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: 1058435
Sex: F
Age: 54
State: MN

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Achiness started about 10-11 hours after 2nd Moderna shot. Overnight, achiness continued. Symptoms were even worse in the morning the next day (18-20 hours after the vaccination). Headache across scalp, pain and swelling at injection site, body aches and stiffness diffusely, significant fatigue, loss of appetite. I had to take the day following the vaccine off work--I stayed in bed most of the day until about 2:30 PM. I did not take any medication/pain medicine and the headache went away around 2 PM (26 hours after the vaccination). Other symptoms improved gradually at that time, too. By 3:00 PM (27 hours after the shot), I felt well enough to file this VAERS report.

Other Meds: lisinopril 40 mg daily, Hydrochlorothiazide 25 mg daily

Current Illness: None

ID: 1058436
Sex: F
Age: 41
State: CT

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Headache, feverish (chills, sweats, aches), soar throat, clogged ears, inflammation of left arm including shoulder (left hand most recent bout of CRPS), nauseous, extreme fatigue. Ibuprofen 800 mg which isn't helping

Other Meds: Hydrocodone 7.5. One a day womens, compound cream with gabapentin, ketaflen, lidocaine, baclofen, pantropazole

Current Illness:

ID: 1058437
Sex: M
Age: 52
State: IN

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: NKDA

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

Symptoms: Fever, chills, body aches, headache, started 2 days later

Other Meds: Centrum silver, D3, B12, amlodipine, glipizide, metoprolol, metformin, folic acid, simvastatin, losartan,

Current Illness: None

ID: 1058438
Sex: F
Age: 42
State: KY

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Nickel

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 1st vaccine 1/31/21; 2nd vaccine 2/21/21; developed N/V/D, HA, chills onset 2/21/21 after vaccine; seen at ICC 2/26/21 for ongoing symptoms; sent to ED from ICC 2/26/21 for treatment of symptoms.

Other Meds:

Current Illness:

ID: 1058439
Sex: F
Age: 26
State: AR

Vax Date: 01/09/2021
Onset Date: 01/09/2021
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: I am allergic to Clindamycin.

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

Symptoms: About 2 hrs after the vaccine, I had a sinus headache, loss of appetite, fatigue, body aches, fever of 100 for two days, a sore throat but I'm not sure if the sore throat is related or not.

Other Meds: I take Prozac.

Current Illness: No

ID: 1058440
Sex: F
Age: 31
State:

Vax Date: 02/26/2021
Onset Date: 02/26/2021
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: Anaphylaxis to allergy shots in past Adverse reaction to pseudophedrine

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

Symptoms: Anaphylaxis - chest pain, shortness of breath, tingling in throat, lightheadedness Responsive to Epipen x 2. Given IM solumerol EMS took her stable to ER

Other Meds: Adderal Trazodone

Current Illness: None

ID: 1058441
Sex: F
Age: 71
State: PR

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

Lab Data:

Allergies: ASA, Penicillin, Sea Food and Steroids

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: AFTER 10 MINUTES OF VACCINATION DEVELOPED PALPITATIONS, SOB AND HIGH BLOOD PRESSURE BP 215/90 TREATED WITH VASOTEC 2.5 MG IV X 1, AND PUT ON CARDIAC MONITOR BY DR. AND IMPROVED

Other Meds: Losartan 50 mg daily

Current Illness: None

ID: 1058442
Sex: M
Age: 65
State: IL

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:

Symptom List: Pharyngeal swelling

Symptoms: patient was given a 3rd dose

Other Meds:

Current Illness:

ID: 1058443
Sex: M
Age: 67
State: NJ

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: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fatigue, aching. slight fever on February 22, rash on chest and back on February 23

Other Meds: Tamsulosin

Current Illness: none

ID: 1058444
Sex: M
Age: 78
State: GA

Vax Date: 01/20/2021
Onset Date: 01/30/2021
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: NKDA prior to event

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Extreme weakness to the point of being unable to stand, lightheaded, numbness, bilateral limb weakness progressing to stroke-like symptoms which persisted for approximately one day; palpitations and frequent PAC and PVCs which have persisted past initial treatment to current date. Patient was treated in the ER and given steroids, anti-histamines, and possibly anticoagulants for stroke-like symptoms, however ER notes not available and going off patient's verbal report. He was sent home on steroids and antibiotics and diagnosed with Vaccine injury from Moderna COVID19 vaccination.

Other Meds: Aspirin 81mg, Tylenol 325 mg q 4 hrs PRN, Fluticason Propionate HFA 110mg/ACT BID, Ipratropium Bromide HFA 17 mcg/ACT 2 puffs QID, Carbidopa-Levodopa ER 25-100mg q HS, Pravastatin Sodium 40mg q day, Gabapentin 300 mg 1 cap q day, Plaquenil

Current Illness: None

ID: 1058445
Sex: F
Age: 113
State: WI

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: SYR
Vax Site: LA

Lab Data:

Allergies: Eggs

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

Symptoms: Chicken Pox

Other Meds: Heroine

Current Illness: Polio

ID: 1058446
Sex: F
Age: 72
State: WI

Vax Date: 01/28/2021
Onset Date: 02/11/2021
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: adhesive azithromycin, IV contrast, PCN, hydrocodone

Symptom List: Rash, Urticaria

Symptoms: Pt tested Covid positive 2/11/2021

Other Meds:

Current Illness:

Date Died:

ID: 1058447
Sex: M
Age: 47
State: PA

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Lamotrigine

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

Symptoms: Moderna COVID- 19 Vaccine EUA Patient was found deceased in the community near his home address on 2/24/21. The Medical Examiner's cause of death is currently listed as "Drug Intoxication - Accidental Overdose." Per the MEO, post mortem urine toxicology was positive for cocaine and fentanyl. His death is believed to be related to a cocaine product that was adulterated with fentanyl and is not believed to be related in any way to the Moderna COVID-19 vaccine. This was explicitly stated by the Medical Examiner's Office.

Other Meds: Albuterol, abilify, mirtazapine, buprenorphine/naloxone,

Current Illness: None known

ID: 1058448
Sex: M
Age: 72
State: CA

Vax Date: 02/21/2021
Onset Date: 02/23/2021
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: none

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

Symptoms: stiff back neck, painful, waking up at night from 2/23/2021 to 2/26/2021. applied 'Tiger Balm' and took aspirin. Getting better by 2/26/2021

Other Meds: Benazepril 40 mg/day; nifedipine 30 mg/day; spironolactone 25 mg/day; ezetimibe10 mg/day; crestor 5mg/day; MSM 200 mg/day; niacin 500 mg/day; triple omega 750 mg/day; folic acid 1000 mcg/day; magnesium 500 mg/day; d3 5000 iu/day; turmeric 1

Current Illness: none

ID: 1058449
Sex: F
Age: 71
State: MN

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: Temporary paralysis and numbness in both legs, numbness and weakness in both arms, no grip in both hands. Soreness at injection site.

Other Meds: Atenolol Lisinopril

Current Illness:

ID: 1058450
Sex: F
Age: 54
State: SC

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

Lab Data:

Allergies: nkda

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

Symptoms: technician went to administer vaccine and syringe/needle malfunctioned causing the immunization to spew out of syringe down patient arm. patient armed was cleaned and new immunization was administered

Other Meds: unknown

Current Illness: unknown

ID: 1058451
Sex: M
Age: 79
State: FL

Vax Date: 01/06/2021
Onset Date: 01/09/2021
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: Penicillin and Tetnus Antipoxin

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

Symptoms: 1st dose recd 1/6 and broke out on foot it looked like small cuts but the capillaries and it spread to the let then to the opposite foot and leg. 3 days later a big rash broke out on shoulders and back of hands. 2nd dose, the same thing happened but it had a mark where it stopped then jumped to the arms and to the back which felt like my nerves in my body was being attacked by fire ants. They did a biopsy on the area on right leg and I feel like ants are crawling all over me and biting. on my back there's no redness but it feels like ants biting and itching. the doctor's stated there's no bacterial or fungal infection. This attack is from the knee down both arms and back only and the doctor had no other treatment for it other than cortisone cream and nothing seems to stop it.

Other Meds: no

Current Illness: no

ID: 1058452
Sex: F
Age: 75
State: WA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: morphine, metformin, codeine, sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: suicidal ideation

Other Meds: Neurontin, levothyroxine, lamotrigine, melatonin

Current Illness:

ID: 1058453
Sex: F
Age: 77
State: KY

Vax Date: 02/07/2021
Onset Date: 02/11/2021
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: Eggs, dust/mold/mildew

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Within one week of second dose vaccine, blue/pink colored "hematoma-looking" 'bruise' underneath the skin about an inch long and an inch wide appear on the same arm as the vaccine location. Painful to lay on, hurt when using the arm. Over the next week, site became red, elevated, hot, and painful (like it was on fire).

Other Meds: Takes heart medicine: Metoprolol.

Current Illness: N/A

ID: 1058454
Sex: M
Age: 78
State: CA

Vax Date: 01/27/2021
Onset Date: 01/30/2021
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: No known allergies.

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

Symptoms: 3 days after the first Pfizer COVID vaccination, the patient had nausea, vomiting, dizziness, hearing loss and loss of equilibrium. These symptoms slowly resolved, but recurred 3 days after the second dose of the Pfizer COVID vaccine.

Other Meds: - Lovastatin 40mg once daily. - Mirtazapine 7.5mg once daily at bedtime. - Miralax 17g once daily as needed. - Effexor 150mg SR once daily in the morning. - Acetaminophen 325mg as needed.

Current Illness: Microscopic hematuria and renal insufficiency.

ID: 1058455
Sex: M
Age: 75
State: OH

Vax Date: 02/03/2021
Onset Date: 02/05/2021
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: none

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

Symptoms: Stiff/sore neck, shoulder/upper arm aches (both left and right...right more than left, even though shot was in left). Pain STILL exists today , 23 days later. Tylenol and Ibuprofin help some.

Other Meds: xralto, metformin, multi vitamin ,thyroxine, allpurinol,, atorvastatin, diltiazem

Current Illness: none

ID: 1058456
Sex: F
Age: 65
State: OH

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: 12 days after vaccine - site of injection started to hurt, approximately 2 inch of raised red rash at site and small nodule size of ping pong on top of shoulder area.

Other Meds: Zoloft, Maxide, Trazadone, Statin

Current Illness: None

ID: 1058457
Sex: F
Age: 55
State: MD

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: First Day: fatigue, headache, stomachache, inability to eat, lightheaded and week; same symptoms for four hours on day 9 and again for four hours or so on day 11. 13 days later: May not be related, but thought should report: Broke out in itchy rash on feet, toes and finger tips, bright red, raised bumps. Itching was so intense I was unable to walk on day 14. Day 15 can walk but for short amounts of time. They also had a burning sensation. Bumps were about the size of a dime, and there were about 10 in total. Never had anything like it before. Have been applying hydrocortisone cream and taking benedryl. Keeping socks and shoes off my feet.

Other Meds: Trental celebrex lexapro tumeric probiotics calcium

Current Illness:

ID: 1058458
Sex: F
Age: 85
State: CA

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: within 5-6 hours..extreme reaction..chills..aches all over body..Migraine headache..nausea..loss of appetite Lasted approx 30 hrs..arm still sore on day 4

Other Meds: crestor zetia ambian

Current Illness: IC

ID: 1058459
Sex: M
Age: 56
State:

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: NKA

Symptom List: Injection site pain, Menorrhagia

Symptoms: 15 minutes after vaccine administration, patient reported feeling "his heart pounding" but denied all other symptoms. Vitals were obtained (HR 72, o2 Sat was 96%, BP 176/102). Pt reported he takes lisinopril daily and normal runs in 120s/80s. Pt remained with nursing staff for additional 15 minutes and vitals rechecked which remained the same. Pt educated on being evaluated at hospital and pt denied. Pt encouraged to call primary care provider. Pt reported to staff he was going to take additional BP med when home.

Other Meds: Lisinopril

Current Illness:

ID: 1058460
Sex: F
Age: 28
State: OR

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

Lab Data:

Allergies: diary, amoxicillin

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

Symptoms: Headache for 48 hours Body aches for 24 hours Fatigue for 48 hours Neck aching for 7 days

Other Meds: multi-vit w/ iron

Current Illness: none

ID: 1058461
Sex: F
Age: 76
State: NJ

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Moderna Covid-19 Vaccine EUA Patient had low grade fever (101.1 degrees) as well as muscle aches and pain

Other Meds:

Current Illness:

ID: 1058462
Sex: M
Age: 97
State: TN

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient developed nose bleed for unknown reasons 2 hours after vaccination.

Other Meds: None

Current Illness: None

ID: 1058463
Sex: F
Age: 66
State: WA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: The only allergy/allergic reaction I ever had was to Ascendin about 35 years ago . It was prescribed for post-partum depression.

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

Symptoms: About 38 hours after receiving the vaccine (2-20-21 - 1:00 am) I realized there was a blister located on my shoulder about 1.5? to the right of the shot area (which was bruised). I don't know exactly when the blister started. I put 2-18-21 on this form since I didn't know. The size of the blister was approx. 1/4 x 3/8. I realized I had taken my blood pressure using the shot arm (3 times about 3 hours after receiving the shot and again the next day) and worried the tightness of the BP cuff had affected the shot and pushed the vaccine to cause the blister. I spoke to a couple of medical people at medical center and they didn't think so and said it was probably ok and to report it. The blister has gone away but the skin is a reddish pink.

Other Meds: Amlodipine Besylate, Atorvastatin Calcium, Vitamin D3. I also take garlic for inflammation of my gums.

Current Illness: No illnesses, colds, etc.

Date Died: 02/13/2021

ID: 1058464
Sex: M
Age: 72
State: WI

Vax Date: 01/25/2021
Onset Date: 02/08/2021
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: NKA

Symptom List: Nausea

Symptoms: Pt tested Covid positive 2/8/2021.

Other Meds:

Current Illness: None

ID: 1058465
Sex: M
Age: 77
State: WA

Vax Date: 02/21/2021
Onset Date: 02/22/2021
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: No allergies to medications or food or other products.

Symptom List: Injection site pain

Symptoms: sore injection site next day. 2 days later started feeling sick, headache, chills and upset stomach, patient has been feeling worse with fever and wanting to vomit and aching all over. Each day goes by he feels worse, Called Doctors office let the nurse know he is not feeling well, no response back yet.

Other Meds: metoprolol 25mg 2 times a day, clopidogrel 75mg once a day, aspirin 81mg one a day, gabapentin 300mg 4 times a day,

Current Illness: No other illnesses at the time of vaccination even up to one month.

ID: 1058466
Sex: F
Age: 31
State: PA

Vax Date: 01/20/2021
Onset Date: 01/28/2021
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: N/A

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

Symptoms: Severe toothache on bottom left that occurred one week after each vaccination. After the first injection, tooth ache lasted 4-5 days after onset. After the second injection, tooth ache still occurring three days upon onset.

Other Meds: Synthroid; Prilosec, Vitamin D, Vitamin B12, Iron, Hair vitamins

Current Illness: N/A

ID: 1058467
Sex: M
Age: 61
State: TN

Vax Date: 02/20/2021
Onset Date: 02/22/2021
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: none

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

Symptoms: Per patient, he received his second dose of Pfizer COVID-19 vaccine on 02/20/2021. Approximately 48 hours later, he developed left-sided lip paralysis. He went to his doctor that day, no medications were prescribed and no tests were ordered. Over the next 24 hours, he states that his symptoms progressively worsened and now the left side of his face seems "completely paralyzed." He described left ear pain, increased sensitivity to loud sounds, runny nose, and inability to close his left eye. He saw another doctor the next day, who diagnosed Bell's Palsy and prescribed valacyclovir for 7 days. Patient also noticed a transient "crooked smile" after his first dose of Pfizer vaccine, but did not relate this

Other Meds: uloric, metoprolol, metformin, propafenone, eliquis,

Current Illness: none

ID: 1058468
Sex: F
Age: 20
State: WA

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

Lab Data:

Allergies: Patient reported no known allergies to any medications. Patient said her allergies to food included: eggs, coconut and milk.

Symptom List: Tremor

Symptoms: Patient reported symptoms of: tachycardia, shakiness, vision changes, tongue numbness and shortness of breath following the first dose of the COVID19 Pfizer-BioNTech Vaccine on 2/5/2021. Patient said that historically has experienced tachycardia and shakiness after getting a flu shot or booster a few years ago. Symptoms reported by patient were enough to suspect potential anaphylaxis, and patient consented pharmacist to administer epinephrine. Patient was then advised by the pharmacist to follow-up with her primary care doctor as soon as possible to report the incident and to discuss the risk versus benefit of the vaccine, whether recieving the second dose would be appropriate for her. Patient returned to assisted living facility for her second dose of the COVID19 Pfizer-BioNTech vaccine on 2/26/2021. Patient said that she discussed the incident with her doctor, was told it would be appropriate to get the second dose despite her reaction and was advised to take "cautious measures". Pharmacist reviewed the patient information and screening questions, discussed the potential side effects and reiterated her risk of experiencing the same reaction with the second dose. Patient stated that she decided on getting the second dose because "her boyfriend is high risk and I'm doing this for him". Patient stated that she decided on getting the second dose because "her boyfriend is high risk and I'm doing this for him". Pharmacist asked patient if she had any questions/concerns or additional information to add prior to getting her vaccine, and patient denied having any at that time. After administering her second dose, pharmacist instructed patient to stay in the observation area for at least 30 minutes and to ask the staff for water given her experience with the first dose. Patient asked pharmacist how common it was for someone to get a reaction from the vaccine, and then mentioned that her family memeber had to drive her to the emergency room after her first dose becuase her throat was "burning", and was told that her throat was "a little swollen" and recieved a second dose of epinephrine at the emergency room. Patient included this information after the fact her second dose was already administered. Approximately 5 minutes after receving her vaccine, the patient reported similar symptoms that she experienced on 2/5/2021: tachycardia, vision changes, shortness of breath and chest tightness. After monitoring patient with no resolvement of her symptoms, patient was then given a dose of epinephrine by the pharmacist, and the paramedics were called in to assess patient and take her to the emergency room.

Other Meds: Patient reports using a rescue inhaler PRN. No other prescriptions, OTC or herbal supplement were reported by patient.

Current Illness: Patient denied having any illnesses one month prior from 2/26/2021 besides having a reaction to the first dose of the COVID vaccine.

ID: 1058469
Sex: F
Age: 60
State: AZ

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: third day, fatique, headache, aching joints

Other Meds: Lamotrigine 150mg 2 tablets daily, Quetiapine 300mg 2 tablets daily Citalopram .5 mg @ 1 tablet daily Liothyronine SOD 5 mcg 2 tablets daily synthroid 137mcg 1 tablet daily Amlodipine Besylate 10mg 1 tabled daily Lutein 40mg 1 tablet da

Current Illness: None

ID: 1058470
Sex: F
Age: 64
State: GA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: Allergic to preservatives in glaucoma medicines

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

Symptoms: In 4 hours, started getting getting very dizzy, then throwing up, and nauseous by 7:30pm felt Luke on worse six flag ride. Blood pressure went up to 166/106. Called 911. Diagnosed with possible reaction and developed TIA

Other Meds: Lisinipril 40gm 2 away 81mg aspirin 100 amitripaline Lovastatin 40gm 2 a day

Current Illness: None

ID: 1058471
Sex: F
Age: 78
State: MD

Vax Date: 02/26/2021
Onset Date:
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: Patient did not report having allergies.

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

Symptoms: 2:37pm Patient reported feeling shortness of breath after walking to car after 30 minute recovery post vaccine administration. Patient was wearing two N95masks. Patient reported having a history of shortness of breath recently and went to pulmologist yesterday for an eval. RN advised patient to remove masks for better oxygenation. Patient declined removing both masks and removed just one N95 mask. RN asked patient to take deep breaths and self administer inhaler as prescribed by provider. Patient refused to use inhaler at vaccine clinic setting. Vitals-135/71, HR-97, Pox-93-95%, RR- 24 pox after 15 minutes after removing mask- 96%. Patient reported feeling better and reported she would use inhaler when she arrived to home.

Other Meds: Patient reported being on inhalers, did not provide the name and a rescue inhaler.

Current Illness:

ID: 1058472
Sex: F
Age: 52
State: WA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
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: Amoxacillin Erythromycin Sulfa - anaphylaxis Cyclobenzaprine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Numbness in jaw, lips, neck on left side. Tachycardia

Other Meds: Levothyroxine

Current Illness:

ID: 1058473
Sex: F
Age: 69
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa, Levaquin, Codeine, Gadolinium contrast media, Benadryl

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

Symptoms: Developed fever of 101 degrees, shaking chills, joint and muscle pain, extreme fatigue, lack of appetite, which persisted for about 24 hours. Low grade fever present Day 2 after vaccine administered.

Other Meds: Trandate, Centrum Silver, Riboflavin, Tums

Current Illness: None

ID: 1058474
Sex: F
Age: 50
State: NY

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: PCN

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

Symptoms: Shaking chills, Fever, Muscle aches and pain, joint pain, migraine

Other Meds: Vitamin C 500 mg daily multivitamin daily Pristiq 50 mg daily

Current Illness: none

ID: 1058475
Sex: F
Age: 67
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: penicillin

Symptom List: Pain in extremity

Symptoms: The weather that day was below freezing and windy. The vaccine froze in the syringe and I was not given the full dose. The pharmacist spoke to me that day, that someone would follow up and I was told to come back for the scheduled second shot, which I did on Feb. 19. No one followed up, so I spoke to someone on Feb. 19th when I received the 2nd dose. I got a follow up phone call yesterday and I will be going for a 3rd dose on March 12th.

Other Meds: none

Current Illness: none

ID: 1058476
Sex: F
Age: 21
State: MA

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/26/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Day of vaccine, 4hrs post vaccine: felt drunk/high/intoxicated (touch was intensified, numbing feeling) Day 2-3: exhausted and fever of 102F, body aches, chills, nausea Day 4: started feeling better, fever went down with Tylenol Day 5 3am: woke up with chest pain (3.5-4/10), went away with Tums; 0930pm chest pain 6/10 while sitting at desk, increased to 7/10, lasting 2 hours by the time I went to the ER

Other Meds: Birth Control Pill (with estrogen) Melatonin Women's multivitamin gummy

Current Illness: None

ID: 1058477
Sex: F
Age: 88
State: OR

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Lisinopril caused cough

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

Symptoms: Delirium, started 2-1/2 hours after injection, admitted to the hospital, required IV sedation, Then, 20 hours after vaccine developed fever up to 100.9, and patient developed somnolence but no longer combative, then about 32 hours after vaccine improved to 50% of normal status, 48 hours after vaccine was 90% normal, and then slowly returned to normal over the next 2 weeks

Other Meds: Metoprolol, Nexium, pravastatin, calcium, vitamin D, naproxen

Current Illness: None

ID: 1058478
Sex: F
Age: 60
State: PA

Vax Date: 02/12/2021
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: Mushrooms Statins

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

Symptoms: Patient believes that the herpes zoster diagnosis (she never had Shingles vaccine) is directly related to the COVID-19 vaccine. She was diagnosed at Hospital.

Other Meds: Acetamenophen 500 mg Allegra 60 mg Aspirin 81 mg Baclofen 20 mg Captopril 12.5 mg Clopidrogel bisulfate Docusate 100 mg Duloxetine 30 mg Fenofibrate micronized 200 mg Fluticasone 50 mcgg nasal spray Humalog 75-25 U-100 Levothyroxine 50 mcg

Current Illness: Herpes Zoster beginning 2-21-2021 Dental abscess 1-27-2-21

ID: 1058479
Sex: F
Age: 57
State: FL

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Fever 101.8, chills, nausea, abdominal pain, muscular and joint pain, increasing throughout day into evening.

Other Meds:

Current Illness:

ID: 1058480
Sex: F
Age: 61
State: NY

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: During the covid clinic by pharmacy the pharmacist was told by the staff members that the patient was receiving his second dose of covid vaccine. Upon returning to the pharmacy they learned that it was his third dose. (1/14 ; 2/4 ; 2/25 )

Other Meds:

Current Illness:

ID: 1058481
Sex: F
Age: 36
State: VA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: shellfish, cinnamon, evergreen, Carafate, chocolate, grapefruit

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

Symptoms: pt stated that she developed a headache with in first thirty minutes after receiving the covid vax. Next day pt was really tired, sore, and still had a headache . On third day you woke fever, body aches, nausea, stomach ache, headache, fatigued and sore throat. She slept the entire day. On the fourth day she still have all of the same symptoms but fever was gone by end of the day. On fifth day, symptoms were still present. On sixth day, she still had headache, sore throat and stomach ache but other symptoms were getting better. By seventh day all of the symptoms have subsided except headache, sore throat and stomach ache which she still has today. Pt stated she spoke w/ her nurse at her PCP's office and she was told to contact us.

Other Meds: multivitamin, Vitamin E Garlic, Peppermint Mint, Echinacea , Cranberry, Tizanidine HCL 2mg, esgic

Current Illness:

ID: 1058482
Sex: F
Age: 41
State:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 12 hours post dose 2 covid vaccine, patient had high heart rate to 160 and temp of 101 and diaphoresis

Other Meds:

Current Illness:

ID: 1058483
Sex: F
Age: 76
State: VA

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: Naproxen

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

Symptoms: patient complained of some slight chest discomfort 2 minutes after receiving vaccination. patient was examined and monitored to include physical exam, vital sign check and ECG all of which were normal. patient was kept in the office for monitoring for 60 minutes and symptoms had subsided. she left the office without any evidence of distress and reported she felt better. She was also advised to seek medical attention if symptoms returned/persisted or worsened. injection site viewed and no signs of reaction.

Other Meds: atorvastatin 40mg daily, Claritin 10mg daily as needed, HCTZ 25mg daily, Losartan 100mg daily, potassium chloride 10 mEq daily, Lopressor 100mg daily

Current Illness: No acute illness that I am aware of

ID: 1058484
Sex: M
Age: 65
State: FL

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/A

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

Symptoms: Blood pressure spike, associated with flushing, headache, dizziness beginning 4.5 hours after dose

Other Meds: Valsartan 320 mg qd; Amlodipine Besylate 5mg qd; Ezetimibe 10 mg qd; Vitamin D3

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm