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: 0931535
Sex: F
Age: 32
State: MA

Vax Date: 12/23/2020
Onset Date: 12/30/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: dairy allergy, allergy to bactrum, sulfas, erythromycin

Symptom List: Dysphagia, Epiglottitis

Symptoms: sore arm 1-2 days post vaccine, exactly 1 week post vaccine (12/30/2020) rash appeared around injection site on L arm, measuring roughly 2 in. across. Initial visit to urgent care dx of allergic reaction, prescribed triamcinolone 0/5% 2x/day and antihistamine as needed. Followup visit following day, separate doctor gave dx of cellulitis to spreading area now 4 in wide and long, given rx of doxycyclin 100 mg 2x/day for 10 days. On 1/9/2021 at followup visit doctor noted cellulitis was gone but rash still persisted. Given order to stop doxy, begin course of prednisone 50mg 1x/day for 5 days. Followup if needed post course of prednisone.

Other Meds: women's daily multivitamin, sertraline

Current Illness:

ID: 0931536
Sex: F
Age: 59
State: NY

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

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

Lab Data:

Allergies: Sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: Jan. 8@9:30-mild soreness- left arm Jan.9@6:30 a.m.- moderate soreness- left arm Jan.9@12:30pm- achey all over + left arm soreness, mild headache Jan 9@1:45- achey all over, left arm soreness and chills

Other Meds: Probiotics, CoQ10, C, D, Zn, omeprazole, incruse, qvar, montelukast, rosuvastatin, lexapro, diltiazem

Current Illness: None

ID: 0931537
Sex: F
Age: 68
State: FL

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codeine Phenergan

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

Symptoms: Patient reported rash, no rash evident on exam, no itching, no trouble breathing, Patient was given 25mg Diphenhydramine, no further treatment needed

Other Meds: Sumatriptan 50mg PRN ASA 81 mg

Current Illness:

ID: 0931538
Sex: F
Age: 74
State: FL

Vax Date: 12/29/2020
Onset Date: 01/01/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Injection sight left red rash ( about 2inches 5 inches high) itches , warm to touch. Still red , itches,

Other Meds: No

Current Illness: No

ID: 0931539
Sex: F
Age: 38
State: FL

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Na

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

Symptoms: I had severe facial swelling that started on my left cheek and lip the morning after the vaccine. That night the swelling mover to the center of my face (mainly my bottom lip and some of my chin). Day 2 the swelling was most severe and moved to my right cheek and lip. The swelling was less the night of day 2 and even better the morning of day 3 after starting oral prednisone . Today on day four I am Almost back to normal but still some puffiness in both cheeks and bottom lip. Per my physicians advice I will be on a 5day course of oral prednisone (10mg 2x/day) The other adverse event I experienced was starting day 2 I had extreme pain and itching as well as some cyst like bumps on both my feet as well as very mild itching on my palms.They are improving on day 4 but still super itchy. I have been advised to take Benadryl as needed for that.

Other Meds: Na

Current Illness: Na

ID: 0931540
Sex: M
Age: 71
State: UT

Vax Date: 12/30/2020
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Minor! After 9 days I developed a itchy, slight, red rash on arm approximately 2cm below injection site. Size 5cm X 8cm. I am only reporting this because the clinic gave us a card to use with a smart phone to report any different occurrence. I do not have a smart phone so I am using this approach, in case you want this information.

Other Meds: Tamsulosin, Omeprizole

Current Illness: None

ID: 0931541
Sex: F
Age: 22
State: IL

Vax Date: 12/16/2020
Onset Date: 12/23/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: NKA.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: About one week after receiving the first dose of the Pfizer Covid-19 vaccine, I developed a rash on two fingers of my left hand that itches. I used OTC hydrocortisone cream on it, which relieved the symptoms temporarily. Rash is still present today. I received the second dose of the vaccine yesterday, 1/9/2021, in my right arm, and today I noticed the rash is spreading to my right hand. I have not had any previous adverse reactions to any other vaccine. I went to urgent care today and the nurse practitioner recommended me to take Benadryl 25 mg at night to relieve symptoms.

Other Meds: None.

Current Illness: None.

ID: 0931542
Sex: F
Age: 28
State: IN

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

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Low grade fever, mild aches, nausea, headache, fatigue

Other Meds: Oral contraception, multivitamin, elderberry supplement, aloe Vera supplement

Current Illness: None

ID: 0931543
Sex: M
Age: 64
State: IN

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

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Sudden onset chills, fatigue, muscle aches all over. No other symptoms.

Other Meds: None

Current Illness: None

ID: 0931544
Sex: F
Age: 29
State: CA

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

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Tightness of throat, sore arm, fatigue

Other Meds: Junel Fe 1.5/30

Current Illness: None

ID: 0931545
Sex: F
Age: 47
State: ME

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Latex, codeine, gluten, dairy, most chemicals, seasonal allergies, dust and mold allergies

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

Symptoms: High fever ( highest 102.6 within 72 hrs. ). Took Tylenol (100mg every 8 hrs and 400 mg of ibuprofen every 3 hrs starting at 10:30 pm on 1/8/21. Severe arm pain for 24 hrs. Nausea, body aches, chills, swollen and painful lymph nodes in neck, blurry vision (first 48 hrs), skin sensitivity, loss of appetite, and moderate to severe joint pain. Also some behavioral issues ( irritability, anxiety).

Other Meds: None

Current Illness: None other than allergies

ID: 0931546
Sex: F
Age: 44
State: IL

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

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

Lab Data:

Allergies: None reported

Symptom List: Rash, Urticaria

Symptoms: Patient was extremely anxious prior to vaccine. She told me she did get seizures but she took medication for it and I informed her that it would still be recommended to get the vaccine. She was visibly anxious even after vaccine. Immediately after she began crying to her friend and said she "was just SO afraid of needles". I told her to take some deep breaths and after a minute or two she went to the observation room. Approximately 15 minutes later she rushed back into the room looking like she might hyperventilate or have hypoglycemia (shaking, cold sweats). She sat down and I tried to calm her down. I asked someone to get her orange juice. During the next couple minutes she did not seem to be getting any better and started shaking. I requested someone call 911. Another staff was helping so I moved to get and administer an epi-pen injection. By this time the patient was not responsive, but was still breathing. I instructed staff to help move her to the floor for monitoring and if needed, cpr. She regain partial consciousness. Her breath and pulse were always present, so there was no need to begin cpr. After a few minutes EMT arrived and transported patient to local hospital. During all of this, other employees at the facility were attempting to contact family members, which they were eventually able to do. About 30 minutes later the staff informed me they had spoken to family members who were at the hospital and that she was improving, but they had not seen her yet.

Other Meds: Not known

Current Illness: Unknown

ID: 0931547
Sex: M
Age: 50
State: AK

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: headache and nausea for 12 houre

Other Meds:

Current Illness:

ID: 0931548
Sex: F
Age: 57
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: no known

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

Symptoms: This is the patient's second shingrix dose and it was entered 6 days before the 2 month interval.

Other Meds: unknown

Current Illness: none

ID: 0931549
Sex: F
Age: 72
State: FL

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, Penicillin, bee stings ( thought not for past 12 years), latex, Cortisone, Anti-Inflammatories, Betadine, Latex, Hydralazine, most antibiotics

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

Symptoms: Developed a rash about 12 hours - approx 1AM) after the injection (1PM) which started on right side of my face and by morning also had a bit on my arms, shoulders. Rash has looked gone and not affected me during part of some days, then will flare up later at night and seems to be in places at times, like legs, other side of my face and then gone. Not particularly itchy, mostly a feeling of irritation and rash on right side of face feels tight, like when you have a sunburn.

Other Meds: Levoththyroxine, Spironlactone, Vitamin D3, Tylenol

Current Illness: Sinus issues, possible infection

ID: 0931550
Sex: F
Age: 56
State: GA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 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: Moderna COVID-19 Vaccine EUA at clinic Within 10 minutes I became extremely light-headed, foggy, and experienced severe headache. Returned to the site to be monitored by the doctor. Was advised to take a Benadryl (within 30 minutes of injection). The head issues continued in waves for about 2 hours. My throat felt tight, but never closed off. Once home I experienced a fever of 100 for approximately 2 hours. Remedied by acetaminophen. Slept well and woke with no further symptoms except slight injection site soreness.

Other Meds: Estrogen (estradol), Unithroid, Vit D, Hair Skin Nail suppl, Culturelle probiotic Benadryl (25 mg) taken 30 minutes after vaccine

Current Illness: None

ID: 0931551
Sex: F
Age: 32
State: CA

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

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: at 11:09 am - minutes after receiving vaccine pt reports feeling chills and palpitations. Pt has a history of angioedema to unknown cause. 11:09 BP 143/95 P 71 11:15 BP 134/81 P 84 11:20 129/83 P 69 11:27 120/81 P 70 pt reports feeling better and declines call to EMS

Other Meds: oral birth control

Current Illness: Anxiety

ID: 0931552
Sex: F
Age: 29
State: IL

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

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

Lab Data:

Allergies: Sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I noticed my heart rate was very high and bounding, and I felt very shaky. I took my heart rate at home with a pulse oximeter and it was 150bpm. I went to the emergency room where they did an EKG, labs, and chest xray; all were within normal limits. I was observed for a few hours and sent home.

Other Meds: IUD

Current Illness: N/A

ID: 0931553
Sex: M
Age: 48
State: GA

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

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

Lab Data:

Allergies: NKDA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Onset of shaking chills, dysasthesia, and myalgias lasting ~20 hours.

Other Meds:

Current Illness: COVID, diagnosed 10/28/2020

ID: 0931554
Sex: M
Age: 30
State: MI

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

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

Lab Data:

Allergies: None

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

Symptoms: 18h: Dissociation (mild), fatigue 24h: nasal congestion, fatigue 26h: fever, chills, headache, nasal discharge and congestion, fatigue, nausea 30h: difficulty sleeping, headache, fatigue, nausea (ibuprofen 800mg, acetaminophen 1000mg, pepto bismol caplets 2) 36h: fatigue, joint pain (hip) 42h: mild fatigue, joint pain (hip)

Other Meds: Escitalopram, atorvastatin

Current Illness: None

ID: 0931555
Sex: F
Age: 61
State: GA

Vax Date: 12/22/2020
Onset Date: 01/01/2021
Rec V Date: 01/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Quinolones

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

Symptoms: Extreme skin sensitivity to torso (chest & back) on left side parallel to the injection site, shingles type sensitivity without a rash or redness

Other Meds: Metformin, norvasc, levothyroxine, zocor, Zyrtec, multivitamin, amitriptyline, robaxin, calcium chews

Current Illness: None

ID: 0931556
Sex: F
Age: 29
State: PA

Vax Date: 12/27/2020
Onset Date: 12/31/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: This is my second pregnancy and at the time of my vaccination, I was 32 weeks 6 days gestation with an estimated delivery date of 2/15/21. I tolerated the vaccine well initially with only a very minor sore arm the day after the vaccine. On 12/31/2020 (4 days after vaccination), I felt muscle fatigue around my hips and buttocks as well as significant fatigue. It seemed to improve over the course of the day and was not very noticeable for the next few days. On 1/4/21 (8 days after vaccination), my muscle fatigue in my hips, buttocks, thighs, and hamstrings bilaterally became very significant, preventing me from doing some activities that I had planned. I also had generalized fatigue. On 1/5/21, I had similar symptoms, but the muscle fatigue also began to include my shoulders bilaterally. 1/6/21, the muscle fatigue also included my neck and I was physically exhausted. 1/7/21 I started to note some improvement, and I also saw my OB who did bloodwork but also did suspect a possibly delayed reaction to my vaccine. Today (1/9/21) I am still experiencing muscle fatigue, but it does seem to be improved from several days ago.

Other Meds: Prenatal vitamin, miralax

Current Illness: None

ID: 0931557
Sex: M
Age: 50
State: IN

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

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

Lab Data:

Allergies: None

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

Symptoms: Hyperglycemia with polyuria. Peak CBG 300 postprandial first night but fasting CBG still 177 at 48hr

Other Meds: Atorvaststin Metformin Januvia

Current Illness: None

ID: 0931558
Sex: F
Age: 47
State: AR

Vax Date: 12/22/2020
Onset Date: 12/30/2020
Rec V Date: 01/09/2021
Hospital: Y

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: 7 day after site itching, hot swelling. Unsure if related 9 day after suffered CVA and have hyper coagulation

Other Meds: None

Current Illness: None

ID: 0931559
Sex: F
Age: 36
State: FL

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

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Fever and chills starting 5 hours after dose, joint pain, myalgia, anxiety, palpitations, loss of appetite, fatigue, abdominal pain, dizziness, near syncope, headache, insomnia, arm soreness, tingling and numbness in my face and mouth about 10 hours after dose and lasting about 30 min, taking ibuprofen one tablet q6 hours for fever and pain. 26 hours dose symptoms are improving

Other Meds: None

Current Illness: None

ID: 0931560
Sex: F
Age: 55
State: CO

Vax Date: 12/28/2020
Onset Date: 01/01/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Garlic, Escitalopram, Acyclovir, Nickel, Morphine, and Bactrim

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

Symptoms: 24 hours very sore/tender arm (felt like getting a typhoid shot) December 29, difficulty sleeping, restlessness, extreme, Fatigue all week, woke up 4 days later (January 1, 2021) with raised painful sore bumps on right side of palate,. Day two crossed midline of palate, Day three entire roof of mouth, and tip of tongue. Painful to drink, eat, and brush teeth.

Other Meds: Tramadol, tinazadine , MVI with iron, Iron Gluconate, Tylenol, gabapentin, Wellbutrin, Premarin, Hydroxyzine, Protonix, Rolaids, Vitamin D3, Biotin, Zyrtec D, Benadryl Lidocaine 5% topical patches, and diclofenac sodium gel as needed. P

Current Illness: None: Currently have c6 and c7 with a protrusion had a steriod injection at c6 &7 in November 2020, and fluid in ears r/t allergies

ID: 0931561
Sex: M
Age: 30
State: CO

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

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

Lab Data:

Allergies: Peanuts, tree nuts, NSAIDs

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Friday 1/8/21 I got a bit of what i think was nerve pain or just shooting pain on the wrist of the right-arm that was not the injection arm. Then today (Sat 1/9/21) that nerve pain is gone, but I developed a worse pain (pain of 6-7 out of 10) and additionally some weakness in the left-forearm closer to my elbow than my wrist, possibly where a tendon is (the injection arm). The pain shoots down from the elbow area towards my wrist on the posterior side. I haven?t done any extraneous work or lifted anything heavy since 1-2 days before the vaccine. It?s also my non-dominant arm so I don?t use it as much as my other arm. So far I have iced it twice and taken Tylenol which has helped the pain. The arm is currently in a sling and I haven?t tried to use it since icing it the first time.

Other Meds: Montelukast, Zyrtec, Advair, Adderall IR, multivitamin, vitamin b complex, vitamin D3, famotidine, Tylenol

Current Illness: No acute illnesses

ID: 0931562
Sex: F
Age: 49
State: FL

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

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

Lab Data:

Allergies: codeine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: mouth itching, slight tongue swelling, tachycardia, coughing, feeling of impending doom, nausea, vomiting, diarrhea, itching This started at minute 13 after the vaccine administration. I have had several infusion reactions before to biologics to treat my autoimmune disease and this is how it always starts. There was nothing available at the administration place so I left and took zyrtec, benadryl and pepcid. The symptoms stopped in about 25 minutes.

Other Meds: cellcept 1000 mg bid cyclosporin 200 mg qam, 100 mg qpm plaquenil 200 mg bid paxil 20 mg daily pilocarpine 5 mg bid prednisone 2 mg daily singulair 10 mg daily sulindac 150 mg bid lisinopril 20 mg daily cardizem 250 mg daily restasis eye d

Current Illness: rheumatoid arthritis chronic hives high blood pressure

ID: 0931563
Sex: F
Age: 58
State: NY

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

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

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: "Pfizer-BioNTech Covid-19 Vaccine EUA. Side Effects: nausea, body aches, chills, headache, fatigue. I took Ibuprofen. Symptoms lasted for approximately 36-40 hours.

Other Meds: Levothyroxine, multi vitamin, baby aspirin, gabapentin, estradiol and norethindrone acetate, calcium, vitamin D3,

Current Illness: none

ID: 0931564
Sex: F
Age: 41
State: CA

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Latex, adhesive

Symptom List: Nausea

Symptoms: Redness to injection arm, severe headache, cough, fever, pain, fogginess. Treated with Benadryl and ASA and overhang cough syrup

Other Meds: Aspirin 325 daily, Vit D daily, melatonin 5mg daily, unasome daily

Current Illness: None

ID: 0931565
Sex: F
Age: 20
State: IN

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

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain

Symptoms: The morning after the shot, I woke up with a sore arm, temperature kept going up/rising during the day, felt nauseous, dizzy, tired, warm stomach.

Other Meds: N/A

Current Illness: N/A

ID: 0931566
Sex: F
Age: 59
State: CO

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

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

Lab Data:

Allergies: Biaxin, azithromycin, pain patch

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

Symptoms: chills, fever ranging from 99.2 to 100.6, extreme body aches, non stop coughing.

Other Meds: vitamins, essential oils

Current Illness: none

ID: 0931567
Sex: F
Age: 25
State: FL

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: no known allergies

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

Symptoms: sudden sensorineural hearing loss in the right ear, audiology and ENT assessment, currently being treated with steroid medication

Other Meds: loloestrin

Current Illness: none

ID: 0931568
Sex: F
Age: 48
State: NC

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

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

Lab Data:

Allergies: latex gloves, ct scan dye, lamictal, Seroquel, Geodon, hydrocodone,

Symptom List: Tremor

Symptoms: pt got shot at 2pm, pt arm started to itch at 2:15pm, pt applied Benadryl cream at 2:20pm, itching started to spread at 3:00pm, 3:00 pt took hydroxyzine, 3:35pm itching not improved, pt applied Benadryl cream to shoulder area at 3:40pm

Other Meds: gabapentin 600mg, turmeric pills, milk thistle, krill oil , co-q-10, novolog ssi, novolog 70/30, klonopin 1mg po tid, flexeril 10mg tid, Adderall 15mg po bid, Cymbalta 30mg po hs, Montelukast po hs, Ventolin hfa 2puffs up to qid prn, olopat

Current Illness:

ID: 0931569
Sex: F
Age: 45
State: NY

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

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Fever 103.4 Nausea Vomiting Headache Chills Large welt at injection site

Other Meds: None

Current Illness: None

ID: 0931570
Sex: F
Age: 25
State: VT

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

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: None

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

Symptoms: I walked in to received my first dose of the Moderna Covid19 vaccine at approx 12:20pm 1/7/21. The RN who was giving me my injection palpated the top of my shoulder and NOT my acromian process and administered the injection closer to the top of my shoulder, the vaccine did initially hurt more than a typical vaccine would when it was being administered but i thought that might have been normal. Approximately 1hr after receiving the vaccine my left shoulder joint started to have this pinching sensation in the anterior joint when I would raise my arm forward. The pain got progressively worse throughout the day with significantly decreased range of motion in that shoulder and significant pain in my shoulder joint. The pain was so bad it actually kept me from sleeping that night. I never had any muscular pain or any other symptoms beside the joint pain, which was alarming since it should have been administered into the muscle. I believe the vaccine my have been incorrectly injected into the shoulder joint or potentially a smaller muscle in the shoulder. The pain and decrease ROM is preventing me from doing most of my regular day to day activities. Today 1/9/21 has been a full 48hrs after receiving the vaccine and the joint pain has not gotten any better and my range of motion is still significantly decreased, which would prevent me from performing my tasks as an RN.

Other Meds: None

Current Illness: None

ID: 0931571
Sex: F
Age: 56
State: MN

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: temp 100 F , chills body aches mainly lower back ache

Other Meds: none

Current Illness: none

ID: 0931572
Sex: F
Age: 24
State: NY

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline and Doxycycline

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Polyphagia and Mild Headache

Other Meds: none

Current Illness: Migraine Disorder

ID: 0931573
Sex: M
Age: 42
State: NC

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

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Vasovagal syncope about 5 minutes after shot. Symptoms lasted about 5-7 minutes. Hypothensive. Diapharetic, Nausea,

Other Meds: NA

Current Illness: NA

ID: 0931574
Sex: F
Age: 25
State: VA

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

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

Lab Data:

Allergies: None that I know of

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

Symptoms: Initially, there was soreness, swelling, and redness (all around upper arm - a bit below deltoid) around injection site over the course of a few days. The area was warm to the touch compared to the rest of the arm. All symptoms went away after 5 days. Exactly 7 days later, a little bit of the soreness came back and there was a redness marking the size of a 50 cent coin. The next day, the soreness grew and the redness spread and the area became warm to the touch again. I talked to a doctor over video chat to talk about what I should do - I was advised to use an ice compress, which I did a few times on and off. The next day (today), redness spread, but soreness and feeling warm to the touch stayed the same. I went to urgent care and was given 7-day antibiotics and told to use Claritin/Zyrtec to lower my histamines. If anything progresses, I should let the provider know.

Other Meds: No

Current Illness: No

ID: 0931575
Sex: F
Age: 27
State:

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

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

Lab Data:

Allergies: tetracyclines

Symptom List: Pain in extremity

Symptoms: chills, muscle pain, join aches, elevated heart rate, weakness, headache @ 12 hours after injection took 650mg tylenol, able to fall asleep awoke again with sweats (did not take temperature) able to fall asleep, slept a total of 18 hours still with headache, weakness, fatigue on wakening, took 325 mg tylenol and 200 mg advil symptoms resolved approximately 25 hours after injection

Other Meds: 150mg sertraline

Current Illness: none

ID: 0931576
Sex: F
Age: 42
State: FL

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Mild allergy to dust might and roaches and pecan

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

Symptoms: My right upper eye lid kept twitching for 5 minutes then it stopped. Then after 2 hours kept twitching for ten minutes then it stopped.

Other Meds: Metformin

Current Illness: Diabetes Gerd

ID: 0931577
Sex: F
Age: 50
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Since administration - Chest pain, Shortness of breath, blurred vision, headache, nausea, and chills

Other Meds:

Current Illness:

ID: 0931578
Sex: F
Age: 45
State: TX

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: After 15 minutes patient reported chest pressure which increased with inspiration. could not report rating on pain scale. Initial BP with complaints was 168/138. HR 88, RR 16, 98 o2sat, Temp 98.8. Follow BP 137/85 5 minutes later .Sent to ED at 12:53. 12 lead EKG, Normal sinus rhythm, no ischemia. CXR negative. Shortly upon arrival in ED chest pressure resolved with out further intervention. Pt discharged to home.

Other Meds: Lisinopril 10mg qday

Current Illness: No

ID: 0931579
Sex: F
Age: 48
State: NE

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: penicillin, sulfa, codeine

Symptom List: Vomiting

Symptoms: fever, chills, arm pain, muscle aches, severe headache,

Other Meds: tylenol, calcium, multivitamins

Current Illness: none

ID: 0931580
Sex: F
Age: 21
State: OH

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

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

Lab Data:

Allergies: Peanuts -anaphylactic reaction Dairy

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient reported having a ?pepper? taste in the mouth about 3 minutes after vaccine administration. Patient thereafter reported having a tingling sensation in the mouth and lightheadedness about 6 minutes after vaccine administration. Patient laid down and vital signs were taken; BP-126/68, HR-100. Patient drank 1/2 of 16oz. bottle of water and a 12oz of a sports drink. Vitals were rechecked 13mins after the first set; BP- 120/62 HR- 64. Patient reported feeling better afterwards I.e lightheadedness had subsided and no tingling sensation.

Other Meds: Concerta (daily) Sertraline (daily)

Current Illness:

ID: 0931581
Sex: F
Age: 44
State: NM

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

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

Lab Data:

Allergies: dairy, mango, latex. cipro, augmentin, peniciliin, macrobid, bactrim, phenergan, compazine

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

Symptoms: faint red rash from waist down through legs within in 1 hour of receiving vaccine. Took Zyrtec, which did not help. 4 hours later, rash all over body - took benadryl which did help. Then proceeded to be up all night vomiting and 103F temp and body aches and severe headache. Next day - 24 hours after vaccine - temp 102, severe body aches and headache. Took tylenol, but fever and bodyaches did not respond to tylenol.

Other Meds: seroquel, gabapentin, lithium, synthroid, estradiol, pantoprazole

Current Illness: none

ID: 0931582
Sex: F
Age: 57
State: WA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa :Rash , Penicillin Rash Amoxi Rash Kelfex Rash Cirpo Sent to hospital eye red and body flushing.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt vaccinated with Moderna COVID vaccine shot number 1. scratchy throat started 5 minutes afterward. Tongue was tingling. throat was dry. no stridor or wheezing. initial BP 128/82 pulse of 80 )2 sat of 100%. normal mucous membranes no wheezing initially no rash. then complained her ears were hot. Shortly thereafter developed a flush on the upper chest and face and ears. 1/9/2021 11:59 AM Patient light headed. Ears feeling hot. 1/9/2021 12:02 PM patient has flushing of face and upper chest. Denies itching. 1/9/2021 12:03 PM patient reports itching of neck. blood pressure 118/78 1/9/2021 12:13 PM Sitting up Flushing is slightly better 1/9/2021 12:41 PM Sitting up Flushing has resolved. 130/70 Pulse 52 96% sat Patient is feeling back to normal Discharged to home OK to get second dose. the patient did take 10 mg Claritin about 90 minutes before the vaccination. she takes Claritin daily . we have sent her home no symptom s

Other Meds: Amour Thyroid Celexa Vit C Vit D Glucosamine

Current Illness: none

ID: 0931583
Sex: F
Age: 27
State: NY

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

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

Lab Data:

Allergies: Medications- Augementin, Minocycline Food: Tree Nuts

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

Symptoms: 10 minutes after getting shot, my lips started swelling and tingling and itching. Hives/ Redness on my face 30 minutes after- throat started itching Treatment- given Benadryl, Pepcid, Steroid in Emergency Room and was observed from 10:30ish until 2:15p

Other Meds: Xyzal Sharobel Vitamin D Prevident Toothpaste Differin Gel

Current Illness: None

ID: 0931584
Sex: M
Age: 29
State: GA

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

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

Lab Data:

Allergies: Ceclor Trazodone

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

Symptoms: Injection site pain, mild Headache, moderate Chills, mild Muscle and joint pain, moderate

Other Meds: Metoprolol Paroxetine

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm