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: 1055738
Sex: M
Age: 36
State: CT

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

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

Lab Data:

Allergies: Minocyline. Lialda/mesalamine

Symptom List: Dysphagia, Epiglottitis

Symptoms: Received 2nd COVID pfizer vaccine approx 11:15am on 2/18/21. No known reaction from first dose on 1/25/21. Woke up morning of 2/19 and observed extensive petechiae and bloody nose consistent with low platelet count and ITP (immune thrombocytopenic purpura). I was previously diagnosed with ITP and platelet count was 262k confirmed by blood work a couple days before 2nd vaccine. Morning after got blood draw confirming platelets dropped to below 1k. Medical emergency and sent to ER. Admitted and received emergency treatment to increase platelet counts. Ended up requiring splenectomy on 2/22/21. Just discharged from hospital. Multiple medical providers advised me to submit report to VAERS.

Other Meds: Entyvio IV infusion for ulcerative colitis. Prednisone oral 40 mg daily for UC flare. N Plate weekly for ITP.

Current Illness:

ID: 1055739
Sex: M
Age: 30
State: HI

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: Nil

Symptom List: Anxiety, Dyspnoea

Symptoms: After less then 5 minutes of receiving the Pfizer vaccine I experienced dizziness, difficulty breathing and I could feel my heart rate accelerating rapidly. This side affect lasted for about 5-10 minutes. After which I left and haven't felt right since and it's been about 8 hours since receiving the vaccine and at the time of writing it is now 1630 time.

Other Meds: Nil

Current Illness: Nil

ID: 1055740
Sex: M
Age: 69
State: TX

Vax Date: 01/20/2021
Onset Date: 01/21/2021
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: skin reaction to latex on adhesives when used for more than 1 week

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

Symptoms: Day after first shot, experienced some arm pain, elevated temperature, chills, very tired. Of concern, blood pressure spiked to 149/78 (usually 120/70) and stayed elevated all day. I contacted my cardiologist late in the afternoon and he advised me to come in if the blood pressure did not return to normal the next day. The next day, all symtoms disappeared and I felt normal. When I received my second shot yesterday the doctor giving the injection said the blood pressure spike after the first shot was unusual and asked me to submit a VAERS report. My symptoms after the second shot were a much more significant loss of mobility in the arm, which has returned to near normal. but no blood pressure issue

Other Meds: Ocuvite, Multivitamin adults 50+, aspirin 81mg, Atorvastatin 20mg, glucosamine chronditin 500 complex, Metoprolol Succinate ER

Current Illness:

ID: 1055741
Sex: F
Age: 51
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Swelling of the lips and tongue, numbness and tingling of the mouth, sweating of the lips and mouth. Patient refused to be seen by EMS

Other Meds:

Current Illness:

ID: 1055742
Sex: M
Age: 65
State: CA

Vax Date: 01/28/2021
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: Sulfa drugs

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

Symptoms: Bells Palsy onset 3 weeks post vaccination.

Other Meds: N/A

Current Illness: N/A

ID: 1055743
Sex: F
Age: 64
State: KS

Vax Date: 02/19/2021
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:

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

Symptoms: Rash at injection site, 6 days post vaccine. 12 hours post vaccine chills, extemely sore arm, headache, body aches, dizziness lasting 48 hours.

Other Meds: synthroid, simvastatin, levocetirizine dihydrochloride, montelukast sodium, multivitamin

Current Illness:

ID: 1055744
Sex: F
Age: 49
State: CO

Vax Date: 02/17/2021
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: Mild allergy Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: (Newly) Skin red around injection site about 6 inches in diameter. Skin tight and hot. No symptoms prior to today. Some soreness and muscle aches. Arm pit soreness (left arm, same side injection site), similar to swollen or infected glands (which have had in past, unrelated to vaccine.)

Other Meds: none

Current Illness: none

ID: 1055745
Sex: F
Age: 36
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Tingling radiating to fingertips.

Other Meds:

Current Illness:

ID: 1055746
Sex: F
Age: 70
State: WA

Vax Date: 01/28/2021
Onset Date: 02/04/2021
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: Penicillin Sulfur

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Covid Arm - onset on day 8 after vaccine. Large red area - approximately 6"x3 Warm, intense itching and sore to touch Lasted approximate 6 days - less reddening and itching as each day passed

Other Meds: Amlodipine 2.5 mg Pravastatin 10 mg Timolol Maleate 0.25 Vitamin D 1000 I.U. Estring Physillum Husk

Current Illness: None

ID: 1055747
Sex: F
Age: 28
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Numbness on lips, tingling.

Other Meds:

Current Illness:

ID: 1055748
Sex: F
Age: 74
State: WV

Vax Date: 02/12/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Christmas trees (bronchitis), grass, weeds & flowers in my garden (skin blisters), tape & band-aides on skin (blisters & skin comes off with tape), aspirin (dysfunctional platelet disorder)

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

Symptoms: Huge itchy red spot - rash around site of vaccination & smaller but darker red rash down the arm about 2" on the bicep

Other Meds: Pravastatin 80mg, Levothyroxin 112 mcg, Women's Daily +50 multivitamin, Potassium gluconate 99mg, OTC stool softener, Tylenol 650 mg

Current Illness: Breast cancer survivor 9 1/2 years - bilateral mastectomy (can only have injections in left are due to removal of lymph nodes from right arm), no other illnesses

ID: 1055749
Sex: F
Age: 68
State: TX

Vax Date: 02/09/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: Sugar, flour, wheat, Levaquin

Symptom List: Rash, Urticaria

Symptoms: Itching and rash began 2/21/21 at injection site. Today (2/25/21) trash now extends from to of L shoulder spiraling toward inside of arm 2 inches above L elbow. Some swelling, hot to touch, itching, no pain.Have put ice on it. Contacted doctor and sent picture. She said it was normal and not to worry.

Other Meds: Multivitamin, AREDS 2, vitamin C, calcium citrate with D3, Flonase as needed

Current Illness:

ID: 1055750
Sex: F
Age: 83
State: WA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
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

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

Symptoms: Patient got Moderna vaccine on 02/15/2021. She was feeling good until today. She called pharmacy and complained that recently all at sudden her arm got swollen and having redness and tenderness at injection site. Just reporting this because she has this side effect after a 10 days.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1055751
Sex: F
Age: 27
State: TX

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

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: REPORTED HISTORY OF ANAPHYLAXIS TO TDAP VACCINATION AS AN INFANT

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

Symptoms: Patient began feeling nauseous about 30 minutes after vaccine, then dizzy. A few minutes later she appeared to faint and became unresponsive. She did not appear to be breathing and looked cyanotic. Epipen was administered and patient began responding a few moments later. EMS arrived and was taken to the emergency room. Patient reported feeling fine and was back at home around 7 pm.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1055752
Sex: F
Age: 38
State: SD

Vax Date: 01/08/2021
Onset Date: 02/01/2021
Rec V Date: 02/25/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: ITP noted appx 4 wks after 1st dose with heavy vaginal bleeding responsive to IVIG and steroids.

Other Meds: None

Current Illness: None

ID: 1055753
Sex: F
Age: 40
State: OH

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

Lab Data:

Allergies: Vancomycin Erythromycin

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

Symptoms: 9pm- chills 11:30pm- fever, nausea, vomiting, tachycardia, diaphoresis Husband Called 911 2/24- all day fever, chills, headache, fatigue 2/25 last fever at 10:30am, still have chills, fatigue, headache

Other Meds: Plaquenil Methotrexate Aspirin Metoprolol Effexor

Current Illness: None

ID: 1055754
Sex: F
Age: 37
State: MD

Vax Date: 02/21/2021
Onset Date: 02/22/2021
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: Arm became sore and swollen and warm to the touch. Also on the 4th day showed signs of a reaction, with red patches and appear to mimic the after effects of a bee sting of sorts.

Other Meds: Atrovastin Metformin

Current Illness: No

ID: 1055755
Sex: M
Age: 28
State: WA

Vax Date: 02/23/2021
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: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: On 02/24 wake up to fever of 101.4 and severe body aches and took day off from work. On next day woke up to nose bleeding with lot of clots coming out of my nose. Only medication i took was OTC ibuprofen that i took month ago as well for fever.

Other Meds: No

Current Illness: No

ID: 1055756
Sex: F
Age: 53
State: CA

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Tachycardia approximately 30 minutes post injection lasting 20 to 30 minutes

Other Meds: Vit D, Synthroid, Adderall, Singulair, folate, biotin

Current Illness: None

ID: 1055757
Sex: F
Age: 76
State: NC

Vax Date: 02/12/2021
Onset Date: 02/21/2021
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: Penicillian

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

Symptoms: Soreness, red swelling--growing from 3"x3-1/2" red raised spot hot to touch to 3" x 5" raised red spot hot to touch.

Other Meds: Gabapentin, Welchol, Metaxalone, Ambient, Hydrochlorothizide, Multivitamin, Omega 3, Ocuvite, Omeprazole, Lorsortan, Vitamin C, Vitamin D3, Baclofen, Synthroid,

Current Illness: N/A

ID: 1055758
Sex: F
Age: 51
State: NY

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: penicillin tetracyclin shell fish

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

Symptoms: syncope, patient was monitored and given IV fluids, low blood pressure

Other Meds: lexapro tamoxiphin

Current Illness: none

ID: 1055759
Sex: F
Age: 61
State: CA

Vax Date: 01/26/2021
Onset Date: 02/10/2021
Rec V Date: 02/25/2021
Hospital: Y

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

Lab Data:

Allergies: Ampicillin, Eggs

Symptom List: Unevaluable event

Symptoms: Loss of use right leg. Paralysis, numbness, tingling, severe pain, and muscle spasms. Acute onset without other trauma

Other Meds: Synthroid, Duloxetime, Gapapentin

Current Illness: CMT Type 1A Hereditary Neuropathy, Sarcoidosis, Thyroid, Psorasis

ID: 1055760
Sex: F
Age: 70
State: NY

Vax Date: 02/12/2021
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: Nickel/aluminum Azithromycin

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

Symptoms: "COVID Arm"--Twelve days after receiving the vaccine, a large circular pink rash developed at the injection site. It is warm to the touch and it is itchy. It is my understanding that this reaction is uncommon but harmless and nothing to worry about. It should go away in a few days.

Other Meds: lisinopril/HCTZ 20/25 Vitamin D3 UI 1000

Current Illness: None

ID: 1055761
Sex: F
Age:
State: NC

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

Lab Data:

Allergies: Iodine , Shellfish

Symptom List: Injection site pain, Pain

Symptoms: Swelling and pain at the injection site 12 hours after vaccination. The pain progressed distally to the elbow and resolved after 3 day. On 21Feb 2021, Tenderness,warmth, swelling and erythema was noted 4 inches below the injection site. A mild non-itchy rash with induration approximately 4 inches was noted. The tenderness, warmth at the site and induration has not resolved at the time of report. No medication was taken for the symptoms. No medical intervention needed.

Other Meds: Multi vitamin, Metformin, Citalopram, Wellbutrin, Zyrtec.

Current Illness: DMII

ID: 1055762
Sex: F
Age: 53
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Tingling in L arm, lightheaded, dizziness, evaluated by EMS-cleared

Other Meds:

Current Illness:

ID: 1055763
Sex: F
Age: 60
State: TX

Vax Date: 02/12/2021
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: none

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

Symptoms: Initial first three days - Rash, swollen arm, headache and sore arm. It went away and two weeks later after exertion the rash returned along with the swelling and soreness.

Other Meds: Potassium, Biotin, Omega-3, Multi-Vitamin, Citalopram, D-amphetamine ER, Anastrozole and Bupropion

Current Illness: none

ID: 1055764
Sex: F
Age: 65
State: CT

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: Allergic to shellfish, kiwi, latex, ceclor, bee stings, cat & dog dander, guinea pigs & horses & pollens - all trees, grasses & shrubs

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Red, Itchy rash on face & neck, skin hot to touch, burning sensation on face day after shot - also some edema under right eye - small sack of fluid - lasted a few days - took benadryl to relieve itching - dissapated after 4 days but skin was very dry & chapped for about 10 days after

Other Meds: 25 mcg levothyroxine 25 mg hydrochlorothiazide My doctor told me to take 1 benadryl an hour before the vaccine due to my previous allergic reactions

Current Illness: No

ID: 1055765
Sex: F
Age: 37
State: IL

Vax Date: 02/07/2021
Onset Date: 02/15/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Shingles - rash, pain, discomfort on left torso... back pain 10 days after shot; rash appear around 14 days after

Other Meds: None

Current Illness: None

ID: 1055766
Sex: M
Age: 29
State: TX

Vax Date: 01/29/2021
Onset Date: 01/30/2021
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: None

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

Symptoms: Strong ache in right deltoid (injection site); Pain in right deltoid preventing motion of deltoid; Flu-like fatigue; 102F-103F fever for 60 hours.

Other Meds: None

Current Illness: None

ID: 1055767
Sex: F
Age: 50
State: MN

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: Penicillin

Symptom List: Nausea

Symptoms: One week after my first monderna shot (Wednesday to Wednesday) I noticed my left arm at the injection site was itchy. The skin feels hard and thick, for lack of better descriptive words. The area around the injection site is red and sore. That?s all I?ve experienced so far.

Other Meds: IUD

Current Illness: None

ID: 1055768
Sex: M
Age: 70
State: WI

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: No adverse events were noted at the time of this report. This report is being filed to document a vaccination error that occurred during the vaccination process.. During the dilution process to prepare a Pfizer Covid vaccine 1.4 mL of normal saline was used instead of the correct 1.8mL as specified by the manufacturer resulting in a overly potent dose. Exactly one shot was given out of the vial prior to the error being discovered. No additional doses were used out of the incorrectly diluted vial. The patient was made aware of the error as soon as it was discovered and contacted at the end of business day to confirm no adverse events at that point.

Other Meds:

Current Illness:

ID: 1055769
Sex: F
Age: 59
State: TX

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

Lab Data:

Allergies: Unknown

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

Symptoms: Wrong 2nd dose COVID Vaccine was administered. Nurse on site inadvertently administered Pfizer 0.3 ml IM as 2nd dose However, patient should have received Moderna 0.5 ml IM as 2nd dose Nurse reported error immediately to patient and supervisor , assessed patient for change in VS and any s/sx indicating reaction. Assessed patient for more than 30 minutes with no negative reaction noted. Patient advised regarding VAERS reporting in case symptoms occur at a later point.

Other Meds: Not reported

Current Illness: Unknown

ID: 1055770
Sex: F
Age: 78
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Bone on left wrist turned red & was swollen for 2-3 days. In addition joint on index finger on right hand turned red & bruised.

Other Meds:

Current Illness:

ID: 1055771
Sex: F
Age: 57
State: AZ

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

Lab Data:

Allergies: Penicillin, sulfa

Symptom List: Tremor

Symptoms: Fever, headache, body aches

Other Meds: Sertraline, Singulair, amlodapine,

Current Illness: None

ID: 1055772
Sex: M
Age: 48
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Facial flushing, diaphoresis, nausea, patient refused to be seen by EMS

Other Meds:

Current Illness:

ID: 1055773
Sex: F
Age: 77
State: CA

Vax Date: 02/24/2021
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: None

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

Symptoms: Redness and sore left arm, tired, headache,sleepy

Other Meds: Metformin, simvastatin, inhaler, fish oil, cinnamon tablets

Current Illness: None

ID: 1055774
Sex: F
Age: 31
State: PA

Vax Date: 01/07/2021
Onset Date: 01/01/2021
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: No

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

Symptoms: Erythema Nodosum in bilateral legs

Other Meds: Birth control(tri-linyah)

Current Illness: Nope

ID: 1055775
Sex: F
Age: 43
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Blurry vision, neck pain, patient refused to be seen by EMS.

Other Meds:

Current Illness:

ID: 1055776
Sex: F
Age: 44
State: MA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
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: cyclosporin

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

Symptoms: episodes of dizziness and "flushing' to face lasting seconds to minutes intermittently all day interfering with day to day living

Other Meds: citalapram

Current Illness: COVID mid January

ID: 1055777
Sex: F
Age: 29
State: MD

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

Lab Data:

Allergies: Nickel

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

Symptoms: Within hours the arm in which I received the injection was sore. By 12 hours I had a mild fever of 100 degrees, chills, body aches, and a bad headache. The symptoms listed so far were expected and were gone by about hour 36 post vaccination. However, within 24 hours of the injection a red, raised rash around injection sight appeared. Slightly itchy and very firm and sore to touch. About 2 inches in diameter. At the time of this reporting the rash has not gone away.

Other Meds: Birth control: Charlotte 24 Fe Oral

Current Illness: None

ID: 1055778
Sex: F
Age: 25
State: IN

Vax Date: 01/26/2021
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: Seasonal allergies

Symptom List: Pain in extremity

Symptoms: First dose: mild arm pain, raised red lump (got about as big as a half dollar in size) near injection site (bruise formed after lump went away), "COVID arm" Second dose: moderate arm pain, raised red lump (so far approx 1.5-2" in diameter and still growing) near injection site, severe pain near top of spine / base of neck causing discomfort and a migraine, nausea, fatigue, overall discomfort.

Other Meds: BCP, Nexium, Zyrtec, vitamins C & D3

Current Illness:

ID: 1055780
Sex: F
Age: 74
State: AR

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Around 5 minutes after 2nd vaccination, patient states she is dizzy, shaky and feeling like she is going to pass out. Provided water, cold towel and being monitored by nurse. Denies any shortness of breath or difficulty breathing. States symptoms persist for the next 30 minutes while refusing to go to ED. Daughter arrives and instructs patient to ED. Escorted to ED with the patient still complaining of persistent dizziness, lightheadedness, and brief chest tightness which subsided within 5 minutes.

Other Meds:

Current Illness:

ID: 1055781
Sex: F
Age: 31
State: PA

Vax Date: 02/04/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Nkda

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

Symptoms: Rash on my back and abdomen Tried zyrtec and benadryl with no improvement. Got decadron IM shot today.

Other Meds: Myo inositol supplement and prednisone for tx of erythema nodosum

Current Illness: Erythema nodosum in legs

ID: 1055782
Sex: F
Age: 64
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Itchy throat, rash around the mouth. Patient cleared by EMS

Other Meds:

Current Illness:

ID: 1055783
Sex: F
Age: 49
State: MI

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/A

Symptom List: Vomiting

Symptoms: Pain and swelling in. arm Fever, low-grade Chills Achiness Fatigue Headache

Other Meds: Buproprion Effexor

Current Illness: N/A

ID: 1055784
Sex: F
Age: 65
State: MS

Vax Date: 02/21/2021
Onset Date: 02/21/2021
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, hydrocodone, lysinapril

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache, tightness in chest, legs hurting from my knees down, hard to focus vision, and super tired. started about an hour later. Did not sleep well. Stayed in bed the next 2 days. Tightness in chest went away the second day. Third day I felt like myself. These were things that I also experienced with Covid.

Other Meds: Flexerill 10mg, Lipitor 10mg, Gabapentin 300mg, Nexium 40mg, Lexapro 20mg, Losartan-Hydro CHLORO Thiazide 50-12.5 mg 1/2, Relafen 500mg, Ditropan 10 mg, Zinc 50mg, Vita. B Complex, Melatonin 1 mg, Imitrex 50mg

Current Illness: I am still on oxygen from having COVID in July. I was sick at home for a week and a half and hospitalized for 2 weeks. I received a plasma transfusion. I have not been sick just stay tired.

ID: 1055785
Sex: F
Age: 38
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: No

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

Symptoms: Body aches, nausea, headache, fever

Other Meds: Lexapro

Current Illness: No

ID: 1055786
Sex: F
Age: 38
State: NE

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient said she was "extremely tired, no energy, headache, my body feels like I have been working out for weeks, hot and hold spells, and I know this sounds crazy but lips numb. "

Other Meds:

Current Illness:

ID: 1055787
Sex: M
Age: 25
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Was normal for 10 min after vaccine, sitting down and waiting. Was about to leave and get on my motorcycle but a wave of dizziness hit, couldn't see (as if I had stood up too fast), started sweating profusely. Lasted for about 3 minutes. Man working brought me a bottle of water which I chugged, symptoms mostly passed a couple minutes later. Was still dizzy for another 20 min but after that it passed.

Other Meds: None

Current Illness: None

ID: 1055788
Sex: M
Age: 39
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Pt reported chills and body aches.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm