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: 1056988
Sex: M
Age: 50
State: IL

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: FEVER, HOT FLASHES, AND EYE PAIN

Other Meds:

Current Illness:

ID: 1056989
Sex: F
Age: 63
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/26/2021
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: Levaquin (swollen limbs and hives), sulfa drugs (fatal)

Symptom List: Anxiety, Dyspnoea

Symptoms: At night my heart started racing, I felt like coughing, I felt extreme fatigue, no chills or fever, body aches. Muscle aches. I felt like I had covid all over again. Had COVID in June 2020 and never really stopped coughing. Since I had the vaccination it seems that the cough got a little better. I also developed Shingles after about a week or so after the vaccine.

Other Meds: Emergen C, Vitamin C and B Complex, Elderberry syrup

Current Illness: Sinus pressure

ID: 1056990
Sex: F
Age: 56
State: LA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Rash on upper thighs, abdomen/stomach and crease of arms. Noticed the morning after injection light red, slightly raised. Doesn't really bother me. No itching, burning or problems breathing. Took a Claritin and worked on 2/25. When I got home from work on2/25 showered and took a Benadryl. Rash is still here this morning. On my arms it is much lighter but still the same everywhere else.

Other Meds: Vyvanse 60MG Divigel 1MG gel packet Estradiol 0.01% (0.1 mg/gram) Venlafaxine 75 MG Albuterol 90 mcg/actuation inhaler

Current Illness: None

ID: 1056991
Sex: M
Age: 23
State: MN

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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: Body Aches

Other Meds:

Current Illness:

ID: 1056992
Sex: F
Age: 59
State:

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Approximately 12 hours after receiving the second dose, I experienced severe aches, rapid heartbeat, headache, and swelling of my lips. All symptoms except lip swelling improved 24 hours later after taking Tylenol.

Other Meds: Synthroid Duloxetine Allegra Mobic

Current Illness: None

ID: 1056993
Sex: F
Age: 64
State: VA

Vax Date: 02/15/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: After 1 week, developed a large red rash around the injection site. Swelling, pain and redness. Used ice to settle down the site and pain. Persisted for 1 week and still there.

Other Meds: Synthroid 137

Current Illness: None

ID: 1056994
Sex: M
Age: 79
State: IA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/26/2021
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: tetracycline

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: weakness, balance issues, fall - requiring hospitalization

Other Meds: carbidopa-levodopa, lorazepam, vitamin D, spironolactone, potassium chloride, furosemide, allopurinol, omeprazole, pravastatin, amlodipine, atenolol, aspirin, nitroglycerin sublingual PRN

Current Illness: none

ID: 1056995
Sex: M
Age: 72
State: MI

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/26/2021
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: Pharyngeal swelling

Symptoms: I received my 2nd Covid vaccine (Moderna) on Tues 2/16. On Wednesday my left knee (the last the replacements) was very sore and felt weak. On Thursday the knee didn't get any worse but my lower back and shoulders were sore. On Friday, there wasn't much change. On Saturday the knee seemed to stabilize and the back and shoulders were tolerable. On Sunday, my stomach was queasy. On Monday, sore joints and queasy stomach. On Tuesday, sore joints especially anything injured back in time, diarrhea started. On Wednesday upset stomach, just a piece of toast to eat, diarrhea, chills, sore joints everywhere, miserable. Thursday was the same as Wednesday plus I vomited twice in the evening with sweats and a 101.1 temperature which went back down. I was miserable. I slept well last night and feel better this morning. The diarrhea seems be abating. I feel like I've turned the corner this morning but wanted to mention due to the vaccine shot as a possible cause.

Other Meds: Atorvastatin 20 mg once per day Lisinopril 10 mg once per day Omeprazole 40 mg twice per day

Current Illness: none

ID: 1056997
Sex: F
Age: 70
State: IN

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
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: chills starting 7 hours after shot muscle aches, headache fever 100.5 starting 16 hours after shot fever of 101.4 one day following shot fever lasting 3 days along with severe headache and muscle aches

Other Meds: none

Current Illness: none

ID: 1056998
Sex: F
Age: 36
State: TN

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
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: No known allergies per patient

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Approximately 5-15 minutes after vaccine patient reported to health department staff that patient felt "funny." Upon assessment patient appeared flushed and pale. Patient reports tightness in throat.

Other Meds: Metformin 500mg once daily and blood pressure medication(patient did not recall name of medication)

Current Illness: none per patient

ID: 1056999
Sex: F
Age: 70
State: CT

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs as a child

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

Symptoms: Rapid heartbeat Numbness in my neck and face Numbness in my lips, swelling in lips Numbness tip of tongue Chills, weakness, headache, blurred vision for a short time Took Benadryl on my own, continued taking non drowsy Claritin 5 days after shot feeling better. Still have slight numbness in my lips and feeling weak

Other Meds: Adair inhaler, pravastatin 40 mg daily, vitamin D, lose dose aspirin

Current Illness: None

ID: 1057000
Sex: F
Age: 33
State: MD

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/26/2021
Hospital: Y

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

Lab Data:

Allergies: Zoloft

Symptom List: Rash, Urticaria

Symptoms: Abdominal pain 7 days post vaccine. Diagnosed with appendicitis 9 days post vaccine.

Other Meds: Multivitamin, Melatonin, Magnesium, Synthroid, Focalin, Famotidine, Celexa

Current Illness: none

ID: 1057001
Sex: F
Age: 47
State: MO

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Moderna COVID-19 Vaccine EUA itchy, red rash on chest, abdomen and left arm

Other Meds: Metformin Glimeperide lipitor bupropion metoprolol escitalopram lisinopril

Current Illness: none

ID: 1057002
Sex: M
Age: 66
State: NC

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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:

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

Symptoms: General side effects, substantially gone by 3rd day (2/26): fatigue -- first and 2nd days headache -- mild. first and 2nd days muscle pain, joint pain -- second day. 600mg Advil helped chills -- 2nd day morning. 5 min fever -- 99.5F. 2nd day morning. 2 hrs These side effects resembled my COVID disease symptoms in early October 2020 (10/2-10/14)

Other Meds: Effexor, Clonozepam, Ketoconazole, Vit D, MultiVit, Fishoil,Zi

Current Illness:

ID: 1057003
Sex: F
Age: 69
State: WI

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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: trospium sanctura

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

Symptoms: The needle of the syringe had not been tight and the vaccine was not administered into the pt but leaked out down the patient arm

Other Meds: none

Current Illness: none

ID: 1057004
Sex: F
Age: 53
State: IL

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/26/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: NAUSEA, FEVER, HOT FLASHES, AND SWOLLEN LEFT ARM.

Other Meds:

Current Illness:

ID: 1057005
Sex: F
Age: 70
State: MN

Vax Date: 02/02/2021
Onset Date: 02/19/2021
Rec V Date: 02/26/2021
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

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

Symptoms: Left breast generalized tenderness, warmth and mild swelling with focal area of induration to inferior breast tissue. Warmth, tenderness and generalized swelling resolved after 5 days. Induration, ? mass persisted 1 week later prompting diagnostic work-up in clinic with imaging ordered

Other Meds: bupropion, levothyroxine, simvastatin, rizatriptan

Current Illness: None

ID: 1057006
Sex: F
Age: 57
State: AZ

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Symptoms started 16 hours after injection. Headache, fever, body aches, chills, fever about 100.2 for 24 hours from onset of side effects. Noticed Rash on right arm below injection site and on upper chest next day. Was able to use Acetaminophen for general side effects. Brought temp to 99.2. Most symptoms resolved except rash within 24 hours of symptoms onset.

Other Meds: Synthroid Calcium Multivitamin

Current Illness: Had allergies a few weeks before

ID: 1057007
Sex: M
Age: 65
State: IN

Vax Date: 02/20/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Bad chills, loss of appetite, sweets, fever , urinating

Other Meds: Levemir, trulicity, Eliquis, pravastatin, torsemide, clopidogrelDofetilide, Montelukast, B-12, Metformin HCL, Magnesium, Super C, D3, Fluticasone, nitroglycerin ( when needed) , Flu booster on Jan 23 2021

Current Illness: No

ID: 1057008
Sex: F
Age: 33
State: MA

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

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

Lab Data:

Allergies: Sulfa (Sulfonamide Antibiotics)

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

Symptoms: Patient reports receiving the 2nd dose of the Pfizer vaccine yesterday around 9:10am. Patient started to noticed mild symptoms about 8 hours afterwards, including a mild headache and backache. She reports then feeling fatigued so she went to sleep early around 8pm. The patient reports waking up at 11pm having to go the bathroom. She notes feeling weak when walking to the bathroom, though as she was on the toilet voiding she felt nauseous. When she got up to wash her hands she felt that she was going to pass out feeling LH and dizzy. She sat down on the bathroom floor as she has a history of orthostatic hypotension, and eventually needed to lay completely flat on the ground. She reports this is when she felt as though she blacked out. She was then able to wake up and walk back to bed feeling better, and fell back to sleep.

Other Meds: Vitamin B-12; imiquimod (ALDARA) 5% cream

Current Illness:

ID: 1057010
Sex: F
Age: 71
State: CA

Vax Date: 02/17/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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: Naprosyn Amoxicellan

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

Symptoms: hard knot vaccination site, itchy, red, raised area 50 cent size

Other Meds: amlodipine 5 mg daily Diphenhydramine 25 mg daily

Current Illness: Slight high blood pressure

ID: 1057011
Sex: M
Age: 38
State: MN

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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: Pain at injection site

Other Meds:

Current Illness:

ID: 1057012
Sex: M
Age: 74
State: WI

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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: lisinopril

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

Symptoms: Hives on chest and bilateral forearms, itching started 24 hrs after administration

Other Meds: loratidine, celebrex, escitalapram, tylenol, muscle rub, amlodipine, atorvastatin, buspirone

Current Illness:

ID: 1057014
Sex: F
Age: 64
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/26/2021
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: Levaquin (swollen limbs and hives), sulfa drugs (fatal)

Symptom List: Injection site pain, Pain

Symptoms: The same day I received the vaccine, some hours later I started feeling like a pressure in my head. It was not a headache, it was a pressure. It made me dizzy. I also experienced extreme fatigue and so much that it was hard to walk. Really hard to just get out of the bed. Like my legs did not want to move. I had to literally mover them from the bed. Cough. My doctor said after I had covid in June 2020 that my lungs were damaged and now they just work on a 61% capacity. I also felt like my lungs were burning. When I am able to have a productive cough and get rid of some phlegm, then I feel better, I can really breathe and feel like clean air in my lungs. But lots of times I just cough and nothing comes out and then it gives me a sensation that my chest is tight. Still, every morning I cough, just like this morning and my chest feel tight.

Other Meds: Emergen C, Vitamin C and B Complex, Elderberry syrup and Zinc

Current Illness: Sinus pressure, Shingles (developed after 1st dose of the vaccine)

ID: 1057015
Sex: F
Age: 66
State: FL

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Client c/o flush feeling 3 minutes after receiving vaccine. Client is seen and assessed by EMS and VS are B/P 128/86, HR-90, O2 98. Client denies any other symptoms and verbalizes that she no longer was having symptoms and velar by EMS.

Other Meds: Vit C,D and Zinc

Current Illness: none

ID: 1057016
Sex: F
Age: 28
State: NV

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/26/2021
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: Dermabond

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

Symptoms: After my second vaccine, I was swelling up for three days. I also had diarrhea for 3 days. The headaches continued lingering to the back of my head. I still have hot flashes that come and go since my first vaccine. On my first vaccine I experienced hot flashes but no fever.

Other Meds:

Current Illness:

ID: 1057018
Sex: F
Age: 59
State: MO

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/26/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: I got an eye infection the day after my shot and then after the second shot, got another one (it was getting better). It took about a week for it to completely go away after second shot.

Other Meds: Flonase, synthroid, water pill, thyroid, high cholesterol pill

Current Illness: none

ID: 1057020
Sex: F
Age: 60
State: CA

Vax Date: 02/19/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
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

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 2/24/21 about midnight I was not feeling well. I was having stomach pain. At 3:00am (2?25/21) i woke hot and stomach pain was worse. About 4:00am diarrhea started. I never went back to sleep that day. At 6:00am after a shower I notice a bump by my left clavicle. I notice it was movement about the size of a nickel. I called Dr. office, they agreed to see me in the afternoon. At 3:30pm I saw Dr. said that it's lymph and I should keep an eye on it. He recommends an ultra sound if not better in two weeks. Left shoulder is painful and it is a little hard to type, but not a big deal. 2/25/21 about 9:00pm I went to the bathroom I had a bright red bowels. 2?26/21 I am waiting for Dr. (she has been my stomach doctor for many years) to speak with her about the bloody bowel. I will also call Dr. a message to keep her up

Other Meds: Probiotic Capsule one per day Linzess 290 MCG one per day Estradiol and Norethindrone 1.0 mg per day Paroxetine Mesylate 7,5 mg one per day Vitamin D 250 MCG per day Vitamin B 2000MCG per day Folic Acid 1 MG per day

Current Illness: none

ID: 1057021
Sex: F
Age: 80
State: NC

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
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: Codine, Torodol

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

Symptoms: Got 2nd vaccine on Monday morning. On Tues (2/23) I had extreme fatigue about 4:30 PM. By the time I went to bed , all my bones and muscles ached and I had a headache. I had a very slight fever that Tylenol took care of .Wed. morning I was OK but it happened again Wed. afternoon.

Other Meds: Citracal, Lexapro, Pantoprazole, Trazodone, Hair, Skin, Nails + Vitamins Gummies, Iron pill

Current Illness: UTI, Osteopenia

ID: 1057022
Sex: M
Age: 57
State: MN

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline, cats, tree pollen

Symptom List: Nausea

Symptoms: Extreme chills, feelings of exhaustion, mental fog

Other Meds: Tylenol prior to administration; routine daily meds: chlorthalidone; Tamsulosin; metoprolol; Allegra, ASA

Current Illness: None

ID: 1057023
Sex: F
Age: 70
State: NC

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Codine , amlodipine, Liptor

Symptom List: Injection site pain

Symptoms: on morning or 1/27/2021 and 2/24/2021 I began to feel flu like symptoms (expected) . As the day progresses my fever increased to 101.4 and I took ibphone and drank liquids. Sever headache, body aches, chills both days. On 1/27/2021, my thoughts were a little foggy but did not try top communicate with anyone so not sure inability to communicate happened on 1/27/2021. On 2/24/2021, around 4 PM I got out of bed and stood beside the bed. Unable to support myself and slumped on the floor. Unable to get back in bed or help anyone to get me back in bed. My son called while I was on the floor and I was not able to form sentences to communicate with him,. He called his wife to check on me and she and friend were able to get me back in bed. Had fever of 101.4 took ibhone for headache and drank water to stay hydrated. Around 10 PM I was able to form sentences and communicate with family members. Next morning (2/25/2021) I got up around 8 AM and was fine. All symptoms were gone and arm was no longer sore.

Other Meds: hydrochlorothizide 255 mg tablet once per day, vitamin d 500 one per day, calcium citrate once per day

Current Illness: None

ID: 1057025
Sex: F
Age: 39
State: CO

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/26/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: As I was administering the vaccine in the left deltoid, about 3 to 4 drops of the vaccine leaked from the base of the needle where it connects to the syringe. The patient and I were concerned. I let another nurse know what had happened and what I should do. She instructed me to chart it in the patients chart and also in VAMS. I charted that a few drops did not make it in her arm. I also noted on the patients vaccination card that those drops did not make it as well.

Other Meds:

Current Illness:

ID: 1057027
Sex: F
Age: 43
State: MN

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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: Pain at injection site

Other Meds:

Current Illness:

ID: 1057028
Sex: M
Age: 66
State: GA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/26/2021
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: Tremor

Symptoms: High fever up to 103 degrees Fahrenheit, body aches, shortness of breath, shivering. He took Tylenol every 2-3 hours, felt better by next morning.

Other Meds: sertraline, ketoconazole shampoo, lotrisone, pantoprazole, testosterone im, HCTZ, Rozerem

Current Illness: HTN, sebhoreic dermatitis, hypogonadism, GERD

ID: 1057029
Sex: F
Age: 69
State: AZ

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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: ocean fish , iodine sulfa

Symptom List: Erythema, Pruritus

Symptoms: None stated.

Other Meds:

Current Illness: none

ID: 1057030
Sex: F
Age: 43
State: VA

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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: Wheezing, Tachycardia

Other Meds: None

Current Illness: None

ID: 1057031
Sex: F
Age: 17
State: WI

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/26/2021
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: NKDA

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

Symptoms: Patient was on the 1A list for a covid vaccine, when the appointment was scheduled we had Pfizer on hand. When she presented to the clinic for her vaccine we had Moderna instead of Pfizer. Vaccine was given to patient. Vaccine administrator was not aware that Moderna was for patients over the age of 18. This was patient's first dose of the covid-19 vaccine series. Patient was officially 17 years at 10 months at the time of the first vaccine. No adverse effects noted in the vaccine clinic at time of vaccination or during the observation time afterward. In addition, Moderna was contacted regarding this incident.

Other Meds:

Current Illness:

ID: 1057032
Sex: F
Age: 77
State: FL

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: struggle breathing and body shakes snd high blood pressure

Other Meds: levothroxin,calc. folic, magn, c, acidpphylus, omeprozel.gaba

Current Illness: arthritus, pain from lime desease

ID: 1057033
Sex: F
Age: 75
State: AZ

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
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: No

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

Symptoms: Really bad headache and need to sleep for at least 36 hours. No treatment.

Other Meds: Lorazapam .05 mg Potassium Chloride 10 meq Furosemide 20 mg Trelogy 100meq/62.5 mcg/25 mcg

Current Illness: none

ID: 1057034
Sex: F
Age: 50
State: MN

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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:

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

Symptoms: Feeling feverish

Other Meds:

Current Illness:

ID: 1057035
Sex: F
Age: 26
State: TN

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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: Pain in extremity

Symptoms: Injection site redness and pain, low grade fever, body aches, fatigue

Other Meds:

Current Illness:

ID: 1057036
Sex: F
Age: 87
State: WI

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Codeine and Ibuprofen

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

Symptoms: Mostly it was nausea ad vomiting and weakness came on suddenly and i couldn't get up. and pain from my head to toe. head ache felt like i was frying my brain and everything hurt. there was no treatment i just stayed in bed. i was sicker with the reaction then i was when i had covid. I got better after about 2 days

Other Meds: Levothyroxine, Xanax, Vitamin D3 and Zinc

Current Illness: None

ID: 1057037
Sex: F
Age: 67
State: MI

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Muscle aches, chills and severe joint pain 9:05PM Treatment: went to bed at 10:00 P Following day 2/25/2021: 7:45 AM extreme fatigue, loss of appetite, taste buds off Treatment: naps, fluids 02/25/2021 9:00PM mild muscle aches and joint pain

Other Meds: Citracal calcium + Vit D3

Current Illness: None

ID: 1057038
Sex: F
Age: 55
State: VA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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: N/A

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

Symptoms: fever, chills, aches, stomach cramps, headache, lethargic

Other Meds:

Current Illness: None

ID: 1057039
Sex: F
Age: 70
State: WA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
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: Codeine and Penicillin.

Symptom List: Vomiting

Symptoms: At about 11:00 at night on the day of the vaccine started to get body chills and shaking, teeth chattering, as well as headache. A few hours later she did throw up. Continue to stay nauseated. The shaking chills lasted until about 8:00 AM the following morning, and still has them off and on with shaking. She did throw up again on the 2nd day, but still nauseated and continues with the headache. The first day was nothing but chills. The next day had intermittent chills to soaking sweats to chills up until last night 2/25/21. She took Tylenol for the symptoms.

Other Meds: Xarelto, Atorvastatin.

Current Illness: Urinary tract infection for which she took antibiotics.

ID: 1057040
Sex: M
Age: 85
State: IA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/26/2021
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: aspirin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: weakness, balance issues, fall - required hospitalization

Other Meds: oxybutynin, warfarin, sertraline, lisinopril, pioglitazone, loperamide, simvastatin, levothyroxine, linolenic acid

Current Illness: none

ID: 1057041
Sex: F
Age: 55
State: IL

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: NAUSEA, FEVER, HOT FLASHES, AND CHILLS

Other Meds:

Current Illness:

ID: 1057042
Sex: M
Age: 85
State: MD

Vax Date: 02/10/2021
Onset Date: 02/21/2021
Rec V Date: 02/26/2021
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: Thirty years ago hives from Ct Scan, Benadryl cured, never repeated

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Mysterious rash appeared under both arms, down sides and on lower back and somewhat on lower abdomen Being treated with Mometasone Furoate Cream 01%

Other Meds: Many for hypertension, sleep apnea, restless leg syndrome, Too many to list given your time limit

Current Illness: None

ID: 1057043
Sex: F
Age: 42
State: KS

Vax Date: 02/17/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Aspirin, Cipro, Tramadol

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

Symptoms: On day of vaccination I had a low grade fever of 99.6. Day 2 my arm was very painful, not like a normal pain after a shot. Day 8 I have developed a red, welted looking rash that is very itchy and painful to the touch. I searched it on the internet and I believe it may be "COVID Arm".

Other Meds: Biotin, Levothyroxine, Women's Daily Vitamin, Vitamin D, Zinc, Lamotrigine, Wellbutrin, Zolpidem. Temazepam, Clonazepam, Calcitriol

Current Illness: Hypothyroidism

ID: 1057044
Sex: F
Age: 72
State: NC

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/26/2021
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: Codeine

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

Symptoms: Hot flashes then ached all over then large redness gradually developing over several days still with tenderness less rom left shoulder and fading area of swelling now 6 to 7 cm in diameter

Other Meds: none

Current Illness: Hypertension and hyperlipidemia

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm