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: 1051588
Sex: F
Age: 69
State: FL

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt in tent f1 at the observation lane felt tingling chest, paramedics assessed pt. Once symptoms subsided paramedics released the pt. to leave.

Other Meds: SYNTHROID

Current Illness:

ID: 1051590
Sex: M
Age: 46
State: OH

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Amoxicillin ( ow allergy reaction)

Symptom List: Anxiety, Dyspnoea

Symptoms: 1. Minor headache 2. Moderate pain in left underarm. Minor swelling of lymph node in the same area. I feel discomfort when trying to place my arm against my body. I have to keep arm extended to avoid discomfort.

Other Meds: Multivitamins (1/daily), vitamin C (500 mg, 1/daily), vitamin D3 (5000, 1/every 2 days), Levothyroxine (0.025 mg, 1/daily)

Current Illness: Low-T.

ID: 1051591
Sex: F
Age: 94
State: AZ

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Headache-Mild

Other Meds:

Current Illness:

ID: 1051592
Sex: F
Age: 66
State: CT

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 02/24/2021
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: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Additional Details: PATIENT PRESENTED FOR SECOND SHOT, STATING SHE STILL HAS MUSCLE PAIN FROM 1ST SHOT 21 DAYS AGO. IN ADDITION THERE WAS STILL BRUISING, AND SOME UNIDENTIFIED RED SPOTS. I INSTRUCTED HER TO CONSULT HER DOCTORE, WHICH SHE HAD NOT YET, AS THIS COULD BE A SIGN OF SOMETHING THAT REQUIRES MEDICAL TREATMENT

Other Meds:

Current Illness:

ID: 1051593
Sex: M
Age: 77
State: FL

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Sore arm, sore body, nausea, can't sleep. No side effect from first shot.

Other Meds: None

Current Illness: None

ID: 1051594
Sex: F
Age: 89
State: MI

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
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:

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

Symptoms: AFTER RECEIVING THE VACCINE, SHE SAID SHE WAS HAVING AN ALLERGIC REACTION. ON SITE EMS RESPONDED. BP 114/72 HR 72. SHE REFUSED FURTHER EVALUATION OR CARE.

Other Meds:

Current Illness:

ID: 1051595
Sex: M
Age: 68
State: AZ

Vax Date: 02/16/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
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: halcol, morphine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: pain in left arm started days after shot

Other Meds: lanoxin, lantus, levothyroxine, allopurinol,zoloft, metoprolol er

Current Illness: none

ID: 1051596
Sex: F
Age: 17
State: NC

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Error: Patient Too Young for Vaccine Administered

Other Meds:

Current Illness:

ID: 1051597
Sex: F
Age: 72
State: PR

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Codeina, Reglan.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Elevated high pressure, nauseas, dizziness and strong headaches. Couldn't sleep well.

Other Meds: None.

Current Illness: None.

ID: 1051598
Sex: F
Age: 55
State: KY

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
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: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fever-Medium, Systemic: Flushed / Sweating-Medium

Other Meds:

Current Illness:

ID: 1051599
Sex: F
Age: 48
State: FL

Vax Date: 02/16/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Red itchy raised bump Hot to touch

Other Meds: Armor thyroid

Current Illness: Hashimotos Anemia

ID: 1051600
Sex: M
Age: 67
State: MA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1051601
Sex: F
Age: 35
State: MN

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1051602
Sex: F
Age: 56
State: KS

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/24/2021
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: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1051603
Sex: F
Age: 94
State: AZ

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: pt was not responding well, urinated on self and felt nauseas. Pt is on hospice and felt dizzy even before the vaccine.-Mild, Systemic: Nausea-Mild, Additional Details: Pt was dizzy and fell 02/21/21 at the site; paramedics called; refused to be hospitalized. Pt vaccinated 02/22/21, was dizzy and urinated on self, paramedics called, refused to be hospitalized. Staff told vaccinators then that pt was hospice and own guardian, so nothing could be done.

Other Meds:

Current Illness:

ID: 1051604
Sex: F
Age: 66
State: PR

Vax Date: 02/18/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
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: Seafood.

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

Symptoms: The next day of vaccination, early in the morning wake up having convulsions.

Other Meds: Losantan 50mg, caltrate

Current Illness: None.

ID: 1051605
Sex: M
Age: 51
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 02/24/2021
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: Sore shoulder

Other Meds:

Current Illness:

ID: 1051606
Sex: F
Age: 31
State: MO

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

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

Lab Data:

Allergies: Latex rash Sulfa Sulfonamide Antibiotics rash Tingly lips

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Started to feel face heat and lips tingle slight rash on cheeks and bridge of nose

Other Meds:

Current Illness: no

ID: 1051607
Sex: F
Age: 70
State: FL

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt. from tent 3 at observation lane was complaining of light headedness + generalized weakness. Paramedics assessed. Once symptoms subsided paramedics released pt. to leave.

Other Meds:

Current Illness: none

ID: 1051608
Sex: F
Age: 46
State: NY

Vax Date: 02/15/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Eggs and dusts

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

Symptoms: Red itchy rash about 1.5? below where the shot was It?s about 2.5? long and 1? wide.

Other Meds: Altavera, , multi vitamins, B complex, vitamins D, fish oil, flonase

Current Illness: None

ID: 1051609
Sex: F
Age: 88
State: NY

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital: Y

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: Bactrim,codiene,lipitor,morphine,meloxicam,phenergin pain, sulfa antibiotics,vicodin,dilaudid [hydromorphone]

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

Symptoms: left arm deltoid region is erythemous, tender to touch, and warm. local reaction to at covid injection site.

Other Meds:

Current Illness: gastroeneteritis, fatigue,unstable angina, acute myocardial infarction, dizziness and giddiness, coronary artery disease involving native coronary artery of native heart without angina pectoris,allergic rhinitis, acute anxiety, elevated blood pressure, elevated d-dimer, partial small bowel resection,history of chemothrapy,ductalcarcinoma in situ of breast,history of mastectomy, gerd, elevated troponin level, parastomal hernia without obstruction, small bowel obstruction, status post colostomy, diverticular stricture, diverticulitis larger, druse of left macula, epiretinal membrane, shoulder pain, right, pain in joint hand, left hand pain, pain of right thumb diverticulosis of colon without hemorrhage, supra ventricular premature beats,dyslipidemia, spinal stenosis, breast cancer, osteoarthritis involving lower leg, family history of malignant neoplasm of breast, mild mitral regurgitation,cardiomegaly hypertensive, benign neoplasm of stomach, reticule, diaphragmatic hernia without mention of obstruction or gangrene.

ID: 1051610
Sex: F
Age: 67
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies, fresh fruits and vegetables allergies

Symptom List: Unevaluable event

Symptoms: Shot was given at approximately 9:05 a.m. Waited the 15 minutes and left the mega-site at approximately 9:30 a.m. On the drive home, approximately 5-10 minutes into the drive my tongue and roof of my mouth started to tingle. Got home in about 15 minutes. Once home, I drank some water. Slowly the tingling of the tongue and roof of mouth disappeared.

Other Meds: Synthroid, Nexium, Eliquis, Metoprolol, Lipitor, Zyrtec, Hydrochlorothiazide and Pot Chlor Er (Potassium Tablet)

Current Illness: None

ID: 1051611
Sex: F
Age: 53
State: OH

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/24/2021
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: Sulpha

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

Symptoms: Immediately felt faint and dizzy,vasovagal reaction exacerbated, I get menopausal hot flashes this was intensified 10 x and immediate pain top head,B/p went up,felt numb face extremities, cancelled 2nd injection and B/p still up currently still feel dizzy and pain top head

Other Meds: Nexium,claritan,benadryl

Current Illness: None

ID: 1051612
Sex: F
Age: 72
State: FL

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Codeine

Symptom List: Injection site pain, Pain

Symptoms: Pt left tent 13 to observation lane. Pt. was complaining of tingling hands. Paramedics monitored until symptoms subsided. Paramedics released pt. to leave.

Other Meds: Magnesium

Current Illness:

ID: 1051613
Sex: F
Age: 50
State: MI

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
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: HE WAS HOT, FLUSHING SWEATING 5 MINUTES AFTER RECEIVING THE VACCINE. ON SITE EMS RESPONDED. BP 163/76 HR 90. AFTER 10 MINUTES HE FELT FINE AND LEFT FOR HOME

Other Meds:

Current Illness:

ID: 1051614
Sex: M
Age: 38
State: MN

Vax Date: 02/14/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
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: Penicillin, morphine

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

Symptoms: Stiff and sore left arm at injection site, redness and swelling. Ice packs and betamethasone cream. Advil. Resolved within 2 days

Other Meds:

Current Illness:

ID: 1051615
Sex: F
Age: 30
State: PA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/24/2021
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: 8 hours after, fever, chills, body aches. 5 days later, severe headache that has lasted over a week (9 days)

Other Meds: Omega dish oil DHA, vitamin b, d, probiotic, mitochondria recharged, yeastonil, digestive enzymes, magnesium

Current Illness:

ID: 1051616
Sex: F
Age: 54
State: NY

Vax Date: 01/27/2021
Onset Date: 02/12/2021
Rec V Date: 02/24/2021
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: Shingles at the right L1-2 dermatome

Other Meds: Vitamin D3 2000 IU B complex Vitamin C 1 gram

Current Illness: None

ID: 1051617
Sex: M
Age: 42
State: MI

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: 42 YEAR OLD MALE WAS DIAPHRETIC AFTER RECEIVING VACCINE. HE WAS ALSO TALKITIVE AND ALERT. ON SITE EMS RESPONDED. BP 104/80 HR 71 PULSE OX 96% GLUCOSE 82 MG/DL His wife got in the drivers seat and left for home

Other Meds: NO MEDICATIONS

Current Illness:

ID: 1051623
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Injection in joint leading to bursitis; Initial information received on 03-Feb-2021 regarding an unsolicited valid non-serious case received from a pharmacist . This case involves patient (unknown demographics) who experienced injection in joint leading to bursitis (bursitis), while he/she received vaccine INFLUENZA VACCINE. It is unknown if the patient had any medical history, concomitant disease or risk factor. Medical treatment, vaccination, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number and expiry date: not reported) via an unknown route in unknown administration site. On an unknown date, the patient developed a non-serious injection in joint leading to bursitis (bursitis) (unknown latency) following the administration of INFLUENZA VACCINE. It is unknown if there were lab data/results available. It was not reported if the patient received a corrective treatment. It is unknown if the patient experienced any additional symptoms/events. At the time of reporting, the outcome of event was reported as unknown. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1051624
Sex: M
Age: 47
State: OH

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
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: My epoglottis began swelling about 8-10 hours after the shot. It was minor, and I did not see a doctor., nor did I take any meds or treatment The swelling was gone by the next morning.

Other Meds: n/a

Current Illness: n/a

ID: 1051625
Sex: F
Age: 34
State: OH

Vax Date: 02/04/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
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: Loss of taste, specifically coffee. Called doctor, advised by nurse to report to VAERS, awaiting doctor recommendation

Other Meds: N/A

Current Illness: N/A

ID: 1051626
Sex: M
Age: 56
State: MI

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/24/2021
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: unknown

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

Symptoms: Patient informed the clinic that he began feeling "itchy like bugs crawling all over" on 2/16/21. He proceeded to take Benadryl which was effective. On 2/20/21 he woke up with swelling on the left side of his face. On 2/21/21 he woke up with swelling on the right side of the mouth and reported "tingling like I just went to the dentist". Symptoms were resolved by 2/22/21.

Other Meds: none reported

Current Illness: none reported

ID: 1051627
Sex: F
Age: 34
State: NC

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Yes - many medications

Symptom List: Tremor

Symptoms: SOB, Hives, Reddness, Swelling in throat and lips. hoarseness and wheezing

Other Meds: Unknown other than EPI Pen

Current Illness: no

ID: 1051628
Sex: F
Age: 65
State: NC

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
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 - delayed reaction rash - itching - mild pain.

Other Meds: Levothyroxine

Current Illness: None

ID: 1051629
Sex: M
Age: 40
State: NC

Vax Date: 11/03/2011
Onset Date: 12/01/2011
Rec V Date: 02/24/2021
Hospital: Y

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: Patient describes receipt of LAIV (lot #50110 7P Nov 3, 2011; dose #15) and onset of double vision changes in December. Progressive symptoms were loss of speech enunciation, difficulty clearing throat, and burning sensation and numbness of upper back and arms. He was diagnosed GBS Miller-Fisher variant in later January and treated with inpatient IVIG. He would like to receive flu vaccine if can be done safely. He does recall significant GI illness with severe diarrhea prior to GBS diagnosis. He also reports episodes of frequent pneumonia, and believes has had at least 5, confirmed by CXR (we found documentation of two, f/u immune function eval results normal) Per event note: Per notes 02 FEB 12: Admitted to Neurology with acute onset of pseudobulbar palsy (dysphagia, dysphonia), diplopia, unsteady gait, and rapidly developing dysarthria, associated with paresthesias and pain in the extremities, and then leading to areflexia, all with a normal sensorium. Symptoms started on 19 JAN. He had negative brain / C-spine MRI, negative EEG, negative myasthenia testing, and NCV/EMG testing suspicious for Guillain-Barre syndrome. Plus, he had positive antibodies to ganglioside GQ1b, pathognomonic of Miller-Fisher syndrome. He was treated with 5 days of IVIG, and rapidly improved, with normalization of all bulbar symptoms. He had persistent back pain and limb paresthesias, as well as feeling "juiced up" and very agitated. Admission dates: 22 JAN - 02 FEB 2012.

Other Meds:

Current Illness: Acute GI illness after vaccine but before symptom onset

ID: 1051630
Sex: F
Age: 36
State:

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: woke during the night with chills, body aches, and migraines, hurts to walk

Other Meds:

Current Illness:

ID: 1051631
Sex: M
Age: 51
State: NY

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 02/24/2021
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: temp 100.5 chills, muscle pain, injection site pain radiating to left armpit which last for 2 weeks

Other Meds:

Current Illness:

ID: 1051632
Sex: F
Age: 42
State: OH

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/24/2021
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: Risperdal, Latex

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

Symptoms: Syringe malfunctioned, causing some of the vaccine to end up on the skin, rather than in the patient

Other Meds: Clonazepam, Gabapentin, Sertraline, Mirtazapine, Noreth, Mirvaso, Colesavam, Metoprolol, Osybutynin, Melatonin, Calcium, MultiVitamin, Probiotics, Lutein, Immodium

Current Illness: none

ID: 1051633
Sex: F
Age: 65
State: VA

Vax Date: 02/15/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: "Covid arm" -- redness, rash and hardness 8-9 days after injection,

Other Meds: multi vitamin daily vitamin D-3 daily Rouvastin for high cholesterol Nefazodone

Current Illness: None

ID: 1051634
Sex: M
Age: 82
State: OH

Vax Date: 02/15/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
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: Pain in extremity

Symptoms: Pt with no previous history of abdominal aortic aneurysm presented to ER on 02.20.2021 with abdominal pain, weakness and BP of 50/30 via EMS. Abdominal pain started on 02.19.2021 approx 10:00 PM. Pain was described as severe in the left flank, radiating into the lower abdomen and worsened through the night. EMS was called around 11 AM. Pt CT Abd/Pelvis angiography shown Ruptured abdominal aortic aneurysm measuring up to 7.9 cm in diameter and 9.8 cm in length with active extravasation of IV contrast. Large volume of predominantly retroperitoneal hemorrhage. Pt was flown hospital for surgical intervention after being given 2 units of O neg blood with 2 L normal saline.

Other Meds:

Current Illness: None

ID: 1051635
Sex: F
Age: 69
State: MI

Vax Date: 02/08/2021
Onset Date: 02/11/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: Too many to name

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

Symptoms: I got a rash in the area where the 1st vaccine was after my 2nd shot. Went to my primary and was given an antibiotic. took pill for couple of days and it cleared up after a day and a half.

Other Meds: Yes

Current Illness:

ID: 1051636
Sex: F
Age: 52
State: MA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/24/2021
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: Morphine causes hypotensive episode

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

Symptoms: Tingling in left shoulder blade and left arm

Other Meds: Simvastatin, Apri

Current Illness:

Date Died: 03/13/2021

ID: 1051637
Sex: M
Age: 77
State: IN

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/24/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: 2/9 received 2nd vaccine in series. 2/10 mild headache and fatigue. 2/11 worsening headache, extreme fatigue, and general malaise. In bed except for bathroom use and minimal food consumption starting 2/11 until hospitalization on 2/17/2021.

Other Meds:

Current Illness:

ID: 1051638
Sex: F
Age: 45
State: CT

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
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: Z-pak antibiotic - hives and diarrhea sulfur drugs cause nausea

Symptom List: Vomiting

Symptoms: About 30 minutes after receiving the vaccine I began to lose my voice. I also had a headache, joint pain and felt fatigue later that evening and it lasted until the 23rd. On the 23rd I developed a fever of 101. Today I still do not have my voice and the fever has went away. The injection site has a red and swollen patch. I still feel tired and fatigued today.

Other Meds:

Current Illness:

ID: 1051639
Sex: F
Age: 43
State: NY

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
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: Ampicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I developed fever of 101.7, had rigors, sweats, bone and muscle ache. I experienced a zapping sensation in my head that traveled down to my jaw. It felt like an electric shock that lasted a few seconds .It went from top of my head to my left jaw and ear. If felt the pain in my back molars. This happened at least 15 times. In a 24 hour period. It was not a headache.

Other Meds: Daily Vitamin

Current Illness: None

ID: 1051640
Sex: F
Age: 31
State: TX

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: -Seasonal allergies

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

Symptoms: -Severe chills -High Fever (Did not measure) -Trouble breathing -Neck pain/facial pain -Arm soreness -Weakness and SOB -Tachycardia - (Peak 132 BPM)

Other Meds: -Vitamins - Multivitamin -Vitamin D -Omega pill

Current Illness: Anemic

ID: 1051641
Sex: F
Age: 71
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
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: Sesame seeds, Cipro

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Moderna COVID-19 Vaccine EUA 10 days after injection, itching, soreness, rash, swelling at injection site

Other Meds: Sertaline Hydrocloride, Atorvastatin, Temazepam, over the counter vitamin supplements

Current Illness: none

ID: 1051642
Sex: F
Age: 58
State: OH

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/24/2021
Hospital:

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

Lab Data:

Allergies: demerol, levequin, keflex, Bees/Wasps, dust, molds,

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

Symptoms: Patient felt warm and lightheaded upon standing. Walked with assistance to lie down on a cot in the patient care tent. BP: 128/70, P: 90, Resp: 17. Patient drank some water and ate pretzels while sitting and denied dizziness after 20 minutes of sitting up. Patient left the building feeling well and denied any dizziness.

Other Meds: Lisinopril HCTZ, Chlorphenermine, imetrax, baby aspirin, previstatin

Current Illness: none

ID: 1051644
Sex: F
Age: 73
State: GA

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 02/24/2021
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: Levaquin amoxicillin Keflex tetracycline augmentin codine

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

Symptoms: Red firm lump at injection site with itching

Other Meds: Restasis for dry eye

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm