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: 0931838
Sex: F
Age: 42
State: OR

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

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

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: headache, fatigue, episodes of vertigo beginning on day 3 following vaccination

Other Meds: none

Current Illness: none

ID: 0931839
Sex: F
Age: 18
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient experienced syncope about 5 minutes after the vaccine. She was also sweaty. Patient sat down and drank some Gatorade. Syncope subsided and she was able to walk out of the pharmacy about 15-20 minutes.

Other Meds:

Current Illness:

ID: 0931840
Sex: F
Age: 47
State: MI

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

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

Lab Data:

Allergies: Ultram-hives, Norco-hives

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

Symptoms: She initially developed and numbness of her face (both sides). This started in about 15 - 30 minutes after the vaccine and lasted about 2 hours. She had no facial muscle issues. She then developed intense vertigo and nausea. I question possible vestibular neuritis. This lasted about 5 days and was more severe the first 3-4 days. At day 7 she was almost back to normal. She also had a frontal tension style headache

Other Meds: Sular 8.5 mg qd, Gianvi 1 qd, vit D3 5000 U/day, Valtrex 500 mg/day

Current Illness: None

ID: 0931841
Sex: F
Age: 55
State: WA

Vax Date: 12/29/2020
Onset Date: 01/03/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: My arm became itchy and hive like lumps. The arm is warm to the touch and the redness is spreading. This happened 5 days post injection.

Other Meds: Vitamin C and D

Current Illness: None

ID: 0931842
Sex: F
Age: 52
State: CA

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

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Tongue became swollen and itchy, throat was scratchy and felt constricted. High blood pressure was high, dizziness and ringing in the ears

Other Meds: None

Current Illness: None

ID: 0931843
Sex: F
Age: 23
State: IL

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

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

Lab Data:

Allergies: Rash, fever, lymphadenopathy to Sulfa Drugs

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

Symptoms: Injection site soreness started about 3 hours after administration Chest pain and headache started about 7 hours after administration, went away after 4-5 hours Severe nausea started about 14 hours after administration and lasted for 4 hours Body aches and chills started about 14 hours after administration, lasted for greater than 12 hours, on and off Took ibuprofen and tylenol alternatingly, started feeling relief of some symptoms about 20 hours after administration

Other Meds: Birth control -Viorele Vitamin D

Current Illness: n/a

ID: 0931844
Sex: F
Age: 45
State: PA

Vax Date: 12/18/2020
Onset Date: 12/31/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Hives 14 days post injections

Other Meds: Methimisole, buspar , multi vitamin

Current Illness: None

ID: 0931845
Sex: F
Age: 26
State: TX

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

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

Lab Data:

Allergies: Pineapple

Symptom List: Pharyngeal swelling

Symptoms: On 01/07/2021 I woke up at 0300am with chills, headache, body aches, joint pain, fever of 101.2 and swollen left axillary lymph nodes. I took Tylenol and Benadryl and it relieved the fever/headache/body aches/joint pain, however the lymph nodes in my left axillary remained swollen. I continue to take Tylenol for the fever/body aches/pains without relief for the swollen and painful axillary lymph nodes. Warm compresses do help to relieve the pain temporarily but they remain painfully swollen. On 01/08/21 I called my doctors office to ask if it was normal to experience such painfully swollen axillary lymph nodes to which they stated ?we don?t know, it is too soon for us to tell what?s normal and what isn?t normal right now.? They did not offer any suggestions to relieve the pain or swelling. The morning of 01/09/2021 , I called Employee Health at my hospital (my place of work and also where I received the vaccine) and they also stated they didn?t know if this was a normal reaction due to the newness of the vaccine. A couple hours later, employee health emailed me a link to the VAERS reporting website and asked me to file a report.

Other Meds: Vraylar 1.5mg daily Trintillix 40mg daily Vyvanse 60mg daily Vitamin C 1000mg daily

Current Illness:

ID: 0931846
Sex: F
Age: 25
State: KY

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: None.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Injection site reaction with increasing redness and swelling with a large indurated area at the center that developed overnight along with a fever that was treated with tylenol. The hive persisted for 4 days after which topical benadryl was applied and symptoms began to desist. The area is no longer red or swollen but is still hard to the touch.

Other Meds: None.

Current Illness: None.

ID: 0931847
Sex: F
Age: 49
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 01/08/21: Sudden onset of extreme body/muscular pain, such that moving was difficult. Extreme chills, headache. Needed pain medicine to alleviate pain. Fatigue. 01/09:21: AM: Less body pain , but feeling of heaviness in head; weak. PM: Had onset of lower GI symptoms: painful abdominal/cramps, stomach pain, nausea. No vomiting, but had several episodes of diarrhea. Feeling like passing out but never did. Loss of appetite. Slowly resolving.

Other Meds:

Current Illness:

ID: 0931848
Sex: F
Age: 25
State: TN

Vax Date: 01/03/2021
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Extreme urticaria and bubbles under the skin

Other Meds: N/A

Current Illness: N/A

ID: 0931849
Sex: U
Age: 57
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: EVS employee stated she had itching at the bandaid site. on arm where vaccine was given. When bandaid removed you could see a redness around the site of bandaid. She only complained of itchiing until bandaid was removed. Later that day she c/o of headache and took tylenol on her own. She told me next day she had a headache most of the night and body aches. All education material was given to her in spanish and she stated she read them and understood. I instructed her to go to ED or call 911 if itching and redness became worse orwas having trouble breathing or swallowing. She denied other sx at time of observation. It was over 30 minutes. She returned to work on floor.

Other Meds:

Current Illness:

ID: 0931850
Sex: F
Age: 64
State: NC

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

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

Lab Data:

Allergies: None . Morphine causes itching

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

Symptoms: Fever99.7, headache, back pain, hip pain, chills , fatigue

Other Meds: Effexor, gabapenton

Current Illness: None

ID: 0931851
Sex: F
Age: 32
State: AK

Vax Date: 12/28/2020
Onset Date: 12/30/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: N/a

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

Symptoms: I am currently breastfeeding my 5-month-old son. I received my first vaccine on 12/28/2020 and directly breastfed within 4 hours of receiving the vaccine. Two days after my vaccine my son was at daycare and had two large diarrhea blowouts and two large emeses followed by a 1-minute episode where he was limp with entire body cyanosis and in-and-out of consciousness. He also had a maculopapular rash on his torso. EMS was called. He was observed in the emergency department for a few hours then recovered well without intervention and did not require hospitalization. EKG was normal. He has continued to be well and back to baseline since the event.

Other Meds: Levothyroxine, prenatal vitamin, vitamin D

Current Illness: N/a

ID: 0931852
Sex: F
Age: 35
State: AZ

Vax Date: 12/28/2020
Onset Date: 12/31/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Demerol, motrin, penicillin, seasonal

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

Symptoms: Rash, on lower back, left arm, abdomen and left leg

Other Meds: None

Current Illness: None

ID: 0931857
Sex: F
Age: 51
State: NC

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

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

Lab Data:

Allergies: Sulfa, shellfish, nickel, seasonal

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

Symptoms: Diarrhea

Other Meds: Prozac, trazodone, meloxicam, zyrtec

Current Illness: Arthritis Mild asthma

ID: 0931858
Sex: F
Age: 59
State: MA

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

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Moderna COVID-19 Vaccine EUA Chills, Rigors , Severe Headache , Extreme fatigue Began at 7:00pm 12/31/2020, , Chills , Rigors resolved at midnight , Headaches and fatigue continued till 1/2/2021

Other Meds: Calcium , vitamin D , Vitamin C

Current Illness: None

ID: 0931859
Sex: F
Age: 53
State: AK

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

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

Lab Data:

Allergies: sulfamethoxazole-trimethoprim, codeine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Customer rec'd COVID-19 vaccine at 1208pm and transferred to post vaccine observation. Customer noted to be frequently rubbing her eyes, initially denies feeling any symptoms. Symptoms of itching eyes persistent followed by customer clearing throat repeatedly. Continues to deny symptoms related to vaccine. States that she has anxiety. Customer noted to be hypotensive at 1226 98/68. Refuses epinepherine, transport to ED for monitoring. Customer accepts Benadryl 50mg PO @ 1227. O2 sat ~94-95%, pulse 79-84. Customer monitored at site, escort and significant other, at chairside. Customer persistent with her request to leave throughout observation, states she is fine. Customer and escort counseled to watch for progressive s/sx of reaction including increase in throat symptoms, swelling, itching/rash, SOB, chest pain or any other symptoms that are outside her baseline. Instructed to contact EMS for transport to ED. Customer and escort in agreement with plan. Customer does not have resolution with dry throat symptoms but does not wish to remain in observation any longer. Vitals at 1307 consistent with baseline as documented previously in chart. Customer instructed to contact PCP Team prior to next vaccine appointment to discuss post vaccine course and discuss risks/benefits and/or pre-treatments prior to next vaccine. Customer denies questions/concerns. Escort verbalizes understanding of instruction and agrees to remain with customer for the next 24 hours. Customer released from site at 1315, ambulating independently with steady gait, no obvious s/sx of distress

Other Meds: Bentyl 20mg PO Hydroxyzine 10mg PO Clonazepam 0.5mg PO Carafate 1gm PO Lexapro 20mg PO Lidocaine 2% topical gel Voltaren 1% topical gel Omeprazole 20mg PO Tylenol 325mg PO Trazodone 50mg PO Vitamin D3 1000 IU PO Colace 100mg PO

Current Illness: Pharyngitis 2/2 COVID-19, GERD, chronic anxiety

ID: 0931860
Sex: F
Age: 44
State: VA

Vax Date: 12/21/2020
Onset Date: 12/24/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Shortly after vaccination I developed tachycardia which continues to persist. Also in the last three days I have started having violent shaking.

Other Meds: None

Current Illness: None

ID: 0931861
Sex: F
Age: 26
State: CA

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Since taking the shot I have not had my period. I missed my period in December and I am not sure if I am getting it on January.

Other Meds: Acetaminophen

Current Illness:

ID: 0931862
Sex: F
Age: 53
State: IL

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

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

Lab Data:

Allergies: no

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

Symptoms: at 12 hours post vaccine I had Headeaches and Body Aches for the next 20 hours

Other Meds: none

Current Illness: none

ID: 0931863
Sex: F
Age: 36
State: DC

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Latex, peanut, egg, milk

Symptom List: Unevaluable event

Symptoms: When I received the shot the left arm itchy immediately yet the itching faded. The next early morning I had pain in the left arm as expected. I had a throbbing head ache and nausea through the morning I woke up at 5am and nausea was better by 8. I felt sore and tired that day. January 1st there were no more symptoms. On January 8th I noticed hives around the injection spot and itching I had not noticed the itching since the day of the shot. I stopped wearing the band aid the morning after the shot, mentioning this in case the bandage could have caused hives.

Other Meds: Claritin-D

Current Illness:

ID: 0931864
Sex: F
Age: 46
State: IL

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

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

Lab Data:

Allergies: none

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

Symptoms: Chills, Headache, Nausea, and Fever

Other Meds: none

Current Illness: no

ID: 0931865
Sex: F
Age: 40
State: CO

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: Headache (4/10) and body aches (5/10) pain respectively began at about 18 hours after injection. Body and head aches, particularly joints and back, continue and have worsened at 30 hours out. Mild-mod soreness at injection site (4/10)

Other Meds: Levothyroxine 25 mcg daily

Current Illness: N/A

ID: 0931866
Sex: F
Age: 25
State: TN

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: Arm is lumpy under skin surface and itchy at injection one week after vaccine.

Other Meds: N/A

Current Illness: None

ID: 0931867
Sex: F
Age: 37
State: NY

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

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

Lab Data:

Allergies: hx penicillin allergy as a child

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

Symptoms: Approximately 20 minutes after receiving Moderna dose # 1, as patient was being observed for 30 minutes due to hx of pen allergy- patient began to experience facial numbness to right cheek area, crossing over mouth towards the left side of her face. Also noticed slight numbness of fingertips to right hand. Patient attributed this to her mask being on too tight and receiving the vaccine in right arm and was discharged from clinic without stating the above. As patient began to drive 50 minutes to home, she called her husband and stated she felt numb inside her right gum and cheek- he advised her to return to clinic. Patient presented to me as screener for COVID testing line- stating she was just here but didn't feel right- I escorted her inside- steady gait, no SOB, dyspnea, speaking in full sentences, upon reaching discharge area, VS 98.3- HR 61 reg- resps 18 unlabored, b/p 122/72 pulse ox r/a 100%. Pt asked to remove mask, no circumoral pallor or swelling noted, uvula midline, right cheek area is reddened, no rash or hives noted, pt described as "hot". MD contacted via phone- spoke with patient, who agreed to stay for observation, no further intervention at this time. Drs also consulted- patient observed for 40 minutes, was discharged to follow up with PMD - no resp distress, lungs clear upon auscultation by RN, repeat VS- 98.7 hr 59 reg- resps 18, b/p 116/73 O2 sat 98% r/a-

Other Meds: none known

Current Illness: denied

ID: 0931868
Sex: F
Age: 72
State: AK

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

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

Lab Data:

Allergies: fish, shellfish

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Had COVID vaccine and was being monitored. At 10:10am, she became nauseous and started vomiting. She felt short of breath and difficulty breathing. Felt dizzy/lightheaded. History of anaphylaxis and allergies. History of COPD/asthma. Due to vomiting, short of breath and dizziness, given epipen at 10:15am and called 911. Continued to monitor and developed worsening shortness of breath. Second epipen given at 10:25am.

Other Meds: albuterol 2.5 mg/3 mL (0.083%) inhalation solution, 2.5 mg= 3 mL, INH, q6hr, PRN, 3 refills albuterol 90 mcg/inh inhalation aerosol, 2 puff(s), INH, q4hr, PRN, 11 refills alendronate 70 mg oral tablet, 70 mg= 1 tab(s), Oral, qWeek, 4 refi

Current Illness: hypokalemia asthma exacerbation

ID: 0931869
Sex: F
Age: 36
State: HI

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

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

Lab Data:

Allergies: Percocet (vertigo)

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Probably with in 30 sec of the vaccine being administered I started to not feel well. Felt like it spread through my body, I felt a weird feeling in my chest, throat, my legs felt weak, I was light headed and my heart started to beat hard and fast. It then started to subside over several minutes. The nurse kept me for 30 minutes and then I felt ok to walk out. I had a bit of a headache and didn?t feel right the rest of the night.

Other Meds: None

Current Illness: None

ID: 0931870
Sex: F
Age: 28
State: OR

Vax Date: 01/02/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Nickle

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

Symptoms: She had red inflammation following vaccine which took 6 days to clear. Day 7 she had the red inflammation return and quickly enlarge from 4.5c, to to 9.5cm x 7.5 in 8 yhours

Other Meds: Wellbutrin, apri, topomax

Current Illness: none

ID: 0931871
Sex: F
Age: 34
State: IN

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

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

Lab Data:

Allergies: No

Symptom List: Nausea

Symptoms: Immediately: Blurred vision, dizzy, tachycardia, sweat, felt I couldn?t breathe, shaking, felt hot, redness of chest ? tx: Oj, cold compress, removed mask, uncrossed legs, waited, deep breaths Day 2: headache, flu like symptoms, fatigue, sore arm,

Other Meds: Nuvaring

Current Illness: No

ID: 0931872
Sex: M
Age: 66
State: CA

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

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

Lab Data:

Allergies: Shell fish, strawberries

Symptom List: Injection site pain

Symptoms: Fever, body ache

Other Meds: Tylenol

Current Illness: None

ID: 0931873
Sex: F
Age: 64
State: CT

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

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

Lab Data:

Allergies: Cephalaxin - hives IVP contrast - hives

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

Symptoms: About 3 minutes after receiving exam went to sit down to wait for 15 minutes. A flush came over my body and I felt myself becoming tachycardic. I spoke to the nurse who hooked me up to bp machine. O2 sat was fine at 98. BP was 158/110, pulse rate was 157. Normal values for me are bp 120/70, pulse 80. BP started to go down and several minutes later another flush happened and bp and pulse rate went back up. Dropped again then third flush with increased bp and pulse happened. After this vitals went back to normal and didn't happen again. I subsequently developed a pounding headache which lasted until the next morning. Arm was sore as expected. BP that night was normal and the next morning normal. No further adverse effects noted other than fatigue.

Other Meds: Stopped Plaquenil 100 mg daily two days prior to vaccination Take magnesium 100 mg qpm Take a probiotic qpm

Current Illness: None

ID: 0931874
Sex: F
Age: 58
State: MD

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

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

Lab Data:

Allergies: Sulfa, Ampicillin

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

Symptoms: 103 fever, chills, arm pain at injection site, headache. Fever lasting 1 day, arm pain lasting 3-4 days.

Other Meds: Not taken at the time of vaccination.

Current Illness: Diabetes Type 2

ID: 0931875
Sex: M
Age: 38
State: GA

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

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

Lab Data:

Allergies: no allergies

Symptom List: Tremor

Symptoms: Received Moderna vaccine 1/6/21 at 9:10 am. Felt fine until approximately 4:00 pm when he noticed his left arm was very sore. At approximately 9:30 pm, the patient became cold with shivering. Temp fluctuated during night between 99 - 103.8. During the night, he experienced nausea and vomiting, dizziness, body aches, and a weird taste in mouth. On 1/7/21, patient still complained of fever, headache, nausea, and the new symptom of diarrhea. His neck was now very sore, with pain moving it right or left. On 1/8/21, slight improvement of symptoms. On 1/8/21 at 7:00 pm, he noticed a very itchy, red raised rash on torso, arms and legs. He called his physician and was called in a prescription for steroids. The pharmacy was closed and he picked the steroids up on the morning of 1/9/21. He took the steroids on 1/9/21 and has noticed major improvements. Rash still present, but not itching. Temp currently 99.1, but all other symptoms improved.

Other Meds:

Current Illness: Positive Covid diagnosis 12/19/2020

ID: 0931876
Sex: F
Age: 60
State: MS

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

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

Lab Data:

Allergies: Penicillin, Cipro

Symptom List: Erythema, Pruritus

Symptoms: Dizziness immmediately post vaccine and continued x 31 hours, malaise,, lower than normal Blood pressure x 31 hours post vaccine, Rash on upper back 6-10 hours post Vaccine Benadryl and increased fluid. Antivert for dizziness.

Other Meds: Triamterene/HCTZ, Wellbutrin, Losartan, Topamax

Current Illness: None

ID: 0931877
Sex: F
Age: 49
State: CA

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

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

Lab Data:

Allergies: PCN, Sulfa, Morphine, Shrimp

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

Symptoms: Heat/flushing from injection site to neck to face to upper body x 20 minutes; sweating

Other Meds: Coreg ASA Elderberry Gummies Vit D Vit C

Current Illness: Cardiomyopathy Neuropathy

ID: 0931878
Sex: F
Age: 52
State: CO

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

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

Lab Data:

Allergies: Sulfa meds One experience of tongue swelling after eating scallops.

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

Symptoms: Moderna COVID-19 Vaccine EUA Soreness and warm at shot site but not hard. Extreme fatigue

Other Meds: None

Current Illness: None. Covid positive w/ mild symptoms ( loss of taste/smell) 11/20/20.

ID: 0931879
Sex: F
Age: 31
State: OK

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

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

Lab Data:

Allergies: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: lymphadenopathy In left armpit

Other Meds: Lexapro Cyclobenzaprine Esomeprazole

Current Illness: N/A

ID: 0931880
Sex: F
Age: 57
State: IN

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 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: HEADACHE, SORE THROAT, BODY ACHES, RUNNY NOSE, DIARHEA

Other Meds: paroxetine 30 mg

Current Illness: none

ID: 0931881
Sex: F
Age: 56
State: AK

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

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

Lab Data:

Allergies: oranges, septra, tomatoes

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

Symptoms: Had COVID vaccine and was being monitored. at 11:25a she developed dizziness, nausea, chest pain, left arm weakness/numbness, skin itching. BP checked and was 190/110, then 180/110. Hx HTN and BP meds taken today. Hx of allergies -- took loratadine and hydroxyzine this AM. Due to the dizziness and skin itching, feeling unwell/woozy with history of anaphylaxis, given epipen and called 911. EMS arrived and taken to ER.

Other Meds: albuterol 90 mcg/inh inhalation aerosol, 2 puff(s), INH, QID, PRN Astelin 137 mcg/inh nasal spray, 2 spray(s), Nasal-Both Nostrils, BID, 2 refills BLM Oral-Topical Suspension, 10 mL, Oral, q4hr, PRN budesonide 32 mcg/inh nasal spray, 2 s

Current Illness: cough

ID: 0931882
Sex: F
Age: 26
State: OH

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

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

Lab Data:

Allergies: chocolate, latex, hay fever, oak pollen, Flonase, Eloquis

Symptom List: Pain in extremity

Symptoms: swelling at injection site, redness at injection site, muscle pain at injection site

Other Meds: Lexapro, Seroquel, Topamax Maxalt, Tylonel

Current Illness:

ID: 0931883
Sex: F
Age: 46
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: 3:40 pm - at 10 minutes after receiving vaccine pt reports feeling warm and dizzy. 3:49 pm pt evaluated by EMS BP 165/99 P 67 O2sat 100 % 4:14 pm EMS transported pt to the hospital

Other Meds: Atenolol, Aspirin

Current Illness:

ID: 0931884
Sex: F
Age: 56
State: MA

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

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

Lab Data:

Allergies: Raglan, Percocet, Wellbutrin

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

Symptoms: Metallic taste, palpitations, nausea, dizziness, flush Subsided after 30 min headache 4 hours later Tylenol taken Next day painful injection site, body aches chills fatigue Tylenol Advil taken with some relief

Other Meds: Aspirin, Zoloft, norvasc, Crestor, centrum silver, caltrate d, elderberry

Current Illness:

ID: 0931885
Sex: F
Age: 61
State: UT

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Injection site became red about an inch around,it, warm to the touch and itchy about a week after the injection

Other Meds: Prozac Wellbutrin Xanax OTC vitamin supplements

Current Illness: None

ID: 0931886
Sex: F
Age: 28
State: CA

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

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Arm soreness starting the next day after injection and lasting for 4 days Fatigue starting about 6 hours after injection and lasting for 2 days Brain fog starting about 6 hours after injection and lasting for 2 days Mild headache starting about 6 hours after injection and lasting for about 4 days

Other Meds: Loratadine, multivitamins, probiotics

Current Illness:

ID: 0931887
Sex: F
Age: 80
State: IN

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

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Skin rash all over body

Other Meds: Levothyroxin, vitamin D2

Current Illness: Going in for right shoulder replacement in a couple weeks.

ID: 0931888
Sex: F
Age: 51
State: UT

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

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

Lab Data:

Allergies: None

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

Symptoms: Fever 24 hours later. Red, swollen, hot at the injection site. Red blotchy skin spread to 4"x6". Painful still, after three days.

Other Meds: Multi-vitamin, Vitamin D, Vitamin B12, Biotin

Current Illness: COVID 19 one month prior

ID: 0931889
Sex: F
Age: 54
State: AK

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

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

Lab Data:

Allergies: flexeril inapsine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Had COVID vaccine #1. Developed a numbness and tingling sensation in hands and legs at 10:45a. Denies any rash, mouth/throat swelling, difficulty breathing, itching, wheezing, or racing heart. Check vitals: O2 98% HR 72 BP 118/80 Monitored until 11:20. Rechecked periodically and her symptoms resolved. Advised that if symptoms return then go to ER. Discharged home.

Other Meds: Artificial Tears preserved ophthalmic solution See Instructions Chondroitin-Glucosamine 1 cap(s), Oral, Daily Fish Oil , Oral Multivitamins and Minerals Premarin 0.625 mg oral tablet 0.625 mg = 1 tab(s), Oral, Daily Premarin 0.625 mg/g vag

Current Illness:

ID: 0931890
Sex: M
Age: 30
State: KS

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

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

Lab Data:

Allergies: Motrin, Mold

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

Symptoms: Hives, Difficulty Breathing. Lasted about 3 hours.

Other Meds: None

Current Illness:

ID: 0931891
Sex: M
Age: 30
State: CO

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

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

Lab Data:

Allergies: None

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

Symptoms: Two hours after injection my pinky toe and digit next to it on right foot went numb for two hours total. Felt slight tingle in both feet that night. Had a fever that night and have been congested since getting the vaccine. Had a covid swab test on 1/7 and was negative.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm