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: 1055372
Sex: F
Age: 66
State: MI

Vax Date: 02/20/2021
Onset Date: 02/24/2021
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: n/a

Symptom List: Dysphagia, Epiglottitis

Symptoms: sore arm, lymph gland swollen, slight sore throat on right side

Other Meds: n/a

Current Illness: n/a

ID: 1055373
Sex: F
Age: 71
State: WA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NSAIDS, Vicodin

Symptom List: Anxiety, Dyspnoea

Symptoms: After waiting the 15 minute observation period, pt became dizzy when she was walking out to leave. She then fell, landing onto her left arm. She was observed for one hour, vital signs taken every 15 minutes. Patient continued to complain of nausea. Patient was then transferred to the emergency department.

Other Meds: hydrochlorothiazide

Current Illness: none

ID: 1055374
Sex: F
Age: 30
State: MI

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa products

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

Symptoms: Severe pain in my upper back and shoulders. Went to the ER in case of blood clots. Had X-rays and blood/urine tests. Was given Toradol and Norco, but nothing changed. At home switching between heat/ice, and taking prescribed muscle relaxer. Not feeling much better after 12 hours.

Other Meds: Atorvastatin Sertraline Tri-Sprintec Collagen supplement

Current Illness: None

ID: 1055375
Sex: F
Age: 70
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: Tetracycline iodine Demerol codeine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Rapid heartbeat, lightheaded, sweating, about 5 min duration. Then again 23 hours after vaccination.

Other Meds: Januvia Synthroid Pantoprazole Biotin Probiotic B12 Rosyvastatin Calcium supplement Vitamin D Fiber supplement Flax seed oil glucosamine

Current Illness:

ID: 1055376
Sex: F
Age: 69
State: WV

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

Lab Data:

Allergies: Nuts, Effexor, Tylenol, naproxen, meclizine

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

Symptoms: Tightness around eyes, eyelids itching, breathing swallow, and stating, ?don?t feel right.? Vital 160/98, pulse 65 95%ra. Put given Benadryl 1tab with relief of sx.

Other Meds: Lamictal, ?cardia?, singular, albuterol, flovent

Current Illness: None verbalized

ID: 1055377
Sex: M
Age: 67
State: WV

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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: Altace-hives

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

Symptoms: Patient complained shortness of breath/feeling hot and vitals 156/96, 65, 97% RA Patient given Benadryl 1tab with resolution of symptoms.

Other Meds: Bisoprolol otherwise unknown

Current Illness: None reported

ID: 1055378
Sex: F
Age: 48
State: OK

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: Eggs Sulfa drugs Casein Lactate

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Diarrhea, heart racing, dizziness

Other Meds: N/A

Current Illness: None

ID: 1055379
Sex: F
Age: 57
State: OH

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin, ceclor, amoxicillin, augmentin, tetracycline, erythromycin

Symptom List: Pharyngeal swelling

Symptoms: pt reported perfect white circles or splotches on right arm after injection around injection site up her arm to her neck, chest, and around her back and down to her elbow they did not itch were not red or raised

Other Meds: multi-vitamin, zinc, immune booster drink, vitamin d

Current Illness: none

ID: 1055380
Sex: F
Age: 77
State: AZ

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: Lyrica

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: At aproximately 15 minutes after patient had the 1st Vaccine she complained of upper and lower lips feeling tingly. A couple of minutes later she said she had some difficulty swallowing saliva and the sensation of her throat feeling tight. She then reported resolve of her lips tingling but reoccurrence of same. She was given water and juice to drink w/o difficulty. She continued complaining of throat swelling sensation becoming worse and denied SOB. Patient stated she does smoke tobacco. VS 142/88 P 90 P/Ox 86% on RA Appears anxious w/o distress Heart RRR Lungs Some very mild diffuse wheezing A/P At approximately 45-55 minutes patient monitored with improvement in P/Ox to 91% on RA but continued complaining of sensation of throat closing. 911 called, IV started, paramedics administered Benadryl and patient was transported to ED without need of O2.

Other Meds: Unknown

Current Illness: None reported

ID: 1055381
Sex: M
Age: 75
State: TX

Vax Date: 02/11/2021
Onset Date: 02/13/2021
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: Sores on tongue swelling of tounge extreme fatigue

Other Meds: Amlodipine besylate 10MG Irbesartan 300MG Tamsulosin 0.4MG Myrbetig 50MG Multivitamin Red Yeast Rice 1200MG Omega 3 1000MG CoQ10 200MG Turmeric 1500 MG

Current Illness: None

ID: 1055382
Sex: F
Age: 53
State: MA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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:

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

Symptoms: Patient received second dose of Moderna rather than Pfizer dose that was due. Received the second dose at day 22.

Other Meds:

Current Illness:

ID: 1055383
Sex: F
Age: 67
State: PA

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Covid Arm Redness, itching, swelling & weeping around the injection site. Started approx 1 month after vaccination.

Other Meds: Citalopram Triamterene Lisinopril Levthyroxine

Current Illness:

ID: 1055384
Sex: M
Age: 74
State: WI

Vax Date: 01/28/2021
Onset Date: 01/29/2021
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: Unknown

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

Symptoms: He had severe vision issues and feeling weak and strange. Also had fever and ended up going to the hospital for 4 days.

Other Meds: Numerous

Current Illness: Has diabetes and heart issues

ID: 1055385
Sex: F
Age: 36
State: KY

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

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

Symptoms: Fatigue, body aches, low grade fever, inability to concentrate

Other Meds: Hydroxyzine

Current Illness: None

ID: 1055386
Sex: F
Age: 49
State: WI

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: Latex, PCN, sulfa, erythromycin, permethrin, Vicodin, etc....

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

Symptoms: Initially, tingling tongue and gums. Tongue felt ?big?. All over body itching. Excessive coughing. Could not clear throat. It felt as if I was put inside a CS chamber. Went to ER. Treated with steroid and antihistamine. Coughing stopped with residual tightness in chest. Tingly stopped and reduced itchiness.

Other Meds: None

Current Illness: None

ID: 1055387
Sex: F
Age: 56
State: VA

Vax Date: 02/08/2021
Onset Date: 02/20/2021
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: None

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

Symptoms: Fatigue, nausea, headache, diarrhea, stomach pain

Other Meds: Vitamins B, D, E

Current Illness: None

ID: 1055388
Sex: M
Age: 62
State: OR

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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: none short of cold induced urticaria

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

Symptoms: Extreme Sore Deltoid (1st sign progressed over day). The following symptoms started around 9 pm and increased through the night: severe headache, nausea, malaise, other joint pain - especially joints of previous injuries (lifetime), chills, hot flashes, tiredness - though inability to sleep. I needed to take Tylenol through the night which did help with headache. The symptoms were significantly decreased by 6 pm that day (Feb 24th).

Other Meds: none

Current Illness: sinus cold (5 day duration) 2 weeks prior

ID: 1055389
Sex: F
Age: 86
State: OH

Vax Date: 01/28/2021
Onset Date: 01/29/2021
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: Patient complained of extreme arm pain for 3 weeks after shot. Went to doctor who said shot was not given in deltoid muscle. Patient was unable to explain where shot was given. She could not lift her arm for 3 weeks and says it is still not back to normal.

Other Meds: UNKNOWN

Current Illness:

ID: 1055390
Sex: M
Age: 63
State: CO

Vax Date: 01/29/2021
Onset Date: 02/01/2021
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: Gluten, Bactrim.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Did not connect adverse event to the vaccination until roughly three days after it was recognized. Had first dose of Pfizer COVID-19 on Friday, January 29, 2021. On the following Sunday or Monday (2 or 3 days post vaccination), I noticed ringing in my ears. I have always had perfect hearing, no issues whatsoever. I knew nothing about tinnitus, so just figured it would go away. Days later, it hadn't gone away so did some research and wondered if it could be associated with the vaccine. Searched the web, but found nothing. Considered calling a hearing specialist (long story so will keep it short), but all info found said there was little that could be done, so did not make the call. Since couldn't find relation to vaccine, received second dose on February 19, 2021 without any other issues. Tinnitus continues as originally noticed. Finally yesterday, I related the Covid vaccine to tinnitus after reading an article on J&J's vaccine candidate that stated tinnitus had been seen as an adverse reaction in the clinical trials.

Other Meds: Humalog and Tresiba for T1 diabetes. Latanoprost for glaucoma. Atorvastatin for high cholesterol. Lisinopril for BP.

Current Illness: None

ID: 1055391
Sex: F
Age: 76
State: MD

Vax Date: 02/15/2021
Onset Date: 02/16/2021
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: headache, fatigue, 02/16 thru 03/25/21 tongue thickening, 02/18 thru 02/25/2021 swollen face, throat, 02/22 thru 02/25/2021 Doctor prescribed PredniSONE 20 MG TAB CADI beginning 02/25/2021 for 5 days, on going, no outcome

Other Meds: Synthroid .75, Humalog, Lantus

Current Illness: None

ID: 1055392
Sex: F
Age: 73
State: AZ

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Extremely allergic to wet suits. Lettuce, carrots, certain dyes

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

Symptoms: Fever of 102.8, chills, body aches, nausea, horrendous headache and feel like I?ve been run over with a bulldozer. This has been occurring since 9:30 pm. Last night and all day today. Never had a reaction before to any vaccine other than a sore arm.

Other Meds: Prempro, tribenzor,, dupixent, vitamin D, allegro, famodine

Current Illness: None

ID: 1055393
Sex: F
Age: 46
State:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Patient received the 2nd dose of the Covid-19 vaccine at 16:26 today (2/25/21). She reported symptoms of difficulty breathing, tight throat and tight and numb lips at 16:34 today and alerted staff. At 16:35 epinephrine was given for suspected anaphylactic reaction. Vitals at 16:35 before administration of epinephrine were pulse ox 100% and pulse 67. Vitals at 16:37 were pulse ox 100%, pulse 170, and BP 162/102. First response called at 16:35. Patient felt immediate improvement in symptoms with epinephrine administration. First response team took patient to ED for further evaluation at roughly 16:40 by wheelchair.

Other Meds:

Current Illness:

ID: 1055394
Sex: F
Age: 53
State: CA

Vax Date: 02/09/2021
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:

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

Symptoms: Body aches, fever, HA x 2 days. Red itchy arm (injection site) x 10 days. Bruise at injection site x 2 weeks. Very red & warm arm (injection site) on day 13 x 1 day.

Other Meds:

Current Illness:

ID: 1055395
Sex: M
Age: 90
State: IL

Vax Date: 01/20/2021
Onset Date: 02/10/2021
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: codeine

Symptom List: Injection site pain, Pain

Symptoms: emergency Room HPI This is a 90 y.o. male who presents presents in the emergency room by ambulance from local nursing home for complaint of fall with no localized pain but was said to have low blood pressure of 80/40 and low O2 sat of 77%. PCP said to send patient to the ER for evaluation. Patient is COVID positive but is said to have completed the vaccine on 19th of January 2021. In the ER blood pressure is 122/71, respiration 18, pulse is 68, temperature 98.7? F and O2 sat of 95% on 4 L. Patient is confused and not answering questions which is his baseline.

Other Meds: Current Outpatient Medications: ? amiodarone (CORDARONE) 200 MG tablet, Take 100 mg by mouth daily (with breakfast) , Disp: , Rfl: ? amLODIPine (NORVASC) 10 MG tablet, Take 10 mg by mouth daily, Disp: , Rfl: ? carvedilol (COREG) 3.12

Current Illness:

ID: 1055396
Sex: M
Age: 79
State:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient received under-diluted dose of vaccine due to measurement confusion with syringe.

Other Meds:

Current Illness:

ID: 1055397
Sex: M
Age: 70
State: OR

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: SYR
Vax Site: LA

Lab Data:

Allergies: mild reaction to penicillin

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

Symptoms: I had painful swelling of the testicles within the first 24 hours. They were hot, red, very much enlarged and extremely painful. I had a mild fever (99.4) which was about 2 degrees above normal. The selling has subsided in the second 24 hours and my temperature returned to normal. There is still moderate swelling and sensitivity. I had not seen this reported as a common side effect of the vaccination. I thought it should be reported.

Other Meds: Meloxocam, Trulicity, Jardiance, Januvia, Lantus SoloStar Insulin Glargine, Losartan, Simvastatin, Fish Oil, B-2, Magnesium, D3, Saw Palmetto, Mature Multi-Vitamin

Current Illness: None

ID: 1055398
Sex: F
Age: 90
State: FL

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: LA

Lab Data:

Allergies: Unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Right arm moderate swelling entire arm No lymph nodes in that arm from mastectomy more than 3 years ago No apparent adverse reaction at injection site

Other Meds: Losartan, Propanolol, Levothyroxine, Mirtazapine

Current Illness: None known

ID: 1055399
Sex: F
Age: 32
State: OK

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa & bee stings

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: throat started to get swollen and raw within two hours with a migraine within 6 hours it was very difficult to breathe or talk.

Other Meds: None

Current Illness: None

ID: 1055400
Sex: F
Age: 88
State: WI

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: Mold, crab meat, Daypril, sulfa drugs, Lexapro, dairy, contrast dye, Metraniazole, leather, betamethazone ointment, and andphylactic reaction to bee stings

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

Symptoms: Patient experienced numbness and tingling to left side of face, tremors, sharp shooting pain in the left temporal area, left upper arm sore shoulder to elbow. Patient was also extremely cold so treated her with warm blankets. Gave patient water and checked blood pressure and hooked her up to heart monitor. Blood pressure was 138/74, pulse 60 and respirations 24. No mediacations were given while in our care. Continued to monitor paient for 2 hours at the clinic site. Patient did not want to go to the hospital

Other Meds: Unknown

Current Illness: Unknown

ID: 1055401
Sex: F
Age: 48
State:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient received under-diluted dose of vaccine due to measurement confusion with syringe.

Other Meds:

Current Illness:

ID: 1055402
Sex: F
Age: 35
State: OK

Vax Date: 12/31/2020
Onset Date: 01/03/2021
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: None

Symptom List: Injection site pain

Symptoms: Joint pain, swelling, and redness of right middle knuckle starting three to four days post vaccination. Unable to grasp and tighten fist with grip weakness. Only on that hand and that specific knuckle. Treated with Tylenol 1000 mg, ibuprofen 400 to 600 mg, and benadryl 25 mg, and zyrtec 10 mg for 3 to 4 days after symptom onset. Returned to normal function in about 10 days. After second dose of Pfizer symptoms did not really develop immediately but noticed 3 weeks after symptoms returned. The symptoms seem to come and go and do not know if they have fully resolved yet.

Other Meds: Pantoprazole 40 mg, Sertraline 50 mg, Trazodone 50 mg, Benadryl 25 mg

Current Illness: None

ID: 1055403
Sex: M
Age: 83
State: OH

Vax Date: 01/25/2021
Onset Date: 01/27/2021
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: known none

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

Symptoms: 2 days after 1st Covid vaccination my right arm at the site of the injection, the muscle became very sore and any exertion such as shoveling snow or lifting is very hard.. The muscle is always sore, even laying on my right side when sleeping is uncomfortable and will wake me up from sleeping

Other Meds: Atorvastatin 10mg/d,, Allipurinol 300mg/d,, Carvedilol 6.25mg 2/d,, Benazepril 20mg/d,, Pregabalin 150mg 2/d Warfarin Sulfate 13.75 mg/week,, Aspirin 81mg/ every other day,, Vit B12 1000Mcg 1/d

Current Illness: Afib, neuropothy,

ID: 1055404
Sex: M
Age: 41
State: TX

Vax Date: 02/24/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Full body aches all night long, then fever of a 102.3 followed by chills, also headaches, feeling of low energy

Other Meds: Ozempic, vitiam d 1000 iu

Current Illness: None

ID: 1055405
Sex: M
Age: 20
State: MA

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

Lab Data:

Allergies: Pollen.

Symptom List: Tremor

Symptoms: After waiting in the monitoring bay for 15 minutes, patient approached the checkout desk. Upon screening, patient endorsing mild nausea. Denies having nausea prior to vaccine. Denies any other symptoms, and asking if it's alright to workout tonight. Encouraged patient to rest, hydrate, and to contact PCP or EMS if symptoms worsen.

Other Meds: Unknown.

Current Illness: Unknown.

ID: 1055406
Sex: F
Age: 62
State: NC

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: Anaphylaxis to Ondansetron

Symptom List: Erythema, Pruritus

Symptoms: Described previously-took OTC medication

Other Meds: None

Current Illness: The 2nd vaccine gave me very high temperature,swollen and tender lymph nodes,severe aches and pains in all extremities and body,nausea for severe headache that did not stop that increased my blood pressure from the pain. Lasted for a week. I was unable to function or go to work.

ID: 1055407
Sex: F
Age: 65
State: WA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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:

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

Symptoms: Patient received a higher dose than indicated 1.8 mls

Other Meds:

Current Illness:

ID: 1055408
Sex: F
Age: 26
State: CO

Vax Date: 01/26/2021
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: hayfever

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

Symptoms: COVID-19 Vaccine. Hives on palms and feet one week later, hives lasted about 4 days and went away after taking benadryl.

Other Meds: Prednivaxinge amiltriptyline, tesanivene, hydroxycine, celebr

Current Illness:

ID: 1055410
Sex: F
Age: 66
State: NM

Vax Date: 02/13/2021
Onset Date: 02/21/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Covid arm, 3-4 inch circumference redness around injection site. Started approximately 1 week after injection, soreness and itchy.

Other Meds: Nifedipine and lecothyroxin

Current Illness: None

ID: 1055411
Sex: M
Age: 17
State: TX

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

Lab Data:

Allergies: nkda

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

Symptoms: Patient was normal and little nervous before vaccination. After receiving vaccinations about 2 minutes patient stated he could get up and was shaking. He was pale and sweating. Pharmacist Rima left the room to get another pharmacist. Patient mom reported she saw him passing out and eyes rolling. Patient was conscious after and had difficulty breathing but return to normal after a few minutes. We gave him a ice pack and called 911 to be ready on hand but was not dispatched. Patient rested in the room and left on their own.

Other Meds: n/a

Current Illness: n/a

ID: 1055412
Sex: F
Age: 91
State: WY

Vax Date: 02/18/2021
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: Penicillin and metronidazole

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

Symptoms: Large red welt- hot and itching

Other Meds: Metformin, Prednisone, GLipizide, Metoprolol, verapamil

Current Illness: Polymyalgia and A fib

ID: 1055413
Sex: M
Age: 55
State: AL

Vax Date: 02/18/2021
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: season, otherwise none

Symptom List: Pain in extremity

Symptoms: 4 days after vaccination, developed isolated RIGHT preauricular adenopathy. No other problems. No ear pain, sore throat, fever, or other evidence of URI. Has happened once before in entire life, and that was with fever and sore throat. After 16 hours of swelling and mild aching from swollen nodes, consumed Naprosyn 250mg 12 hours apart. 2 doses total. awoke the next morning with isolated, painless, 2 cm bullae on left abdomen, 3 cm bullae on left forearm, 1 cm reddened patch adjacent to arm bullae (suspected this area to also develop bullae). Discontinued Naprosyn. Abdominal bullae spontaneously drained. Reddened patch disappeared. 3 cm bullae persists but no growth or change. No new lesions, though right preauricular adenopathy slightly increased in swelling and tenderness.

Other Meds: discovy, claritin, lipitor, naprosyn

Current Illness: none

ID: 1055414
Sex: F
Age: 68
State: FL

Vax Date: 02/12/2021
Onset Date: 02/21/2021
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: 8-9 days after vaccine, my arm at vaccination site was extremely swollen, very itchy, and had a white raised pimple in the center. The swelling lasted at least 2 days, but it is still itchy, red, and has the white spot and warm to the touch.

Other Meds: Levoxyl 50 and 75 mcg Liothyronine Sod 5mcg Hydroxyurea 50 mg Vit C 500mg

Current Illness: none

ID: 1055415
Sex: F
Age: 78
State: CA

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

Lab Data:

Allergies:

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

Symptoms: lightheadness

Other Meds:

Current Illness:

ID: 1055416
Sex: F
Age: 40
State: NY

Vax Date: 01/18/2021
Onset Date: 02/25/2021
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:

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

Symptoms: fever, pain in the left arm

Other Meds:

Current Illness:

ID: 1055417
Sex: M
Age: 91
State: IL

Vax Date: 01/20/2021
Onset Date: 02/02/2021
Rec V Date: 02/25/2021
Hospital: Y

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

Lab Data:

Allergies: nka

Symptom List: Vomiting

Symptoms: Emergency room HPI Patient is a 91 y.o. male who presents from nursing home with positive coronavirus a and flu A positive tests. Test was done yesterday. Patient sent to ER because of low oxygen saturation. Patient unable to answer or respond to questions. No fever or chills, no cough or shortness of breath and no complaint of pain when patient was moved around. Oxygen saturation on presentation was 89% on room air and went up to 93% on 4 L of oxygen admission: HPI: Patient is a 91 y.o. male with a history of severe dementia and severe COPD. He currently resides at Rehab. He had a routine coronavirus (COVID-19) test yesterday that was positive. Then, today he started having increasing oxygen requirement. He was not responding to his typical breathing treatments or oxygen and so they sent him in. In the ER he was found to be in some respiratory distress and did require increased oxygen concentration. Once they got him calm down, his oxygen saturation state over 90% with 4 L. His ABG did show an oxygen Saturation of 86% on 4 L. The patient reportedly had coronavirus (COVID-19) several months ago, but then did test positive for both coronavirus (COVID-19) and influenza on rapid testing at the nursing home yesterday. The patient is being admitted due to his increasing oxygen requirement and respiratory distress

Other Meds: Current Outpatient Medications: ? acetaminophen (TYLENOL) 325 MG tablet, Take 650 mg by mouth every 6 hours as needed for Pain, Disp: , Rfl: ? Ascorbic Acid (VITAMIN C) 1000 MG TABS, Take 1,000 mg by mouth daily, Disp: , Rfl: ? aspiri

Current Illness:

Date Died: 02/24/2021

ID: 1055418
Sex: F
Age: 71
State: TN

Vax Date: 02/15/2021
Onset Date: 02/24/2021
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: Codeine, Morphine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient suffered a stroke and passed away

Other Meds: Lisinopril/HCTZ, Prasugrel, Rosuvastatin

Current Illness:

ID: 1055419
Sex: F
Age: 60
State: WI

Vax Date: 02/25/2021
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: Victoza

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

Symptoms: Pt presented with uncontrollable coughing and reported lightheadedness 30 minutes after vaccine administration. RN treated w/ 50 mg Benadryl PO. Cough and lightheadedness gradually improved and was resolved 45 minutes after Benadryl administration.

Other Meds: Unknown

Current Illness: Unknown

ID: 1055420
Sex: F
Age: 69
State: TX

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I had a headache of *migrane level, debilitating pain* for 66 hours.

Other Meds: None

Current Illness: Allergy headache 1 month prior

ID: 1055421
Sex: F
Age: 71
State: WI

Vax Date: 02/19/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: sulfa medications

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

Symptoms: when she got home after getting her vaccine she lost her voice. She compared it to having laryngitis

Other Meds: Unknown

Current Illness: Unknown/none known

ID: 1055422
Sex: F
Age: 72
State: VA

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: IM
Vax Site: RA

Lab Data:

Allergies: Naproxen, Shellfish, ceftriaxone, levofloxacin, ace inhibitors, adhesive tape, atorvastatin, ciprofloxacin, codeine, pitavastatin, simvastatin

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

Symptoms: patient developed hives to shoulder, face and scalp 10 minutes after receiving covid vaccine. Treated with Benadryl 50 mg by mouth. Doctor in to examine patient.

Other Meds: Vit. B 1 tablet by mouth daily Vit. D3 1 tablet by mouth daily Coenxyme Q10 1 tablet by mouth daily Epinephrine 0.3ml/0.3 mg auto injection pen as needed Avapro 150mg by mouth daily Protonix 40 mg by mouth daily Crestor 20mg by mouth daily

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm