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: 1052960
Sex: F
Age: 69
State: IN

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

Lab Data:

Allergies: Aspirin, shrimp

Symptom List: Dysphagia, Epiglottitis

Symptoms: Temperature of 101 headache, extreme fatigue, body aches, brain fog, shortness of breath, loss of taste and smell for 4 days

Other Meds: Armour thyroid , gabapentin D3 zinc B12 vitamin C

Current Illness: covid 19

ID: 1052961
Sex: F
Age: 78
State: MN

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:

Symptom List: Anxiety, Dyspnoea

Symptoms: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1052962
Sex: F
Age: 29
State: MN

Vax Date: 02/23/2021
Onset Date: 02/24/2021
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: Extreme exhaustion: dozing off while driving to work. I left early and had to be picked up, because I was too tired to drive. Pounding headache: my head feels like it?s in a rock tumbler. Body aches: my body feels like I got hit by a truck. Anything that touches me hurts, including clothes or blankets. Fever: 101.3F Injection site pain: my arm feels like it?s severed. Treatment: I have been taking 800mg of Ibuprofen every few hours, but have not had any relief. I took Tylenol initially and also did not have any relief.

Other Meds: Burpropion XL, Duloxetine

Current Illness: None

ID: 1052964
Sex: F
Age: 90
State: MI

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient was feeling extremely fatigued after the vaccine. Patient also was shivering and said she felt cold. Her blood pressure was 107/78. Her mental state did not seem far from normal. She was taken home by her son.

Other Meds:

Current Illness:

ID: 1052965
Sex: F
Age: 37
State: OR

Vax Date: 02/20/2021
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: vicodin

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

Symptoms: Hives and itching on my arms, hands, ears, neck, stomach and backs of legs. This started 4 days after my 2nd Covid dose. I am taking Benadryl multiple times a day.

Other Meds: Metoprolol, citalopram, birth control, prenatal vitamins, melatonin, vitamin c

Current Illness:

ID: 1052966
Sex: F
Age: 70
State: OK

Vax Date: 02/22/2021
Onset Date: 02/22/2021
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: None

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

Symptoms: Moderna Covid 19 Vaccine EUA Nausea , diarrhea, Joint pain, muscle aches, low grade fever, chilling

Other Meds: Diltiazem 300 mg; Triametrene HCTZ75-50 mg;;Atorvastin 20mg;Aspirin 81 mg; Elderberry (Sambucus)

Current Illness: None

ID: 1052967
Sex: M
Age: 69
State: MN

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered. Patient did not report any adverse effects

Other Meds:

Current Illness:

ID: 1052968
Sex: M
Age: 73
State: AZ

Vax Date: 02/15/2021
Onset Date: 02/16/2021
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: Pharyngeal swelling

Symptoms: Second day after receiving Moderna, vaccine developed measles like rash on my left bicep and around injection site. By the next day rash had effected chest, stomach and back as well as the right arm. Also developed a low grade fever (under 100) . Rash is exacerbated by heat of the shower. Rash migrated to the legs and is especially severe around socks. rash seems to become more prevalent late in the day and in the mornings. Mild dizziness when looking up or down. Low energy and feeling very tired after mild activity. Symptoms persist 9 days after injection

Other Meds: vitamin D, 20mg Lisonopril

Current Illness: Tested positive for Covid19 on Jan 19, 2021 with very mild symtoms

ID: 1052969
Sex: F
Age: 80
State: TN

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: IM
Vax Site: LA

Lab Data:

Allergies: NO KNOWN ALLERGIES

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Dr. called (pt's PCP) to report reaction that was reported to her by pt's sitter and husband. States pt would not eat and was lethargic the night after receiving the vaccine. The next morning pt was extremely fatigued and "not acting like herself." By Tuesday night, pt was experiencing rapid breathing, sweating, and was very agitated. PCP states sitter reported that she heard "rattling" in pt's chest. Pt short of breath this morning with heart rate of 123. Pt will not eat or drink and is very weak. Pt has not been communicating with them like she normally does. Can only walk a few steps before having to rest. Pt was on her way to ED when PCP called to report this.

Other Meds:

Current Illness:

ID: 1052970
Sex: F
Age: 39
State: OR

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: With both the first and second doses I experienced vaginal bleeding, possibly an early menstrual cycle the day following the shot.

Other Meds: Prozac, Wellbutrin, biotin, Allegra

Current Illness:

ID: 1052971
Sex: F
Age: 42
State: PA

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

Lab Data:

Allergies: Penicillin: itchy hives

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

Symptoms: One week after the 1st dose of the vaccine, I experienced itchiness on my back, arms neck and head. No hives or bumps but severe itchiness

Other Meds: Vybriid 50mg, metoprolol 25mg, bupropion 450mg, montelukast, vitamin D,

Current Illness: None

Date Died:

ID: 1052972
Sex: F
Age: 87
State: MO

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: NO

Symptom List: Rash, Urticaria

Symptoms: RESIDENT EXPIRED

Other Meds: NO

Current Illness: NO

ID: 1052974
Sex: F
Age: 66
State: MN

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: LA

Lab Data:

Allergies:

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

Symptoms: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1052975
Sex: M
Age: 44
State: NV

Vax Date: 02/17/2021
Onset Date: 02/18/2021
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: None

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

Symptoms: Fever, chills, body aches, fatigue

Other Meds: Losartan, nexium, bystolic, victoza, simvastatin, zyrtec

Current Illness: None

ID: 1052976
Sex: F
Age: 68
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Just hay fever, dogs, cats, dust mites, and mold.

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

Symptoms: Fever 101, teeth chattering chills, body aches, bad migraine headaches, vomiting, and very sore right arm for 3 days!

Other Meds: Hydrochlorathiazide 25 mg. Twice a day, Meloxicam 7.5 mg, Rosuvastatin 5 mg, lorazepam .5 mg as needed, potassium Cit ER Tab 1080 mg. 3 times a day, niacinamide 500 mg, D3 1000 mg. Zinc sulfate 220 mg, Qunol Ultra CoQ19, Omega 1000 mg, lut

Current Illness: No

ID: 1052977
Sex: M
Age: 60
State: FL

Vax Date: 02/20/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Fever 101.2 gum tooth nerve pain dentist prescribed antibiotic before fever registered

Other Meds: Escitalopram, Advair, Tylenol, Metformin, Allegra, Astelin

Current Illness:

ID: 1052978
Sex: F
Age: 75
State: FL

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: Augmentin, Symbicort, Wellbutrin

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

Symptoms: Very sore and stiff injection site, fatigue, aches in all joints and muscles, fever rising to maximum of 101.6. Applied ice to vaccination site and joints, took 2 8-hour Tylenol (650 mg). Entire adverse event lasted 12 hours (except injection site soreness, which continued for several days).

Other Meds: Ramipril, Amlodipine besylate, Fluoxetine, Metformin, Metoprolol ER, Simvastatin, Budesonide, Iprat-Albut, Centrum Silver, Vitamin B12, Vitamin C, Vitamin D3, Famotidine, Omega 3, Calcium

Current Illness: Bronchitis

ID: 1052979
Sex: F
Age: 69
State: NJ

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 02/24/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: pain neck shoulders head, dehydration, electrolytes, elevated heart rate, vomiting, fever

Other Meds: Kolonipin Lamotrigine Bupropion Lipitor Lipitor

Current Illness: none

ID: 1052980
Sex: M
Age: 70
State: MO

Vax Date: 02/24/2021
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: About 3 hours after receiving the vaccine I started to feel pressure to have a bowel movement. It came on suddenly. While on the toilet I felt a little nauseous. For a minute or so, I thought I was going to throw up as well. The nausea passed after a few minutes, but I felt very fatigued. Got home and have been laying down. It's now 5:20pm, 3 hours later, I'm feeling better, but still a little tired. I have a slight "flu like" feeling that I feel "off". I blessed with good health but I feel a little "off kilter". I thinking I'll feel better tomorrow.

Other Meds: daily multi vitamin

Current Illness: none

ID: 1052981
Sex: M
Age: 74
State: MN

Vax Date: 02/22/2021
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:

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

Symptoms: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1052982
Sex: F
Age: 84
State: TX

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/24/2021
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: Sulfa, Morphine

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

Symptoms: Swollen, Itchy arm for three days, first night I kept getting up to Pee and the next day I slept the entire day. My second shot, same reaction, but still do not feel well. Also had temperature of 100 both shots

Other Meds: Pravastatin, DiltiazemXR, Pradaxa ,Multaq , Prolia Shot, Myrebetriq , Albuterol Sulfate, Vitamins D3 ,Magnesium Citrate, Calcium, Biotin, B-12

Current Illness:

ID: 1052983
Sex: F
Age: 30
State: TX

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: Penicillin

Symptom List: Unevaluable event

Symptoms: Body aches, chills, fever, fatigue, headache

Other Meds: Airborne: Immunity support supplement

Current Illness: cold

ID: 1052984
Sex: F
Age: 66
State: AL

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: None

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

Symptoms: Massive headache

Other Meds: None

Current Illness: None

ID: 1052985
Sex: M
Age: 73
State: MN

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1052986
Sex: F
Age: 30
State: PA

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: SYR
Vax Site: LA

Lab Data:

Allergies: Keflex, Amoxicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Onset of chills approximately 3-4 hours after injection. Duration = 6 hours.

Other Meds: Lamotrigine, Fluvoxamine, Doxepin, Amitiza, Aimovig, Omeprazole, Colace, Multivitamin

Current Illness:

ID: 1052987
Sex: F
Age: 61
State: TX

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

Lab Data:

Allergies: N/A

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

Symptoms: arm sore and swollen at injection site, fatigue, a little light headed, occasional chills, occasional nausea, elevated blood pressure day of shot

Other Meds: Omeprazole 40 mg 1x day, -Pravastatin 40mg 1x day, Carvedilol 12.5mg 2x day, Hydorchlorothiaide 12.5mg 1x day, Valacyclovir 1g 1x day, Aspirin 81mg 1x day, Vitamin E Heart Health 180mg 1x day, Airborne Immune Supplement, 2 Tylenols mg as n

Current Illness: N/A

ID: 1052988
Sex: F
Age: 33
State: CA

Vax Date: 02/10/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Lactose

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Sudden sensorineural hearing loss in the left ear. 60 MG prednisone seems to have improved symptoms so far

Other Meds: None

Current Illness: None

ID: 1052989
Sex: F
Age: 62
State: TX

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: morphine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Rapid heart rate which lasted pretty much all day, stronger than normal heartbeat, chills with temp of 96.2.

Other Meds: Levothyroxine, Fluoxetine, Pravastatin, Meloxicam

Current Illness: no

Date Died: 02/24/2021

ID: 1052990
Sex: F
Age: 73
State: TX

Vax Date: 02/20/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

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

Symptoms: Likely not be related directly to vaccine adverse event other than Fatigue and sleepiness reported 2/22/2021. Patient missed her clinic appointment and we called in to check in with her. She had no other symptoms. She rescheduled her appointment to come in for her clinic visit to Tuesday, 2/23/2021 but did not arrive. We could not contact her thereafter on Tuesday. We were able to reach her medical power of attorney on Wednesday morning who with the help of EMS was able to enter her home. We do not know what other symptoms patient was experiencing. We also had the major winter storm between 2/11 /2021 and 2/19/2021. This affected are elderly severely. Unclear what utility she had or how she managed. On 2/20/2021 patient had only come in for her Covid vaccine appeared tired on that day but most of was struggling through the winter storm and not recovered yet. Patient was found deceased by her friend and officer who assisted her to enter patient's house. Unknown time or circumstances of patient demise.

Other Meds: gabapentin, levothyroxine, iron, vitamin D3, Protonix, vitamin B12, Tylenol as needed, Claritin as needed, Anoro inhaler, albuterol inhaler, IV Zometa every 3 months, Herceptin every 3 weeks, Perjeta every 3 weeks, Faslodex monthly and Ibra

Current Illness: Metastatic breast cancer on treatment with, severe arthritis of hip, peripheral neuropathy, recent winter storm with loss of utilities unknown how much she was affected as she lives alone without family nearby

ID: 1052991
Sex: F
Age: 51
State: NM

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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Itching on left arm and back of neck. I offered the patient Benadryl, but she was going to church tonight, and didn't want to be drowsy. Happened during 15 minute monitoring period.

Other Meds:

Current Illness:

ID: 1052992
Sex: F
Age: 25
State: HI

Vax Date: 12/29/2020
Onset Date: 12/29/2020
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: No

Symptom List: Injection site pain

Symptoms: I was hurting a lot. 8 out of 10 - the pain. My arm was so but my chest was in pain. I couldn't breathe. I was so light headed I thought I would pass out if I stood up. I went to ER - Dr thought it was from my wearing personal protection equipment - mask and goggles for work after receiving the vaccine. He told me I was fine but I was so much in pain that I was too out of it to ask for tests. I was in pain for two week. Chest was in pain. I had to use my inhaler once a day at least - sometimes more.

Other Meds: Albuterol inhaler for asthma

Current Illness: No

ID: 1052993
Sex: F
Age: 69
State: MI

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: NKDA

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

Symptoms: Patient experienced vertigo within 15 minutes of administration of COVID 19 shot. Her blood pressure was 97/73. Five minutes later it was 123/83 and a third reading approximately 15 minutes after the original was 120/81. The patient slowly felt better and was able to walk to find her companion. She had a headache and decided to go home and forgo grocery shopping. The next day she came in person to report experiencing tinnitus and mild headache still. I sat with patient until she felt good enough to walk and then walked with her per her request to help her find her friend. After about an hour of slowly getting better, but not good enough to follow through with her grocery shopping plans. She decided to go home with her friend and rest and come back tomorrow to grocery shop and report back with any further symptoms. She was feeling better enough to grocery shop and she was reminded to please fill out form for reporting purposes.

Other Meds: Vitamin B12, Biotin

Current Illness: Patient reported occasionally experiencing tinnitus and vertigo induced by stress.

ID: 1052994
Sex: M
Age: 47
State: CA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
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: None

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

Symptoms: The day after the injection I had a sore arm, slight headache and slight nausea. Since that time I have had a slight "pressure" headache almost continuously. Today is 2/24/21, more than 6 weeks after the first shot and the symptoms have only slightly subsided. I have decided to forego the second shot until the symptoms completely disappear. I have not sought any medical care because the symptoms are not severe enough and I am hoping they will subside by themselves. If they continue for a long period I will seek medical care but my guess is there will not be a lot that can be done.

Other Meds: None

Current Illness: None

ID: 1052995
Sex: F
Age: 51
State: CO

Vax Date: 02/01/2021
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: MILK - LACTOSE INTOLERANT SOY AMOXICILLIN - GI EVENT

Symptom List: Tremor

Symptoms: 6 DAYS AFTER THE SHOT I GOT JOINT PAIN AND MUSCLE PAIN TO THE POINT OF NOT BEING ABLE TO WALK. HAD SEVERE STOMACH PAIN, CHEST HURT WAS NOT ABLE TO DRAW A DEEP BREATH. RAN A FEVER OF 102.5 OFF AND ON.

Other Meds: NYQUIL - CHLORTHALIDONE - POTASSIUM

Current Illness: SINUS INFECTION

ID: 1052996
Sex: F
Age: 26
State: TX

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient complained of tingly lips, itchy left arm (near vaccine site). Patient waited 30 minutes with improvement of symptoms and left the site.

Other Meds:

Current Illness:

ID: 1052997
Sex: F
Age: 68
State: WY

Vax Date: 02/11/2021
Onset Date: 02/19/2021
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: PCN, sulfa, quinine, bupivicaine, ASA, mult other medication allergies

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

Symptoms: Firm swelling of soft tissues over the R deltoid area accompanied by marked erythema and itching , onset 8 days post-vaccination. Worsened over subsequent 2-3 days then gradually improved but still persisting fairly minimally today with continued mild warmth and erythema - 13 days s/p injection - covering an area approx 7cm x 10cm. (Some photos available). Unknown if related but have also had bilateral serous otitis over this same time frame, with no previous hx of this. Also experiencing muscle aches in both legs posteriorly.

Other Meds: Losartan, oxyCodone, fentanyl patch, Lipogen, methylated B vits,

Current Illness: N/A

ID: 1052998
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: 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: None stated.

Other Meds:

Current Illness:

ID: 1052999
Sex: F
Age: 69
State: MN

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1053000
Sex: F
Age: 55
State: WI

Vax Date: 02/20/2021
Onset Date: 02/21/2021
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: None

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

Symptoms: Initially only normal symptoms for 36 hours of fever, body aches, chills, shivers. Once those cleared, vision became blurry. Thought I was tired so went to bed. Woke up the next morning (Monday) to severe dizziness, nausea, vomiting, blurred vision. Went to ER and was diagnosed with Benign Paroxysmal Positional Vertigo. Was given Zofran and prescription strength Meclizine and sent home. Spent two days sleeping it off. Better on second day but still slightly dizzy. Much better on third day. I had never had Vertigo prior to this.

Other Meds: Zegrid, Atorvastatin, Losartan, Bystolic, Aspirin, Amitiza

Current Illness: None

ID: 1053001
Sex: F
Age: 69
State: MA

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: Mild - med allergic to shellfish at times Latex around the mouth Sulpha

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

Symptoms: Moderna covid -19 vaccine EUA Sleepy 4;30 pm then flu symptoms nausea chills headache extreme fatigue went to bed 7pm to 9 am On the couch all day the 24 with ice and fatigue Severe pain both sides of arm and front of arm pain felt like awful deep pain like down to the bone ilimited range of motion abduction only to 70 degrees flexion 80 degrees

Other Meds: Steriods prednisone since oct 2021 Exemestane. Sertelene metoporol. Losartan

Current Illness: Polymyalgia rheumatica ( pmr) Breast cancer ) remission) Cardiomyopathy High blood pressure

ID: 1053002
Sex: F
Age: 74
State: CA

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

Lab Data:

Allergies: latex

Symptom List: Pain in extremity

Symptoms: itching rash around neck and chest area. Very intense the first nigth, which was reduced with a cold pad. Much better the next day but still the area itch mildly once in a while.

Other Meds: lipitor 40mg, fluoxetine 30 mg, metformin 1000mg, calcium, Bco

Current Illness: none

ID: 1053003
Sex: M
Age: 81
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: None

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

Symptoms: Patient received the vaccination and within 5 minutes began to feel a frontal head ache and sensation of palpitations without chest pain or SOB. During evaluation he reported significant improvement of sensations/symptoms but medic obtained EKG and he was then advised to be transported to ED for full evaluation.

Other Meds: UNKNOWN

Current Illness: None

ID: 1053004
Sex: F
Age: 72
State: FL

Vax Date: 02/11/2021
Onset Date: 02/20/2021
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: Naproxen

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

Symptoms: Large red swollen rash

Other Meds: Calcium Levothyroxine Ezetimibe Vitamin D Vitamin K Omeprazole Lute in Prolia

Current Illness: None

ID: 1053005
Sex: F
Age: 42
State: CO

Vax Date: 02/13/2021
Onset Date: 02/14/2021
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: Lactated Ringers General Anesthesia

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

Symptoms: 02/13/2021: sore left arm, extreme fatigue started in afternoon 02/14/2021 - 02/15/2021: muscular pain, headache, exhaustion, slight nausea, joint pain 02/16/2021 - 02/17/2021: extreme fatigue, joint pain 02/18/2021 - 02/24/2021: fatigue, joint pain (7 on a scale of 1-10)

Other Meds: Hizentra Lyrica Cymbalta Tramadol Diclofenac Propranolol Omega 3 Oil Clonidine Topomax Oxcarbazepine Senna Probiotic

Current Illness: None

ID: 1053006
Sex: F
Age: 73
State: WA

Vax Date: 02/05/2020
Onset Date: 02/06/2020
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: penecillin; sulfa

Symptom List: Vomiting

Symptoms: 2/6/2020 and 2/7/2020: severe chills/horrible headache--rizatriptan 2/11/2020 through 2/14/2020: severe abdominal pain; low backahe; headache--aleve and rizatriptan 2/21/2020 through 2/25/2020 severe stiff neck; headache; aleve X4 pills Only a sore arm from the fist vaccine.

Other Meds: statin; valacyclovir;Mg,

Current Illness: none

ID: 1053007
Sex: F
Age: 66
State: MN

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered to the patient. The patient did not report any adverse effects.

Other Meds:

Current Illness:

ID: 1053008
Sex: F
Age: 27
State: OR

Vax Date: 02/12/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Patient had a syncopal episode within 10 minutes of having her vaccine. She was standing at the check out desk having her information entered into our state system and she passed out. She had no warning it was coming. She fell backwards and hit her head. She was aroused to sternal rub. She was emotional when she aroused. She new where she was and that she had a vaccine. Her vital signs were normal. Her significant other was contacted. Do to hitting her head we advised she be evaluated through an emergency department. She was called the next day. She had a brain CT which was normal and she was released. On follow-up she was feeling well.

Other Meds:

Current Illness:

ID: 1053009
Sex: M
Age: 17
State: MN

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pfizer vaccine was reconstituted with sterile water instead of normal saline and administered. Patient has not reported any adverse effects

Other Meds:

Current Illness:

ID: 1053010
Sex: F
Age: 56
State: WA

Vax Date: 01/13/2021
Onset Date: 01/17/2021
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: RA

Lab Data:

Allergies: Sulfa

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

Symptoms: 01/14/2021 102 fever, myalgias, exhaustion. Lasted about a day. 01/17/2021 hives on face, right ear, neck, chest, bilateral hands and bilateral feet for 5 days. Washed gently with clear water, patted dry, used Benedryl, Benedryl cream and bag balm. None helped. No new laundry soap, bath soaps, foods etc. Started Chantix 01/23/2021, stopped smoking. 02/20/2021 Discontinued Chantix, still no smoking. 01/31/2021 occasional (5-10 times daily) dyspnea, frequent need to clear throat, constant sinus congestion with clear thin mucus.

Other Meds: Metoprolol; HCTZ; gabapentin; ibuprofen; OTC multivitamin; Vitamin D 2000U/day

Current Illness: none

ID: 1053011
Sex: F
Age: 26
State: ME

Vax Date: 01/25/2021
Onset Date: 02/04/2021
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: allergic to shellfish, cat dander

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

Symptoms: The day after I received the vaccination my arm was very sore and I was tired and had a headache. 10 days after the vaccine I developed a red mark directly under the vaccination site on my left arm. It was 4 inches long and 2 inches wide at the widest point (it was shaped like a guitar). The mark was very red and hot to the touch. I noticed it on the morning of the 10th day and by evening time it was the reddest it got (it was not itchy or painful, just hot and red). By the next morning it had lightened and was no longer hot, as of writing this (Feb 24th) the mark has continued to lighten, it is still visible on my left arm.

Other Meds: birth control, levothyroxine

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm