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: 1051645
Sex: F
Age: 39
State: FL

Vax Date: 01/27/2021
Onset Date: 02/17/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Positive COVID test after household exposure (daycare-child). No symptoms.

Other Meds:

Current Illness:

ID: 1051646
Sex: F
Age: 44
State: CT

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: Z-pak antibiotic - hives and diarrhea sulfur drugs cause nausea

Symptom List: Anxiety, Dyspnoea

Symptoms: I had the vaccine around 8 in the morning, a few hours later I lost my voice. I also developed a slight headache, arm soreness and fatigued. This lasted about 3 days.

Other Meds:

Current Illness:

ID: 1051647
Sex: F
Age: 30
State: MD

Vax Date: 02/14/2021
Onset Date: 02/21/2021
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: None

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

Symptoms: Injection site swelling, stiff neck/back/left arm, pain under armpit, feeling of coming down with a cold

Other Meds: None

Current Illness: None

ID: 1051648
Sex: M
Age: 27
State: CT

Vax Date: 01/16/2021
Onset Date: 02/12/2021
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: no known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: No issues with vaccine number 1. With receiving second dose he experienced light headedness and chronic low blood sugars for 4 days post vaccine. He was unable to rise his BS above 100 . He had to check his glucose every 2 hours. Since post 4 days he has been able to maintain his BS as normal.

Other Meds: insulin -sliding scale, Melatonin , Zolipidem , Pro Air inhaler, Montelukast, Fluoxetine

Current Illness: none

ID: 1051649
Sex: M
Age: 65
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:
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: Severe chills from 11pm to 6am.; mild nauasea; headache in morning

Other Meds: Zucor; baby Aspirin; Vitamen D; Salmon oil;

Current Illness: NA

ID: 1051650
Sex: F
Age: 37
State:

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: Employee developed severe dizziness about 10 minutes after vaccine. Has a hx. of vertigo. Also had GI upset. Speech was sluggish, but she was oriented. Symptoms did not improve after an hour so significant other drove her home. Symptoms continued on 2/7/21 so Patient went to ER. Given IV fluids and sent home. Was able to return to work 3/9/21 and has been feeling fine.

Other Meds:

Current Illness:

Date Died: 02/24/2021

ID: 1051651
Sex: M
Age: 58
State: NY

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

Lab Data:

Allergies: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death. Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving.

Other Meds: Lisinopril, metoprolol, simvastatin, acetaminophen, ibuprofen, calcium carbonate, furosemide, diphenoxylate/atropine, magnesium chloride, omeprazole, Carafate, testosterone, vitamin D3, levothyroxine

Current Illness: None

ID: 1051652
Sex: F
Age: 69
State: NY

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

Lab Data:

Allergies: Codeine

Symptom List: Pharyngeal swelling

Symptoms: Injection site has red blotch that itches twelve days after receiving vaccine

Other Meds: Letrozole, Hydrochlorthiazide, Losartan, Carvedilol, Amlodipine, Pravastatin

Current Illness: HBP, Cancer, Sleep apnea, Esophogeal reflux

ID: 1051653
Sex: M
Age: 77
State: ME

Vax Date: 01/28/2021
Onset Date: 02/01/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderate pain in chest behind sternum when breathing. Admitted to Hospital on 1 February 2021. Diagnosed as pericarditis. Treatment: Ibuprofen 600 mg 3x/day for 2 weeks, and Colchicine 0.6 mg 2x/day for 3 months.

Other Meds: Rosuvastatin 20 mg 1tab/day Lisinopril/HCTZ 10-12.5 mg 1 tab/day Melatonin 10mg Vitamin D3 25 mg

Current Illness: None

ID: 1051654
Sex: F
Age: 63
State: VA

Vax Date: 02/10/2021
Onset Date: 02/16/2021
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: Soy, MSG, Scents (perfumes)

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Swollen at the site within 7 days and continues to the present. No rash but hot to the touch, itches, & hurts.

Other Meds: duloxetine (30 mg), Zinc, Vitamin C & D

Current Illness: None

ID: 1051655
Sex: F
Age: 47
State: GA

Vax Date: 02/13/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: "Covid Arm" started on day 8, following initial injection; symptoms include red rash about 5 inches in length, from top of shoulder to mid-bicep area, slight swelling, and itching.

Other Meds: Atorvastatin Balance Supplement Methyl CPG Supplement

Current Illness: None

ID: 1051656
Sex: F
Age: 40
State: WI

Vax Date: 02/03/2021
Onset Date: 02/03/2021
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: Penicillin, citric acid, and seasonal allergies

Symptom List: Rash, Urticaria

Symptoms: Following the injection, after approximately four hours later I began to feel some slight disorientation and tiredness. Later the same evening I experienced brain fog and confusion for the next several days as well as a terrible headache. Additionally my tongue felt tingly. All of these symptoms passed within several 3- 4 days following the vaccination. injection site discomfort was also a symptom.

Other Meds: Bupropion xl, adderall xr, zaleplon, magnesium, vitamin d3, loratadine, fish oil, collagen w/ biotin, and mirena (IUD)

Current Illness: None known of

ID: 1051657
Sex: F
Age: 65
State: OH

Vax Date: 02/11/2021
Onset Date: 02/17/2021
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: Buspar, none

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

Symptoms: Sore arm, red site, hot, 1/2 inch in size. Lasted 3 days, 4th day redness spreading, hot to touch. 5th day, redness spreading more, soreness comes back, tender to touch, warm area. 6th day itching started, redness area becomes becomes larger, still sore, soreness moves also inner arm, away from actual injection site. 13th day, it has not changed at all, red area 3" in diameter, still sore, warm and itchy. Have done acetaminophen, ibuprofen, ice packs, benadryl.

Other Meds: Zolpidem Tartrate 5mg, Rosuvastatin 20mg, Anastrozole 1mg, Duloxetine 60mg, Benadryl 1 tablet, 35,000 units vitamin D, melatonin 10mg

Current Illness: Cold, UTI

ID: 1051658
Sex: M
Age: 66
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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: Penecillin

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

Symptoms: Onset of chills after 20 hours of injection followed by nausea and lightheadedness as day progressed. Symptoms completely gone after twelve hours.

Other Meds: Levothyroxine Atorvastatin

Current Illness: None

ID: 1051660
Sex: F
Age: 55
State:

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: 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: One week after the vaccination it started itching at the site of the vaccination. The next day it became red . Diameter around 3 inches

Other Meds:

Current Illness:

ID: 1051661
Sex: F
Age: 43
State: TX

Vax Date: 02/08/2021
Onset Date: 02/20/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: At and around the site of the shot: red rash, blotchy and itchy. It started a week or so after the shot.

Other Meds:

Current Illness: none

ID: 1051662
Sex: F
Age: 54
State: NM

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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: Allergic to Sulfa, Demerol and foods allergic to all corn, soy, nuts and eggs.

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

Symptoms: Waited 15 minutes as required and left. At 20-25 minutes as I was driving my mouth began to severely itch. Arrived home, and took Benadryl which lessened the itch and it was almost gone by 2am on 2/24/2021.

Other Meds: Folic acid, leuflodimide (stopped 4 days prior to vaccine), multi vitamin women's 50+.

Current Illness: No other illness other than rheumatoid arthritis.

ID: 1051663
Sex: F
Age: 77
State: NY

Vax Date: 02/14/2021
Onset Date: 02/23/2021
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: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: red warm swelling at injection site Noticed 9 days after injection

Other Meds: synthetic, centrim sr, vit D

Current Illness: none

ID: 1051664
Sex: F
Age: 22
State: MI

Vax Date: 02/23/2021
Onset Date: 02/24/2021
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: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: fever, chills, body aches

Other Meds: fluoxetine 60mg phentermine 37.5mg apri oral contraceptive omeprazole 20mg

Current Illness: none

ID: 1051665
Sex: F
Age: 82
State: NJ

Vax Date: 02/11/2021
Onset Date: 02/17/2021
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: None now but when young allergic to wool, cat fur and shrimp (outgrew these)

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

Symptoms: About five days after receiving first COVID shot I felt itchiness in left arm. Then I noticed large three large red blotches from almost shoulder to about six inches from elbow. They became a darker pink and outlined in red. They were very itchy for several days, but otherwise I felt fine. As of today I still have the blotches, but they seem to have faded a bit (red outline still visible) and the itchiness is much less.

Other Meds: No prescription medicine only vitamin D3

Current Illness: None

Date Died: 02/02/2021

ID: 1051666
Sex: M
Age: 85
State: OH

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Heparin,Cipro,Imdur

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

Symptoms: Pt presented to ER with SOB on 01-29-2021. He was admitted to Healthcare with acute CHF exacerbation, elevated lactate, anemia and elevated d-dimer. Pt reports getting SOB getting up to go to the bathroom. Pt was intubated. He developed pulmonary edema. Pt expired on 02-02-2021 at 10:13 PM.

Other Meds:

Current Illness: None

ID: 1051667
Sex: F
Age: 30
State: NY

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: Peanuts

Symptom List: Unevaluable event

Symptoms: Localized rash

Other Meds: Sprintec

Current Illness: No

ID: 1051668
Sex: M
Age: 51
State: IL

Vax Date: 02/08/2021
Onset Date: 02/12/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Sore throat

Other Meds:

Current Illness:

ID: 1051669
Sex: F
Age: 36
State: TX

Vax Date: 02/10/2021
Onset Date: 02/12/2021
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: Aspirin

Symptom List: Injection site pain, Pain

Symptoms: Rash all over neck and shoulders. Under breast and armpits. Red and painful. Itchy. Treated with steroid shot and steroid given to take orally for 1 week

Other Meds: None

Current Illness: None

ID: 1051670
Sex: F
Age: 55
State: NY

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: My arm was red and raised and hot directly at injection site at first. Then hotness went away the next day but was still raised up and red about the size of a silver dollar. After a couple of days, it was slightly itchy too. Today marks 2 weeks and I still have an small egg shaped red mark just slightly raised on my left arm at injection site that at times seems itchy. It is not bothersome at all, but I felt like you would want to know.

Other Meds: Synthroid and Meloxicam

Current Illness: None

ID: 1051671
Sex: M
Age: 77
State: WI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: 1. Cefalexin 2. Yellow Jacket venom

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

Symptoms: 1. Pain at site of injection started about 6 hours post second vaccine injection (7-8 on a 0-10 scale) that lasted for almost 48 hours, most intense during the day following injection. No treatment for that. 2. Significant fatigue on the morning 14 hours following the injection (could have started during the night) . Difficult to maintain balance. Just rested the whole day. Unable to exercise on stationary bike. 3. Low grade fever (just under 99 F; base line for me has been 97.6 F) in the evening following injection, gone next morning. No treatment.

Other Meds: CoQ10; multiple vitamins; Omega 3; Metformin; Simvastatin; Finasteride; Losartan + HTZ (100/25); Metoprolol.

Current Illness: None per se. Completed radiation treatment to right face and posterolateral upper neck.

ID: 1051672
Sex: M
Age: 62
State: NJ

Vax Date: 02/12/2021
Onset Date: 02/20/2021
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: Penicillin, clindamycin, nutra-sweet, adavan, Crestor (rosuvatatin), Albuterol Sufate, porazepam

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Red rash, VERY itchy area around injection site. Did I mention VERY itchy. No medications, ointments, or creams used on itchy area. No oral medications taken for itch or rash. Currently on day three of itchy and it seems a little better. Waiting for a few days for condition to clear.

Other Meds: 81 mg aspirin, One-A-Day multi-vitamin

Current Illness: none

ID: 1051673
Sex: F
Age: 69
State: NC

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

Lab Data:

Allergies: Walnuts, erthromyacin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Large raised sore red circle at the injection site

Other Meds: Omeprazole, doxycycline, cimiditine, multi-vitamins, Soothe XP,

Current Illness: None

ID: 1051674
Sex: M
Age: 64
State: TX

Vax Date: 02/19/2021
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: None

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

Symptoms: Chills, leg aches, for one full day, took Tylenol, fluids,rest, much better this morning.

Other Meds: Warfarin Metoprolol Lisinopril Multi vitamin Flowmax

Current Illness: None

Date Died: 02/01/2021

ID: 1051675
Sex: F
Age: 78
State: WI

Vax Date: 01/28/2021
Onset Date: 02/01/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient passed away on 2/1/21 at the Health System. She was there for congestive heart failure (CHF) which had been a problem for her since contracting COVID-19 (symptoms began 10/29/20 and tested positive 10/30/20). She had been to see her medical provider several times after her isolation period as well as a few trips to the hospital for, what they called "CHF flare-ups". Her last hospitalization began on January 30, 2021. Her social worker reported on t1/31/21 that "she would likely be returning in another day or two".

Other Meds:

Current Illness: congestive heart failure

ID: 1051676
Sex: F
Age: 30
State: MO

Vax Date: 02/13/2021
Onset Date: 02/20/2021
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: None

Symptom List: Injection site pain

Symptoms: I had the reaction colloquially called ?covid arm?. About 7 days after my first dose, my injection site started to itch and swell. The next day the injection site had swollen rather large in diameter, was red, itchy, and painful to the touch. The redness has has finally started to subside and the swelling is down but not entirely gone yet.

Other Meds: Birth control

Current Illness:

ID: 1051677
Sex: M
Age: 78
State: VA

Vax Date: 01/27/2021
Onset Date: 02/14/2021
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: No known allergies

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

Symptoms: I noticed that the left side of my mouth was a little droopy around 10:00am on 2/14/2021 but didn?t think anything of it. Then around 4pm my daughter saw me and noticed it as well. We went to the ED immediately and got a stroke rule out work up. There were no other deficits besides the left sided facial palsy.

Other Meds: Aspirin 81mg daily Losartan 50mg daily Atorvastatin 40mg daily Fish oil One a day men?s vitamin

Current Illness: None

ID: 1051678
Sex: M
Age: 70
State: AZ

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital: Y

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

Lab Data:

Allergies: none

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

Symptoms: 70-year-old male who presents to the emergency department for evaluation of abdominal pain. The patient was awakened from sleep this morning with severe sharp, stabbing pain in his epigastric region. Pain radiates into his lower abdomen and his back. He associates his symptoms with a bloating sensation. He took omeprazole with mild relief of symptoms. Symptoms recurred a few hours later. States that he became confused and diaphoretic at that time. He called EMS to transport him to the emergency department. The patient was found to have an objective fever at that time. He was given Zofran; Notes COVID vaccine several days earlier; on antibiotics, will need cholecystectomy while in hospital

Other Meds: aspirin, atorvastatin, omeprazole, miralax, probiotic, vitamin C

Current Illness: none

ID: 1051679
Sex: F
Age: 67
State: CT

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Developed Rash on Lower Back, on 2/23 since rash is still on back.

Other Meds: Sertraline HCL 50 mg Lisinopril HCTZ 10-12.5 mg Women?s Multivitamin Caltrate

Current Illness: None

ID: 1051681
Sex: F
Age: 67
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: woke up this morning and fainted

Other Meds: Ramipril 10ng synthroid 75mcg escitalopram 5 mg rosuvastatin 10 mg metoprolol stearate 25 mg

Current Illness: none

ID: 1051682
Sex: F
Age: 80
State: VA

Vax Date: 02/10/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
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: Biomax

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

Symptoms: after 11 days i couldn't move my hand and painful . the redness and hardness and itchiness. started to spread for the last four four days

Other Meds: thyroid, anti acid, blood pressure, Vitamin

Current Illness:

ID: 1051683
Sex: F
Age: 24
State: MI

Vax Date: 02/09/2021
Onset Date: 02/12/2021
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: Ceftin, Pineapple

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

Symptoms: Continued weakness, limited range of motion, area injection site gets inflamed and rise in temperature when stressed

Other Meds: Lamictal, Vraylar

Current Illness:

ID: 1051684
Sex: M
Age: 58
State: NY

Vax Date: 02/17/2021
Onset Date: 02/22/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: From shoulder to elbow swelling with itching around injection site appeared 7 days days after 2nd shot of Moderna

Other Meds: Rituxan Flecainide 50mg 2x Metoprolol 25mg 1x Simvastatin 20mg 1x Tamsulosin 0.4mg 1x Levothyroxine 200mcg 1x Aspirin 81mg 1x

Current Illness: Nodular Lymphocyte predominant hodgkins lymphoma

ID: 1051685
Sex: F
Age: 71
State: CT

Vax Date: 02/13/2021
Onset Date: 02/01/2021
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: seasonal, mold

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

Symptoms: I noticed a 3'X3" red, warm, slightly raised patch about 4 inches below vaccination site on my arm a couple of days after vaccination...itchy at times....slowly subsifing now.

Other Meds: Restasis, Cozaar, Crestor, Omeprazole, Bystolic, Allegra, Ubiquinol, Milk Thistle, Glutathione, Vit B12,C,D,E, Tumeric

Current Illness: n/a

ID: 1051686
Sex: M
Age: 24
State:

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: fever, chills, headache, nausea, muscle aches, and SORE THROAT Treated with ibuprofen with mild improvement. Presented the following morning to COVID Testing Center with symptoms and was tested for COVID due to sore throat (not a "common side effect")

Other Meds:

Current Illness:

ID: 1051687
Sex: F
Age: 49
State: WA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: aspirin all NSAIDS raw sugar

Symptom List: Pain in extremity

Symptoms: I had a fast heart beat that started about an hour to half hour after my shot. My heart rate was at 120 BPM and I called 911. The highest my hear rate went was 140 BPM. The paramedics but me on an EKG and my heart rate dropped to 116 BPM. I was not admitted to the hospital, and after the paramedics left I was able to go back to sleep. I had heart palpitations for the next 8-10 days after the vaccine. I saw a cardiologist and they didn't find anything out of the ordinary, and then I saw an allergist and I'm following up with him soon.

Other Meds: metformin spirnolactone mulitvitamin vitamin D

Current Illness: No

ID: 1051688
Sex: M
Age: 74
State: OH

Vax Date: 01/29/2021
Onset Date:
Rec V Date: 02/24/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1051689
Sex: F
Age: 88
State: MI

Vax Date: 02/11/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
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: Amoxicillin (nausea), diphenhydramine (delirium)

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

Symptoms: Presented to emergency department on 2/20/21 with shortness of breath and nasal congestion with symptoms starting 2 days prior to presenting. Had virtual appointment on 2/19/21 with primary care provider for sinus infection and was started on Bactrim. Patient was discharged on 2/23/21 then presented back to ED on 2/23/21 and was re-admitted. Patient is currently admitted at the time of reporting.

Other Meds: Ventolin, amlodipine, anastrozole, Eliquis, aspirin, atorvastatin, Symbicort, Calcium+D, Flonase, levothyroxine, mag-ox, meclizine, metoprolol, montelukast, Verzenio

Current Illness: Atrial fibrillation, metastatic breast cancer

ID: 1051690
Sex: F
Age: 69
State: NC

Vax Date: 02/14/2021
Onset Date: 02/23/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: red rash at injection area

Other Meds: metoporal, vitamin D, biotin, Alleve

Current Illness:

ID: 1051691
Sex: F
Age: 65
State: FL

Vax Date: 02/19/2021
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:

Symptom List: Vomiting

Symptoms: pfizer jan 29 pfizer feb 19 Pfizer #1 EL 9263 Pfizer #2 EL 9267 low grade fever of 99.0, palpitations, and diarrhea yesterday. Recommended that she see her primary provider if symptoms worsen.

Other Meds:

Current Illness:

ID: 1051692
Sex: F
Age: 90
State: MN

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: no known allergies

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fall on 1/21/2021 following first vaccination and fall on 2/18/2021 following 2nd vaccination. No falls since admit in 3/2020. Falls causing increase pain with head strike on 1/21/2021. Is recovering slowly from pain of events

Other Meds: unnknown --manages own meds

Current Illness: none

ID: 1051693
Sex: F
Age: 71
State: NC

Vax Date: 02/12/2021
Onset Date: 02/20/2021
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: None

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

Symptoms: Day 2 2/13, herpes breakout back of upper rt leg Day 8 red itchy rash at injection sight, some soreness and heat. Enlarged to slight whelp about 2x4 inches. Reaction almost resolved 2/24. Treated with acetaminophen.

Other Meds: Atenelol, Amlodopine, HCTZ, Synthroid, Atorvastatin, Escitalopram, Latanoprost, Cosopt, Vitamin D, famotidine Prolia injection due May

Current Illness: Glaucoma, thyroid

ID: 1051694
Sex: F
Age: 27
State: WI

Vax Date: 01/22/2021
Onset Date: 02/04/2021
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: sulfa drugs, latex

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Rash appeared on the trunk, small red maculopapular spots, bright red in color, slightly itchy, with clusters of a few at each spot. Majority of the spots appears within the bra line of the patient, started about a week and a half after the first done (1/22/21) but became increasingly worse two days after the second dose (was received on 2/12/21). First there were many more on the trunk with some patches increasing in size and rash starting to appear on arms and legs as well. Tried benadryl, fexofenadine, and hydrocortisone which helped minorly. Sought medical advice in the clinic (5 days post second dose) and couldn't identify other source of rash (no new product, no bugs bites, etc). Was prescribed triamcinilone acetate cream to help relive itching and redness, which as of 2/24/2021 is improving slowly.

Other Meds: daily multivitamin OCP (orthotricyclin-lo) rosuvastiatin levothyroxine fish oil

Current Illness: none

ID: 1051695
Sex: F
Age: 25
State: OK

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

Lab Data:

Allergies: None

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

Symptoms: Raised red circle around injection site with another circle around it. Warm, sore, firm to the touch.

Other Meds: Estarylla

Current Illness: None

ID: 1051696
Sex: M
Age: 67
State: MD

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: RA

Lab Data:

Allergies: none known

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

Symptoms: Within 4 hours developed cephalgia, myalgias, fatigue, nausea, chills and fever that spiked to 102 deg. 24 hours later still fatigued, but afebrile.

Other Meds: ASA 81 mg/d, clopidogrel 75 mg/d; lisinopril 2.5 mg/d; atorvastatin 40 mg/d; ezitimibe 10 mg/d; tadalafil 5 mg/d; multiple vitamin, fish oil, vitamin D

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm