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: 1054327
Sex: M
Age: 67
State: MS

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/25/2021
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: lisinopril

Symptom List: Dysphagia, Epiglottitis

Symptoms: pt stated that later the day after receiving the vax that he started having pain on the left side of his head. The pain went from jaw to temple. He wasn't able to speak for 3 days. On 2/17/2021 he went to the hospital. They thought he may have Bell's Palsy so the they did a XRAY and CT. They were not able to find anything other than facial swelling so he was discharged and told to come back if he did not get better and they would make him an appt w/ an ENT. He started taking Aleve. He no longer has constant pain but his mouth still hurts when he opens it. He will contact his PCP to let her know what happened and to let her know that he will not be taking his 2nd covid vax dose.

Other Meds: Zinc 50mg, Vitamin C, D, glipizide, clopidogrel, losartan, metoprolol,

Current Illness: no

ID: 1054328
Sex: F
Age: 49
State: CA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt found sitting upright with allergic reaction. Pt states she received the Moderna vaccine and started felling tingling down the arm that was vaccinated. Pt denies sob, - weakness, - dizziness, +warm/ itching sensation to chest. IV initiated and pt given Benadryl IVP. Pt is getting relief with Benadryl. Changes in patient condition en route. Care transferred to ED staff.

Other Meds: Levothyroxine

Current Illness: None

ID: 1054329
Sex: F
Age: 52
State: VA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
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-only seasonal allergies

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

Symptoms: DAY ONE after vaccine: 11:15 am Racing heart, rate between 110-125 as measured by patient's fitness watch, chest tightness went to ER, was feeling more ill and was told it would be 4 hours until test results, patient left ER 8:30 pm Temperature 102.9, chills, patient took Tylenol every 4 hours, awoken from sleep with chills and tool Tylenol each time DAY TWO: Chest tightness, fever, swelling/hardness/redness at injection site DAY THREE: Chest tightness, vomiting from 3:30 am-9:30 am, fever, swelling/hardness/redness at injection site, still feeling unwell

Other Meds: OTC vitamins OTC generic zytec

Current Illness: none

ID: 1054330
Sex: F
Age: 67
State: IN

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: History of allergies to many different things according to pt but never to a vaccine or vaccine component

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 30 minutes post vaccine, pt had c/o throat fullness. Pt states that she has a history of allergies to various things that will cause a ''pinchy tight throat'' but allergy medication has always cleared it in the past. Pt was given 1 25mg pill of Benadryl at 10:57am. BP at 11:00am 145/80. Pt was kept for observation on cot for 30 minutes. BP at 11:26 128/78. 11:30 Pt left clinic ambulatory, stating throat felt better and had no distress. 02/04/2021 telephone call to patient for follow up. Pt states that she feels fine but that she took a second Benadryl at home 6 hours after the vaccine because ''throat still didn't feel quite normal''.

Other Meds:

Current Illness:

ID: 1054331
Sex: F
Age: 71
State: FL

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
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: Skin peeling off arms(less so?mostly flaking) and legs. Enough sloughing off to create a snow mound. Trunk not affected. Noticed 48 hours after shot but did not think anything of it. Peeling skin increased. Purchased Nivea intensive healing lotion on Saturday and started applying liberally. Peeling/flaking gradually declined. Minor flaking on legs currently.

Other Meds: Vitamin C,D, zinc

Current Illness: None

ID: 1054332
Sex: F
Age: 38
State: WY

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: PENICILLIN, HAS NEVER HAD EPINEPHRINE FOR ANY ALLERGIC REACTION

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

Symptoms: CLIENT HAD ITCHING, NO HIVES VISIBLE AND NO AIRWAY PROBLEMS. CLIENT GIVEN BENADRYL 50MG THAT RESOLVED ITCHING. SHE TOOK AT SECOND DOSE AT 2100 LATER THAT NIGHT FOR ITCHING AND HAD RESOLVED COMPLETELY THE DAY AFTER.

Other Meds:

Current Illness:

ID: 1054333
Sex: F
Age: 62
State: IN

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
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: Patient reported yes, but did not provide what allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Tongue swelling per patient. No obvious swelling and visualization or wheezing, hives, itching, redness, dyspnea. Advised to be monitored until 9:15am, but patient refused to stay the entire time and left at 8:55 am.

Other Meds: Unknown

Current Illness: unknown

ID: 1054334
Sex: F
Age: 22
State: FL

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/25/2021
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: 1/5 @5:15, called out 1/6 due to low grade fever, sore throat, body chills, headache.

Other Meds:

Current Illness:

ID: 1054335
Sex: F
Age: 40
State: KS

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Felt hot and sweaty x 10 min. Felt like she needed to take her mask off. Denies SOB difficulty breathing or swelling of the tongue or throat 1445 BP was 133/89 P 76 R 16 O2 100% 1500 BP 116/81, P 73, R 16, 02 100%

Other Meds:

Current Illness:

ID: 1054336
Sex: F
Age: 66
State: CA

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Two days later pt had sl numbness and tingling in L forearm and hand

Other Meds: none

Current Illness: May have slept funny

Date Died: 02/01/2021

ID: 1054337
Sex: M
Age: 90
State: DE

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

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

Symptoms: FOUND DEAD IN HIS OWN BED

Other Meds: several including METOPROLOL ER SUCCINATE 50 MG TABS

Current Illness: NONE

ID: 1054339
Sex: F
Age: 57
State: NC

Vax Date: 02/17/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital: Y

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

Lab Data:

Allergies: Not known

Symptom List: Rash, Urticaria

Symptoms: 2/22/21- Husband reported redness to injection site. Took to ER 2/23/21- Husband reported patient was admitted as inpatient for cellulitis and will be kept in hospital for IV antibiotics until 2/25/21 or 2/26/2021

Other Meds: Not known

Current Illness: Not known

ID: 1054340
Sex: F
Age: 74
State: MS

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Codeine and Penicillin.

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

Symptoms: She got home and after 3 hours she started seeing things, and talking nonsense. Every bone in her body was hurting. It was early in the morning and she thought it was in the middle of the night. Her husband had to help her to walk with the walker, and was out of her head. She has not been able to walk since Monday afternoon about 4:00. She is now just today able to get to the bathroom. She has taken Extra Strength Tylenol, Trazedone and Klonopin so she could sleep as she has not been able to. She has never experienced anything like this in her life due to the pain. She is a little better today, she gets dizzy when she gets up but still in the bed. She called the doctor yesterday and spoke to the nurse who told her to go to the ER but did not as her husband cannot help her much as he has prostate cancer.

Other Meds: Telmisartan, Prozac, Trazodone, Klonopin.

Current Illness: None.

ID: 1054341
Sex: F
Age: 27
State: KS

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/25/2021
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: Nexium

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

Symptoms: After my second dose of the Moderna vaccine, I had an elevated HR that started at 5:00PM the following night. My resting HR was in the 110s and would be 130s with activity. It came back down in about 12-24 hours to "normal", but I am still having episodes of an elevated heart rate at times weeks after the second vaccine.

Other Meds: lo loestrin FE zyrtec

Current Illness: chondromalacia patella

ID: 1054342
Sex: F
Age: 53
State: OH

Vax Date: 02/01/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
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: Wheat. Antibiotics. Suffer ans sulfate. Milk. Preservatives. Fragrance

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

Symptoms: Throat swelled

Other Meds: Singular, zertec, ic hydroxychloroquine, advair, gabapentin, hormone replacement, biotin, omega, multi vitamin, vitamin c. D, magnesium, dhea. Vitamin e, Gaba. Turmeric, glucosamine

Current Illness: None except usual.

ID: 1054343
Sex: F
Age: 71
State: UT

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: EGGS

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

Symptoms: MUSCLE ACHES FATIGUE HEADACE LASTED 2 DAYS RESTED TOOK TYLENOL FINE 3 RD DAY

Other Meds: LEVOTHYROXINE LISINOPRIL ROSUVASTATIN

Current Illness: NONE

ID: 1054344
Sex: M
Age: 69
State: NJ

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: patient received 2 doses of Moderna Covid vaccine no immediate symptoms seen. Education given to patient to watch for any adverse events

Other Meds: unkonwn

Current Illness: unkown

ID: 1054346
Sex: F
Age: 33
State:

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: severe itching at injection site

Other Meds:

Current Illness:

ID: 1054347
Sex: F
Age: 91
State: MA

Vax Date: 02/03/2021
Onset Date: 02/06/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: After 2-3 days developed redness to arm where the vaccine was given, appears to have a blister at injection site. Saw NP and was given hydrocortisone to apply to area, area still noted to be reddened, no pain noted at this time.

Other Meds:

Current Illness:

ID: 1054348
Sex: F
Age: 64
State: FL

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/25/2021
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: ANXIETY REPORTED , IMPORVED WITH DISTRACTION

Other Meds:

Current Illness:

ID: 1054349
Sex: F
Age: 86
State: OH

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
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: Wheat products

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

Symptoms: Chills, Diarrhea, soreness at Injection site, red line streaking from injection site

Other Meds: Tylenol

Current Illness:

ID: 1054350
Sex: F
Age: 43
State: CO

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: SULFA,VICODIN,MORPHINE

Symptom List: Unevaluable event

Symptoms: About 45 to 50 minutes after vaccine was administered body and face felt warm and face was itching for the rest of the afternoon. 02/23/2021 itching of face and genitals. 02/24/2021 mild rash appeared on hands and face and continues to itch. Advised to take Benadryl or Claritin to help the itch.

Other Meds: N/A

Current Illness: N/A

ID: 1054351
Sex: M
Age: 41
State: MO

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: Fever and fatigue

Other Meds: Biktarvy, Aspirin

Current Illness: None

ID: 1054352
Sex: F
Age: 33
State: FL

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/25/2021
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: Felt hot and cold, sat extra 5 mins

Other Meds:

Current Illness:

ID: 1054353
Sex: F
Age: 60
State: CT

Vax Date: 01/06/2021
Onset Date: 01/16/2021
Rec V Date: 02/25/2021
Hospital: Y

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

Lab Data:

Allergies: Vyvanse [Lisdexamfetamine] Chest Pain High 12/21/2020 Past Updates... Pt states she had chest tightness Alteplase Angioedema Not Specified 1/17/2021 Past Updates... OF NOTE: pt has stated that if she were to need tPA in the future because of stroke that she believes benefit outweighs risk and would still like it administered if needed along with benadryl and solumedrol Cats Not Specified 7/6/2017 Past Updates... Dogs Not Specified 7/6/2017 Past Updates... Environmental Allergies Not Specified 1/23/2016 Past Updates... Grass Pollen Not Specified 7/6/2017 Past Updates... Not the drug Ibuprofen Not Specified 3/28/2008 Past Updates... --BLURRED VISION ; Nitrate Analogues Headache Not Specified 5/19/2017 Past Updates... Sulfites Headache Not Specified 5/19/2017 Past Updates... Tree And Shrub Pollen Not Specified 7/6/2017 Past Updates... Not the drug Yeast, Dried Not Specified 8/28/2014 Past Updates... Pt get headaches

Symptom List: Injection site pain, Menorrhagia

Symptoms: 10 daya after receiving Moderna vaccine: 60 year old right handed woman with migraine + chronic headaches, nephrolithiasis, who presented to the hospital with expressive aphasia and right facial weakness and was found to have at least to distal left MCA occlusions for which she received IV tPA. MRI brain shows a small left frontal cortical acute ischemic stroke. Post tPA ICU course has been notable for angioedema of the tongue now improved. TTE showed PFO. LDL 111, new diagnosis HLD.

Other Meds: Culturelle 1 capsule qd Magnesium 30 mg po QD/prn

Current Illness: None

ID: 1054354
Sex: M
Age: 77
State: LA

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/25/2021
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: Pennicillin

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

Symptoms: morning after vaccine woke up with the worse headache and left are soreness. The following morning headache and body aches from the hips and both legs. In the following days pain got progressively worse until it was very difficult to walk. After a week of this the pain settled into my left hip. On the 9th day of pain and difficulty walking went to see my PCP. Treated me for bursitis of the left hip with a steroid injection to the left hip joint. Pain has gotten better but still painful. The vaccine was given at Urgent Care. Post vaccine visit was with PCP

Other Meds: Bactrim

Current Illness: abcess on back of neck

ID: 1054355
Sex: M
Age: 68
State: IN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/25/2021
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: Mild reaction to eggs. Mild reaction to flu shot.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: About 1/2 hour after injection, started a cough similar to a catch in the throat. About another hour later had chills. All went away after 2 hours.

Other Meds: atenolol/chlorthalidone, ezetimibe, rosuvastatin, omega-3 acid ethyl ester, metformin, allopurinol & losartan.

Current Illness: None

ID: 1054356
Sex: M
Age: 28
State: CT

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Gluten and dairy

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever (101.2), Chills, sweating, severe head ache, muscle aches, trouble walking (very fatigued).

Other Meds: Lexapro, Flonase, Xyzal

Current Illness: N/A

ID: 1054357
Sex: F
Age: 34
State: VA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
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: Bee sting allergies, allergies to adhesive bandaids, and seasonal allergies nearly year round.

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

Symptoms: Nausea, diarrhea, vomiting. Chills, headache, body aches, and low grade fever on and off.

Other Meds: Adderall 20mg, Fluoxetine, Tylenol

Current Illness: Occasional, random diarrhea

ID: 1054358
Sex: F
Age: 67
State: IN

Vax Date: 02/11/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
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: Received Moderna on 2/11/21. She was exposed to COVID 19 on 2/15/2021. She was tested for COVID on 2/19/2021 and was negative. On 2/21/2021 she developed redness and itching at the injection site. On 2/22/2021 she developed hives on her hands and has had fatigue and intermittent nausea and chills.

Other Meds:

Current Illness:

ID: 1054359
Sex: F
Age: 48
State: WI

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Rash to trazadone

Symptom List: Injection site pain

Symptoms: 1-2 hours after injection had sore arm 20 hours after injection had fatigue, chills and body aches. I rested and it helped. 27 hours after injection i had fatigue, chills, low grade fever and body aches. Took 400 mg ibuprofin and slept. woke up feeling better 30 hours after injection started my menses (I had had it the week prior. I am very regular every 28 days) only lasted 1-2 days 60 hours after injection arm got swollen, red and hot for about 12 hours and then it started to subside and was better by the follwoing morning. Only residula is a small muscle twitch every now and then. getting less with each day

Other Meds: Bupropion

Current Illness: none

ID: 1054360
Sex: M
Age: 51
State: NM

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: After receiving vaccine, patient began to complain of feeling dizzy. His vitals were checked and they were stable, but he was unable to stand without feeling like he was going to fall. Patient was given food to see if that would help. He still continued to feel dizzy and was transported to see one of our doctors. The patients dizziness continued and he was unable to stand alone. Patient was moved to the ER for further work up.

Other Meds:

Current Illness:

ID: 1054361
Sex: M
Age: 65
State: NC

Vax Date: 01/25/2021
Onset Date: 02/01/2021
Rec V Date: 02/25/2021
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: Bee Stings

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

Symptoms: "COVID Arm". Large (2"-3") redness and swelling at injection site, rash at injection site and across half of chest.

Other Meds:

Current Illness:

ID: 1054362
Sex: F
Age: 57
State: FL

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/25/2021
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: Tremor

Symptoms: ANXIETY REPORTED , IMPORVED WITH DISTRACTION

Other Meds:

Current Illness:

ID: 1054363
Sex: F
Age: 58
State: MD

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/25/2021
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: Adhesive and ceclor

Symptom List: Erythema, Pruritus

Symptoms: Began with fever, chills, sweats and has progressed 10 days later to now swollen glands in neck, swollen roof of mouth, nerve pain in left side of face, nauseous, vomiting, severe congestion and sinus pressure and pain.

Other Meds: Wellbutrin, NP Thyroid, metropolol, losarten potassium, Vit D, iron , fish oil

Current Illness: None

ID: 1054364
Sex: F
Age: 67
State: IN

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/25/2021
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: Penicillin, corn dust

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

Symptoms: I received my vaccine at 11:40 am on February 18, On Friday, February 19 in the morning, my back started itching. I thought it was due to dry skin. By Saturday February 20, I had developed a rash on my entire torso and had continual itching. I applied cortizone cream to relieve the itch. I had knee replacement surgery on Feb. 3 and felt it could be either a reaction of the vaccine to the pain medication I am taking and or a reaction to the vaccine itself.

Other Meds: Atorvastatin, Fish Oil, Multivitamin, Asprin, Hydrcdn-apap 5/325, Vitamin D3, Vitamin C, Calcium w/vitamin D, Colace

Current Illness: I had knee replacement surgery on Feb. 3.

ID: 1054365
Sex: M
Age: 74
State: IL

Vax Date: 01/28/2021
Onset Date: 02/01/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: patient received his vaccine 1/28/2021. on 2/1/2021 it was noted that his platelet count was 7, previously on 1/8/2021 his platelets were 198. patient was seen and evaluated by a hematologist. platelets rechecked 2/8/2021 and they were 8.

Other Meds: albuterol, atenolol, atorvastatin, calcium, cyanocobalamin, famotidine, folic acid, lisinopril, MVI, thiamine, vitamin d

Current Illness: high blood pressure, hypercholesterolemia, chronic kidney disease, BPA, prostate cancer, hydonephrosis with ureteral stricture

ID: 1054368
Sex: F
Age: 37
State: OH

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: Sulfa

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever 102.4 Chills Headache Nausea

Other Meds:

Current Illness:

ID: 1054369
Sex: F
Age: 30
State: FL

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/25/2021
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:

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

Symptoms: CAME BACK APPROX. 4 HOURS LATER C/O PAIN AT SITE.

Other Meds:

Current Illness:

ID: 1054370
Sex: F
Age: 70
State: KS

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
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: Sulfa, penicillin.

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

Symptoms: 2/23/21 after 4 hours - fatigue, body ache 2/23/21 after 5 hours - EYEBALLS ached, shoulder and neck ache 2/24/21 woke to flu-like symptoms, chills, fever 99 to 102, fatigue 2/25/21 fever broke during the night.

Other Meds: Latanoprost 0.005%, Trazodone 50 mg, multivitamin, calcium, Elderberry tablet, Vitamin D,

Current Illness: none

ID: 1054371
Sex: F
Age: 75
State: MA

Vax Date: 02/15/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: bee stings

Symptom List: Pain in extremity

Symptoms: Around site of injection, arm has red rash, hard and hot skin, itch

Other Meds: NA

Current Illness: No

ID: 1054372
Sex: F
Age: 69
State: NC

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: Exactly one week from the day shot was administered, injection site enlarged, was red and swallon and started to itch.

Other Meds: Tylenol PM night before and gummy multiple vitamins, day before, Vit. D 4 days before

Current Illness: None

ID: 1054373
Sex: F
Age: 89
State: MA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: The patient received their second pfizer dose on day 13 which is noted to be an early administered dose.

Other Meds:

Current Illness:

ID: 1054380
Sex: M
Age: 24
State: CA

Vax Date: 02/01/2020
Onset Date: 02/22/2020
Rec V Date: 02/25/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Vomited approximately half an hour after taking Vivotif; Spontaneous report received on 24FEB2020. A physician reported that a male consumer vomited approximately half an hour after taking Vivotif (PT: Vomiting). He was receiving Vivotif for immunisation. The consumer took his first three doses of Vivotif as per schedule. On 22FEB2020, he took his last dose of Vivotif and vomited approximately half an hour after taking the dose. He had only one episode of vomiting. He did not receive any treatment for vomiting. Action taken with Vivotif with respect to the reported event was not applicable. The consumer had recovered from the reported event. Company Comment: A consumer vomited approximately half an hour after taking last dose of Vivotif (Vomiting). This patient had only one episode of vomiting and the event was resolved without any treatment. Considering the potential of Vivotif to cause vomiting and the case information, the causality of vomiting is assessed as possible with Vivotif.; Sender's Comments: A consumer vomited approximately half an hour after taking last dose of Vivotif (Vomiting). This patient had only one episode of vomiting and the event was resolved without any treatment. Considering the potential of Vivotif to cause vomiting and the case information, the causality of vomiting is assessed as possible with Vivotif.

Other Meds:

Current Illness:

ID: 1054381
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/25/2021
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: flu; Initial information was received on 11-Feb-2021 regarding an unsolicited valid non-serious case from a patient via media. This case involves an patient of unknown age and gender who had flu (influenza), after receiving INFLUENZA VACCINE. The patient's medical history, past medical treatment(s), vaccination(s), family history and concomitant medication(s) were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (batch number and expiration date not reported) via unknown route and site of administration for prophylactic vaccination. On an unknown date, the patient had a non-serious flu (influenza) (unknown latency) following the administration of INFLUENZA VACCINE. Also reported that, patient never had the flu but a few years ago Dr(doctor) said patient needed to get flu shot, patient did and one-week later patient was at doctor with the flu. No more flu shot. No laboratory data was provided. It was not reported if the patient received any corrective treatment. At the time of report, the event outcome was unknown. There will be no information on the batch number for this case.; Sender's Comments: Narrative demography- patient age group is not reported in case (adult was captured to avoid EVAERS error) hence should not mention adult patient in narrative

Other Meds:

Current Illness:

ID: 1054382
Sex: F
Age: 27
State: MN

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
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: Patient reported itching, stinging and had a fevered arm instantly after giving her the vaccine Was given Benadryl 25mg at 9:23am. Still had pain and feverish arm after 1st dose, but itching resolved. Another dose of Benadryl 25mg at 9:35am. This relieved the pain, and she stated she felt fine. Patient also took Tylenol. All symptoms were local to the site of injection.

Other Meds:

Current Illness: Had Covid-19 in January. Was hospitalized 2 times for this. Had every symptoms of Covid except for loosing taste. Had respiratory problems.

ID: 1054383
Sex: F
Age: 69
State:

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: Daughter states less than 24 hours after receiving vaccine pt had fever and chills. Was shaking/ jerking and confused. Went to ED. Was told bloodwork was good and was sent home.

Other Meds:

Current Illness:

ID: 1054384
Sex: F
Age: 67
State: MO

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
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: Unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt called to report chills, muscle cramps, joint pain, headache and upset stomach on 2/24/2021. Pt took Tylenol for symptoms. Reported on 2/25/2021 that she had not fever today, but still had cold sweats, muscle cramps and her hands were swollen. She is seeing per primary provider for an annual check-up today and will make them aware.

Other Meds: Unknown

Current Illness: none reported

ID: 1054386
Sex: F
Age: 58
State: ME

Vax Date: 02/14/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: Augmentin, Macrobid, environmental

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

Symptoms: Rash and itching started on hands and back as of 2/17/21. By the next day full body rash (bumpy, red, itchy) had begun. Cleared up as of 2/21/21. Not pregnant.

Other Meds: Latanoprost Ophthalmic, .005% 1 drop each eye nightly Simbrinza, 1-.2% 1 drop each eye twice daily Hydrochlorothiazide, 25 mg 1 tab daily Losartan, 100 mg 1 tab daily Sertraline, 100 mg 1 tab daily Levothyroxine, 125 mcg. 1 t

Current Illness: On chemotherapy

ID: 1054387
Sex: F
Age: 50
State: NJ

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
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: Seasonal Allergies Bee Allergy

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

Symptoms: I waited the recommended 15 minutes after my vaccine and felt okay. When I got to my car, my face felt very hot and was flushed and the right side of my tongue felt thick for a day or more. Yesterday was one week ago from my vaccine and my tongue intermittently still feels thick. My tongue feels like it does when novocaine starts to wears off from the dentist. My right arm also felt sore and puffy; however, there was no skin reaction. The next day or so the right side of my neck was sore. As to be expected, my arm was also sore.

Other Meds: Ribavirin 200 mg: 3 tablets AM/2 tablets PM Symbicort 160 MCG/2 puffs twice daily PROAIR inhaler as needed Restasis/1 drop each eye twice daily Fluticasone 2 sprays each nostril once daily Calcium (Magnesium & Vitamin D2 Refresh Plus Eye

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm