injection site was noted about 3 days later. Itching is insignificant, and the arm is otherwise completely normal. Since it is now about 10 days after the injection, I don't know how long it will take before the rash disappears.

Other Meds:

Current Illness:

ID: 1047186
Sex: F
Age: 77
State: WA

Vax Date: 02/18/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Problem # 1: Allergic contact dermatitis (ICD-692.9) (ICD10-L23.9) Diffuse erythematous plaque-like allergic appearing rash on face trunk arms and scalp. Timeline suggest it is a reaction to her second Covid vaccine injection. Only other new exposure was going to be pewter day prior to symptoms and eating popcorn but she has had this in the past with no problems Suggest we stated before that this is a reaction to Moderna Covid vaccine I would suggest she not get it in the future if able to We will treat with oral prednisone and continue antihistamines. Also use ice packs , oatmeal baths and calamine to help with itching She will call or portal if symptoms or not improving.

Other Meds: 1) Efudex 5 % External Cream (Fluorouracil) .... apply thin layer to sun damaged lesion once daily for 2-4 weeks. wash hands after use 2) Atorvastatin Calcium 40 Mg Oral Tablet (Atorvastatin Calcium) .... Take 1 tablet by mouth daily for ch

Current Illness: none

ID: 1047187
Sex: F
Age: 63
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient complained of tingling sensation of the mouth and tongue, no numbness, sensation remains intact., not in respiratory distress, able to respond verbally. Patient stated that she also experienced tingling on f the mouth and tongue and pain on lower back after her first dose, but resolved after 15 minutes.

Other Meds: Atenolol, Metformin

Current Illness: DM 2, Hypertension

ID: 1047188
Sex: F
Age: 71
State:

Vax Date: 02/12/2021
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:

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

Symptoms: Day 7 post COVID shot she got redness around injections site and very itchy

Other Meds:

Current Illness:

ID: 1047189
Sex: F
Age: 37
State: TX

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: rash with antibiotics like Amoxicillin, rash with peanut butter .

Symptom List: Nausea

Symptoms: Fever, chills, body pain, headache and mild rash on the chest and back. took Advil every 8 hours. rash disappeared after 24 hours.

Other Meds: Excedrin Migraine. Omega-3 .

Current Illness: N/A

ID: 1047190
Sex: F
Age: 48
State: AZ

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: artichokes, latex, chemical allergies, adhesives

Symptom List: Injection site pain

Symptoms: Felt as though she was having an asthma attack. Used her own inhaler with relief. Has clear lung sounds and oxygen sat. is good. Has minor swelling to both hands which she sts she had with the first COVID vaccine.

Other Meds: Synthroid, albuterol, singular

Current Illness:

ID: 1047191
Sex: F
Age: 33
State: NJ

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/a

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

Symptoms: For about 8 hours on the day after I received the second shot, I experienced sweats (no chills) and (possibly) a fever. I felt slightly achy and tired. I did not have pain at the injection site or any difficulty lifting my arm.

Other Meds: No pregnancy complications, due 3/23/21

Current Illness: n/a

ID: 1047192
Sex: F
Age: 82
State: MO

Vax Date: 01/14/2021
Onset Date: 02/01/2021
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: Pt refused second dose of vaccine. She cited adverse effects but couldnt not provide specific details.....

Other Meds:

Current Illness:

ID: 1047194
Sex: F
Age: 52
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
Hospital: Y

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

Lab Data:

Allergies: sulfur, flagyl,

Symptom List: Tremor

Symptoms: ed in ER: given predisone and breathing treatment and was was released at 1:36 pm. Was given an Rx to take 50 MG of Prevacid to take 1x a day for 5 days. Saturday: 2/20/2021 -- Took 50 mg of prevacid at 9 am and 10 mg of pepcid 4:50 pm. Eyes swelled, lump in throat Went to ER Was admitted for observation at hospital. Received predisone and benedryl through IV 1:30 bottom lip started to swell was given 25 mg of benadryl by mouth Around 7:30 am scalp started to itch - Was given 20 mg of predisone orally Around 9 am rash on face was given 50 mg of benadryl Around 2:30 pm Doctor came into room because my throat felt tight. She looked at it and said "its not too bad." She had the nurse give me benadryl via interveniously Was discharged around 3:30 pm on Sunday, February 21, 2021 Monday: 2/22/2021 Around 1:15 pm felt lump in throat, felt like my neck was swollen, took 25 mg of benadryl. Called Doctor. Took another 25 mg of Benadryl. Still didn't feel right. Went over to Dr office, my asthma and allergy doctor. At Dr office, I was given two injections of medication. (He told me what it was, but I cant recall the names.) He sent me home with the following instructions: zyretc 10 mg am and pm bendryl 25 mg every 4 hours as needed pepcid 20 mg am and pm predisone 20 mg 3x1 day tomorrow take 20 mg of predisone I am to call his office after 1 pm tomorrow 2/23/2021 to give status report on how I am doing

Other Meds: zyrtec, multi vitamins, rhinocort

Current Illness: No active illness. Was healthy at the time

ID: 1047195
Sex: F
Age: 69
State: TN

Vax Date: 02/08/2021
Onset Date: 02/17/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Covid arm Itchy, rash, a little swollen and warm Almost a cramping like pain in thigh muscle and bicep, which came and went for three days

Other Meds: Zyrtec d

Current Illness: No

ID: 1047196
Sex: F
Age: 81
State: MA

Vax Date: 02/10/2021
Onset Date: 02/21/2021
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: Sulfur drugs

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

Symptoms: Rash,itch, swelling. Headache, fatigue.

Other Meds: Lisinoprile, Hydro, Amlodipine, omeprosole.

Current Illness: none

Date Died: 02/20/2021

ID: 1047197
Sex: M
Age: 84
State: KS

Vax Date: 02/12/2021
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: NKDA

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

Symptoms: death

Other Meds: Morphine concentrate, Lorazepam Intensol, Clopidogrel, Vitamin D2, Tamsulosin, Amlodipine, Atovastatin

Current Illness: Pt on hospice

ID: 1047198
Sex: F
Age: 77
State: FL

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: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: swelling hard red itching and burning at the site. 10 days after injection.

Other Meds: thyroid meds

Current Illness: none

ID: 1047199
Sex: M
Age: 73
State: NY

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: Alphagan drops

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

Symptoms: First dose received 01/22/2021 and second dose on above date (02/11/2021) These events may have no relation to the vaccination but due to their concomitance, I eventually felt it might be best to report them. Three days following the first dose, I started to experience hematuria as well as constipation. It has happened before as a result of radiation treatment back in 2005/2006. Saw my urologist on 02/02/2021, and had several tests, ruling out any return of cancer. Antibiotics improved the situation, which was getting closer to normal prior to getting the second dose. Again, three days following the second dose, hematuria returned and still prevails at various degrees. Also experience fatigue and weight loss.

Other Meds:

Current Illness: Glaucoma

ID: 1047200
Sex: M
Age: 40
State: OR

Vax Date: 01/13/2021
Onset Date: 02/05/2021
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: NKDA

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

Symptoms: Patient had breakthrough seizure on 2/5/2021. Last prior seizure was 5/2020 before starting Keppra. It is not clear if seizure was related to vaccine.

Other Meds: Hydroxychloroquine, keppra, fenofibrate, aspirin

Current Illness: Chronic lupus, seizure disorder, hypertriglyceridemia

ID: 1047201
Sex: F
Age: 35
State: KS

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: Penicillin, Sulfa, Cipro, Cephalaxin

Symptom List: Pain in extremity

Symptoms: Rash and itchiness within 30 minute waiting period

Other Meds:

Current Illness:

ID: 1047202
Sex: F
Age: 75
State: OH

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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: PCN, Norco, codiene, phenergan, Darvon. mild latex, seasonal, sole, flounder

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

Symptoms: About 11 am I was masked in church and developed a tickle in my throat. I cleared my throat to no relief. I took 2 cough drops. About 11:30 I got a bottle of water. No relief after drinking 8 ounces. I left the service, went outside, removed my mask and was coughing forcibly for about 15 minutes or so. Expectorated clear phlegm 6 - 8 times. Gradually I settled to normal. Just some residual soreness in throat. This was an unusual occurrence for me. I was covid positive in early Dec, but had a very mild case. Back in the 70's I would have reaction to allergy shots. I waited in the office 15 minutes, but 45 minutes later when I arrived home I had huge hives and severe itching.

Other Meds: Diltazem CD, pravastatin, fenobibrate, chlortrimeton, EC aspirin, MVI, calcium

Current Illness: n/a

ID: 1047203
Sex: F
Age: 44
State: AR

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

Lab Data:

Allergies: Codeine, hydrocodone, tramodol

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

Symptoms: Intermittent Loss of taste, rash, body aches, muscle aches, sore throat, tiredness, weakness, migraine, shortness of breath, ear pain

Other Meds: Lisinopril, adavan, lamotrogine, metropolol, trazodone

Current Illness: None

ID: 1047204
Sex: F
Age: 73
State: ME

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

Lab Data:

Allergies: Januvia, NSAIDs

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

Symptoms: Acute thalamic cerebrovascular event

Other Meds: Fish oil, gabapentin, glipizide, HCTZ, losartan, metformin, metoprolol, aspirin, oxybutynin, tramadol, Tresiba, venlafaxine

Current Illness: none

ID: 1047205
Sex: F
Age: 80
State: VA

Vax Date: 02/13/2021
Onset Date: 02/19/2021
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: none

Symptom List: Vomiting

Symptoms: very labored breathing i used albuterol nebulizer for breathing treatments to relieve symptoms. symptoms lasted for 2 days.

Other Meds: albuterol, calcium-vitamin D, diclofenac DR, gabapentin, levothyroxine, losartan-hydroCHLOROyhiazide, multi-Vitamin PO, Omega-3 Fatty Acids-Vitamin E, tramadol

Current Illness:

ID: 1047206
Sex: F
Age: 41
State: MA

Vax Date: 01/27/2021
Onset Date: 02/04/2021
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: Shellfish (specifically mollusks)

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Red, itchy rash at injection site. Started 8 days after vaccine, increasingly worsening until day 12 after vaccine. Initially started about the size of a dime. Got to 6 x 6 inches with a raised red edge. After day 12 gradually improved. Now at day 26, still have a small red itchy patch at site of injection surrounded by a slightly larger discolored patch that is lighter than the skin around it.

Other Meds: None

Current Illness: None

ID: 1047207
Sex: F
Age: 36
State: NC

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Modern vaccine

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

Symptoms: Itching, eyes swelling immediately after vaccine administration that did not resolve with Benadryl, and BP 140/90, patient was later taken away by EMS

Other Meds: Benadryl

Current Illness:

ID: 1047208
Sex: F
Age: 75
State: SC

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: Penicillin; Tetracycline; Cleocin; Cipro; Bactrim

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Sore arm; Temp of 100 for 2 days; general aches; fatigue; zero energy; headache on day 3

Other Meds: Armour Thyroid; Simvastatin; Singular: Meloxicam; Lisinoprol; Prilosec; Zolpidem - ASA 325; Melatonin; Zyrtec, Mucinex; Nasocort; Multi vitamin; Fish Oil; Salmon oil (I don't eat fish!!); Big B 100; C; Calcium; CLA; Cranberry; E; Flaxseed

Current Illness: None. Receive allergy shots every 1 - 2 weeks.

ID: 1047209
Sex: M
Age: 88
State: NC

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

Lab Data:

Allergies:

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

Symptoms: Upon entering vaccine administration information from today's clinic into immunization registry, I noticed the patient already received 2 doses of this vaccine.

Other Meds:

Current Illness:

ID: 1047210
Sex: F
Age: 84
State: MO

Vax Date: 01/14/2021
Onset Date: 02/01/2021
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 was discharge by the facility with no follow up instructions or their vaccination card. Pt is lost to followup

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm