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: 1057989
Sex: F
Age: 55
State: AL

Vax Date: 02/20/2021
Onset Date: 02/21/2021
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: Rocephine, Regaline, Latex,

Symptom List: Dysphagia, Epiglottitis

Symptoms: I received injection at approx. 1:30 on 02/20/21. No issues. At around 5-6PM started to feel tired. Went to bed around 9 PM. Woke at around 4 AM to go to bathroom felt fine upon awakening, Once in bathroom felt nauseated, and dizzy. Washing hands felt REALLY nauseated, next thing I know, my husband is hovered over me, as I had passed out unconscious onto bathroom floor. I landed on my left side. No blood. Started immediately with visiable chills, and fever accompanied by headache and dizziness. Fever lasted until Wednesday mid morning. Dizzy lightheadedness, and Headache is still on going. Primary care Dr. had X-rays, and MRI to rule out broken bones and/or concussion. Tests confirmed I had not broken anything, and I had not a concussion. Dr. suspects the issues I am experiencing are from vaccine reaction.

Other Meds: Effexor 37.5mg 1x day, Amlodipine 5mg 1 x day, Vitamin D 5,000 units, 1xday,

Current Illness: none

ID: 1057990
Sex: F
Age: 65
State: AZ

Vax Date: 02/25/2021
Onset Date: 02/26/2021
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: Morphine, raw fruits and vegetables

Symptom List: Anxiety, Dyspnoea

Symptoms: 15 minutes after vaccination: stomach queasy and burning in esophagus 12 hours after vaccination: vomiting and diarrhoea and sore arm

Other Meds: None

Current Illness:

ID: 1057991
Sex: M
Age: 47
State: ND

Vax Date: 02/25/2021
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: About 30 minutes after vaccination the client experienced numbness and tingling on the entire left side of his body lasting for a couple hours. It included the left side face, neck, arm and lower extremity. Client did have PCR diagnosed COVID 10/29/20. The symptoms resolved spontaneously with no residual effect.

Other Meds: Omeprazole, metoprolol, atvorstatin, allopurinol,

Current Illness: None

ID: 1057992
Sex: F
Age: 67
State: CA

Vax Date: 02/10/2021
Onset Date: 02/17/2021
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: medicine for muscle spasm

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: pt stated she developed a warm, red, swollen area around the injection site about a week after receiving the covid vax. Pt states on 2/26/2021 she still has a large red swollen area that is warm to the touch. Pt has only been taking Benadryl for her symptoms.

Other Meds: metformin 500mg, benazepril 20mg, aspirin 81mg, vitamin D3 1000 un,

Current Illness: no

ID: 1057993
Sex: F
Age: 46
State: TX

Vax Date: 01/30/2021
Onset Date: 01/31/2021
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, reaction to flu shot in past

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

Symptoms: days 1-4 most extreme; very fatigued and no temperature regulation (body burning but cold extremities) day 5-6 kind of Ok but still recovering day 7 fatigue returns days 8-9 right side of body achy esp. in joints. sensitive to touch inside from knee to ankle on right side. must keep leg up. limping along with some fatigue and dizziness, some disruption of regulation of temperature day 10 improving day 11 reaction done

Other Meds: for asthma/allergy - montelukast,advair, nasal spray

Current Illness: none

ID: 1057994
Sex: M
Age: 39
State: OH

Vax Date: 02/20/2021
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: Amoxicillin

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

Symptoms: Lump on opposite arm on inside of forearm near elbow. First noticed two days after vaccination, still present six days later. Somewhat firm and tender, no redness.

Other Meds: None

Current Illness:

ID: 1057995
Sex: F
Age: 40
State: OH

Vax Date: 02/22/2021
Onset Date: 02/24/2021
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: bactrum, demeral, latex

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Developed Shingles after 2nd Vaccine

Other Meds: Multi vitamin, effexor, welbutrin, buspar, prilosec, singulair, claratin, flonase, tylenol prn, benadryl prn

Current Illness:

ID: 1057996
Sex: M
Age: 57
State: WA

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

Lab Data:

Allergies: Unknown

Symptom List: Pharyngeal swelling

Symptoms: Within 7-10 minutes after receiving his second dose of COVID-19, patient started complaining of rapid heart rate and palpitations which then progressed into dizziness and lightheadedness during his observation period. Patient was subsequently moved to a room and further evaluated including vital signs and 12 lead EKG. It was determined that patient is currently undergoing workup for possible cardiac issue, was recently started on Nitroglycerin yesterday and has a tentative angiogram scheduled Monday 3/1/21. After lying down during the evaluation patient's dizziness began to worsen. Talked with patient and spouse and recommended transport to the hospital for further evaluation.

Other Meds: Nitro

Current Illness: Unknown cardiac issue being worked up.

Date Died: 02/26/2021

ID: 1057997
Sex: M
Age: 69
State: SC

Vax Date: 02/25/2021
Onset Date: 02/26/2021
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: Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: "Feeling Hot" without fever and nausea 10 hours post vaccine and resolved within 1 hour. Seizure, Hypotension, Unresponsive followed shortly by cardiac arrest and pulseless electrical activity 21 hours post vaccine. Pronounced dead 22 hours post vaccine

Other Meds: Ibuprofen

Current Illness: None

ID: 1057998
Sex: F
Age: 46
State:

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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: latex

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Within 3-4 minutes of receiving my 2nd COVID vaccine I had sudden onset of pounding in my chest. I was immediately hooked up to a monitor and found to be tachycardic to 160's. hypertensive to 160's/90's. My hands were clamped down and white. About 10 minutes later I was overcome with chills. I drank water and tea and gradually returned to baseline. I was monitored at the vaccine site for 1 hour.

Other Meds: ASA, pravastatin, cranberry, MVI

Current Illness: red rash 1 week after 1st COVID vaccine near injecction site

ID: 1057999
Sex: F
Age: 39
State: KY

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

Lab Data:

Allergies:

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

Symptoms: She was given the vaccine at 12:00. At 12:07 she (she is an RN employee here at the hospital) reported feeling as if she had lump in her throat and asked for some benadryl. Rapid response team was called at 12:08 as she became diaphoretic, flushed and reported blurred vision. MD ordered an IV to be started and a NS bolus x 1 liter. She broke out in hives on bilateral upper extremities. Benadryl, solumedrol, albuterol inhaler, zofran, scopolamine patch were all ordered and given to the patient. She reported that she felt some better and was transferred to the ER at 1245 for further monitoring.

Other Meds:

Current Illness:

ID: 1058000
Sex: F
Age: 48
State: VA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Morphine, diladuid, aspirin, scopolamine, contrast dye, iodine, barium, gluten, soy, tree nots, peanuts, Lima bean, peas, mollusks, sweet potatoes, sesame, sunflower, celery

Symptom List: Rash, Urticaria

Symptoms: Fatigue, headaches, muscle and joint pain, neck pain, nausea and nosebleeds. Had shot yesterday morning and still having these side effects

Other Meds: Solu-cortef, spriva, breo, atenolol, Topamax, cymbalta, Wellbutrin, Buspar, Xanax, protonix, Fludrocortisone, Levothyroxine, abcrose, norethendrone, B12, D3, Lamictal, Zophran, combivent, Botox

Current Illness: None

ID: 1058001
Sex: M
Age: 69
State: WI

Vax Date: 02/19/2021
Onset Date: 02/26/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Patient received vaccine on 2/19 noticed rash on arm yesterday 2/25 did not report to pharmacy, reported today 2/26 because it was spreading to chest/trunk. Was advised to take benadryl, told to report if still spreading and watch out for any other side effects and report to us. Of course any difficulty in breathing or any more serious reactions to seek medical attention

Other Meds: Famotidine

Current Illness: None

ID: 1058002
Sex: F
Age: 43
State: SD

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: rash/hives when I take metaxalone, latex allergy as well, get a rash

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

Symptoms: As a prophylactic measure after my reaction to the 1st dose. I took 50mg of IM Benadryl prior to receiving the vaccine. . My vaccine appointment was for 9:40AM. I waited 30min at the vaccine site and felt ok so I went home. Got home around 10:30 and laid down. Felt drowsy because of the Benadryl. I woke up around noon feeling my lips "buzzing" and my tongue numb. Called my PCP who sent a RX for another IM Benadryl 50mg. I was able to take it around 3:30PM and that made the feeling on my tongue and lips go away. Around 9PM I started feeling chills, general malaise. And it went on through the night. Next day I felt really fatigued and slept most of the day. I went to work that night and it was a struggle. Took a Tylenol during my shift and next day once again slept throughout the day. At night I was feeling much better.

Other Meds: Omeprazole 40mg/daily, Vitamin D3, Zinc Sulfate 50mg, 5mg Melatonin and a probiotic

Current Illness:

ID: 1058003
Sex: F
Age: 52
State: WA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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:

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

Symptoms: JOINT PAIN, CHILLS FOR 3 HOURS, FEVER, NAUSEA, FATIGUE

Other Meds:

Current Illness:

ID: 1058005
Sex: F
Age: 58
State: CA

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: Patient declined assessment.

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

Symptoms: Patient stated that she felt dizzy immediately following administration of the 1st dose of Moderna vaccine. Patient refused vital signs and assessment. Patient stated that she did not want to upset husband by staying long and that her dizziness was a result of anxiety.

Other Meds: Patient declined assessment.

Current Illness: Patient declined assessment.

ID: 1058006
Sex: F
Age: 39
State: IA

Vax Date: 12/29/2020
Onset Date: 01/05/2021
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: no except nickel allergy

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

Symptoms: Woke up really fatigued. Within one hour January 6 - 10:00 and 10:45 here are all the symptoms that showed up in that 45 minutes. I was in the middle of treating a PT. Scratchy throat; mild cough; persistent moderate headache; runny nose; diarrhea; very pale. Never had a fever. I had weird neurological side affects (didn't lose taste or smell ) issues with facial recognition - didn't recognize my own face and finding words for every day objects and making sentences was difficult . I was easily winded and had tightness in my lungs. I called Public Health office - and asked them what to do. She told me to go home. Dr (telehealth visit) told me to take a test in the parking lot that day for COVID January 6. Treatment - none. All o f my symptoms lasted until Friday January 8 except being winded and fatigued. Those last two symptoms lasted until January 19. Verbal issues also lasted until the 19th of January. Facial recognition came back around January 12. On January 27 I had second dose.

Other Meds: Vit D; Echinacea; Probiotic; as needed I was taking Tramadol for shoulder surgery in October 2020

Current Illness: no

ID: 1058007
Sex: M
Age: 67
State: OK

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe Headache Body Aches Swollen lymph nodes under arms Congestion

Other Meds: Norco Amlodipine Labetalol Plavix Tizanadine

Current Illness: None

ID: 1058008
Sex: M
Age: 45
State: PA

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

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

Lab Data:

Allergies: shellfish

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Diffuse urticarial rash, fevers, tachycardia, transient hypotension, body aches

Other Meds: Servino, Lisinopril, Halobetasol, Flonase and clobtasol

Current Illness: eczema, HTN

ID: 1058009
Sex: M
Age: 86
State: MI

Vax Date: 02/16/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient contracted COVID-19 8 days after administration of 2nd dose of Pfizer COVID-19 vaccine - confirmed with nasal PCR

Other Meds:

Current Illness:

ID: 1058010
Sex: F
Age: 37
State: MI

Vax Date: 02/25/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa NSAIDS Compazine Flagyl Vicodin

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

Symptoms: Within minutes my arms had huge red blotches. I took a Benadryl from my purse and alerted a nurse. She talked to me and then my throat went tight. They had to administer an epi-pen. My throat did not feel better so I was transported by EMS to the hospital and was treated with IV Benadryl, steroids and Pepcid. I was prescribed Pepcid and Medrol 6 day dose pack to take home to prevent a delayed reaction.

Other Meds: Flonase, Allegra 12 hr, Inflectra, Vitamin D, Vitamin B-12, Multivitamin

Current Illness: None

ID: 1058011
Sex: F
Age: 72
State: GA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
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: Sulfa and Penicillin allergy

Symptom List: Unevaluable event

Symptoms: Patient reported redness and swollenness from shoulder to elbow of left arm. Also experienced itching and flu-like symptoms.

Other Meds: Paroxetine 10mg; Pravastatin 40mg; Furosemide 20mg; Metoprolol Tartrate 25mg; Omeprazole 40mg; Zolpidem 10mg; Lorazepam 1mg

Current Illness: None

ID: 1058012
Sex: F
Age: 68
State: FL

Vax Date: 02/15/2021
Onset Date: 02/21/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Low grade fever and fatigue 2 days after injection, resolved in 2 days. 6 days after vaccine noted swollen supraclavicular lymph node left side, became larger, tender. 11days post vaccine node is no longer tender, slightly less swollen but still evident

Other Meds: None

Current Illness: None

ID: 1058013
Sex: F
Age: 66
State: CA

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

Lab Data:

Allergies: dust, grass

Symptom List: Injection site pain, Pain

Symptoms: Client c/o sensation of throat closing at 9:15AM, immediately after vaccine was administered. RN and MD notified. Assessed. 50MG IM Benadryl given at 09:25AM. BP 148/62, HR 64, Resp 18. MD/RN continued to monitor. ALS team contacted hospital to assess client and advised client to be transferred to hospital. Client stated she was feeling better and declined transport. AMA form signed with ALS transport team. Monitored for additional 30 minutes. Client left with husband (driver).

Other Meds: Unknown

Current Illness: Hx of lupus, diabetes

ID: 1058014
Sex: F
Age: 56
State: PA

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

Lab Data:

Allergies: penicillin-hives

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt. presents today at 1347pm after receiving 1st dose of pfizer vaccine to left arm at 1230 pm on 2/26/2021. Pt. states that she started feeling dizzy and sleepy along with a feeling of not catching breath which started about 3 minutes after receiving the vaccine. Pt. states that she was instructed to come to health facility. Patient states that she developed a headache about five minutes after receiving the covid vaccine. Pt. denies treatment.

Other Meds: multivitamin, vitamin d, vitamin b

Current Illness: denies

ID: 1058015
Sex: F
Age: 75
State: FL

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

Lab Data:

Allergies: Almost all antibiotics, penicillin, cephacisporin and z-pac

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

Symptoms: After vaccine, the next day 3-4am woke up with horrible headache, slight fever, sweaty. injection site raised and red and still is, also has trouble keeping liquid or food in. Still gets fleeting headaches and sweats ever morning.

Other Meds: Acidophilus and Metamucil

Current Illness: no

ID: 1058016
Sex: F
Age: 43
State: WY

Vax Date: 02/23/2021
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: Cephlasporins

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Swelling and pain in right armpit started Thursday February 25 in the early afternoon. Causing pain to radiate down arm. acetaminophen and cold packet to help with pain

Other Meds: Potassium 99mg D3 5000IU Fish oil 4000mg (1200 mg Mega 3) buPROPion XL 150 mg 24 Hr tablet

Current Illness: N/A

ID: 1058017
Sex: F
Age: 65
State: MD

Vax Date: 02/13/2021
Onset Date: 02/26/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Site: Itching at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium

Other Meds:

Current Illness:

ID: 1058018
Sex: F
Age: 54
State: NE

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: temperature of 100.3 F

Other Meds:

Current Illness:

ID: 1058019
Sex: F
Age: 41
State: TX

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: IM
Vax Site: RA

Lab Data:

Allergies: NSAIDS give me hives, seasonal allergies

Symptom List: Nausea

Symptoms: 6-7pm after 4pm injection sore arm. 9pm sore arm, slight headache. Day 2 morning: headache, fatigue, sore arm, diarrhea. Day 2 evening: chills, joint pain, fatigue, sore arm, headache. Day 3: diarrhea, slight fatigue.

Other Meds: None

Current Illness: none

ID: 1058020
Sex: F
Age: 69
State: CA

Vax Date: 02/22/2021
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: Coediene, compazine

Symptom List: Injection site pain

Symptoms: Two days after receiving my Covid-19 second vaccine (Pfizer) I removed the bandage. I discovered a large area with red rash. Actually the there was also bruising and rash within the affected area. I would have periods when it was very itchy to points where it was extremely sore and tender. Upon this submittal, 48 hours from onset I also seem to have a large knot/lump in that area.

Other Meds: Claritin, Losartan, Lorazapam, Citalopcram, Multiple Vitamin, Vitamin C, E, D3, B12, B12, Biotin, Caltrate, Melatonin, Metamucil, Mucinex, Nascort spray, Azelastine Spray, Fonase Spray, Spiriva inhaler, Breo Inhaler,

Current Illness: Asthma,

ID: 1058021
Sex: M
Age: 71
State: NY

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: swilling in right arm at vaccination site, started that day and has continued upon inspection at second dose 28 days later (02/26/21) injected second dose into left arm. Swelling if right arm is visible at deltoid muscle. also has got shingles rash soon after immunization.

Other Meds:

Current Illness:

ID: 1058022
Sex: F
Age: 45
State: OR

Vax Date: 01/24/2021
Onset Date: 01/24/2021
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: Unknown if any

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

Symptoms: Moderna vaccination #1: Low back around kidneys immediately tightened up. Got up 3-4 times in the night to urinate (which is not normal) FIRST THING IN THE MORNING WHEN GOT UP around 6:30/7:00am: body temperature felt extremely HOT and stopped being able to walk or function. Almost fell down from feeling dizzy/out of it. Had to drop to the ground and stay there for a while. Within about an hour felt mostly normal again. Did NOT take temperature or blood pressure, would have if I hadn't been in a state of fear/shock. Also itchiness in left deltoid 12 days after the vaccination, fingers on left hand accompanied this itchiness. Felt irritated in general at injection site up to two weeks after. Digestion affected - loose stools for the week after and increased gas up to a month after injection (current)

Other Meds: Multi Vitamins

Current Illness: N/A

ID: 1058023
Sex: F
Age: 80
State: IN

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: Keflex

Symptom List: Tremor

Symptoms: large red circle that is swollen & irritating. Also a mark where neddle inserted.Put cool compress on & took tylenol

Other Meds: levothroxine-propananol-asprin-valsartin-vitaminD

Current Illness: None

ID: 1058024
Sex: F
Age: 22
State: NC

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

Lab Data:

Allergies: Pencillin

Symptom List: Erythema, Pruritus

Symptoms: Urticaria on right arm, chest, and neck starting about 3.5 hours after injection. No concern at time of evaluation for anaphylaxis.

Other Meds: None

Current Illness: None

ID: 1058025
Sex: F
Age: 39
State: IA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: no except nickel allergy

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

Symptoms: Around 5PM - arm hurting at site of injection - swelling red and itchy. Was getting fatigue, chills and fevers. I was talking in my sleep a lot which is something that I never do. The next morning severe migraine, nausea, my spine hurt, extreme fatigue, only spine was sore but it felt very hard to move my body - like I was moving in slow motion. I was back to having trouble forming sentences and finding correct words. These symptoms were far more severe than my actual COVID symptoms when I was sick with that. I had no appetite. That lasted all day. Tylenol - took that and did go to work to see two patients but should have stayed home. When I woke up the next morning (third day after the vaccine) I felt fine except for lingering fatigue. The fatigue was gone by the afternoon on Friday (the 29th).

Other Meds: Vit D; Echinacea; Probiotic; as needed I was taking Tramadol for shoulder surgery in October 2020

Current Illness: COVID after dose 1 of Moderna Vaccine

ID: 1058026
Sex: F
Age: 98
State: UT

Vax Date: 02/02/2021
Onset Date: 02/12/2021
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: PCN & Sulfa

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

Symptoms: Client's daughter described events to me. Stated mother experienced tingling, weakness in legs about 7-14 days after receiving 2nd Covid vaccine. Also spoke with client for a few minutes. Stated could only walk a few minutes then legs felt like they were paralyzed and became really hot feeling. States toes felt like they were curling under left foot. Daughter took mother (client) to ER on Feb. 17 (after this had been going on for 4 days). Client was not admitted to hospital. Client stated no adverse events noted with 1st Pfizer Covid Vaccination. Client & daughter stated that client had bladder infection 1 week after receiving 2nd Covid vaccination. Client states problem with legs improving each day.

Other Meds: Albuterol 90 mcg as needed --inhaler a couple of times a day Carbedilol 25 mg 1 tablet twice a day Cefurosine axteail 250 mg citalopram 10 mg once a day levothroxine 125 mcg 1 tablet a day flusiomide 20 mg 1 tablet a day, sometimes twice

Current Illness: UTI

ID: 1058027
Sex: F
Age: 58
State: WA

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Temperature 99.9 F

Other Meds:

Current Illness:

ID: 1058028
Sex: F
Age: 64
State: MI

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

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

Lab Data:

Allergies: none

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

Symptoms: Moderna COVID-19 Vaccine EUA adverse event. Approximately 7 hours after the 1st COVID vaccination on 2/22/2021, patient developed symptoms of fatigue, aches, chills & fever. Her symptoms worsened into 2/23/21 with increasing shortness of breath. On arrival in the emergency center on 2/23/21, she was hypoxic with SpO2 81% on room air. Oxygen supplement via nasal cannula was given which improved her oxygenation. Covid 19 test negative. Chest Xray shows pulmonary edema and CTA chest shows no PE. She was admitted to the hospital and provided supportive care. Pulmonary Edema and inflammatory process is likely associated with the vaccine. Patient appeared to be improving, however, on 2/26/21, she was working with Physical Therapy/Occupational Therapy and had a pulse ox reading of 75% on room air. She was on 10 Liters of oxygen via nasal cannula by the time she make it back to bed and her pulse ox was 89%. Neurology exam shortly afterward the above event demonstrated an NIHSS of 21. Patient became non-verbal and stat imaging revealed an acute hemorrhage in the left occipatal lobe likely representing a SAH. Patient then transferred to another hospital that could provide neurosurgical intervention.

Other Meds: cetirizine tablets, fluticasone nasal spray, folic acid tablet ammonium lactate cream, isosorbide nitrate, lisinopril, metoprolol, nifedipine, semaglutide, sitagliptin, metformin, chlorthalidone

Current Illness:

ID: 1058029
Sex: F
Age: 28
State: CA

Vax Date: 02/26/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: 0941 Patient vomited upon leaving vaccine area. Patient stated that she has a needle phobia. Assisted patient to sitting position for assessment. VItals: T 96.6, P 61, BP 110/70, O2 98%. Will monitor for 30 minutes. 1009 Patient states that she is feeling better. Vitals: T 97.2, P 49, BP 110/65, O2 99%. Educated patient on vitals and low heart rate. Patient states she will follow up with healthcare provider. Patient discharged to friend.

Other Meds: None

Current Illness: None

ID: 1058030
Sex: F
Age: 61
State: AZ

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

Lab Data:

Allergies: none known

Symptom List: Pain in extremity

Symptoms: Pt received vaccine at 10:52am and at 11:03 reported slight difficulty to breath and tingles throughout body. EMS took over with patient at 11:04 blood pressure 138/67. Pt received Benadryl IM at 11:10am on right deltoid. Pt released by EMS at 11:25am.

Other Meds: Metformin, HTN medication, Thyroid medication.

Current Illness: none reported

ID: 1058031
Sex: F
Age: 74
State: MO

Vax Date: 02/17/2021
Onset Date: 02/20/2021
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:

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

Symptoms: Large area of redness down arm. showed up around 2/22 or so. she said it had been there for a few days. vaccine was on 2/17/21

Other Meds:

Current Illness:

ID: 1058032
Sex: F
Age: 47
State: TX

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: Gluten

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

Symptoms: Small red area which spread to approx. 30% of my upper arm over next few days. Faded within a week or so. Hot and itchy (both minor). Faded within a week to 10 days.

Other Meds: Amlodipine, Progesterone

Current Illness:

Date Died: 02/22/2021

ID: 1058033
Sex: F
Age: 94
State: CA

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 02/26/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Patient had a stroke two days after vaccine. Recevied TPA for treatment of stroke due to acute onset of altered mental status. Had a history of afib, not on anticoagulation, which is likely cause of stroke. Family opted for comfort measures given poor neurologic status. Passed awaiting hospice placement

Other Meds: Xanax, celecoxib, lexapro, lisinopril, mirtazapine, zolpidem valsartan

Current Illness: afib

ID: 1058034
Sex: F
Age: 51
State:

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

Symptom List: Vomiting

Symptoms: Hair falling out

Other Meds: None

Current Illness:

ID: 1058035
Sex: F
Age: 45
State: IL

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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Saturday morning after waking up I felt extreme dizziness, fever, cold sweats, aches throughout shoulders, spine, and hips, and after getting up passed out twice.

Other Meds: Levothyroxine

Current Illness: None

ID: 1058036
Sex: F
Age: 65
State: CA

Vax Date: 02/15/2021
Onset Date: 02/16/2021
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: Sulfa, formaldehyde

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

Symptoms: Chills, fever, muscle and body aches, nauseous, extreme fatigue.

Other Meds: Levothyroxine Progestrone Estradot,

Current Illness: None

ID: 1058037
Sex: F
Age: 21
State: OH

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: IM
Vax Site: LA

Lab Data:

Allergies: n/a

Symptom List: Injection site swelling, Limb discomfort

Symptoms: large warm red welt and pain. approx 3 inches in diameter

Other Meds: vitamin b, magnesium, coq-10, aspirin

Current Illness: n/a

ID: 1058038
Sex: F
Age: 62
State: NY

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

Lab Data:

Allergies:

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

Symptoms: Patient reports feeling lightheaded after receiving her first dose of pfizer vaccine. Vital signs taken, BP 162/78, slightly elevated, no other concerns. Patient refused second set of vitals or any other care, refused any transport. Patient left by self.

Other Meds:

Current Illness:

ID: 1058039
Sex: M
Age: 43
State: GA

Vax Date: 02/13/2021
Onset Date: 02/24/2021
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: None

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

Symptoms: 13 days since 2nd shot. Breaking g out in rashes throughout body

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm